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HomeMy WebLinkAboutResolutions - 2013.10.17 - 21074MISCELLANEOUS RESOLUTION #13270 October 17, 2013 BY: General Government Committee, Christine Long, Chairperson IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2013/2014 COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) AGREEMENT ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Michigan Department of Community Health (MDCH) has awarded the Oakland County Health Division funding via the Comprehensive Planning, Budgeting, and Contracting Agreement for the period October 1, 2013through September30, 2014; and WHEREAS the 2012/2013 Comprehensive Planning, Budgeting, and Contracting Agreement award included a total funding amount of $9,202,948 in grant revenue and expenditures; andWHEREAS the 2013/2014 Comprehensive Planning, Budgeting, and Contracting Agreement award reflects grant funding in the amount of $9,681,849, an increase of $478,901 (5.2%) from the previous year; and WHEREAS additional funding is expected in future contract amendments this fiscal year; and WHEREAS the budget detail for the various programs is a matter of negotiation between the Health Division and MDCH; amendments will be recommended to the FY 2014 Budget when details are finalized; and WHEREAS the CPBC Agreement has been submitted through the County Executive Review Process and is recommended for approval. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby accepts the 2013/2014 Comprehensive Planning, Budgeting, and Contracting (CPBC) agreement for funding in the amount of $9,681,849 for the period of October 1, 2013 through September 30, 2014. BE IT FURTHER RESOLVED that the future level of service, including personnel, be contingent upon the level of funding for this program. BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute this agreement, any changes and extensions to the agreement not to exceed fifteen percent (15%), which is consistent with the agreement as originally approved. BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its Chairperson to execute this Agreement subject to the following additional condition: That the County's approval for entering into this Agreement is specifically conditioned and premised upon the acceptance, approval and execution of the Agreement containing Addendum A, by the Michigan Department of Community Health, and that the failure of the Michigan Department of Community Health to execute the Agreement as specified shall, without any further act of the Oakland County Board of Commissioners, automatically negate and void the County's approval and/or acceptance of this agreement as provided for in this resolution. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution.GENERAL GOVERNMENT COMMITTEE GENERAL GOVERNMENT COMMITTEE Motion carried unanimously on a roll call vote. COUNTY OF OAKLAND DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH DIVISION FY 2013/2014 COMPREHENSIVE PLANNING, BUDGETING, AND CONTRACTING AGREEMENT (CPBC) ACCEPTANCE The Oakland County Health Division (OCHD) is accepting funding through the CPBC Agreement from the Michigan Department of Community Health (MDCH) in the total amount of $9,681,849. The Agreement is for the period October 1,2013 through September 30,2014. The Agreement provides for categorical grant funding and partial reimbursement for services provided in accordance with^the Public Health Code (P.A. 368 of 1978, as amended). Changes included in the FY 2013/14 Agreement include: • The following projects are allocated funding through 12/31/13. Continued funding is expected in future contract amendments: • Adolescent Screening Project • Sexually Transmitted Disease Control • Funding has been discontinued for the following project: • Obesity Prevention • Funding has been added for the following new projects: • Infant Safe Sleep • Michigan Health & Wellness 4x4 Plan GRANT REVIEW SIGN OFF - Health Division GRANT NAME: FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement FUNDING AGENCY: Michigan Department of Community Health DEPARTMENT CONTACT PERSON: Rachel Shymkiw 1452-2151 STATUS: Grant Acceptance DATE: September 19,2013 Pursuant to Misc. Resolution #13180, please be advised the captioned grant materials have completed internal grant review. Below are the returned comments. The captioned grant materials and grant acceptance package (which should include the Board of Commissioners' Liaison Committee Resolution, the grant agreement/contract, Finance Committee Fiscal Note, and this Sign Off email containing grant review comments) may be requested to be placed on the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. DEPARTMENT REVIEW Department of Management and Budget: Approved. - Laurie Van Pelt (9/11/2013) Department of Human Resources: Approved. — Karen Jones (9/11/2013) Risk Management and Safety: Approved by Risk Management. - Robert Erlenbeck (9/12/2013) Corporation Counsel: Approved. - Bradley G. Benn (9/19/2013) COMPLIANCE The grant agreement and attachments reference an extensive number of federal and state regulations. Please refer to the documents for specifically cited compliance requirements for this grant. Katie West Cc: Subject: To Sent From:VanPelt, Laurie <vanpeltl@oakgov.com> Wednesday, September 11, 2013 2:10 PM 'Shymkiw, Rachel'; 'West, Catherine'; 'Julie Secontine'; 'Karen Jones'; 'Pat Davis' 'Forzley, Kathy'; 'Pisacreta, Antonio.'; 'Lane, Kathy' RE: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance Thanks, that answers my question. Approved. From: Shymkiw, Rachel rmailto:shvmkiwr@oakaov.corrn Sent: Wednesday, September 11, 2013 2:08 PM To: VanPelt, Laurie'; 'West, Catherine'; 'Julie Secontine'; 'Karen Jones'; 'Pat Davis' Cc: 'Forzley, Kathy'; 'Pisacreta, Antonio'; 'Lane, Kathy' Subject: RE: GRANT REVIEW: Health & Human Services/Heatth Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance Hi Laurie. You are correct. Last year we were initially allocated only 3 months of funding for the HIV Prevention program. We received the remaining funds in amendment#! that came in December. For this year, we received 3 months of funding for the Adolescent Screening Project and STD. We expect to get the remaining funds in a future amendment. Let me know if you have any other questions. Thanks, From: VanPelt, Laurie fmailto:vanpelti@oakaov.com] Sent: Wednesday, September 11, 2013 1:26 PM To: 'West, Catherine'; 'Juiie Secontine'; 'Karen Jones'; 'Pat Davis' Cc; 'Shymkiw, Rachel'; 'Forzley, Kathy'; 'Pisacreta, Antonio'; 'Lane, Kathy' Subject: RE: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance I have just one question. There's a significant increase in the HIV prevention allocation. Was last year's a partial year amount, such as % year of funding? If not, I just need a general understanding of why the significant increase in funding. From: West, Catherine \mailto:westca@oakqov.coml Sent: Wednesday, September 11, 2013 1:04 PM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; Forzley, Kathy; Pisacreta, Antonio; Lane, Kathy Subject: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance COUNTY MICHIGAN DeMrtmcnt of Healths Human Services HEALTH DIVISION fbAKIANDFc ft n n t y m i r mi r; & » ; Rachel Shymkiw, MBA, Administrator ' Oakland County Health Division 1200N Teiegraph Bldg 34E Pontiac Ml 48341 j 243-452-2151 1 Katie West From: Jones, Karen <jonesk@oakgov.com> Sent: Wednesday, September 11, 2013 3:34 PM To: 'West, Catherine'; 'Julie Secontine'; 'Laurie VanPelf; 'Pat Davis' Cc: 'Shymkiw, Rachel'; 'Forzley, Kathy'; 'Pisacreta, Antonio'; lane, Kathy'.. Subject: RE: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance Approved. From: West, Catherine fmailto:westca@oakQov.cQml Sent: Wednesday, September 11, 2013 1:04 PM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; Forzley, Kathy; Pisacreta, Antonio; Lane, Kathy Subject: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS-Laurie Van Pelt - Karen Jones-Julie Secontine - Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE - Health & Human Services/Health Division FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement Michigan Department of Community Health Attached to this email please find the grant document(s) to be reviewed. Please provide your review stating your APPROVAL, APPROVAL WITH MODIFICATION, or DISAPPROVAL, with supporting comments, via reply (to all) of this email. Time Frame for Returned Comments: September 18, 2013 GRANT INFORMATION Date: September 11, 2013 Operating Department: Health and Human Services/Health Division Department Contact: Rachel Shymkiw Contact Phone: 2-2151 Document Identification Number: REVIEW STATUS: Acceptance - Resolution Required Funding Period: 10/1/13 through 9/30/14 New Facility / Additional Office Space Needs: N/A IT Resources (New Computer Hardware / Software Needs or Purchases): N/A M/WBE Requirements: Yes, Compliance with OMB Circular A-102 Funding Continuation/New: Continuation Application Total Project Amount: $9,681,849.00 i Katie West Sent: To: Cc: From: Subject: Erlenbeck, Robert <erlenbeckr@oakgov.com> Thursday, September 12, 2013 10:08 AM 'West, Catherine'; 'Julie Secontine'; 'Karen Jones'; 'Laurie VanPelt'; 'Pat Davis' 'Shymkiw, Rachel'; 'Forzley, Kathy'; 'Pisacreta, Antonio'; 'Lane, Kathy' RE: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance Approved by Risk Management. RE. 9-12-13. From: Easterling, Terri fmailto:ea5terlinat@oakoov.coml Sent: Wednesday, September 11, 2013 2:32 PM To: 'West, Catherine'; 'Julie Secontine"; 'Karen Jones'; 'Laurie VanPelt'; 'Pat Davis' Cc: 'Shymkiw, Rachel'; 'Forzley, Kathy'; 'Pisacreta, Antonio"; lane, Kathy*Subject: RE: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance Please be advised that your request for Risk Management's assistance has been assigned to Bob Erlenbeck, (ext. 8- 1694). If you have not done so already, please forward all related information, documentation, and correspondence. Also, please include Risk Management's assignment number, RM13-0335, regarding this matter. Thank you. From: West, Catherine fmailto:westca@oakaov.com1 Sent: Wednesday, September 11, 2013 1:04 PM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; Forzley, Kathy; Pisacreta, Antonio; Lane, KathySubject: GRANT REVIEW: Health & Human Services/Health Division - FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement - Grant Acceptance TO: REVIEW DEPARTMENTS - Laurie Van Pelt - Karen Jones - Julie Secontine - Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE - Health & Human Services/Health Division FY 2014 Comprehensive Planning, Budgeting, and Contracting Agreement Michigan Department of Community Health Attached to this email please find the grant document(s) to be reviewed. Please provide your review stating your APPROVAL, APPROVAL WITH MODIFICATION, or DISAPPROVAL, with supporting comments, via reply (to all) of this email. Time Frame for Returned Comments: September 18, 2013 GRANT REVIEW FORM i Katie West From: Benn, Bradley G <bennb@oakgov.com> Sent: Thursday, September 19, 2013 12:36 PM To: 'Shymkiw, Rachel'; 'Katie West' Cc: 'Forzley (Mgr.), Kathy'; 'Miller, George' Subject: #2013-0866 FY2014 CPBC (Comprehensive, Planning, Budgeting & Contracting) Grant Agreement - Grant Acceptance Approved. Bradley G. Benn Assistant Corporation Counsel Department of Corporation Counsel 1200 N. Telegraph Road Bldg 14 East Courthouse West Wing Extension, 3rd Floor Pontiac, Ml 48341-0419 Phone: (248) 858-0558 Fax: (248)858-1003 Email: bennb@oakQov.com PRIVILEGED AND CONFIDENTIAL - ATTORNEY CLIENT COMMUNlCATiON This e-maii is intended only for those persons to whom it is specifically addressed. It is confidentiai and is protected by the attorney- client privilege and work product doctrine. This privilege belongs to the County of Oakland, and individual addressees are not authorized to waive or modify this privilege in any way. Individuals are advised that any dissemination, reproduction or unauthorized review of this information by persons other than those listed above may constitute a waiver of this privilege and is therefore prohibited. If you have received this message in error, please notify the sender immediately. If you have any questions, please contact the Department of Corporation Counsel at (248) 858-0550. Thank you for your cooperation. 1 09/10/2013 Contract #: Agreement Between Michigan Department of Community Health hereinafter referred to as the "Department" and County of Oakland hereinafter referred to as the "Local Governing Entity" on Behalf of Health Department Oakland County Department of Health and Human Services/ Health Division 1200 N. Telegraph Rd. Pontiac Ml 48341 0432 Federal LD.#: 38-6004876 hereinafter referred to as the "Contractor" for The Delivery of Public Health Services under the Comprehensive Agreement Parti 1. Purpose This agreement is entered into for the purpose of setting forth a joint and cooperative Contractor/Department relationship and basis for facilitating the delivery of public health services to the citizens of Michigan under their jurisdiction, as described in the attached Annual Budget, established Minimum Program Requirements, and all other applicable Federal, State and Local laws and regulations pertaining to the Contractor and the Department. Public health services to be delivered under this agreement include Essential Local Public Health Services (ELPHS) and Categorical Programs as specified in the attachments to this agreement. 2. Period of Agreement: This agreement shall commence on October 1, 2013 and continue through September 30, 2014. This agreement is full force and effect for the period specified. The Department has the option to assume no responsibility for costs incurred by the Contractor prior to the signing of this agreement. 3. Program Budget and Agreement Amount A. Agreement Amount In accordance with Attachment IV - Funding/Reimbursement Matrix, the total State budget and amount committed for this period for the program elements covered by this agreement is $9,681,849.00. Comprehensive Agreement - FY 2014 Page: 1 of 160 09/10/2013 B. Equipment Purchases and Titie Any equipment purchases supported in whole or in part by the Department with categorical funding must be specified in an attachment to the Program Budget Summary. Equipment means tangible, non-expendable, personal property having useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. Title to equipment having a unit acquisition cost of less than $5,000 shall vest with the Contractor upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department's proportionate interest in such equipment supports such retention or transfer of title. C. Budget Transfers and Adjustments 1. Transfers between categories within any program element budget supported in whole or in part by state/federal categorical sources of funding shall be iimited to increases in an expenditure budget category by $10,000 or fifteen percent (15%) whichever is greater. This transfer authority does not authorize purchase of additional equipment items or new subcontracts with state/federal categorical funds without prior written approval of the Department. 2. Any transfers or adjustments involving State/Federal categorical funds, other than those covered by C.1, including any related adjustment to the total state amount of the budget, must be made in writing through a formal amendment executed by all parties to this agreement in accordance with Section VIII. A. of Part II. 3. The C.1 and C.2 provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the Department shall be recovered proportionately from each local Contractor that, during the course of the agreement period, chose to reduce or transfer local funds from the Family Planning program. 4. Agreement Attachments A. The following documents are attachments to this Agreement Part I and Part li - General Provisions, which are part of this agreement through reference: 1. Attachment I - Annual Budget 2. Attachment II - Guidance to State Agencies Regarding the Use of Funds Received Under the American Recovery and Reinvestment Act (ARRA) 3. Attachment Ml - Program Specific Assurances and Requirements 4. Attachment IV - Funding/Reimbursement Matrix 5. Attachment V - FY13/14 Agreement Addendum A B. The attachments are added into this Agreement as follows: 1. Original Agreement (Part I and Part II) - Attachment \, III, IV Comprehensive Agreement - FY 2014 Page: 2 of 160 09/10/2013 5. Statement of Work The Contractor agrees to undertake, perform and complete the services described in Attachment III - Program Specific Assurances and Requirements and the other applicable attachments to this agreement which are part of this agreement through reference. 6. Method of Payments and Financial Reports The payment procedures shall be followed as described in Part li and Attachment I - Annual Budget and Attachment !V - Funding/Reimbursement Matrix, which are part of this agreement through reference. 7. Performance/Progress Report Requirements The progress reporting methods, as applicable, shall be followed as described in IV - Funding/Reimbursement Matrix, which are part of this agreement through reference. 8. General Provisions The Contractor agrees to comply with the General Provisions outlined in Part II, which are part of this agreement through reference. 9. Administration of the Agreement The person acting for the Department in administering this agreement (hereinafter referred to as the Contract Consultant) is: Name: Brenda Roys, COMP Liaison Location/Building: 4th Floor, Lewis Cass Building Telephone No.: 517-373-1207 Email Address: roysb@michigan.gov 10. Special Conditions A. This agreement is valid upon approval by the State Administrative Board as appropriate and approval and execution by the Department. B. The Department and Contractor, under the terms of this agreement shall, subject to availability of funding and other applicable conditions, provide resources and continuous services throughout the period of this agreement as shown in Attachment I - Annual Budget. C. The Department will not assume any responsibility or liability for costs incurred by the Contractor prior to the signing of this agreement. D. The Contractor is required by PA 533 of 2004 to receive payments by electronic funds transfer. Comprehensive Agreement - FY 2014 Page: 3 of 160 09/10/2013 11. Special Certification The individual or officer signing this agreement certifies by his or her signature that he or she is authorized to sign this agreement on behalf of the responsible governing board, official or Contractor. 12. Signature Section FOR Oakland County Department of Health and Human Services/ Health Division Michael J Gingell Chairperson Name Title For the Michigan Department of Community Health Kim Stephen 09/10/2013 Kim Stephen, Director Date Bureau of Budget and Purchasing Comprehensive Agreement - FY 2014 Page: 4 of 160 09/10/2013 Part il General Provisions I. Responsibilities - Contractor The Contractor in accordance with the general purposes and objectives of this agreement will: A. Publication Rights 1. Where the Contractor exclusively develops books, films, or other such copyrightable materials through activities supported by this agreement, the Contractor may copyright those materials. The materials that the Contractor copyrights cannot include service recipient information or personal identification data. Contract grants the Department a royalty-free, non¬ exclusive and irrevocable license to reproduce, publish and use such materials and authorizes others to reproduce and use such materials. 2. Any materials copyrighted by the Contractor or modifications bearing acknowledgment of the Department's name must be approved by the Department before reproduction and use of such materials. The State of Michigan may modify the material copyrighted by the Contractor and may combine it with other copyrightable intellectual property to form a derivative work. The State of Michigan will own and hold all copyright and other intellectual property rights in any such derivative work, excluding any rights or interest grated in this agreement to the Contractor. If the Contractor ceases to conduct business for any reason, or ceases to support the copyrightable materials developed under this agreement, the State of Michigan has the right to convert its licenses into transferable licenses to the extent consistent with any applicable obligations the Contractor has to the federal government. 3. The Contractor shall give recognition to the Department in any and all publication papers and presentations arising from the program and service contract herein; the Department will do likewise. 4. The Contractor must notify the Department's Grants and Purchasing Division 30 days before applying to register a copyright with the U.S. Copyright Office. The Contractor must submit an annual report for all copyrighted materials developed by the Contractor through activities supported by this agreement and must submit a final invention statement and certification within 90 days of the end of the agreement period. B. Fees Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report these as outlined by the Department's fiscal procedures. Any underrecoveries of otherwise available fees resulting from failure to bill for eligible services will be excluded from reimbursable expenditures. Comprehensive Agreement - FY 2014 Page: 5 of 160 09/10/2013 C. Program Operation Provide the necessary administrative, professional, and technical staff for operation of the program. D. Reporting Utilize all report forms and reporting formats required by the Department at the effective date of this agreement, and provide the Department with timely review and commentary on any new report forms and reporting formats proposed for issuance thereafter. E. Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation to support program activities and all expenditures made under the terms of this agreement, as required. Assure that all terms of the agreement will be appropriately adhered to; and, that records and detailed documentation for the project or program identified in this agreement will be maintained for a period of not less than three (3) years from the date of termination, the date of submission of the final expenditure report or until litigation or audit findings have been resolved. F. Authorized Access Permit upon reasonable notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to records, files and documentation related to this agreement, to the extent authorized by applicable state or federal law, rule or regulation. G. Audits 1. Single Audit Provide, consistent with the regulations set forth in the Single Audit Act Amendments of 1996, P.L. 104-156, and Section .320 of the Office of Management and Budget (OMB) Circular A-133, "Audits of States, Local Governments, and Non-Profit Organizations," a copy of the Contractor's annual Single Audit reporting package, including the Corrective Action Plan, and management letter (if one is issued) with a response to the Department. The Contractor must assure that the Schedule of Expenditures of Federal Awards includes expenditures for all federally-funded grants. 2. Other Audits The Department or federal agencies, may also conduct or arrange for "agreed upon procedures" or additional audits to meet their needs. Comprehensive Agreement - FY 2014 Page: 6 of 160 09/10/2013 3. Due Date The Single Audit reporting package, management letter (if one is issued) with a response and Corrective Action Plan shall be submitted to the Department within nine months after the end of the Contractor's fiscal year. The Single Audit reporting package, management letter, and Corrective Action Plan shall be filed with the Department even if there are no findings or disclosures reported in the audit pertaining to Department programs. 4. Penalty If the Contractor does not submit the required Single Audit reporting package, management letter (if one is issued) with a response, and Corrective Action Plan within nine months after the end of the Contractor's fiscal year and an extension has not been approved by the cognizant or oversight agency for audit, the Department may withhold from the current funding an amount equal to five percent of the audit year's grant funding (not to exceed $200,000) until the required filing is received by the Department. The Department may retain the amount withheld if the Contractor is more than 120 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. The Department may terminate the current grant if the Contractor is more than 180 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. 5. Where to Send A copy of the Single Audit reporting package, management letter (if one is issued) with a response, and Corrective Action Plan must be forwarded by e- mail to the Department at MDCH-AuditReports@michigan.gov. The required materials must be assembled as one document in a PDF file compatible with Adobe Acrobat (read only). The subject line must state the agency name and fiscal year end. The Department reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. H. Subrecipient/Vendor Monitoring The Contractor must ensure that each of its subrecipients comply with the Single Audit Act requirements. The Contractor must issue management decisions on audit findings of their subrecipients as required by OMB Circular A- 133. Comprehensive Agreement - FY 2014 Page: 7 of 160 09/10/2013 The Contractor must also develop a subrecipient monitoring plan that addresses "during the award monitoring" of subrecipients to provide reasonable assurance that the subrecipient administers Federal awards in compliance with laws, regulations, and the provisions of contracts, and that performance goals are achieved. The subrecipient monitoring plan should include a risk-based assessments determine the level of oversight, and monitoring activities such as reviewing financial and performance reports, performing site visits, and maintaining regular contact with subrecipients. The Contractor must establish requirements to ensure compliance by for-profit subrecipients as required by OMB Circular A-133, Section .210(e). The Contractor must ensure that transactions with vendors comply with laws, regulations and provisions of contracts or grant agreements in compliance with OMB Circular A-133, Section .210 (f). I. Notification of Modifications Provide timely notification to the Department, in writing, of any action by the Contractor, its governing board or any other funding source which would require or result in significant modification in the provision of services, funding or compliance with operational procedures. J. Software Compliance The Contractor must ensure that software compliance and compatibility with the Department's data systems for services provided under this agreement including but not limited to: stored data, databases, and interfaces for the production of work products and reports. All required data under this agreement shall be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Contractor's business operations for processing date/time data. K. Human Subjects The Contractor will comply with Protection of Human Subjects Act, 45 CFR, Part 46. The Contractor agrees that prior to the initiation of the research, the Contractor will submit Institutional Review Board (IRB) application material for all research involving human subjects, which is conducted in programs sponsored by the Department or in programs which receive funding from or through the State of Michigan, to the Department's IRB for review and approval, or the IRB application and approval materials for acceptance of the review of another IRB. All such research must be approved by a federally assured IRB, but the Department's IRB can only accept the review and approval of another institution's IRB under a formally-approved interdepartmental agreement. The manner of the review will be agreed upon between the Department's IRB Chairperson and the Contractor's IRB Chairperson or Executive Officer(s). Comprehensive Agreement - FY 2014 Page: 8 of 160 09/10/2013 L. Terms To abide by the terms of this agreement including all attachments. M. Minimum Program Requirements To comply with Minimum Program Requirements promulgated in accordance with Section 2472.3 of 1978 PA 368 as amended, MCL 333.2472.3, MSA 14.15 (2472.3), for each applicable program element funded under this agreement. N. Annual Budget and Plan Submission To submit an Annual Budget and Plan request to the Department, in accordance with instructions established by the Department, to serve as the basis for completion of specific details for Attachments I and IV of this agreement via Contractor/Department negotiated amendment(s). Failure to submit a complete Annual Budget and Plan by the due date through Ml E-Grants will result in the deferral of Department payments until these documents are submitted. 0. Maintenance of Effort All agencies shall comply with maintenance of effort requirements for ELPHS, as defined in the current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part I. P. Accreditation 1. All Contractors shall comply with the local public health accreditation standards and follow the accreditation process and schedule established by the Department to achieve full accreditation status. Contractors that fail to meet all accreditation requirements and/or implement corrective plans of action within the prescribed time period will receive the status of "Not Accredited." Contractors designated as "Not Accredited" may have their Department allocations reduced for costs incurred in the assurance of service delivery. Contractors that disagree with on-site review findings or their accreditation status may request an inquiry through written request to the Department. The request must identify the disagreement and resolution sought. The inquiry participants will be comprised of Contractor staff, Department staff, the Accreditation Commission Chair, and the Accreditation Coordinator as needed. Participants will clarify facts, verify information and seek resolution. 2. Consent Agreements/Administrative Compliance Orders/Administrative Hearings for "Not Accredited" Contractors: a. Contractors designated as "Not Accredited", will receive a Consent Agreement Package from the Department. Contractors and their local governing entities shall be given 75 days to review the package, meet with the Department, and sign/return the Consent Agreement. Comprehensive Agreement - FY 2014 Page: 9 of 160 09/10/2013 b. Fulfillment of the terms and conditions of the Consent Agreement will not affect accreditation status, but impacts the Contractors' ability to fulfill its contractual obligations under the Comprehensive Planning, Budgeting and Contracting Agreement. Contractors designated as "Not Accredited", will retain this designation until the subsequent accreditation cycle. c. Contractor failure to fulfill the terms and conditions of the Consent Agreement within the prescribed time period will result in the issuance of an Administrative Compliance Order by the Department. d. Within 60 working days after receipt of an Administrative Compliance Order and proposed compliance period, a local governing entity may petition the Department for an administrative hearing. If the local governing entity does not petition the Department for a hearing within 60 days after receipt of an Administrative Compliance Order, the order and proposed compliance date shall be final. After a hearing, the Department may reaffirm, modify, or revoke the order or modify the time permitted for compliance. e. If the local governing entity fails to correct a deficiency for which a final order has been issued within the period permitted for compliance, the Department may petition the appropriate circuit court for a writ of mandamus to compel correction. Q. Medicaid Outreach Activities Reimbursement The Contractor agrees to report allowable costs and request reimbursement for the Medicaid Outreach activities it provides in accordance with 2 CFR, Part 225 (OMB Circular A-87) and the requirements in Medicaid Bulletin number: MSA 05- 29. The Contractor agrees to submit a Cost Allocation Plan Certification to the Department to bill for the Medicaid Outreach Activities. The Cost Allocation Plan Certification is valid until a change is made to the cost allocation plan or the Department determines it is invalid. The Contractor will submit quarterly FSRs for the Medicaid Outreach activities and an annual FSR for the Children with Special Health Care Services Medicaid Outreach activities in accordance with the instructions contained in Attachment I. Comprehensive Agreement - FY 2014 Page: 10 of 160 09/10/2013 !n accordance with the Medicaid Bulletin, MSA 05-29, the Contractor agrees to target their Medicaid outreach effort toward Department established priorities. For FY 12/13, the Department priorities are: lead testing, outreach and enrollment for the Family Planning waiver, and outreach for pregnant women, mothers and infants for the Maternal and Infant Health Program. The Contractor will submit a report using the MDCH Local Health Department Medicaid Outreach form describing their outreach activities targeting the priorities 30 days after the end of a fiscal year quarter and at the same time as the final COMPREHENSIVE FSR is due into the Department. The Local Health Department Medicaid Outreach report are to be sent through Ml E-Grants as an attachment report. II. Responsibilities - Department The Department in accordance with the general purposes and objectives of this agreement will: A. Payment Provide payment in accordance with the terms and conditions of this agreement based upon appropriate reports, records, and documentation maintained by the Contractor. B. Report Forms Provide any report forms and reporting formats required by the Department at the effective date of this agreement, and to provide the Contractor with any new report forms and reporting formats proposed for issuance thereafter at least ninety (90) days prior to required usage to afford the Contractor an opportunity for review and commentary. C. Terms Abide by the terms of this agreement including ail attachments. D. Notification of Modifications To notify the Contractor in writing of modifications to Federal or State laws, rules and regulations affecting this agreement. E. Identification of Laws To identify for the Contractor relevant laws, rules, regulations, policies, procedures, guidelines and State and Federal manuals, and provide the Contractor with copies of these documents to the extent they are not otherwise available to the Contractor. F. Modification of Funding To notify the Contractor in writing within thirty (30) calendar days of becoming aware of the need for any modifications in agreement funding commitments made necessary by action of the Federal Government, the Governor, the Legislature or the Department of Management and Budget on behalf of the Governor or the Legislature. Implementation of the modifications will be determined jointly by the Contractor and the Department. G. Monitor Compliance Comprehensive Agreement - FY 2014 Page: 11 of 160 09/10/2013 To monitor compliance with all applicable provisions contained in federal grant awards and their attendant rules, regulations and requirements pertaining to program elements covered by this agreement. H. Reimbursement To reimburse local agencies for costs based upon timely, accurately completed Financial Status Reports in accordance with Section IV. I. Technical Assistance To make technical assistance available to the Contractor for the implementation of this agreement. J. Health Insurance Portability and Accountability The Department assures that it will be in compliance with the Health Insurance Portability and Accountability Act. K. Accreditation The Department agrees to adhere to the accreditation requirements including the process for "Not Accredited" Contractors. The process includes developing and monitoring consent agreements, issuing and monitoring administrative compliance orders, participating in administrative hearings and petitioning appropriate circuit courts. L. Medicaid Outreach Activities Reimbursement The Department agrees to reimburse the Contractor for all allowable Medicaid Outreach activities that meet the standards of the Medicaid Bulletin: MSA 05-29 including the cost allocation plan certification and that are billed in accordance with the requirements in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, the Department will identify each fiscal year the Medicaid Outreach priorities and establish a reporting requirement for the Contractor. III. Assurances The following assurances are hereby given to the Department. A. Compliance with Applicable Laws The Contractor will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this agreement. The Contractor will also comply with all applicable general administrative requirements such as OMB Circulars covering cost principles, grant/agreement principles, and audits in carrying out the terms of this agreement. Comprehensive Agreement - FY 2014 Page: 12 of 160 09/10/2013 B. Anti-Lobbying Act The Contractor will comply with the Anti-Lobbying Act, 31 USC 1352 as revised by the Lobbying Disclosure Act of 1995, 2 USC 1601 et seq, and Section 503 of the Departments of Labor, Health and Human Services and Education, and Related Agencies section to the FY 1997 Omnibus Consolidated Appropriations Act (Public Law 104-209). Further, the Contractor shall require that the language of this assurance be included in the award documents of all subawards at al! tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. C. Non-Discrimination 1. The Contractor agrees not to discriminate against any employee or applicant for employment or service delivery and access, with respect to their hire, tenure, terms, conditions or privileges of employment, programs and services provided or any matter directly or indirectly related to employment, because of race, color, religion, national origin, ancestry, age, sex, height, weight, marital status, physical or mental disability unrelated to the individual's ability to perform the duties of the particular job or position or to receive services. The Contractor further agrees that every subcontract entered into for the performance of any contract or purchase order resulting herefrom will contain a provision requiring non-discrimination in employment, service delivery and access, as herein specified binding upon each subcontractor. This covenant is required pursuant to the Elliot Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2201 et seq, and the Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et seq, and any breach thereof may be regarded as a material breach of the contract or purchase order. 2. The Contractor will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: a. Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; b. Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; c. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; d. the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101- 6107), which prohibits discrimination on the basis of age; e. the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; Comprehensive Agreement - FY 2014 Page: 13 of 160 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals - (Law) Act 491 of 1988 - (Rules) 325.176 Immunization - Reaching More Children andAdults - Guidance to State Agencies Regarding the Use of • Funds Received Under the American Recovery andReinvestment Act (ARRA) Healthy Homes - Lead Safe Home Program - (Law) Lead AbatementActt - Lead Hazard ControlRules - Lead Safe Home Program Regional Field Consultant Policy and Procedures Field Guide Local PublicHealth Operations(LPHO) - (Law) Public HealthCode PA 368 of 1978 (as amended)- (Law) PA 92 of 2000 - (Rules) R327.41 - R327.65 Infectious/ Communicable Disease Controi - (Law) Public Health Code PA 368 of 1978, 333.2433; Parts 51and 52 - (Rules) 325.171 et. seq. Maternal Infant Health Program - 0)- (Law) Comprehensive Omnibus ReconciliationAct of 1985 (COBRA)- (Law) OmnibusReconciliation Acts of1987 and 1989 - (Law) OBRA 89 P.L101 -239 (Amendment toTitle V) - (D - 2008 Ml Medicaid ProviderManual Nutrition Services - (Law) Public Health Code PA 368 of 1978,MCL 333.2433 Pregnancy TestRelated to Informed Consent to Abortion - (Law) Public Health Code PA 368 of 1978,MCL 333.17015 (18) Prenatal CareClinic Services - <1>&(2) - (Law) OBRA 89 P.L.101-239 (Amendment toTitle V)- (Law) OBRA 90- (Law) PA 368,1978 - (1) 09/10/2013 f. the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616) as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; g. §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records h. any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and, i. the requirements of any other nondiscrimination statute(s) which may apply to the application. 3. Additionally, assurance is given to the Department that efforts will be made to identify and encourage the participation of minority owned and women owned businesses, and businesses owned by persons with disabilities in contract solicitations. The Contractor shall incorporate language in all contracts awarded:. (1) prohibiting discrimination against minority owned and women owned businesses and businesses owned by persons with disabilities in subcontracting; and (2) making discrimination a material breach of contract. D. Debarment and Suspension Assurance is hereby given to the Department that the Contractor will comply with Federal Regulation 2 CFR part 180 and certifies to the best of its knowledge and belief that the Contractor's local health department or an official of the Contractor's local health department and the Contractor's subcontractors: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or Contractor; 2. Have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in section 2, and; 4. Have not within a three-year period preceding this agreement had one or more public transactions (federal, state or local) terminated for cause or default. Comprehensive Agreement - FY 2014 Page: 14 of 160 09/10/2013 E. Federal Requirement: Pro-Children Act 1. Assurance is hereby given to the Department that the Contractor will comply with Public Law 103-227, also known as the Pro-Children Act of 1994, 20 USC 6081 et seq, which requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted by and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by federal programs either directly or through state or local governments, by federal grant, contract, loan or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where Women, Infants, and Children (WIC) coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. The Contractor also assures that this language will be included in any subawards which contain provisions for children's services. 2. The Contractor also assures, in addition to compliance with Public Law 103- 227, any service or activity funded in whole or in part through this agreement will be delivered in a smoke-free facility or environment. Smoking shall not be. permitted anywhere in the facility, or those parts of the facility under the control of the Contractor. If activities or services are delivered in facilities or areas that are not under the control of the Contractor (e.g., a mall, restaurant or private work site), the activities or services shall be smoke-free. F. Hatch Political Activity Act and Intergovernmental Personnel Act The Contractor will comply with the Hatch Political Activity Act 5,USC 1501- 1509 and 7324-7328 and the Intergovernmental Personnel Act of 1970, as amended by Title VI of the Civil Service Reform Act, Public Law 95-454, Section 42 USC 4728- 4763. Federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs. G. Home Health Services If the Contractor provides Home Health Services (as defined in Medicare Part B), the following requirements apply: 1. The Contractor shall not use State ELPHS or categorical grant funds provided under this agreement to unfairly compete for home health services available from private providers of the same type of services in the Contractor's service area. Comprehensive Agreement - FY 2014 Page: 15 of 160 09/10/2013 2. For purposes of this agreement, the term "unfair competition" shall be defined as offering of home health services at fees substantially less than those generally charged by private providers of the same type of services in the Contractor's area, except as allowed under Medicare customary charge regulations involving sliding fee scale discounts for low-income clients based upon their ability to pay. 3. If the Department finds that the Contractor is not in compliance with its assurance not to use state ELPHS and categorical grant funds to unfairly compete, the Department shall follow the procedure required for failure by local health departments to adequately provide required services set forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15 (2497) and (2498). H. Subcontracts Assure for any subcontracted service, activity or product: 1. That a written subcontract is executed by all affected parties prior to the initiation of any new subcontract activity. Exceptions to this policy may be granted by the Department upon written request. 2. That any executed subcontract shall require the subcontractor to comply with all applicable terms and conditions of this agreement. In the event of a conflict between this agreement and the provisions of the subcontract, the provisions of this agreement shall prevail. A conflict between this agreement and a subcontract, however, shall not be deemed to exist where the subcontract: a. Contains additional non-conflicting provisions not set forth in this agreement; or b. Restates provisions of this agreement to afford the Contractor the same or substantially the same rights and privileges as the Department; or c. Requires the subcontractor to perform duties and/or services in less time than that afforded the Contractor in this agreement. 3. That the subcontract does not affect the Contractor's accountability to the Department for the subcontracted activity. 4. That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5. That the Contractor will submit a copy of the executed subcontract if requested by the Department. 6. That subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $10,000 shall contain provisions or conditions that will: Comprehensive Agreement - FY 2014 Page: 16 of 160 09/10/2013 a. Allow the Contractor or Department to seek administrative, contractual or legal remedies in instances in which the Contractor violates or breaches contract terms, and provide for such remedial action as may be appropriate. b. Provide for termination by the Contractor, including the manner by which termination will be effected and the basis for settlement. 7. That ail subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government of amounts in excess of $100,000 shall contain a provision that requires compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970 (42 DSC 1857(h)), Section 508 of the Clean Water Act (33 USC 1368), Executive Order 11738 and Environmental Protection Agency regulations (40 CFR Part 15). 8. That all subcontracts and subgrants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Contractor shall include a provision: a. For compliance with the Copeland "Anti-Kickback" Act (18 USC 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b. For compliance with the Davis-Bacon Act (40 USC 276a to a-7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). c. For compliance with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, Part 5). This provision also applies to all other contracts in excess of $2,500 that involve the employment of mechanics or laborers. I. Procurement Assure that all purchase transactions, whether negotiated or advertised, shall be conducted openly and competitively in accordance with the principles and requirements of OMB Circular A-102 as revised, implemented through applicable portions of the associated "Common Rule" as promulgated by responsible federal Contractor(s), or 2 CFR, Part 215 (OMB Circular A-110) as amended, as applicable and that records sufficient to document the significant history of all purchases are maintained for a minimum of three years after the end of the agreement period. Comprehensive Agreement - FY 2014 Page: 17 of 160 09/10/2013 J. Health Insurance Portability and Accountability Act To the extent that this act is pertinent to the services that the Contractor provides to the Department under this agreement, the Contractor assures that it is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements including the following: 1. The Contractor must not share any protected health data and information provided by the Department that falls within HIPAA requirements except to a subcontractor as appropriate under this agreement. 2. The Contractor must require the subcontractor not to share any protected health data and information from the Department that falls under HIPAA requirements in the terms and conditions of the subcontract. 3. The Contractor must only use the protected health data and information for the purposes of this agreement. 4. The Contractor must have written policies and procedures addressing the use of protected health data and information that falls under the HIPAA requirements. The policies and procedures must meet all applicable federal and state requirements including the HIPAA regulations. These policies and procedures must include restricting access to the protected health data and information by the Contractor's employees. 5. The Contractor must have a policy and procedure to report to the Department unauthorized use or disclosure of protected health data and information that falls under the HIPAA requirements of which the Contractor becomes aware. 6. Failure to comply with any of these contractual requirements may result in the termination of this agreement in accordance with Part II, Section V. Termination. 7. In accordance with HIPAA requirements, the Contractor is liable for any claim, ioss or damage relating to unauthorized use or disclosure of protected health data and information received by the Contractor from the Department or any other source. 8. The Contractor will enter into a business associate agreement should the Department determine such an agreement is required under HIPAA. Comprehensive Agreement - FY 2014 Page: 18 of 160 09/10/2013 IV. Payment and Reporting Procedures A. Operating Advance Under the pre-payment reimbursement method, no additional operating advances will be issued. B. Comprehensive Prepayments The Department will make monthly prepayments equal to 1/12th of the agreement amount for each non-fee-for-service program contained in Attachment IV of this agreement. One single payment covering all non-fee-for-service programs will be made within the first week of each month. The Department will send to the Contractor a worksheet itemizing the individual program amounts included in the monthly prepayment within five working days of processing the monthly prepayment. Prepayments for the months of October thru January will be based upon the initial agreement amounts in Attachment IV. Subsequent monthly prepayments may be adjusted based upon agreement amendments and/or Contractor adjustment requests per Department approval. C. Prepayment Adjustments If the sum of the prepayments do not equal at least 90% of the Contractor's expenditures for a quarter of the contract period, the Contractor may submit documentation for an adjustment to the monthly prepayment amount via the following process: 1. Submit a written request for the adjustment to the Department's Accounting Division, Expenditure Operations Section. 2. The adjustment request must be itemized by program and must list the amount received from the Department, the expenditure amount reported per the quarterly Financial Status Report (FSR), and the difference. The amount received from the Department and the expenditures must be for the same reporting quarterly FSR period. 3. The Department will review the requests and if an adjustment is approved, it will be included in the next scheduled monthly prepayment. 4. Adjustment requests will not be accepted prior to submission of the FSR for the quarter ending December 31. No adjustments will be made prior to the February monthly prepayment. 5. The ability of the Department to approve adjustments may be limited by the quarterly allotments of spending authority in the Department's appropriation account mandated by the Office of the State Budget Director. The quarterly allotment limits the amount of each account (program) that the Department may expend during each fiscal quarter. Comprehensive Agreement - FY 2014 Page: 19 of 160 09/10/2013 D. Financial Status Report Submission A Financial Status Report (FSR) must be submitted for all programs listed on Attachment IV. All FSR's must be prepared in accordance with the Department's FSR instructions and submitted not later than thirty (30) days after the dose of the fiscal quarters. The reports are due 1/30, 4/30, and 7/30. FSR's must report total actual program expenditures regardless of the source of funds. The Department will reimburse the Contractor for expenditures in accordance with the terms and conditions of this agreement. Failure to comply with the reporting due dates will result in the deferral of the Contractor's monthly prepayment. E. Reimbursement Method The Contractor will be reimbursed in accordance with the reimbursement methods for applicable program elements described as follows: 1- Performance Reimbursement - A reimbursement method by which local health departments are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of State funds. Any local funds used to support program elements operated under such provisions of this agreement may be transferred by the Contractor within, among, to or from the affected elements without Department approval, subject to applicable provisions of Sections 3.B. and 3.C.3 of Part I and Section XIV of Part II. If local health department performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the State maximum allocation will be reduced equivalent to actual performance in relation to the minimum performance. 2- Staffing Grant Reimbursement - A reimbursement method by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total State allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable as a source before any local funding requirement unless a specific local match condition exists. 3- Fixed Unit Rate Reimbursement - A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. Comprehensive Agreement - FY 2014 Page: 20 of 160 09/10/2013 4- Essential Local Public Health Services (ELPHS) - A reimbursement method by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required services, as noted in the current Appropriations Act. F. Reimbursement Mechanism All Contractors must sign up through the on-line vendor registration process to receive all State of Michigan payments as Electronic Funds Transfers (EFT)/Direct Deposits. Vendor registration information is available through the Department of Management and Budget's web site: http://www.cpexpress.state.mi.us/ G. Unobligated Funds Any unobligated balance of funds held by the Contractor at the end of the agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. H. Fiscal Year-End Reporting A Obligation Report is based on annual guidelines and due date using the format provided by the Department through Ml E-Grants. The Contractor must provide, by program, an estimate of total expenditures for the entire agreement period (October 1 through September 30). This report must represent the Contractor's best estimate of total program expenditures for the agreement period. The information on the report will be used to record the Department's year-end accounts payables and receivables by program for this Agreement The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Contractor in the monthly prepayments and quarterly fee-for- service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of agreement amendments, the Contractor may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of a program at fiscal year-end. Within 75 days after the agreement fiscal year-end, the Contractor must liquidate any unpaid year-end commitments and obligations. Any obligation remaining unliquidated after 75 days from the end of the agreement period shall revert to the Department for disposition in accordance with applicable state and/or federal requirements, except as specifically authorized in writing by the Department. Comprehensive Agreement - FY 2014 Page: 21 of 160 09/10/2013 I. Final Total Contractor FSR Project Bioterrorism WIC Final FSR Due Date 11/15/XX 11/30/XX All Remaining Projects 12/15/XX The final total Contractor FSR is due December 15, after the agreement period end date. WIC financial data reporting and final FSR must be received by November 30. Upon receipt of the final FSR electronically through Ml E-Grants, the Department will determine by program, if funds are owed to the Contractor or if the Contractor owes funds to the Department, if funds are owed to the Contractor, payment will be processed. However, if the Contractor underestimated their year-end obligations in the Obligation Report as compared to the final FSR and the total reimbursement requested does not exceed the agreement amount that is due to the Contractor, the Department will make every effort to process full reimbursement to the Contractor per the final FSR. Final payment may be delayed pending final disposition of the Department's year-end obligations. If funds are owed to the Department, it will generally not be necessary for Contractor to send in a payment. Instead the Department will make the necessary entries to offset other payments and as a result the Contractor will receive a net monthly prepayment. When this does occur, clarifying documentation will be provided to the Contractor by the Department's Accounting Division. J. Penalties for Reporting Noncompliance For failure to submit the final total Contractor FSR report by December 15, through Ml E-Grants after the agreement period end date, the Contractor may be penalized with a one-time reduction in their current ELPHS allocation for noncompliance with the fiscal year-end reporting deadlines. Any penalty funds will be reallocated to other Comprehensive Contractors (local health departments). Reductions will be one-time only and will not carryforward to the next fiscal year as an ongoing reduction to a Contractor's ELPHS allocation. Penalties will be assessed based upon the submitted date in M! E-Grants: ELPHS Penalties for Noncompliance with Reporting Requirements: 1. 1 % -1 day to 30 days late; 2. 2% - 31 days to 60 days late; 3. 3% - over 60 days late with a maximum of 3% reduction in the Contractor's ELPHS allocation. V. Agreement Termination The Department may cancel this agreement without further liability or penalty to the Department for any of the following reasons: Comprehensive Agreement - FY 2014 Page: 22 of 160 09/10/2013 A. This agreement may be terminated by either party by giving thirty (30) days written notice to the other party stating the reasons for termination and the effective date. B. This agreement may also be terminated on thirty (30) days prior written notice upon the failure of either party to carry out the terms and conditions of this agreement, provided the alleged defaulting party is given notice of the alleged breach and fails to cure the default within the thirty (30) day period. C. This agreement may be terminated immediately if the Contractor's local health department, or an official of the Contractor's local health department, is convicted of any activity referenced in Part II, Section III.D, of this agreement during the term of this agreement or any extension thereof. VI. Final Reporting upon Termination Should this agreement be terminated by either party, within thirty (30) days after the termination, the Contractor shall provide the Department with all financial performance, and other reports required as a condition of the agreement. The Department will make payments to the Contractor for allowable reimbursable costs not covered by previous payments, other state or federal programs. The Contractor shall immediately refund to the Department funds not authorized for use and any payments advanced to the Contractor in excess of allowable reimbursable expenditures. Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. VII. Severability If any provision of this agreement or any provision of any document attached to or incorporated by reference is waived or held to be invalid, such waiver or invalidity shall not affect other provisions of this agreement. VIII. Amendments Any changes to this agreement will be valid only if made in writing and accepted by all parties to this agreement. A. This agreement, including attachments, may be amended by mutual written consent of the Contractor and the Department. When submitting a proposed agreement/budget amendment, the Contractor must submit copies of the revised sheets and a summary description of the changes. B. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Contractor's or Department's control, which reduce or otherwise interfere with the Contractor's or Department's ability to provide or maintain specified services or operational procedures, immediate written notification must be provided to the other party and an amendment to this agreement negotiated. C. Amendments to this agreement shall be made as follows: Comprehensive Agreement - FY 2014 Page: 23 of 160 09/10/2013 1. Any change proposed by the Contractor which would affect the State funding of any element funded in whole or in part by funds provided by the Department, subject to Part I, Section 3.C, of the agreement, must be submitted in writing to the Department immediately upon determining the need for such change. The proposed change may be implemented upon receipt of written notification from the Department. Within thirty (30) days after receipt of the proposed change, the Department shall advise the Contractor in writing of its determination. Subsequently the Department will initiate any necessary formal amendment to the agreement for execution by all parties to the agreement. Any changes proposed by the Department must be agreed to in writing by the Contractor and upon such written agreement, the Department shall initiate any necessary formal amendment as above. 2. Other amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Contractor at any time prior to June 2nd. The Department will provide a written response within thirty (30) calendar days. All amendments must be submitted to the Department by June 15 through Ml E- Grants to assure the amendment can be executed prior to the end of the agreement period. IX, Liability A. All liabiiity to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as direct service delivery, to be carried out by the Contractor in the performance of this agreement shall be the responsibility of the Contractor, and not the responsibility of the Department, if the liability, loss, or damage is caused by, or arises out of, the actions or failure to act on the part of the Contractor, any subcontractor, anyone directly or indirectly employed by the Contractor, provided that nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Contractor or its employees by statute or court decisions. Comprehensive Agreement - FY 2014 Page: 24 of 160 09/10/2013 B. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as the provision of policy and procedural direction, to be carried out by the Department in the performance of this agreement shall be the responsibility of the Department, and not the responsibility of the Contractor, if the liability, loss, or damage is caused by, or arises out of, the action or failure to act on the part of any Department employee or agent, provided that nothing herein shall be construed as a waiver of any governmental immunity by the State, its agencies (the Department) or employees as provided by statute or court decisions. C. In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Contractor and the Department in fulfillment of their responsibilities under this agreement, such liability, loss, or damage shall be borne by the Contractor and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein shall be construed as a waiver of any governmental immunity by the Contractor, the State, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. X. Conflict of Interest The Contractor and the Department are subject to the provisions of 1968 PA 317, as amended, MCL 15.321 et seq, MSA 4.1700(51) et seq, and 1973 PA 196, as amended, MCL 15.341 et seq, MSA 4.1700(71) et seq. XL State of Michigan Agreement This is a State of Michigan Agreement and is governed by the laws of Michigan. Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. XIL Confidentiality Both the Department and the Contractor shall assure that medical services to and information contained in medical records of persons served under this agreement, or other such recorded information required to be held confidential by federal or state law, rule or regulation, in connection with the provision of services or other activity under this agreement shall be privileged communication, shall be held confidential, and shall not be divulged without the written consent of either the patient or a person responsible for the patient, except as may be otherwise required by applicable law or regulation. Such information may be disclosed in summary, statistical, or other form which does not directly or indirectly identify particular individuals. XIIL Waiver Any clause or condition of this agreement found to be an impediment to the intended and effective operation of this agreement may be waived in writing by the Department or the Contractor, upon presentation of written justification by the requesting party. Such waiver may be temporary or for the life of the agreement and may affect any or all program elements covered by this agreement. Comprehensive Agreement - FY 2014 Page: 25 of 160 09/10/2013 XIV. Funding A. State funding for this agreement shall be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds shall be as stated in the approved Annual Budget - Attachment I, the Program Specific Assurances and Requirements - Attachment III, and as outlined in the Funding/Reimbursement Matrix - Attachment iV. B. The funding provided through the Department for this agreement shall not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Contractor must advise the Department in writing by May 1 if the amount of Department funding may not be used in its entirety or appears to be insufficient for any program element. ELPHS transfer requests between MDCH, MDA and MDEQ must also be requested in writing by May 1. All ELPHS required services must be maintained throughout the entire period of the agreement. C. The Department may periodically redistribute funds between agencies during the agreement period in order to ensure that funds are expended to meet the varying needs for services. Such redistributions will be based upon projections obtained in consultation with the Contractor. Any redistributions will be effected through the established amendment process. Comprehensive Agreement - FY 2014 Page: 26 of 160 09/10/2013 AA Attachments A1 Attachment I - Instructions for the Annual Budget Attachment I - Instructions for the Annual Budget A2 Attachment II - Guidance to State Agencies Regarding the Use of Funds Received Under the American Recovery and Reinvestment Act Attachment II - Guidance to State Agencies Regarding the Use of Funds Received Under ARRA A3 Attachment III - Program Specific Assurances and Requirements Attachment III - Program Specific Assurances and Requirements Comprehensive Agreement - FY 2014 Page: 27 of 160 Contract# Date: 09/10/2013 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH ATTACHMENT IV - Comprehensive Agreement - FY 2014 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source(a)MDCH Source Fed/St FundingAmount ReimbursementMethod(b) PerformanceTargetOutput Measurement Total (c)PerformExpect State (d)FundedTargetPerform State Funded Minimum Performance Percent Number (e) Vendor/Subrecepient(f) Adolescent STD Screening Reg. Alloc.F 18,250 Staffing (6)HIA N/A N/A N/A N/A Subrecepient Bioterrorism Regional EPI Reg. Alloc.F 7,500 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Support Body Art Fixed Fee Calc. Amt.F 250.00/VarioUS Fixed Unit Rate (2)N/A N/A N/A N/A N/A Vendor Childrens Special HIth Care Calc. Amt.F 150.00/Vario Fixed Unit Rate (1),N/A N/A N/A N/A N/A Vendor Services (CSHCS) Care us (7)Coordination Childrens Special HIth Care Reg. Alloc.F 142,500 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Services (CSHCS) Outreach &Advocacy Reg. Alloc.S 142,500 FDA Tobacco Retailer (A&L)Calc. Amt.s 325.20/Numb Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient Inspections ers Fetal Infant Mortality Review Reg. Alloc.F 5,400 Staffing (6)N/A N/A N/A N/A N/A Subrecepient (FIMR) Case Abstraction Food ELPHS ELPHS Food S 827,691 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor General Communicable Disease ELPHS S 331,204 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor ELPHS MDCH Other Hearing ELPHS ELPHS s 219,078 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor Hearing HIV Prevention Reg. Alloc.F 373,425 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 124,475 ELPHS S 362,407MDCH Other Immunization Action Plan (IAP)Reg. Alloc.F 478,833 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Immunization ELPHS ELPHS S 641,190 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor MDCH Other Immunization Fixed Fees Calc. Amt.S 300.00/Numb Fixed Unit Rate (2),N/A N/A N/A N/A N/A Vendor ers (7) Immunization Vaccine Quality Reg. Alloc.S 105,464 Staffing (6)N/A N/A N/A N/A N/A Vendor Assurance Comprehensive Agreement - FY 2014 Page: 28 of 160 Contract # Date: 09/10/2013 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH ATTACHMENT IV - Comprehensive Agreement - FY 2014 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source(a)MDCH Source Fed/St FundingAmount ReimbursementMethod(b) PerformanceTargetOutput Measurement Total (c)PerformExpect State (d)FundedTargetPerform State Funded Minimum Performance Percent Number (e) Vendor/ Subrecepient(f) Infant Safe Sleep Reg. Alloc.S 22,500 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Laboratory Services Bio Reg. Alloc.F 82,605 Staffing (6)N/A N/A N/A N/A N/A SubrecepientLocal Health Department SNAP-ED Reg. Alloc.F 50,073 Staffing (6), (18)N/A N/A N/A N/A N/A Subrecepient MDEQ Drinking Water ELPHSDrinkingWater S 495,433 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor MDEQ On-site Sewage ELPHSOnsiteSewage S 358,763 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor Ml Health and Wellness 4X4Plan Reg. Alloc. Reg. Alloc. F S 1,835 23,165 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Nurse Family PartnershipServices Reg. Alloc. Reg. Alloc. F S 242,500 242,500 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Other-MCH Local MCH S 321,457 Staffing (6)N/A N/A N/A N/A N/A Subrecepient Public Health EmergencyPreparedness (PHEP) 10/1/13 -6/30/14 Reg. Alloc.F 204,470 Staffing (6), (14),(18)N/A N/A N/A N/A N/A Subrecepient Public Health EmergencyPreparedness (PHEP) CRI10/1/13-6/30/14 Reg. Alloc.F 154,411 Staffing (6), (14),(18)N/A N/A N/A N/A N/A Subrecepient Sexually Transmitted Disease(STD) Control Reg. Alloc. Reg. Alloc. ELPHSMDCH Other F S S 9,501 11,162 818,028 Staffing (6)N/A N/A N/A N/A N/A Subrecepient SIDS Calc. Amt.S 85.00/Numbe rs Fixed Unit Rate (2),(11)N/A N/A N/A N/A N/A Vendor TB Control Reg. Alloc.F 60,024 Staffing (6)N/A N/A N/A N/A N/A Vendor Comprehensive Agreement - FY 2014 Page: 29 of 160 Contract # Date: 09/10/2013 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH ATTACHMENT IV - Comprehensive Agreement - FY 2014 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source(a)MDCH Source Fed/St FundingAmount ReimbursementMethod<b) PerformanceTargetOutputMeasurement Total (c)PerformExpect State (d)FundedTargetPerform State Funded Minimum Performance Percent Number (e) Vendor/Subrecepient(f) Vision ELPHS ELPHSVision s 213,433 ELPHS (3), (4)N/A N/A N/A N/A N/A Vendor WIC Breastfeeding Reg. Alloc. Reg. Alloc. F F 13,038 51,095 Staffing (6)N/A N/A N/A N/A N/A Subrecepient WIC Resident Services Reg. Alloc.F 2,525,939 Performance (8)# AverageMonthlyParticipation N/A 15800 97 15326 Subrecepient TOTAL MDCH FUNDING 9,681,849 ^SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Attachment IV Notes Attachment IV Notes A5 Attachment V - FY 12/13 Agreement Addendum A Oakland County FY Agreement Addendum A Comprehensive Agreement - FY 2014 Page: 30 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Aqreement - FY 2014 / Administration DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street)1200 N. Telegraph Rd. BUDGET AGREEMENT p" Original f Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 4,359,513.00 0.00 0.00 4,359,513.00 2 Fringe Benefits 3,211,064.00 0.00 0.00 3,211,064.00 3 Cap. Exp. for Equip & Fac.21,950.00 0.00 0.00 21,950.00 4 Contractual 142,384.00 0.00 0.00 142,384.00 5 Supplies and Materials 406,538.00 0.00 0.00 406,538.00 6 Travel 57,055.00 0.00 0.00 57,055.00 7 Communication 50,612.00 0.00 0.00 50,612.00 8 County-City Central Services 653,491.00 0.00 0.00 653,491.00 9 Space Costs 1,070,460.00 0.00 0.00 1,070,460.00 10 All Others (ADP, Con. Employees, Misc.) .792,245.00 0.00 0.00 792,245.00 Total Program Expenses 10,765,312.00 0.00 0.00 10,765,312.00 TOTAL DIRECT EXPENSES 10,765,312.00 0.00 0.00 10,765,312.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs -6,330,231.00 0.00 0.00 -6,330,231.00 2 Other Costs Distributions -2,545,829.00 0.00 0.00 -2,545,829.00 Total indirect Costs -8,876,060.00 0.00 0.00 -8,876,060.00 TOTAL INDIRECT EXPENSES -8,876,060.00 0.00 0.00 -8,876,060.00 TOTAL EXPENDITURES 1,889,252.00 0.00 0.00 1,889,252.00 Comprehensive Agreement - FY 2014 Page: 31 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 270,651.00 0.00 270,651.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 15,273.00 0.00 15,273.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 1,603,328.00 0.00 1,603,328.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate 0.00 0.00 0.00 0.00 Total Source of Funds 0.00 1,889,252.00 0.00 1,889,252.00 Totals 0.00 1,889,252.00 0.00 1,889,252.00 Comprehensive Agreement - FY 2014 Page: 32 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 4,359,513.00 0.00 0.00 4,359,513.00 2 Fringe Benefits 3,211,064.00 0.00 0.00 3,211,064.00 3 Cap. Exp. for Equip & Fac.21,950.00 0.00 0.00 21,950.00 4 Contractual 142,384.00 0.00 0.00 142,384.00 5 Supplies and Materials 406,538.00 0.00 0.00 406,538.00 6 Travel 57,055.00 0.00 0.00 57,055.00 7 Communication 50,612.00 0.00 0.00 50,612.00 8 County-City Central Services 653,491.00 0.00 0.00 653,491.00 9 Space Costs 1,070,460.00 0.00 0.00 1,070,460.00 10 All Others (ADP, Con. Employees, Misc.) 792,245.00 0.00 0.00 792,245.00 Total Program Expenses 10,765,312.00 0.00 0.00 10,765,312.00 TOTAL DIRECT EXPENSES 10,765,312.00 0.00 0.00 10,765,312.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs -6,330,231.00 0.00 0.00 -6,330,231.00 2 Other Costs Distributions Other Cost Distributions-Non- Community Water & STD -1,226,580.00 0.00 0.00 -1,226,580.00 Other Cost Distributions-Misc Distribution -1,317,374.00 0.00 0.00 -1,317,374.00 Other Cost Distributions-SIDS fee -1,875.00 0.00 0.00 -1,875.00 Total for Other Costs Distributions -2,545,829.00 0.00 0.00 -2,545,829.00 Total Indirect Costs -8,876,060.00 0.00 0.00 -8,876,060.00 TOTAL INDIRECT EXPENSES -8,876,060.00 0.00 0.00 -8,876,060.00 TOTAL EXPENDITURES 1,889,252.00 0.00 0.00 1,889,252.00 Comprehensive Agreement - FY 2014 Page: 33 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECTComprehensive Agreement - FY 2014 / Environmental Administration CONTRACTOR NAMEOakland County Department of Health and Human Services/Health Division MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. CITY STATE ZIP CODE DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 BUDGET AGREEMENT S7 Original Amendment AMENDMENT#0 FEDERAL ID NUMBER Category Amount Cash Inkind Total DIREECT EXPENSES Program Expenses 1 Salary & Wages 3,426,182.00 0.00 0.00 3,426,182.00 2 Fringe Benefits 2,384,221.00 0.00 0.00 2,384,221.00 3 Cap. Exp. for Equip & Fac.5,000.00 0.00 0.00 5,000.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 70,808.00 0.00 0.00 70,808.00 6 Travel 231,336.00 0.00 0.00 231,336.00 7 Communication 98,967.00 0.00 0.00 98,967.00 8 County-City Central Services 513,585.00 0.00 0.00 513,585.00 9 Space Costs 100,336.00 0.00 0.00 100,336.00 10 All Others (ADP, Con. Employees, Misc.) 292,951.00 0.00 0.00 292,951.00 Toteil Program Expenses 7,123,386.00 0.00 0.00 7,123,386.00 TOTAL DIRECT EXPENSES 7,123,386.00 0.00 0.00 7,123,386.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 1,527,581.00 0.00 0.00 1,527,581.00 2 Other Costs Distributions -5,977,305.00 0.00 0.00 -5,977,305.00 Tot<jl indirect Costs -4,449,724.00 0.00 0.00 -4,449,724.00 TOTAL INDIRECT EXPENSES -4,449,724.00 0.00 0.00 -4,449,724.00 TOTAL EXPENDITURES 2,673,662.00 0.00 0.00 2,673,662.00 Comprehensive Agreement - FY 2014 Page: 34 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 592,250.00 0.00 592,250.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 1,881,102.00 0.00 1,881,102.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 18,964.00 0.00 18,964.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 181,346.00 0.00 181,346.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate 0.00 0.00 0.00 0.00 Total Source of Funds 0.00 2,673,662.00 0.00 2,673,662.00 Totals 0.00 2,673,662.00 0.00 2,673,662.00 Comprehensive Agreement - FY 2014 Page: 35 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Amount Cash Inkind Total DiRECrr EXPENSES Program Expenses 1 Salary & Wages 3,426,182.00 0.00 0.00 3,426,182.00 2 Fringe Benefits 2,384,221.00 0.00 0.00 2,384,221.00 3 Cap. Exp. for Equip & Fac.5,000.00 0.00 0.00 5,000.00 4 Contractual 5 Supplies and Materials 70,808.00 0.00 0.00 70,808.00 6 Travel 231,336.00 0.00 0.00 231,336.00 7 Communication 98,967.00 0.00 0.00 98,967.00 8 County-City Central Services 513,585.00 0.00 0.00 513,585.00 9 Space Costs 100,336.00 0.00 0.00 100,336.00 10 All Others (ADP, Con. Employees, Misc.) 292,951.00 0.00 0.00 292,951.00 Total Program Expenses 7,123,386.00 0.00 0.00 7,123,386.00 TOTAL DIRECT EXPENSES 7,123,386.00 0.00 0.00 7,123,386.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 1,527,581.00 0.00 0.00 1,527,581.00 2 Other Costs Distributions EH Adm Distribtions -5,912,305.00 0.00 0.00 -5,912,305.00 Other Cost Distributions-Body Art Fees -15,000.00 0.00 0.00 -15,000.00 Other Cost Distributions-Tobacco Retailer Fees -50,000.00 0.00 0.00 -50,000.00 Total for Other Costs Distributions -5,977,305.00 0.00 0.00 -5,977,305.00 Total Indirect Costs -4,449,724.00 0.00 0.00 -4,449,724.00 TOTAL INDIRECT EXPENSES -4,449,724.00 0.00 0.00 -4,449,724.00 TOTAL EXPENDITURES 2,673,662.00 0.00 0.00 2,673,662.00 Comprehensive Agreement - FY 2014 Page: 36 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Adolescent STD Screening DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 12/31/2013 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT |7 Original fj Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 9,325.00 0.00 0.00 9,325.00 2 Fringe Benefits 3,164.00 0.00 0.00 3,164.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 316.00 0.00 0.00 316.00 6 Travel 85.00 0.00 0.00 85.00 7 Communication 84.00 0.00 0.00 84.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADR, Con. Employees, Misc.) 3,878.00 0.00 0.00 3,878.00 Total Program Expenses 16,852.00 0.00 0.00 16,852.00 TOTAL DIRECT EXPENSES 16,852.00 0.00 0.00 16,852.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 1,398.00 0.00 0.00 1,398.00 2 Other Costs Distributions 1,727.00 0.00 0.00 1,727.00 Total Indirect Costs 3,125.00 0.00 0.00 3,125.00 TOTAL INDIRECT EXPENSES 3,125.00 0.00 0.00 3,125.00 TOTAL EXPENDITURES 19,977.00 0.00 0.00 19,977.00 Comprehensive Agreement - FY 2014 Page: 37 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections -1 st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Locai 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 18,250.00 0.00 0.00 18,250.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS - MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 1,727.00 0.00 1,727.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 18,250.00 1,727.00 0.00 19,977.00 Comprehensive Agreement - FY 2014 Page: 38 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse Notes : Public Health Nurse III Employee to be named 250.000 17.593 HRS 4,398.00 0.00 0.00 4,398.00 Assistant Notes: Public Health Nurse III Employee to be named 75.000 17.759 HRS 1,332.00 0.00 0.00 1,332.00 Technician Notes: Office Assistant II Employee to be named 125.000 28.763 HRS 3,595.00 0.00 0.00 3,595.00 Total for Salary & Wages 9,325.00 0.00 0.00 9,325.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Workers Comp 0.000 33.930 3,164.00 0.00 0.00 3,164.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.000 0.000 25.00 0.00 0.00 25.00 Medical Supplies 0.000 0.000 41.00 0.00 0.00 41.00 Printing 0.000 0.000 250.00 0.00 0.00 250.00 Total for Supplies and Materials 316.00 0.00 0.00 316.00 6 Travel Mileage Notes : 150 miles @ .565 0.000 0.000 85.00 0.00 0.00 85.00 7 Communication Telephone 0.000 0.000 84.00 0.00 0.00 84.00 8 County-City Central Services 9 Space Costs Comprehensive Agreement - FY 2014 Page: 39 of 160 09 WO 01? :96ed P10Z Ad " JUSUJSSJBV 9A!SU9L|9jdUJ00 oo'zze'ei.OO'O 000 oo'zze'et ssyniiaNadxa nvioi 00'S21.'S 00-0 OO'O ocgzi-'e sasNadxa i03yiaNi ivioi OO'SZl-'S OO'O OO'O OO'SSl-'S sjsoo pejfpu] |Bjoi OO'lZl'i OO'O OO'O OO'LZL'I OOO'O OOO'O uognquisia ujpv MJiesH suounqujsia sjsoo Jeqjo Z OO'960'l-OO'O OO'O |00'86£'[.066't?l.OOO'O a;By JBQA leosy S)5O0 )33i!pU|J. SJSOO )03J!PU| s3SN3dX3 loaymNi 00'398'91.OO'O OO'O OO'SSS'QI-S3SN3dX3 ±03*310 IVIOI OO'SSS'Ql-OO'O OO'O OO'ZSS'Ql-sasuadxg uiejBoJd [6)01 00'8Z8'£OO'O OO'O 00'8Z8'S (¦osiifli 'saeAoidiug -uoo 'dQV) sasmo IIV JQi iejoj. oo'sei-'e OO'O OO'O ocsei-'e OOO'O OOO'O 6u!S!y9Apv OO'OOi OO'O OO'O OO'OOZ OOO'O OOO'O X60|0ULj091 UO!}BUJJO|U[ OO'St?OO'O OO'O OO'St-OOO'O OOO'O aouejnsuj {¦osiifli 'ssaAoidajg -uoo 'dQV) sjqiho IIV Ok IBJOl puj^ui MSBO }unoaiv lAJOD AiO uiail aun £ 103/01./60 ;9lBQ # PBJJUOO Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Local Health Department SNAP-ED DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT J7 Original p Amendment AMENDMENT#0 CITY STATE ZIP CODE Pontiac Ml 48341-0432 FEDERAL ID NUMBER 38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 23,566.00 0.00 0.00 23,566.00 2 Fringe Benefits 4,541.00 0.00 0.00 4,541.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 24,062.00 0.00 0.00 24,062.00 6 Travel 1,265.00 0.00 0.00 1,265.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 5,624.00 0.00 0.00 5,624.00 Total Program Expenses 59,058.00 0.00 0.00 59,058.00 TOTAL DIRECT EXPENSES 59,058.00 0.00 0.00 59,058.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 3,533.00 0.00 0.00 3,533.00 2 Other Costs Distributions 5,922.00 0.00 0.00 5,922.00 Total Indirect Costs 9,455.00 0.00 0.00 9,455.00 TOTAL INDIRECT EXPENSES 9,455.00 0.00 0.00 9,455.00 TOTAL EXPENDITURES 68,513.00 0.00 0.00 68,513.00 Comprehensive Agreement - FY 2014 Page: 41 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 50,073.00 0.00 0.00 50,073.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 5,922.00 0.00 5,922.00 Inkind Match 0.00 0.00 12,518.00 12,518.00 MDCH Fixed Unit Rate Totals 50,073.00 5,922.00 12,518.00 68,513.00 Comprehensive Agreement - FY 2014 Page: 42 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Supervisor Notes : MATCH 41.000 33.836 HRS 1,387.00 0.00 0.00 1,387.00 Health Educator 1065.00 0 17.628 HRS 18,774.00 0.00 0.00 18,774.00 Health Educator Notes : MATCH 104.000 23.432 HRS 2,437.00 0.00 0.00 2,437.00 Outreach Worker Notes : MATCH 21.000 18.699 HRS 393.00 0.00 0.00 393.00 Epidemiologist Notes : MATCH 21.000 27.404 HRS 575.00 0.00 0.00 575.00 Total for Salary & Wages 23,566.00 0.00 0.00 23,566.00 2 Fringe Benefits Composite Rate Notes : Portion Match 0.000 19.270 4,541.00 0.00 0.00 4,541.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Provisions - Food 0.000 0.000 5,100.00 0.00 0.00 5,100.00 Postage 0.000 0.000 4,008.00 0.00 0.00 4,008.00 Printing 0.000 0.000 9,738.00 0.00 0.00 9,738.00 Supplies - Food Demo 0.000 0.000 2,078.00 0.00 0.00 2,078.00 Educational Supplies 0.000 0.000 3,138.00 0.00 0.00 3,138.00 Total for Supplies and Materials 24,062.00 0.00 0.00 24,062.00 6 Travel Mileage Notes : 1622 @ .565 0.000 0.000 916.00 0.00 0.00 916.00 Conferences 0.000 0.000 349.00 0.00 0.00 349.00 Total forTravel 1,265.00 0.00 0.00 1,265.00 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 180.00 0.00 0.00 180.00 Comprehensive Agreement - FY 2014 Page: 43 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Interpretation 0.000 0.000 500.00 0.00 0.00 500.00 Staff Training 0.000 0.000 344.00 0.00 0.00 344.00 Advertising 0.000 0.000 1,800.00 0.00 0.00 1,800.00 IT Operations Notes : MATCH 0.000 0.000 2,800.00 0.00 0.00 2,800.00 TotaI for All Others (ADP, Con. Employees, Misc.)5,624.00 0.00 0.00 5,624.00 Total Program Expenses 59,058.00 0.00 0.00 59,058.00 TOTAL DIRECT EXPENSES 59,058.00 0.00 0.00 59,058.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate Notes: portion Match 0.000 14.990 3,533.00 0.00 0.00 3,533.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 5,922.00 0.00 0.00 5,922.00 Total Indirect Costs 9,455.00 0.00 0.00 9,455.00 TOTAL INDIRECT EXPENSES 9,455.00 0.00 0.00 9,455.00 TOTAL EXPENDITURES 68,513.00 0.00 0.00 68,513.00 Comprehensive Agreement - FY 2014 Page: 44 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Public Health Emerqencv Preparedness (PHEP) 10/1/13 - 6/30/14 DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 6/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT 17 Original f" Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 105,062.00 0.00 0.00 105,062.00 2 Fringe Benefits 63,320.00 0.00 0.00 63,320.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 9,883.00 0.00 0.00 9,883.00 6 Travel 4,271.00 0.00 0.00 4,271.00 7 Communication 2,295.00 0.00 0.00 2,295.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 8,211.00 0.00 0.00 8,211.00 10 All Others (ADP, Con. Employees, Misc.) 18,001.00 0.00 0.00 18,001.00 Total Program Expenses 211,043.00 0.00 0.00 211,043.00 TOTAL DIRECT EXPENSES 211,043.00 0.00 0.00 211,043.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 13,874.00 0.00 0.00 13,874.00 2 Other Costs Distributions 21,282.00 0.00 0.00 21,282.00 Total Indirect Costs 35,156.00 0.00 0.00 35,156.00 TOTAL INDIRECT EXPENSES 35,156.00 0.00 0.00 35,156.00 TOTAL EXPENDITURES 246,199.00 0.00 0.00 246,199.00 Comprehensive Agreement - FY 2014 Page: 45 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 204,470.00 0.00 0.00 204,470.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS-Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 21,282.00 0.00 21,282.00 Inkind Match 0.00 0.00 20,447.00 20,447.00 MDCH Fixed Unit Rate Totals 204,470.00 21,282.00 20,447.00 246,199.00 Comprehensive Agreement - FY 2014 Page: 46 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash inkinc Total DIRECT EXPENSES Pro jram Expenses 1 Salary & Wages Coordinator 1560.00 0 31.570 FTE 49,250.00 0.00 0.00 49,250.00 Assistant 780.000 14.458 FTE 11,277.00 0.00 0.00 11,277.00 Health Educator 780.000 17.628 FTE 13,750.00 0.00 0.00 13,750.00 Specialist 780.000 23.432 FTE 18,277.00 0.00 0.00 18,277.00 Manager Notes: Manager - K. Forzley MATCH FUNDS 249.000 50.234 FTE 12,508.00 0.00 0.00 12,508.00 TotsI for Salary & Wages 105,062.00 0.00 0.00 105,062.00 2 Fringe Benefits Composite Rate Notes : MATCH $7,939 0.000 60.269 63,320.00 0.00 0.00 63,320.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.000 0.000 2,044.00 0.00 0.00 2,044.00 Postage 0.000 0.000 206.00 0.00 0.00 206.00 Printing 0.000 0.000 1,500.00 0.00 0.00 1,500.00 Educational Supplies 0.000 0.000 1,500.00 0.00 0.00 1,500.00 Disaster Supplies 0.000 0.000 4,633.00 0.00 0.00 4,633.00 TotaI for Supplies and Materials 9,883.00 0.00 0.00 9,883.00 6 Travel Mileage Notes : 2250 miles @ .565 0.000 0.000 1,271.00 0.00 0.00 1,271.00 Conferences 0.000 0.000 3,000.00 0.00 0.00 3,000.00 Tota for Travel 4,271.00 0.00 0.00 4,271.00 7 Communication Telephone Communications 0.000 0.000 2,295.00 0.00 0.00 2,295.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 8,211.00 0.00 0.00 8,211.00 Comprehensive Agreement - FY 2014 Page: 47 of 160 09 Ho gfr :s6Ed HOZ AJ - 1U9LU99J6V aAjsusqajdaioo ooeei'gtz 000 OO'O 00*661'QPZ S3aniiaN3dX3 nvioi 00'9SI.'SS OO'O OO'O oo'9si.'se S3SN3dxa losyiaNi nv±oi ocgsi-'se OO'O OO'O 00'99l.'9£S)SOO P8J!PU| I3;oi QO'ZVZ'IZ 00-0 OO'O OO'ZQZ'IZ OOO'O OOO'O uotinqujsia tupv LRIB9H suoijnquisja sjsoo Jamo z OO'WS'Sl.OO'O OO'O OO'WS'Sl 066'* L OOO'O S0fr'2$ HOiVIA!: sa^ON 9iey JB0A |eosy S^SOQ )09JjpU|l SJSOQ pSiipU] S3SN3dX3 103aiGNI 00'£^0'H2 OO'O OO'O oo'ew'n-z S3SN3dX3 103^10 nvioi OO'St'O'H-2 OO'O OO'O OO'SW'H-Z sesuadxg uiejBojd leioj. 00" LOO'S ^OO'O OO'O 00" LOO'S 1-( osiifti 'sseAoiduia 'uoq 'dQV) sjsqio IIV JOl 1re o1- oo'ooo'e OO'O OO'O ocooo'e OOO'O OOO'O eujuieji yejs 00- lot' I OO'O OO'O 00'LOS'L OOO'O OOO'O jaidoo 00'00£'9 OO'O OO'O 00'00S'9 OOO'O OOO'O SU0|JBJ8dO 11 oo'ooo'e OO'O OO'O 00'000'S OOO'O OOO'O BuisjysApv 00'0SZ'£OO'O OO'O OO'OSZ'S OOO'O OOO'O jiedey luaiudinbg 00"0S9 OO'O OO'O 00'0S9 OOO'O OOO'O 80UBjnSU[ {¦ossiN 'seeXoidujg uoo 'dQV) sjeqio IIV OL |B?01 puj^u)qseo lunoiuv !/\ion aiey ^0 IU3)| 9UI1 e 1-02/0 [./60 :9iea # PBJIUOO Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comorehensive Aareement- FY 2014 / Bodv Art Fixed Fee DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT 17 Original f Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual.0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 . 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 15,000.00 0.00 0.00 15,000.00 Total indirect Costs 15,000.00 0.00 0.00 15,000.00 TOTAL INDIRECT EXPENSES 15,000.00 0.00 0.00 15,000.00 TOTAL EXPENDITURES 15,000.00 0.00 0.00 15,000.00 Comprehensive Agreement - FY 2014 Page: 49 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Body Art Fee 15,000.00 0.00 0.00 15,000.00 Totals 15,000.00 0.00 0.00 15,000.00 Comprehensive Agreement - FY 2014 Page: 50 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 Ail Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Cost Distributions for Fees-from Environmental Administration 0.000 0.000 15,000.00 0.00 0.00 15,000.00 Total indirect Costs 15,000.00 0.00 0.00 15,000.00 TOTAL INDIRECT EXPENSES 15,000.00 0.00 0.00 15,000.00 TOTAL EXPENDITURES 15,000.00 0.00 0.00 15,000.00 Comprehensive Agreement - FY 2014 Page: 51 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECTComprehensive Agreement - FY 2014 / Childrens SpecialHith Care Services (CSHCS) Care Coordination CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. CITY STATE ZIP CODE DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 BUDGET AGREEMENT J7; Original p Amendment AMENDMENT#0 FEDERAL ID NUMBER Category Amount Cash Inkind Total DIRlECT EXPENSES Proqram Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 IND RECT EXPENSES Indirect Costs 1 indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 273,576.00 0.00 0.00 273,576.00 Toteil Indirect Costs 273,576.00 0.00 0.00 273,576.00 TOTAL INDIRECT EXPENSES 273,576.00 0.00 0.00 273,576.00 TOTAL EXPENDITURES 273,576.00 0.00 0.00 273,576.00 Comprehensive Agreement - FY 2014 Page: 52 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate CSHCS Care Coordination 273,576.00 0.00 0.00 273,576.00 Totals 273,576.00 0.00 0.00 273,576.00 Comprehensive Agreement - FY 2014 Page: 53 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIREECT EXPENSES Proqram Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Cost Distributions for Fees-from CSHCS Outreach & Advoc 0.000 0.000 273,576.00 0.00 0.00 273,576.00 Total Indirect Costs 273,576.00 0.00 0.00 273,576.00 TOTAL INDIRECT EXPENSES 273,576.00 0.00 0.00 273,576.00 TOTAL EXPENDITURES 273,576.00 0.00 0.00 273,576.00 Comprehensive Agreement - FY 2014 Page: 54 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / CSHCS MedicaidOutreach DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT JT" Original p Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 697,128.00 0.00 0.00 697,128.00 Total Indirect Costs 697,128.00 0.00 0.00 697,128.00 TOTAL INDIRECT EXPENSES 697,128.00 0.00 0.00 697,128.00 TOTAL EXPENDITURES 697,128.00 0.00 0.00 697,128.00 Comprehensive Agreement - FY 2014 Page: 55 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 210,811.00 0.00 0.00 210,811.00 Required Match - Local 0.00 210,811.00 0.00 210,811.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 275,506.00 0.00 275,506.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 210,811.00 486,317.00 0.00 697,128.00 Comprehensive Agreement - FY 2014 Page: 56 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Distributions for Medicaid 0.000 0.000 697,128.00 0.00 0.00 697,128.00 Total Indirect Costs 697,128.00 0.00 0.00 697,128.00 TOTAL INDIRECT EXPENSES 697,128.00 0.00 0.00 697,128.00 TOTAL EXPENDITURES 697,128.00 0.00 0.00 697,128.00 Comprehensive Agreement - FY 2014 Page: 57 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECT Comprehensive Agreement - FY 2014 / Public HealthEmergency Preparedness (PHEP) CR110/1/13 - 6/30/14 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. CITY STATE ZIP CODE DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To : 6/30/2014 BUDGET AGREEMENT p; Original n Amendment AMENDMENT#0 FEDERAL ID NUMBER Category Amount Cash Inkind Total DIREECT EXPENSES Proqram Expenses 1 Salary & Wages 53,626.00 0.00 0.00 53,626.00 2 Fringe Benefits 42,178.00 0.00 0.00 42,178.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 ' 0.00 0.00 0.00 5 Supplies and Materials 18,600.00 0.00 0.00 18,600.00 6 Travel 1,413.00 0.00 0.00 1,413.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 5,263.00 0.00 0.00 5,263.00 10 All Others (ADP, Con. Employees, Misc.) 40,733.00 0.00 0.00 40,733.00 Toteil Program Expenses 161,813.00 0.00 0.00 161,813.00 TOTAL DIRECT EXPENSES 161,813.00 0.00 0.00 161,813.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 8,039.00 0.00 0.00 8,039.00 2 Other Costs Distributions 16,071.00 0.00 0.00 16,071.00 Total Indirect Costs 24,110.00 0.00 0.00 24,110.00 TOTAL INDIRECT EXPENSES 24,110.00 0.00 0.00 24,110.00 TOTAL EXPENDITURES 185,923.00 0.00 0.00 185,923.00 Comprehensive Agreement - FY 2014 Page: 58 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State {Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 154,411.00 0.00 0.00 154,411.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 16,071.00 0.00 16,071.00 Inkind Match 0.00 0.00 15,441.00 15,441.00 MDCH Fixed Unit Rate Totals 154,411.00 16,071.00 15,441.00 185,923.00 Comprehensive Agreement - FY 2014 Page: 59 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate DOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Specialist 780.000 23.432 FTE 18,277.00 0.00 0.00 18,277.00 Assistant 780.000 13.189 FTE 10,287.00 0.00 0.00 10,287.00 Health Educator 780.000 18.634 FTE 14,535.00 0.00 0.00 14,535.00 Administrator Notes: Administrator - Rachel Shymkiw MATCH FUNDS 217.000 40.022 FTE 8,685.00 0.00 0.00 8,685.00 Overtime 100.000 18.420 HRS 1,842.00 0.00 0.00 1,842.00 Total for Salary & Wages 53,626.00 0.00 0.00 53,626.00 2 Fringe Benefits Composite Rate Notes : MATCH $5,454 0.000 78.652 42,178.00 0.00 0.00 42,178.00 3 Cap. Exp. for Equip & Fac. 4 Contractua! 5 Supplies and Materials Office Supplies 0.000 0.000 2,000.00 0.00 0.00 2,000.00 Postage 0.000 0.000 600.00 0.00 0.00 600.00 Printing 0.000 0.000 3,000.00 0.00 0.00 3,000.00 Educational Supplies 0.000 0.000 3,000.00 0.00 0.00 3,000.00 Disaster Supplies 0.000 0.000 10,000.00 0.00 0.00 10,000.00 Total for Supplies and Materials 18,600.00 0.00 0.00 18,600.00 6 Travel Mileage Notes : 2500 miles @ .565 0.000 0.000 1,413.00 0.00 0.00 1,413.00 7 Communication 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 5,263.00 0.00 0.00 5,263.00 10 All Others (ADP, Con. Employees, Misc.) Staff Training 0.000 0.000 8,000.00 0.00 0.00 8,000.00 Insurance 0.000 0.000 490.00 0.00 0.00 490.00 IT Operations 0.000 0.000 8,340.00 0.00 0.00 8,340.00 Comprehensive Agreement - FY 2014 Page: 60 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Copier 0.000 0.000 1,500.00 0.00 0.00 1,500.00 Professional Services 0.000 0.000 15,000.00 0.00 0.00 15,000.00 Advertising 0.000 0.000 3,903.00 0.00 0.00 3,903.00 Equipment Repair 0.000 0.000 3,500.00 0.00 0.00 3,500.00 Total for All Others (ADP, Con. Employees, Misc.)40,733.00 0.00 0.00 40,733.00 Total Program Expenses 161,813.00 0.00 0.00 161,813.00 TOTAL DIRECT EXPENSES 161,813.00 0.00 0.00 161,813.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate Notes : MATCH $1,302 0.000 14.990 8,039.00 0.00 0.00 8,039.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 16,071.00 0.00 0.00 16,071.00 Total Indirect Costs 24,110.00 0.00 0.00 24,110.00 TOTAL INDIRECT EXPENSES 24,110.00 0.00 0.00 24,110.00 TOTAL EXPENDITURES 185,923.00 0.00 0.00 185,923.00 Comprehensive Agreement - FY 2014 Page: 61 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014/ Childrens SpecialHlth Care Services (CSHCS) Outreach & Advocacy DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT Jyf Original n Amendment CITYPontiac AMENDMENT#0 STATE ZIP CODE48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Proqram Expenses 1 Salary & Wages 287,147.00 o.uo 0.00 287,147.00 2 Fringe Benefits 141,893.00 0.00 0.00 141,893.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 10,300.00 0.00 0.00 10,300.00 6 Travel 1,928.00 0.00 0.00 1,928.00 7 Communication 11,500.00 0.00 0.00 11,500.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 22,000.00 0.00 0.00 22,000.00 10 All Others (ADP, Con. Employees, Misc.) 40,765.00 0.00 0.00 40,765.00 Total Program Expenses 515,533.00 0.00 0.00 515,533.00 TOTAL DIRECT EXPENSES 515,533.00 0.00 0.00 515,533.00 INDIRECT EXPENSES indirect Costs 1 Indirect Costs 43,043.00 0.00 0.00 43,043.00 2 Other Costs Distributions -273,576.00 0.00 0.00 -273,576.00 Total Indirect Costs -230,533.00 0.00 0.00 -230,533.00 TOTAL INDIRECT EXPENSES -230,533.00 0.00 0.00 -230,533.00 TOTAL EXPENDITURES 285,000.00 0.00 0.00 285,000.00 Comprehensive Agreement - FY 2014 Page: 62 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 285,000.00 0.00 0.00 285,000.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 285,000.00 0.00 0.00 285,000.00 Comprehensive Agreement - FY 2014 Page: 63 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Proqram Expenses 1 Salary & Wages Supervisor 1.000 70378.000 PTE 70,378.00 0.00 0.00 70,378.00 Public Health Nurse 1000.00 0 20.415 HRS 20,415.00 0.00 0.00 20,415.00 Public Health Nurse 1000.00 0 20.415 HRS 20,415.00 0.00 0.00 20,415.00 Assistant 1000.00 0 13.189 HRS 13,189.00 0.00 0.00 13,189.00 Assistant 1000.00 0 13.189 HRS 13,189.00 0.00 0.00 13,189.00 Assistant 700.000 13.189 HRS 9,232.00 0.00 0.00 9,232.00 Assistant 700.000 13.189 HRS 9,232.00 0.00 0.00 9,232.00 Assistant 300.000 13.189 HRS 3,957.00 0.00 0.00 3,957.00 Assistant 1.000 30072.000 PTE 30,072.00 0.00 0.00 30,072.00 Assistant 1.000 36938.000 PTE 36,938.00 0.00 0.00 36,938.00 Public Health Nurse 700.000 24.396 HRS 17,077.00 0.00 0.00 17,077.00 Public Health Nurse 1038.00 0 29.939 HRS 31,077.00 0.00 0.00 31,077.00 Public Health Nurse 400.000 29.939 HRS 11,976.00 0.00 0.00 11,976.00 Total for Salary & Wages 287,147.00 0.00 0.00 287,147.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.000 49.415 141,893.00 0.00 0.00 141,893.00 3 Cap. Exp. for Equip & Fac. 4 Contractual Comprehensive Agreement - FY 2014 Page: 64 of 160 Contract# Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total 5 Supplies and Materials Office Supplies 0.000 0.000 4,100.00 0.00 0.00 4,100.00 Postage 0.000 0.000 3,200.00 0.00 0.00 3,200.00 Printing 0.000 0.000 3,000.00 0.00 0.00 3,000.00 Total for Supplies and Materials 10,300.00 0.00 0.00 10,300.00 6 Travel Mileage Notes : 1500 miles @.565 0.000 0.000 848.00 0.00 0.00 848.00 Conferences 0.000 0.000 500.00 0.00 0.00 500.00 client transportation 0.000 0.000 580.00 0.00 0.00 580.00 Total for Travel 1,928.00 0.00 0.00 1,928.00 7 Communication Telephone 0.000 0.000 11,500.00 0.00 0.00 11,500.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 22,000.00 0.00 0.00 22,000.00 10 All Others (ADP, Con. Employees, Misc.) Convenience Copier 0.000 0.000 1,000.00 0.00 0.00 1,000.00 Insurance 0.000 0.000 765.00 0.00 0.00 765.00 IT Operations 0.000 0.000 39,000.00 0.00 0.00 39,000.00 Total for All Others (ADP, Con. Employees, Misc.)40,765.00 0.00 0.00 40,765.00 Total Program Expenses 515,533.00 0.00 0.00 515,533.00 TOTAL DIRECT EXPENSES 515,533.00 0.00 0.00 515,533.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 43,043.00 0.00 0.00 43,043.00 2 Other Costs Distributions Other Cost Distributions-CSHCS Care Coor Fees 0.000 0.000 -273,576.00 0.00 0.00 -273,576.00 Health Adm Distribution 0.000 0.000 52,853.00 0.00 0.00 52,853.00 Other Cost Distributions-Nursing Staff 0.000 0.000 627,797.00 0.00 0.00 627,797.00 Nursing Adm 0.000 0.000 16,478.00 0.00 0.00 16,478.00 Comprehensive Agreement - FY 2014 Page: 65 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Distribution Other Cost Distributions-CSHCS - Medicaid Outreach 0.000 0.000 -697,128.00 0.00 0.00 -697,128.00 Total for Other Costs Distributions -273,576.00 0.00 0.00 -273,576.00 Total Indirect Costs -230,533.00 0.00 0.00 -230,533.00 TOTAL INDIRECT EXPENSES -230,533.00 0.00 0.00 -230,533.00 TOTAL EXPENDITURES 285,000.00 0.00 0.00 285,000.00 Comprehensive Agreement - FY 2014 Page: 66 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / BioterrorismRegional EPI Supoort DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street)1200 N. Telegraph Rd. BUDGET AGREEMENT p Original f- Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 2,513.00 0.00 0.00 2,513.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 344.00 0.00 0.00 344.00 8 County-City Central Services ' 0.00 0.00 0.00 0.00 9 Space Costs 1,818.00 0.00 0.00 1,818.00 10 All Others (ADP, Con. Employees, Misc.) 2,825.00 0.00 0.00 2,825.00 Total Program Expenses 7,500.00 0.00 0.00 7,500.00 TOTAL DIRECT EXPENSES 7,500.00 0.00 0.00 7,500.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 710.00 0.00 0.00 710.00 Total Indirect Costs 710.00 0.00 0.00 710.00 TOTAL INDIRECT EXPENSES 710.00 0.00 0.00 710.00 TOTAL EXPENDITURES 8,210.00 0.00 0.00 8,210.00 Comprehensive Agreement - FY 2014 Page: 67 of 160 Contract # Date: 09/10/2013 2 Program Budget-Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 7,500.00 0.00 0.00 7,500.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 710.00 0.00 710.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 7,500.00 710.00 0.00 8,210.00 Comprehensive Agreement - FY 2014 Page: 68 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash tnkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Printing 0.000 0.000 2,513.00 0.00 0.00 2,513.00 6 Travel 7 Communication phones 0.000 0.000 344.00 0.00 0.00 344.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 1,818.00 0.00 0.00 1,818.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 25.00 0.00 0.00 25.00 IT Operations 0.000 0.000 2,800.00 0.00 0.00 2,800.00 Total for All Others (ADP, Con. Employees, Misc.)2,825.00 0.00 0.00 2,825.00 Total Program Expenses 7,500.00 0.00 0.00 7,500.00 TOTAL DIRECT EXPENSES 7,500.00 0.00 0.00 7,500.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 710.00 0.00 0.00 710.00 Total Indirect Costs 710.00 0.00 0.00 710.00 TOTAL INDIRECT EXPENSES 710.00 0.00 0.00 710.00 TOTAL EXPENDITURES 8,210.00 0.00 0.00 8,210.00 Comprehensive Agreement - FY 2014 Page: 69 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECTComprehensive Agreement - FY 2014 / FDA TobaccoRetailer (A&L) Inspections DATE PREPARED9/10/2013 CONTRACTOR NAMEOakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To: 8/14/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT p" Original p Amendment AMENDMENT#0 CITY Pontiac STATE ZIP CODE48341-0432 FEDERAL ID NUMBER 38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Proqram Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 50,000.00 0.00 0.00 50,000.00 Total Indirect Costs 50,000.00 0.00 0.00 50,000.00 TOTAL INDIRECT EXPENSES 50,000.00 0.00 0.00 50,000.00 TOTAL EXPENDITURES 50,000.00 0.00 0.00 50,000.00 Comprehensive Agreement - FY 2014 Page: 70 of 160 Contract # Date: 09/10/2013 2 Program Budget-Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate FDA Fee for Services 50,000.00 0.00 0.00 50,000.00 Totals 50,000.00 0.00 0.00 50,000.00 Comprehensive Agreement - FY 2014 Page: 71 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIREICT EXPENSES Proqram Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Cost Distributions for Fees-from Environmental Administration 0.000 0.000 50,000.00 0.00 0.00 50,000.00 Total indirect Costs 50,000.00 0.00 0.00 50,000.00 TOTAL INDIRECT EXPENSES 50,000.00 0.00 0.00 50,000.00 TOTAL EXPENDITURES 50,000.00 0.00 0.00 50,000.00 Comprehensive Agreement - FY 2014 Page: 72 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / Fetal Infant Mortality Review (FIMR) Case Abstraction DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT # jv Original f"" Amendment 0 CITY STATE ZIP CODE Pontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 4,491.00 0.00 0.00 4,491.00 2 Fringe Benefits 206.00 0.00 0.00 206.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others {ADP, Con. Employees, Misc.) 30.00 0.00 0.00 30.00 Total Program Expenses 4,727.00 0.00 0.00 4,727.00 TOTAL DIRECT EXPENSES 4,727.00 0.00 0.00 4,727.00 INDIRECT EXPENSES indirect Costs 1 Indirect Costs 673.00 0.00 0.00 673.00 2 Other Costs Distributions 670.00 0.00 0.00 670.00 Total Indirect Costs 1,343.00 0.00 0.00 1,343.00 TOTAL INDIRECT EXPENSES 1,343.00 0.00 0.00 1,343.00 TOTAL EXPENDITURES 6,070.00 0.00 0.00 6,070.00 Comprehensive Agreement - FY 2014 Page: 73 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 5,400.00 0.00 0.00 5,400.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 670.00 0.00 670.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 5,400.00 670.00 0.00 6,070.00 Comprehensive Agreement - FY 2014 Page: 74 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse 150.000 29.939 VAR 4,491.00 0.00 0.00 4,491.00 2 Fringe Benefits Composite Rate 0.000 4.590 206.00 0.00 0.00 206.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 30.00 0.00 0.00 30.00 Total Program Expenses 4,727.00 0.00 0.00 4,727.00 TOTAL DIRECT EXPENSES 4,727.00 0.00 0.00 4,727.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 673.00 0.00 0.00 673.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 511.00 0.00 0.00 511.00 Nursing Adm Distribution 0.000 0.000 159.00 0.00 0.00 159.00 Total for Other Costs Distributions 670.00 0.00 0.00 670.00 Total Indirect Costs 1,343.00 0.00 0.00 1,343.00 TOTAL INDIRECT EXPENSES 1,343.00 0.00 0.00 1,343.00 TOTAL EXPENDITURES 6,070.00 0.00 0.00 6,070.00 Comprehensive Agreement - FY 2014 Page: 75 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Food ELPHS CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT J7 Original f" Amendment AMENDMENT#0 CITY Pontiac STATEMl ZIP CODE48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10.All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 3,633,604.00 0.00 0.00 3,633,604.00 Total Indirect Costs 3,633,604.00 0.00 0.00 3,633,604.00 TOTAL INDIRECT EXPENSES 3,633,604.00 0.00 0.00 3,633,604.00 TOTAL EXPENDITURES 3,633,604.00 0.00 0.00 3,633,604.00 Comprehensive Agreement - FY 2014 Page: 76 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 1,135,000.00 0.00 1,135,000.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 827,691.00 0.00 0.00 827,691.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 1,670,913.00 0.00 1,670,913.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 827,691.00 2,805,913.00 0.00 3,633,604.00 Comprehensive Agreement - FY 2014 Page: 77 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRE:CT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) IND RECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Environmental Hlth Adm Distribution 0.000 0.000 3,633,604.00 0.00 0.00 3,633,604.00 Total Indirect Costs 3,633,604.00 0.00 0.00 3,633,604.00 TOTAL INDIRECT EXPENSES 3,633,604.00 0.00 0.00 3,633,604.00 TOTAL EXPENDITURES 3,633,604.00 0.00 0.00 3,633,604.00 Comprehensive Agreement - FY 2014 Page: 78 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / General Communicable Disease ELPHS DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT (7 Original p Amendment AMENDMENT #0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 1,569,656.00 0.00 0.00 1,569,656.00 Total Indirect Costs 1,569,656.00 0.00 0.00 1,569,656.00 TOTAL INDIRECT EXPENSES 1,569,656.00 0.00 0.00 1,569,656.00 TOTAL EXPENDITURES 1,569,656.00 0.00 0.00 1,569,656.00 Comprehensive Agreement - FY 2014 Page: 79 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - Island 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 331,204.00 0.00 0.00 331,204.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS-Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 1,238,452.00 0.00 1,238,452.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 331,204.00 1,238,452.00 0.00 1,569,656.00 Comprehensive Agreement - FY 2014 Page: 80 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Other Cost Distributions-CD Unit Staff Notes : 50% of PTE Medical Director's salary and fringes 100% of CD Staff Unit time includes,Epidemiologist s, PHN's, PHN Supervisor, Office Assistants 0.000 0.000 1,226,580.00 0.00 0.00 1,226,580.00 Other Cost Distributions-Misc Cost distibution Notes : 1 % of total Health Division Clinic Expenses (based on a workload management program that tracks Clinic Nursing time) 0.000 0.000 61,257.00 0.00 0.00 61,257.00 Health Adm Distribution Notes : 4.25 % of Central Support Unit Staff expenses 0.000 0.000 281,819.00 0.00 0.00 281,819.00 Comprehensive Agreement - FY 2014 Page: 81 of 160 Contract# Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total 0.3 % of Lab Support staff expenses 0.13% of Health Division Administration Expenses Total for Other Costs Distributions 1,569,656.00 0.00 0.00 1,569,656.00 Total Indirect Costs 1,569,656.00 0.00 0.00 1,569,656.00 TOTAL INDIRECT EXPENSES 1,569,656.00 0.00 0.00 1,569,656.00 TOTAL EXPENDITURES 1,569,656.00 0.00 0.00 1,569,656.00 Comprehensive Agreement - FY 2014 Page: 82 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Aqreement - FY 2014 / Hearina ELPHS DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT jpf Original p Amendment AMENDMENT #0 CITY STATE ZIP CODE Pontiac Ml 48341-0432 FEDERAL ID NUMBER 38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 246,945.00 0.00 0.00 246,945.00 2 Fringe Benefits 68,742.00 0.00 0.00 68,742.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 3,030.00 0.00 0.00 3,030.00 6 Travel 6,127.00 0.00 0.00 6,127.00 7 Communication 654.00 0.00 0.00 654.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 17,356.00 0.00 0.00 17,356.00 10 All Others (ADR, Con. Employees, Misc.) 5,701.00 0.00 . 0.00 5,701.00 Total Program Expenses 348,555.00 0.00 0.00 348,555.00 TOTAL DIRECT EXPENSES 348,555.00 0.00 0.00 348,555.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 37,017.00 0.00 0.00 37,017.00 2 Other Costs Distributions 103,155.00 0.00 0.00 103,155.00 Total Indirect Costs 140,172.00 0.00 0.00 140,172.00 TOTAL INDIRECT EXPENSES 140,172.00 0.00 0.00 140,172.00 TOTAL EXPENDITURES 488,727.00 0.00 0.00 488,727.00 Comprehensive Agreement - FY 2014 Page: 83 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 219,078.00 0.00 0.00 219,078.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 269,649.00 0.00 269,649.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 219,078.00 269,649.00 0.00 488,727.00 Comprehensive Agreement - FY 2014 Page: 84 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Cost Detail not provided 1.000 246945.000 FTE 246,945.00 0.00 0.00 246,945.00 2 Fringe Benefits Composite Rate 0.000 100.000 68,742.00 0.00 0.00 68,742.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office/E d uc/M ed ica I, Postage, Printing 0.000 0.000 3,030.00 0.00 0.00 3,030.00 6 Travel Travel-terms not specified 0.000 0.000 6,127.00 0.00 0.00 6,127.00 7 Communication Telephone 0.000 0.000 654.00 0.00 0.00 654.00 8 County-City Central Services 9 Space Costs Bldg Space Costs 0.000 0.000 17,356.00 0.00 0.00 17,356.00 10 All Others (ADP, Con. Employees, Misc.) Copier, Equip Maint, Exp Equip, Training 0.000 0.000 5,701.00 0.00 0.00 5,701.00 Total Program Expenses 348,555.00 0.00 0.00 348,555.00 TOTAL DIRECT EXPENSES 348,555.00 0.00 0.00 348,555.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 37,017.00 0.00 0.00 37,017.00 2 Other Costs Distributions Nursing Adm Distribution 0.000 0.000 11,374.00 0.00 0.00 11,374.00 Other Cost Distributions-Misc. 0.000 0.000 55,298.00 0.00 0.00 55,298.00 Health Adm Distribution 0.000 0.000 36,483.00 0.00 0.00 36,483.00 Total for Other Costs Distributions 103,155.00 0.00 0.00 103,155.00 Total Indirect Costs 140,172.00 0.00 0.00 140,172.00 Comprehensive Agreement - FY 2014 Page: 85 of 160 Contract# Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total TOTAL INDIRECT EXPENSES 140,172.00 0.00 0.00 140,172.00 TOTAL EXPENDITURES 488,727.00 0.00 0.00 488,727.00 Comprehensive Agreement - FY 2014 Page: 86 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / HIV Prevention DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT {7 Original f" Amendment AMENDMENT#0 CITY STATE ZIP CODE Pontiac Ml 48341-0432 FEDERAL ID NUMBER 38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 266,196.00 0.00 0.00 266,196.00 2 Fringe Benefits 140,865.00 0.00 0.00 140,865.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 . 0.00 0.00 0.00 5 Supplies and Materials 5,742.00 0.00 0.00 5,742.00 6 Travel 8,259.00 0.00 0.00 8,259.00 7 Communication 4,200.00 0.00 0.00 4,200.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 5,638.00 0.00 0.00 5,638.00 10 All Others (ADP, Con. Employees, Misc.) 27,097.00 0.00 0.00 27,097.00 Total Program Expenses 457,997.00 0.00 0.00 457,997.00 TOTAL DIRECT EXPENSES 457,997.00 0.00 0.00 457,997.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 39,903.00 0.00 0.00 39,903.00 2 Other Costs Distributions 764,677.00 0.00 0.00 764,677.00 Total Indirect Costs 804,580.00 0.00 0.00 804,580.00 TOTAL INDIRECT EXPENSES 804,580.00 0.00 0.00 804,580.00 TOTAL EXPENDITURES 1,262,577.00 0.00 0.00 1,262,577.00 Comprehensive Agreement - FY 2014 Page: 87 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State {Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 497,900.00 0.00 0.00 497,900.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 362,407.00 0.00 0.00 362,407.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 402,270.00 0.00 402,270.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 860,307.00 402,270.00 0.00 1,262,577.00 Comprehensive Agreement - FY 2014 Page: 88 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse Notes : Public Health Nurse III Employee to be named 1000.00 0 23.898 HRS 23,898.00 0.00 0.00 23,898.00 Coordinator Notes: Health Program Coordinator Employee to be named 1.000 65666.000 PTE 65,666.00 0.00 0.00 65,666.00 Assistant Notes: Office Assistant Employee to be named 1.000 36938.000 PTE 36,938.00 0.00 0.00 36,938.00 Public Health Nurse Notes : Public Health Nurse II Employee to be named 1000.00 0 25.264 HRS 25,264.00 0.00 0.00 25,264.00 Public Health Nurse Notes : Public Health Nurse III Employee to be named 1.000 62274.000 PTE 62,274.00 0.00 0.00 62,274.00 Overtime Notes: 100 Hrs Overtime 100.000 29.939 HRS 2,994.00 0.00 0.00 2,994.00 Public Health Nurse Notes: Public Health Nurse HI Employee to be named 1000.00 0 25.264 HRS 25,264.00 0.00 0.00 25,264.00 Public Health Nurse Notes: PHNII Employee to be named 1000.00 0 23.898 HRS 23,898.00 0.00 0.00 23,898.00 Total for Salary & Wages 266,196.00 0.00 0.00 266,196.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance 0.000 52.918 140,865.00 0.00 0.00 140,865.00 Comprehensive Agreement - FY 2014 Page: 89 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Workers Comp Short and Long Term Disability Insurance 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.000 0.000 500.00 0.00 0.00 500.00 Medical Supplies 0.000 0.000 3,000.00 0.00 0.00 3,000.00 Postage 0.000 0.000 200.00 0.00 0.00 200.00 Printing 0.000 0.000 1,242.00 0.00 0.00 1,242.00 Lab Supplies 0.000 0.000 800.00 0.00 0.00 800.00 TotaI for Supplies and Materials 5,742.00 0.00 0.00 5,742.00 6 Travel Mileage Notes : 10,970 miles @ .565 0.000 0.000 6,198.00 0.00 0.00 6,198.00 Client Transportation 0.000 0.000 600.00 0.00 0.00 600.00 Conferences 0.000 0.000 1,461.00 0.00 0.00 1,461.00 Total for Travel 8,259.00 0.00 0.00 8,259.00 7 Communication Telephone 0.000 0.000 4,200.00 0.00 0.00 4,200.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 5,638.00 0.00 0.00 5,638.00 10 All Others (ADP, Con. Employees, Misc.) IT Operations Notes : it operations 0.000 0.000 11,200.00 0.00 0.00 11,200.00 Convenience Copier Notes : copier 0.000 0.000 200.00 0.00 0.00 200.00 Interpretation Notes : printing 0.000 0.000 500.00 0.00 0.00 500.00 Insurance 0.000 0.000 1,385.00 0.00 0.00 1,385.00 Advertising Notes : interpretation 0.000 0.000 13,812.00 0.00 0.00 13,812.00 Total for All Others (ADR, Con. Employees, Misc.)27,097.00 0.00 0.00 27,097.00 Total Program Expenses 457,997.00 0.00 0.00 457,997.00 TOTAL DIRECT EXPENSES 457,997.00 0.00 0.00 457,997.00 Comprehensive Agreement - FY 2014 Page: 90 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 39,903.00 0.00 0.00 39,903.00 2 Other Costs Distributions Nursing Adm Distribution 0.000 0.000 14,688.00 0.00 0.00 14,688.00 Other Cost Distributions- Miscellaneous 0.000 0.000 702,878.00 0.00 0.00 702,878.00 Health Adm Distribution 0.000 0.000 47,111.00 0.00 0.00 47,111.00 Total for Other Costs Distributions 764,677.00 0.00 0.00 764,677.00 Total Indirect Costs 804,580.00 0.00 0.00 804,580.00 TOTAL INDIRECT EXPENSES 804,580.00 0.00 0.00 804,580.00 TOTAL EXPENDITURES 1,262,577.00 0.00 0.00 1,262,577.00 Comprehensive Agreement - FY 2014 Page: 91 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECT Comprehensive Agreement - FY 2014 / Immunization Action Plan (IAP) DATE PREPARED9/10/2013 CONTRACTOR NAMEOakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT Original f? Amendment AMENDMENT#0 CITY Pontiac STATE ZIP CODE48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DiR!=CT EXPENSES Proqram Expenses 1 Salary & Wages 247,119.00 0.00 0.00 247,119.00 2 Fringe Benefits 161,926.00 0.00 0.00 161,926.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 ' 0.00 0.00 5 Supplies and Materials 22,681.00 0.00 0.00 22,681.00 6 Travel 5,796.00 0.00 0.00 5,796.00 7 Communication 4,632.00 0.00 0.00 4,632.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 12,839.00 0.00 0.00 12,839.00 10 All Others (ADP, Con. Employees, Misc.) 26,797.00 0.00 0.00 26,797.00 Total Program Expenses 481,790.00 0.00 0.00 481,790.00 TOTAL DIRECT EXPENSES 481,790.00 0.00 0.00 481,790.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 37,043.00 0.00 0.00 37,043.00 2 Other Costs Distributions 24,397.00 0.00 0.00 24,397.00 Total Indirect Costs 61,440.00 0.00 0.00 61,440.00 TOTAL INDIRECT EXPENSES 61,440.00 0.00 0.00 61,440.00 TOTAL EXPENDITURES 543,230.00 0.00 0.00 543,230.00 Comprehensive Agreement - FY 2014 Page: 92 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections -1 st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State {Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 478,833.00 0.00 0.00 478,833.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 64,397.00 0.00 64,397.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 478,833.00 64,397.00 0.00 543,230.00 Comprehensive Agreement - FY 2014 Page: 93 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash inkind Total DIRECT EXPENSES Proqram Expenses 1 Salary & Waqes Coordinator Notes: Health Program Coordinator Employee to be named 1.000 64378.000 PTE 64,378.00 0.00 0.00 64,378.00 Public Health Nurse Notes : Public Health Nurse III Employee to be named 1.000 62274.000 PTE 62,274.00 0.00 0.00 62,274.00 Assistant Notes: Office Assistant II Employee to be named 1.000 36938.000 PTE 36,938.00 0.00 0.00 36,938.00 Clerk 1520.00 0 18.699 HRS 28,423.00 0.00 0.00 28,423.00 Office Manager 1.000 39068.000 PTE 39,068.00 0.00 0.00 39,068.00 Aux Hith Wkr 1000.00 0 16.038 HRS 16,038.00 0.00 0.00 16,038.00 TotaI for Salary & Wages 247,119.00 0.00 0.00 247,119.00 2 Frinqe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.000 65.526 161,926.00 0.00 0.00 161,926.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.000 0.000 1,100.00 0.00 0.00 1,100.00 Postage 0.000 0.000 16,000.00 0.00 0.00 16,000.00 Printing 0.000 0.000 4,000.00 0.00 0.00 4,000.00 Educational Supplies 0.000 0.000 1,581.00 0.00 0.00 1,581.00 Comprehensive Agreement - FY 2014 Page: 94 of 160 Contract # Date: 09/10/2013 Line item Qty Rate UOM Amount Cash Inkind Total Total for Supplies and Materials 22,681.00 0.00 0.00 22,681.00 6 Travel Mileage Notes : 5327 miles @ .565 0.000 0.000 3,010.00 0.00 0.00 3,010.00 Conferences 0.000 0.000 2,786.00 0.00 0.00 2,786.00 Total for Travel 5,796.00 0.00 0.00 5,796.00 7 Communication Telephone 0.000 0.000 4,632.00 0.00 0.00 4,632.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.000 0.000 12,839.00 0.00 0.00 12,839.00 10 All Others (ADP, Con. Employees, Misc.) Equipment Repair 0.000 0.000 200.00 0.00 0.00 200.00 Convenience Copier Notes: copier 0.000 0.000 2,400.00 0.00 0.00 2,400.00 IT Operation Notes: printing 0.000 0.000 23,047.00 0.00 0.00 23,047.00 Insurance 0.000 0.000 1,150.00 0.00 0.00 1,150.00 Total for All Others (ADP, Con. Employees, Misc.)26,797.00 0.00 0.00 26,797.00 Total Program Expenses 481,790.00 0.00 0.00 481,790.00 TOTAL DIRECT EXPENSES 481,790.00 0.00 0.00 481,790.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 37,043.00 0.00 0.00 37,043.00 2 Other Costs Distributions Other Cost Distributions-Nurse Train/VFC/AFIX 0.000 0.000 -40,000.00 0.00 0.00 -40,000.00 Health Adm Distribution 0.000 0.000 49,092.00 0.00 0.00 49,092.00 Nursing Adm Distribution 0.000 0.000 15,305.00 0.00 0.00 15,305.00 Total for Other Costs Distributions 24,397.00 0.00 0.00 24,397.00 Total indirect Costs 61,440.00 0.00 0.00 61,440.00 TOTAL INDIRECT EXPENSES 61,440.00 0.00 0.00 61,440.00 TOTAL EXPENDITURES 543,230.00 0.00 0.00 543,230.00 Comprehensive Agreement - FY 2014 Page: 95 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / ImmunizationELPHS DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT jy: Original p Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIR=CT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 4,898,024.00 0.00 0.00 4,898,024.00 Total Indirect Costs 4,898,024.00 0.00 0.00 4,898,024.00 TOTAL INDIRECT EXPENSES 4,898,024.00 0.00 0.00 4,898,024.00 TOTAL EXPENDITURES 4,898,024.00 0.00 0.00 4,898,024.00 Comprehensive Agreement - FY 2014 Page: 96 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 2,317,412.00 0.00 2,317,412.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 641,190.00 0.00 0.00 641,190.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 1,939,422.00 0.00 1,939,422.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 641,190.00 4,256,834.00 0.00 4,898,024.00 Comprehensive Agreement - FY 2014 Page: 97 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRE:CT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Other Cost Distributions-Field Nursing 0.000 0.000 706,272.00 0.00 0.00 706,272.00 Other Cost Distributions-Clinic 0.000 0.000 1,874,340.00 0.00 0.00 1,874,340.00 Federally Provided Vaccines Notes: Used 2012-13 budgetary figure/current not available yet 0.000 0.000 2,317,412.00 0.00 0.00 2,317,412.00 Total for Other Costs Distributions 4,898,024.00 0.00 0.00 4,898,024.00 Total Indirect Costs 4,898,024.00 0.00 0.00 4,898,024.00 TOTAL INDIRECT EXPENSES 4,898,024.00 0.00 0.00 4,898,024.00 TOTAL EXPENDITURES 4,898,024.00 0.00 0.00 4,898,024.00 Comprehensive Agreement - FY 2014 Page: 98 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM 1 PROJECT Comorehensive Aareement - FY 2014 / Infant Safe Sleeo DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIOD From : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT Original f~ Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2,385.00 0.00 0.00 2,385.00 2 Fringe Benefits 1,895.00 0.00 0.00 1,895.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 12,237.00 0.00 0.00 12,237.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 5,625.00 0.00 0.00 5,625.00 Total Program Expenses 22,142.00 0.00 0.00 22,142.00 TOTAL DIRECT EXPENSES 22,142.00 0.00 0.00 22,142.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 358.00 0.00 0.00 358.00 2 Other Costs Distributions 2,129.00 0.00 0.00 2,129.00 Total Indirect Costs 2,487.00 0.00 0.00 2,487.00 TOTAL INDIRECT EXPENSES 2,487.00 0.00 0.00 2,487.00 TOTAL EXPENDITURES 24,629.00 0.00 0.00 24,629.00 Comprehensive Agreement - FY 2014 Page: 99 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 22,500.00 " 0.00 0.00 22,500.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 2,129.00 0.00 2,129.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 22,500.00 2,129.00 0.00 24,629.00 Comprehensive Agreement - FY 2014 Page: 100 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amouni Cash Inkinc Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Health Educator 128.000 18.634 2,385.00 0.00 0.00 2,385.00 2 Fringe Benefits Composite Rate 0.000 79.450 1,895.00 0.00 0.00 1,895.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Printing 0.000 0.000 2,032.00 0.00 0.00 2,032.00 Educational Supplies 0.000 0.000 6,830.00 0.00 0.00 6,830.00 Incentives 0.000 0.000 3,375.00 0.00 0.00 3,375.00 Tota1 for Supplies and Materials 12,237.00 0.00 0.00 12,237.00 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Advertising 0.000 0.000 5,625.00 0.00 0.00 5,625.00 Total Program Expenses 22,142.00 0.00 0.00 22,142.00 TOTAL DIRECT EXPENSES 22,142.00 0.00 0.00 22,142.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 358.00 0.00 0.00 358.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 2,129.00 0.00 0.00 2,129.00 Total Indirect Costs 2,487.00 0.00 0.00 2,487.00 TOTAL INDIRECT EXPENSES 2,487.00 0.00 0.00 2,487.00 TOTAL EXPENDITURES 24,629.00 0.00 0.00 24,629.00 Comprehensive Agreement - FY 2014 Page: 101 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014/ Laboratory Services Bio DATE PREPARED9/10/2013 CONTRACTOR NAMEOakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT# Original f* Amendment 0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 41,432.00 0.00 0.00 41,432.00 2 Fringe Benefits 13,504.00 0.00 0.00 13,504.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 15,592.00 0.00 0.00 15,592.00 6 Travel 1,141.00 0.00 0.00 1,141.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 4,725.00 0.00 0.00 4,725.00 Total Program Expenses 76,394.00 0.00 0.00 76,394.00 TOTAL DIRECT EXPENSES 76,394.00 0.00 0.00 76,394.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 6,211.00 0.00 0.00 6,211.00 2 Other Costs Distributions 7,816.00 0.00 0.00 7,816.00 Total Indirect Costs 14,027.00 0.00 0.00 14,027.00 TOTAL INDIRECT EXPENSES 14,027.00 0.00 0.00 14,027.00 TOTAL EXPENDITURES 90,421.00 0.00 0.00 90,421.00 Comprehensive Agreement - FY 2014 Page: 102 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 82,605.00 0.00 0.00 82,605.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS-Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 7,816.00 0.00 7,816.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 82,605.00 7,816.00 0.00 90,421.00 Comprehensive Agreement - FY 2014 Page: 103 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Technician Notes : Medical Technologist 1000.00 0 24.766 HRS 24,766.00 0.00 0.00 24,766.00 Supervisor 520.000 32.049 PTE 16,666.00 0.00 0.00 16,666.00 Total for Salary & Wages 41,432.00 0.00 0.00 41,432.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.000 32.592 13,504.00 0.00 0.00 13,504.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Lab Supplies 0.000 0.000 15,292.00 0.00 0.00 15,292.00 Office Supplies 0.000 0.000 200.00 0.00 0.00 200.00 Postage 0.000 0.000 100.00 0.00 0.00 100.00 Total for Supplies and Materials 15,592.00 0.00 0.00 15,592.00 6 Travel Mileage Notes : 250 miles @ .565 0.000 0.000 141.00 0.00 0.00 141.00 Conferences 0.000 0.000 1,000.00 0.00 0.00 1,000.00 Total for Travel 1,141.00 0.00 0.00 1,141.00 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Comprehensive Agreement - FY 2014 Page: 104 of 160 Contract# Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Insurance 0.000 0.000 225.00 0.00 0.00 225.00 CLIA License 0.000 0.000 2,500.00 0.00 0.00 2,500.00 Equipment Rental 0.000 0.000 2,000.00 0.00 0.00 2,000.00 Total for Ail Others (ADP, Con. Employees, Misc.)4,725.00 0.00 0.00 4,725.00 Total Program Expenses 76,394.00 0.00 0.00 76,394.00 TOTAL DIRECT EXPENSES 76,394.00 0.00 0.00 76,394.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 6,211.00 0.00 0.00 6,211.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 7,816.00 0.00 0.00 7,816.00 Total Indirect Costs 14,027.00 0.00 0.00 14,027.00 TOTAL INDIRECT EXPENSES 14,027.00 0.00 0.00 14,027.00 TOTAL EXPENDITURES 90,421.00 0.00 0.00 90,421.00 Comprehensive Agreement - FY 2014 Page: 105 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Ml Health andWellness 4X4 Plan DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT p; Original p Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Saiary & Wages 16,055.00 0.00 0.00 16,055.00 2 Fringe Benefits 3,098.00 0.00 0.00 3,098.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 9,610.00 0.00 0.00 9,610.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 80.00 0.00 0.00 80.00 Total Program Expenses 28,843.00 0.00 0.00 28,843.00 TOTAL DIRECT EXPENSES 28,843.00 0.00 0.00 28,843.00 INDIRECT EXPENSES Indirect Costs 1 indirect Costs 2,407.00 0.00 0.00 2,407.00 2 Other Costs Distributions 2,957.00 0.00 0.00 2,957.00 Total Indirect Costs 5,364.00 0.00 0.00 5,364.00 TOTAL INDIRECT EXPENSES 5,364.00 0.00 0.00 5,364.00 TOTAL EXPENDITURES 34,207.00 0.00 0.00 34,207.00 Comprehensive Agreement - FY 2014 Page: 106 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 25,000.00 0.00 0.00 25,000.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS-Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 2,957.00 0.00 2,957.00 inkind Match 0.00 0.00 6,250.00 6,250.00 MDCH Fixed Unit Rate Totals 25,000.00 2,957.00 6,250.00 34,207.00 Comprehensive Agreement - FY 2014 Page: 107 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Health Educator Notes : PINE - Public Health Educator II 700.000 18.282 HRS 12,798.00 0.00 0.00 12,798.00 Supervisor Notes : Health Education Supervisor- MATCH 27.000 33.836 HRS 914.00 0.00 0.00 914.00 Health Educator Notes: Health Educator III-MATCH 100.000 23.432 HRS 2,343.00 0.00 0.00 2,343.00 Total for Salary & Wages 16,055.00 0.00 0.00 16,055.00 2 Fringe Benefits Composite Rate Notes : MATCH $2504 0.000 19.295 3,098.00 0.00 0.00 3,098.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Printing 0.000 0.000 1,000.00 0.00 0.00 1,000.00 Materials & Supplies 0.000 0.000 8,110.00 0.00 0.00 8,110.00 Incentives 0.000 0.000 500.00 0.00 0.00 500.00 Total for Supplies and Materials 9,610.00 0.00 0.00 9,610.00 6 Travel 7 Communication 8 County-City Centra! Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 80.00 0.00 0.00 80.00 Total Program Expenses 28,843.00 0.00 0.00 28,843.00 TOTAL DIRECT EXPENSES 28,843.00 0.00 0.00 28,843.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate Notes : Portion MATCH 0.000 14.990 2,407.00 0.00 0.00 2,407.00 Comprehensive Agreement - FY 2014 Page: 108 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total on salaries $488.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 2,957.00 0.00 0.00 2,957.00 Total Indirect Costs 5,364.00 0.00 0.00 5,364.00 TOTAL INDIRECT EXPENSES 5,364.00 0.00 0.00 5,364.00 TOTAL EXPENDITURES 34,207.00 0.00 0.00 34,207.00 Comprehensive Agreement - FY 2014 Page: 109 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / Nurse Family Partnershio Medicaid Outreach DATE PREPARED 9/1.0/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT# & Original n Amendment 0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 A!i Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 0.00 0.00 0.00 0.00 Total Indirect Costs 0.00 0.00 0.00 0.00 TOTAL INDIRECT EXPENSES 0.00 0.00 0.00 0.00 TOTAL EXPENDITURES 0.00 0.00 0.00 0.00 Comprehensive Agreement - FY 2014 Page: 110 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 0.00 0.00 0.00 0.00 Comprehensive Agreement - FY 2014 Page:111 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Total Indirect Costs 0.00 0.00 0.00 0.00 TOTAL INDIRECT EXPENSES 0.00 0.00 0.00 0.00 TOTAL EXPENDITURES 0.00 0.00 0.00 0.00 Comprehensive Agreement - FY 2014 Page: 112 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Nurse Family Partnership Services DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT p; Original f" Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 252,023.00 0.00 0.00 252,023.00 2 Fringe Benefits 181,668.00 0.00 0.00 181,668.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 15,493.00 0.00 0.00 15,493.00 5 Supplies and Materials 7,855.00 0.00 0.00 7,855.00 6 Travel 6,939.00 0.00 0.00 6,939.00 7 Communication 4,560.00 0.00 0.00 4,560.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 3,712.00 0.00 0.00 3,712.00 10 All Others (ADP, Con. Employees, Misc.) 12,750.00 0.00 0.00 12,750.00 Total Program Expenses 485,000.00 0.00 0.00 485,000.00 TOTAL DIRECT EXPENSES 485,000.00 0.00 0.00 485,000.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 45,891.00 0.00 0.00 45,891.00 Total Indirect Costs 45,891.00 0.00 0.00 45,891.00 TOTAL INDIRECT EXPENSES 45,891.00 0.00 0.00 45,891.00 TOTAL EXPENDITURES 530,891.00 0.00 0.00 530,891.00 Comprehensive Agreement - FY 2014 Page: 113 of 160 Contract# Date: 09/10/2013 2 Program Budget-Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 485,000.00 0.00 0.00 485,000.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 45,891.00 0.00 45,891.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 485,000.00 45,891.00 0.00 530,891.00 Comprehensive Agreement - FY 2014 Page:114 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse 1.000 62274.000 FTE 62,274.00 0.00 0.00 62,274.00 Public Health Nurse 1.000 62274.000 FTE 62,274.00 0.00 0.00 62,274.00 Public Health Nurse 1.000 62274.000 FTE 62,274.00 0.00 0.00 62,274.00 Public Health Nurse 1.000 50743.000 FTE 50,743.00 0.00 0.00 50,743.00 Assistant 1000.00 0 14.458 HRS 14,458.00 0.00 0.00 14,458.00 Total for Salary & Wages 252,023.00 0.00 0.00 252,023.00 2 Fringe Benefits Composite Rate 0.000 72.084 181,668.00 0.00 0.00 181,668.00 3 Cap. Exp. for Equip & Fac. 4 Contractual NFP National Office Program Support 0.000 0.000 7,046.00 0.00 0.00 7,046.00 NFP Consultation 0.000 0.000 8,447.00 0.00 0.00 8,447.00 Total for Contractual 15,493.00 0.00 0.00 15,493.00 5 Supplies and Materials Office Supplies 0.000 0.000 1,500.00 0.00 0.00 1,500.00 Postage 0.000 0.000 155.00 0.00 0.00 155.00 Printing 0.000 0.000 2,500.00 0.00 0.00 2,500.00 Incentives supplies 0.000 0.000 2,000.00 0.00 0.00 2,000.00 Educational Supplies 0.000 0.000 1,700.00 0.00 0.00 1,700.00 Total for Supplies and Materials 7,855.00 0.00 0.00 7,855.00 6 Travel Conferences 0.000 0.000 749.00 0.00 0.00 749.00 Client T ransportation 0.000 0.000 190.00 0.00 0.00 190.00 Mileage Notes : 10,620 miles @ .565 0.000 0.000 6,000.00 0.00 0.00 6,000.00 Total for Travel 6,939.00 0.00 0.00 6,939.00 7 Communication Telephone Communications 0.000 0.000 4,560.00 0.00 0.00 4,560.00 8 County-City Central Services Comprehensive Agreement - FY 2014 Page: 115 of 160 091-P 91-1 :e6Bd frlOZ Ad - }usuja0j6v aAisueqejdiuoQ oo'l-68'ocs 000 000 oo'ies'oes s3yniiaN3dX3 nv±oi oo'tes's^OO'O OO'O oones'sfr S3SN3dX3 103UICINI HVlOl 00"168'S>OO'O OO'O 00'l-68'St7 sisoo psjjpui |eiox 00'1.68'St 00-0 OO'O 00'1.68's^OOO'O OOO'O uonnqujsia aipv L11IB9H suounqjjisia sjsoo jamo Z sjsoq )09j!pu|V sjsoq pejjpui S3SN3dX3 loayiaNi OO'OOO'SSt?00-0 OO'O 00'000'S8t7 S3SN3dX3 103aia 1V101 OO'OOO'SSI?OCTO OO'O OO'OOO'SSt?sasuedxg uiejbojd ibjoi OO'OSZ'Sl-OO'O OO'O OO'OSZ'31.(¦osjw 'saaAoidiug -uoo 'dqv) sjaqjo iiv joi lejoi OOOOfr'S OO'O OO'O oo'oot^'g OOO'O OOO'O suoiiejedo o^ui OO'OQl'l OO'O OO'O OO'OSt'i.OOO'O OOO'O eouejnsui oo'oos'e OO'O OO'O 00'003'S OOO'O OOO'O 6uju!eji yejs (¦osiifti 'seaAoiduig -uoo 'dQV) sjaqio IIV 01 QQ'ZW£OO'O OO'O OO'SIZ'S OOO'O OOO'O IBiuay soeds Bulling sisoo aoeds 6 |B}01 puj^ui qseo )unoLuv ajey Aio uia)l aun £ 1-03/01/60 :siBa # J0B4UO0 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Aareement- FY 2014 / Medicaid Outreach DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT pr Original p Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 65,000.00 0.00 0.00 65,000.00 Total Program Expenses 65,000.00 0.00 0.00 65,000.00 TOTAL DIRECT EXPENSES 65,000.00 0.00 0.00 65,000.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 6,150.00 0.00 0.00 6,150.00 Total Indirect Costs 6,150.00 0.00 0.00 6,150.00 TOTAL INDIRECT EXPENSES 6,150.00 0.00 0.00 6,150.00 TOTAL EXPENDITURES 71,150.00 0.00 0.00 71,150.00 Comprehensive Agreement - FY 2014 Page: 117 of 160 Contract# Date: 09/10/2013 2 Program Budget-Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - Istand 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 35,575.00 0.00 0.00 35,575.00 Required Match - Locai 0.00 35,575.00 0.00 35,575.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 35,575.00 35,575.00 0.00 71,150.00 Comprehensive Agreement- FY 2014 Page: 118 of 160 Contract# Date: 09/10/2013 3 Program Budget-Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Supporting Services 0.000 0.000 65,000.00 0.00 0.00 65,000.00 Total Program Expenses 65,000.00 0.00 0.00 65,000.00 TOTAL DIRECT EXPENSES 65,000.00 0.00 0.00 65,000.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 6,150.00 0.00 0.00 6,150.00 Total Indirect Costs 6,150.00 0.00 0.00 6,150.00 TOTAL INDIRECT EXPENSES 6,150.00 0.00 0.00 6,150.00 TOTAL EXPENDITURES 71,150.00 0.00 0.00 71,150.00 Comprehensive Agreement - FY 2014 Page: 119 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECTComorehensive Aareement- FY 2014 / Other-MCH DATE PREPARED9/10/2013 CONTRACTOR NAMEOakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT p. Original Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 185,273.00 0.00 0.00 185,273.00 2 Fringe Benefits 83,202.00 0.00 0.00 83,202.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 2,428.00 0.00 0.00 2,428.00 6 Travel 6,527.00 0.00 0.00 6,527.00 7 Communication 2,078.00 0.00 0.00 2,078.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 14,177.00 0.00 0.00 14,177.00 Total Program Expenses 293,685.00 0.00 0.00 293,685.00 TOTAL DIRECT EXPENSES 293,685.00 0.00 0.00 293,685.00 INDIRECT EXPENSES indirect Costs 1 Indirect Costs 27,772.00 0.00 0.00 27,772.00 2 Other Costs Distributions 6,270,290.00 0.00 0.00 6,270,290.00 Total Indirect Costs 6,298,062.00 0.00 0.00 6,298,062.00 TOTAL INDIRECT EXPENSES 6,298,062.00 0.00 0.00 6,298,062.00 TOTAL EXPENDITURES 6,591,747.00 0.00 0.00 6,591,747.00 Comprehensive Agreement - FY 2014 Page: 120 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash inkind Total 1 Source of Funds Fees and Collections -1 st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 321,457.00 0.00 0.00 321,457.00 Local Funds - Other 0.00 6,270,290.00 0.00 6,270,290.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 321,457.00 6,270,290.00 0.00 6,591,747.00 Comprehensive Agreement - FY 2014 Page: 121 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRE.CT EXPENSES Proqram Expenses 1 Salary & Wages Coordinator 1.000 65666.000 FTE 65,666.00 0.00 0.00 65,666.00 Public Health Nurse 550.000 29.939 HRS 16,467.00 0.00 0.00 16,467.00 Nutritionist/Dietician 1000.00 0 24.952 HRS 24,952.00 0.00 0.00 24,952.00 Nutritionist/Dietician 1.000 51901.000 FTE 51,901.00 0.00 0.00 51,901.00 Public Health Nurse 878.000 29.939 HRS 26,287.00 0.00 0.00 26,287.00 i otal for Salary & Wages 185,273.00 0.00 0.00 185,273.00 2 Fringe Benefits Composite Rate 0.000 44.908 83,202.00 0.00 0.00 83,202.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Educational Supplies 0.000 0.000 1,950.00 0.00 0.00 1,950.00 Printing 0.000 0.000 478.00 0.00 0.00 478.00 Total for Supplies and Materials 2,428.00 0.00 0.00 2,428.00 6 Travel Mileage Notes : 10,000 miles @ .565 0.000 0.000 5,650.00 0.00 0.00 5,650.00 Conferences 0.000 0.000 750.00 0.00 0.00 750.00 Client Transportation 0.000 0.000 127.00 0.00 0.00 127.00 Total for Travel 6,527.00 0.00 0.00 6,527.00 7 Communication Telephone communications 0.000 0.000 2,078.00 0.00 0.00 2,078.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Workshops & Meetings 0.000 0.000 300.00 0.00 0.00 300.00 Insurance 0.000 0.000 789.00 0.00 0.00 789.00 Translation 0.000 0.000 2,000.00 0.00 0.00 2,000.00 Info Tech Operations 0.000 0.000 11,088.00 0.00 0.00 11,088.00 Comprehensive Agreement - FY 2014 Page: 122 of 160 Contract# Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Total for All Others (ADP, Con. Employees, Misc.)14,177.00 0.00 0.00 14,177.00 Total Program Expenses 293,685.00 0.00 0.00 293,685.00 TOTAL DIRECT EXPENSES 293,685.00 0.00 0.00 293,685.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 27,772.00 0.00 0.00 27,772.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 30,416.00 0.00 0.00 30,416.00 Other Cost Distributions-Nursing 0.000 0.000 6,003,313.00 0.00 0.00 6,003,313.00 Other Cost Distributions- Clinic/Education 0.000 0.000 227,078.00 0.00 0.00 227,078.00 Other Cost Distributions-PPHS Admin 0.000 0.000 9,483.00 0.00 0.00 9,483.00 Total for Other Costs Distributions 6,270,290.00 0.00 0.00 6,270,290.00 Total Indirect Costs 6,298,062.00 0.00 0.00 6,298,062.00 TOTAL INDIRECT EXPENSES 6,298,062.00 0.00 0.00 6,298,062.00 TOTAL EXPENDITURES 6,591,747.00 0.00 0.00 6,591,747.00 Comprehensive Agreement - FY 2014 Page: 123 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / MDEQ On-site Sewage CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT Original f- Amendment AMENDMENT#0 CITY Pontiao STATE ZIP CODE48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 1,293,317.00 0.00 0.00 1,293,317.00 Total Indirect Costs 1,293,317.00 0.00 0.00 1,293,317.00 TOTAL INDIRECT EXPENSES 1,293,317.00 0.00 0.00 1,293,317.00 TOTAL EXPENDITURES 1,293,317.00 0.00 0.00 1,293,317.00 Comprehensive Agreement - FY 2014 Page: 124 of 160 Contract # Date: 09/10/2013 2 Program Budget-Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 358,763.00 0.00 0.00 358,763.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 934,554.00 0.00 934,554.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 358,763.00 934,554.00 0.00 1,293,317.00 Comprehensive Agreement - FY 2014 Page: 125 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services g Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 indirect Costs 2 Other Costs Distributions Environmental HIth Adm Distribution 0.000 0.000 1,293,317.00 0.00 0.00 1,293,317.00 Total Indirect Costs 1,293,317.00 0.00 0.00 1,293,317.00 TOTAL INDIRECT EXPENSES 1,293,317.00 0.00 0.00 1,293,317.00 TOTAL EXPENDITURES 1,293,317.00 0.00 0.00 1,293,317.00 Comprehensive Agreement-FY 2014 Page: 126of160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Aareement - FY 2014 / SIDS DATE PREPARED9/10/2013 CONTRACTOR NAME Oakiand County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT f? Original f" Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00.0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADR, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 1,875.00 0.00 0.00 1,875.00 Total Indirect Costs 1,875.00 0.00 0.00 1,875.00 TOTAL INDIRECT EXPENSES 1,875.00 0.00 0.00 1,875.00 TOTAL EXPENDITURES 1,875.00 0.00 0.00 1,875.00 Comprehensive Agreement - FY 2014 Page: 127 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Sudden Infant Death Syndrome Fees 1,875.00 0.00 0.00 1,875.00 Totals 1,875.00 0.00 0.00 1,875.00 Comprehensive Agreement - FY 2014 Page: 128 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Health Adm Distribution Notes: Cost Distributions for SIDS Fees from Health Adminstration 0.000 0.000 1,875.00 0.00 0.00 1,875.00 Total Indirect Costs 1,875.00 0.00 0.00 1,875.00 TOTAL INDIRECT EXPENSES 1,875.00 0.00 0.00 1,875.00 TOTAL EXPENDITURES 1,875.00 0.00 0.00 1,875.00 Comprehensive Agreement-FY 2014 Page: 129 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECTComprehensive Agreement - FY 2014 / Sexually TransmittedDisease (STD) Control DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 12/31/2013 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT# J7 Original n Amendment 0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 14,957.00 0.00 0.00 14,957.00 2 Fringe Benefits 5,691.00 0.00 0.00 5,691.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 15.00 0.00 0.00 15.00 Total Program Expenses 20,663.00 0.00 0.00 20,663.00 TOTAL DIRECT EXPENSES 20,663.00 0.00 0.00 20,663.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 2,893,800.00 0.00 0.00 2,893,800.00 Total Indirect Costs 2,893,800.00 0.00 0.00 2,893,800.00 TOTAL INDIRECT EXPENSES 2,893,800.00 0.00 0.00 2,893,800.00 TOTAL EXPENDITURES 2,914,463.00 0.00 0.00 2,914,463.00 Comprehensive Agreement - FY 2014 Page: 130 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 20,663.00 0.00 0.00 20,663.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 818,028.00 0.00 0.00 818,028.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 2,075,772.00 0.00 2,075,772.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 838,691.00 2,075,772.00 0.00 2,914,463.00 Comprehensive Agreement - FY 2014 Page: 131 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIREICT EXPENSES Program Expenses 1 Salary & Wages Technician 520.000 28.763 PTE 14,957.00 0.00 0.00 14,957.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.000 38.050 5,691.00 0.00 0.00 5,691.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 15.00 0.00 0.00 15.00 Total Program Expenses 20,663.00 0.00 0.00 20,663.00 TOTAL DIRECT EXPENSES 20,663.00 0.00 0.00 20,663.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 1,955.00 0.00 0.00 1,955.00 Nursing Adm Distribution 0.000 0.000 13,461.00 0.00 0.00 13,461.00 Other Cost Distributions-Misc Distribution 0.000 0.000 2,878,384.00 0.00 0.00 2,878,384.00 Comprehensive Agreement - FY 2014 Page: 132 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Total for Other Costs Distributions 2,893,800.00 0.00 0.00 2,893,800.00 Total Indirect Costs 2,893,800.00 0.00 0.00 2,893,800.00 TOTAL INDIRECT EXPENSES 2,893,800.00 0.00 0.00 2,893,800.00 TOTAL EXPENDITURES 2,914,463.00 0.00 0.00 2,914,463.00 Comprehensive Agreement - FY 2014 Page: 133 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECTComprehensive Agreement - FY 2014/TB Control DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT p. Original P Amendment AMENDMENT#0 CITY Pontiac STATE ZIP CODE48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 15,225.00 0.00 0.00 15,225.00 2 Fringe Benefits 706.00 0.00 0.00 706.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 52,750.00 0.00 0.00 52,750.00 6 Travel 16,784.00 0.00 0.00 16,784.00 7 Communication 895.00 0.00 0.00 895.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 51,084.00 0.00 0.00 51,084.00 Total Program Expenses 137,444.00 0.00 0.00 137,444.00 TOTAL DIRECT EXPENSES 137,444.00 0.00 0.00 137,444.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2,282.00 0.00 0.00 2,282.00 2 Other Costs Distributions 777,143.00 0.00 0.00 777,143.00 Total Indirect Costs 779,425.00 0.00 0.00 779,425.00 TOTAL INDIRECT EXPENSES 779,425.00 0.00 0.00 779,425.00 TOTAL EXPENDITURES 916,869.00 0.00 0.00 916,869.00 Comprehensive Agreement - FY 2014 Page: 134 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections -1 st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 60,024.00 0.00 0.00 60,024.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 856,845.00 0.00 856,845.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 60,024.00 856,845.00 0.00 916,869.00 Comprehensive Agreement - FY 2014 Page: 135 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Outreach Worker Notes: Public Health Nurse Employee to be named 1000.00 0 15.225 FTE 15,225.00 0.00 0.00 15,225.00 2 Fringe Benefits Composite Rate 0.000 4.640 706.00 0.00 0.00 706.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Medical Supplies 0.000 0.000 900.00 0.00 0.00 900.00 Postage 0.000 0.000 50.00 0.00 0.00 50.00 Incentives supplies 0.000 0.000 1,300.00 0.00 0.00 1,300.00 County TB medical,office.drugs, etc 0.000 0.000 50,500.00 0.00 0.00 50,500.00 Total for Supplies and Materials 52,750.00 0.00 0.00 52,750.00 6 Travel Mileage Notes : 22,930 miles @ .565 0.000 0.000 12,955.00 0.00 0.00 12,955.00 Conferences 0.000 0.000 3,829.00 0.00 0.00 3,829.00 Total for Travel 16,784.00 0.00 0.00 16,784.00 7 Communication Communication 895.00 0.00 0.00 895.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 180.00 0.00 0.00 180.00 Lab Fees 0.000 0.000 21,297.00 0.00 0.00 21,297.00 Professional Svcs, Translation/Interpret 0.000 0.000 450.00 0.00 0.00 450.00 Equipment Repair 0.000 0.000 250.00 0.00 0.00 250.00 County TB, prof svcs, interpretation, et 0.000 0.000 28,907.00 0.00 0.00 28,907.00 Comprehensive Agreement - FY 2014 Page: 136 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Total for All Others (ADP, Con. Employees, Misc.)51,084.00 0.00 0.00 51,084.00 Total Program Expenses 137,444.00 0.00 0.00 137,444.00 TOTAL DIRECT EXPENSES 137,444.00 0.00 0.00 137,444.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 2,282.00 0.00 0.00 2,282.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 13,221.00 0.00 0.00 13,221.00 Other Cost Distributions-Field Nursing distribution 0.000 0.000 39,237.00 0.00 0.00 39,237.00 Nursing Adm Distribution 0.000 0.000 6,123.00 0.00 0.00 6,123.00 Other Cost Distributions-Misc 0.000 0.000 718,562.00 0.00 0.00 718,562.00 Total for Other Costs Distributions 777,143.00 0.00 0.00 777,143.00 Total Indirect Costs 779,425.00 0.00 0.00 779,425.00 TOTAL INDIRECT EXPENSES 779,425.00 0.00 0.00 779,425.00 TOTAL EXPENDITURES 916,869.00 0.00 0.00 916,869.00 Comprehensive Agreement - FY 2014 Page: 137 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Agreement - FY 2014 / Immunization Fixed Fees DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT # p Original p Amendment 0 CITY STATE ZIP CODEPontiac Mi 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 40,000.00 0.00 0.00 40,000.00 Total Indirect Costs 40,000.00 0.00 0.00 40,000.00 TOTAL INDIRECT EXPENSES 40,000.00 0.00 0.00 40,000.00 TOTAL EXPENDITURES 40,000.00 0.00 0.00 40,000.00 Comprehensive Agreement - FY 2014 Page: 138 of 160 Contract # Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 .0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate IMM: VFC-AFIX Visits 40,000.00 0.00 0.00 40,000.00 Totals 40,000.00 0.00 0.00 40,000.00 Comprehensive Agreement - FY 2014 Page: 139 of 160 Contract # Date: 09/10/2013 3 Program Budget-Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRE:CT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Cost Distributions for Fees-from IAP 0.000 0.000 40,000.00 0.00 0.00 40,000.00 Tota! Indirect Costs 40,000.00 0.00 0.00 40,000.00 TOTAL INDIRECT EXPENSES 40,000.00 0.00 0.00 40,000.00 TOTAL EXPENDITURES 40,000.00 0.00 0.00 40,000.00 Comprehensive Agreement - FY 2014 Page: 140 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Aqreement - FY 2014 / Vision ELPHS DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street)1200 N. Telegraph Rd. BUDGET AGREEMENT Original f Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary SWages 229,483.00 0.00 0.00 229,483.00 2 Fringe Benefits 63,881.00 0.00 0.00 63,881.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 2,815.00 0.00 0.00 2,815.00 6 Travel 5,693.00 0.00 0.00 5,693.00 7 Communication 607.00 0.00 0.00 607.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 16,128.00 0.00 0.00 16,128.00 10 All Others (ADP, Con. Employees, Misc.) 5,299.00 0.00 0.00 5,299.00 Total Program Expenses 323,906.00 0.00 0.00 323,906.00 TOTAL DIRECT EXPENSES 323,906.00 0.00 0.00 323,906.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 34,400.00 0.00 0.00 34,400.00 2 Other Costs Distributions 99,771.00 0.00 0.00 99,771.00 Total Indirect Costs 134,171.00 0.00 0.00 134,171.00 TOTAL INDIRECT EXPENSES 134,171.00 0.00 0.00 134,171.00 TOTAL EXPENDITURES 458,077.00 0.00 0.00 458,077.00 Comprehensive Agreement - FY 2014 Page: 141 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 213,433.00 0.00 0.00 213,433.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 244,644.00 0.00 244,644.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 213,433.00 244,644.00 0.00 458,077.00 Comprehensive Agreement - FY 2014 Page: 142 of 160 Contract # Date: 09/10/2013 3 Program Budget-Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages No cost detail provided 1.000 229483.000 luI—ll 229,483.00 0.00 0.00 229,483.00 2 Fringe Benefits Composite Rate 0.000 100.000 63,881.00 0.00 0.00 63,881.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office,Medical,Educ, Postage, Printing 0.000 0.000 2,815.00 0.00 0.00 2,815.00 6 Travel Travel-terms not specified 0.000 0.000 5,693.00 0.00 0.00 5,693.00 7 Communication Telephone 0.000 0.000 607.00 0.00 0.00 607.00 8 County-City Central Services 9 Space Costs Bldg Space Costs 0.000 0.000 16,128.00 0.00 0.00 16,128.00 10 All Others (ADP, Con. Employees, Misc.) Coper, Equip Maint, Exp Equip, Train,etc 0.000 0.000 5,299.00 0.00 0.00 5,299.00 Total Program Expenses 323,906.00 0.00 0.00 323,906.00 TOTAL DIRECT EXPENSES 323,906.00 0.00 0.00 323,906.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 34,400.00 0.00 0.00 34,400.00 2 Other Costs Distributions Nursing Adm Distribution 0.000 0.000 10,570.00 0.00 0.00 10,570.00 Other Cost Distributions-Misc Distribution 0.000 0.000 55,298.00 0.00 0.00 55,298.00 Health Adm Distribution 0.000 0.000 33,903.00 0.00 0.00 33,903.00 Total for Other Costs Distributions 99,771.00 0.00 0.00 99,771.00 Comprehensive Agreement - FY 2014 Page: 143 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Total indirect Costs 134,171.00 0.00 0.00 134,171.00 TOTAL INDIRECT EXPENSES 134,171.00 0.00 0.00 134,171.00 TOTAL EXPENDITURES 458,077.00 0.00 0.00 458,077.00 Comprehensive Agreement - FY 2014 Page: 144 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / ImmunizationVaccine Quality Assurance DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT J* Original f" Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 1,909,278.00 0.00 0.00 1,909,278.00 2 Fringe Benefits 1,329,802.00 0.00 0.00 1,329,802.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 809,651.00 0.00 0.00 809,651.00 6 Travel 10,325.00 0.00 0.00 10,325.00 7 Communication 27,817.00 0.00 0.00 27,817.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 160,371.00 0.00 0.00 160,371.00 10 All Others (ADR, Con. Employees, Misc.) 280,265.00 0.00 0.00 280,265.00 Total Program Expenses 4,527,509.00 0.00 0.00 4,527,509.00 TOTAL DIRECT EXPENSES 4,527,509.00 0.00 0.00 4,527,509.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 286,201.00 0.00 0.00 286,201.00 2 Other Costs Distributions -3,759,957.00 0.00 0.00 -3,759,957.00 Total Indirect Costs -3,473,756.00 0.00 0.00 -3,473,756.00 TOTAL INDIRECT EXPENSES -3,473,756.00 0.00 0.00 -3,473,756.00 TOTAL EXPENDITURES 1,053,753.00 0.00 0.00 1,053,753.00 Comprehensive Agreement - FY 2014 Page: 145 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 848,025.00 0.00 848,025.00 Fees and Collections - 3rd Party 0.00 90,000.00 0.00 90,000.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 10,264.00 0.00 10,264.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 105,464.00 0.00 0.00 105,464.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS - Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 105,464.00 948,289.00 0.00 1,053,753.00 Comprehensive Agreement - FY 2014 Page: 146 of 160 Contract # Date: 09/10/2013 3 Program Budget-Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Clerk Notes: Vaccine Supply Clerk Employee to be named 1.000 38894.000 FIE 38,894.00 0.00 0.00 38,894.00 Clerk Notes : Vaccine Supply Clerk Employee to be named 560.000 18.699 HRS 10,471.00 0.00 0.00 10,471.00 Public Health Nurse Notes: Various Clinic Public Health Nurses 1.000 1859913.000 VAR 1,859,913.00 0.00 0.00 1,859,913.00 Total for Salary & Wages 1,909,278.00 0.00 0.00 1,909,278.00 2 Fringe Benefits Composite Rate Notes : PICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.000 90.691 44,770.00 0.00 0.00 44,770.00 Composite Rate 0.000 100.000 1,285,032.00 0.00 0.00 1,285,032.00 Total for Fringe Benefits 1,329,802.00 0.00 0.00 1,329,802.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Medical, Office, Educ, Postage, etc. 0.000 0.000 809,651.00 0.00 0.00 809,651.00 6 Travel Mileage Notes : 4653 miles @ .565 VQA 0.000 0.000 6,214.00 0.00 0.00 6,214.00 Conferences Notes : VQA 0.000 0.000 1,000.00 0.00 0.00 1,000.00 Comprehensive Agreement - FY 2014 Page: 147 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Mileage Notes : 10,998 miles @ .565 Clinic 0.000 0.000 2,629.00 0.00 0.00 2,629.00 Conferences Notes: Clinic 0.000 0.000 482.00 0.00 0.00 482.00 Total for Travel 10,325.00 0.00 0.00 10,325.00 7 Communication Telephone 0.000 0.000 27,817.00 0.00 0.00 27,817.00 8 County-City Central Services 9 Space Costs Bldg Space Cost 0.000 0.000 160,371.00 0.00 0.00 160,371.00 10 All Others (ADP, Con. Employees, Misc.) Laundry, IT Oper, Memberships, Prof Svcs 0.000 0.000 280,265.00 0.00 0.00 280,265.00 Total Program Expenses 4,527,509.00 0.00 0.00 4,527,509.00 TOTAL DIRECT EXPENSES 4,527,509.00 0.00 0.00 4,527,509.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 7,400.00 0.00 0.00 7,400.00 Indirect Costs - Other- General Fund 0.000 14.990 278,801.00 0.00 0.00 278,801.00 Total for Indirect Costs 286,201.00 0.00 0.00 286,201.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 1,915,994.00 0.00 0.00 1,915,994.00 Nursing Adm Distribution 0.000 0.000 181,363.00 0.00 0.00 181,363.00 Other Cost Distributions-misc 0.000 0.000 -5,857,314.00 0.00 0.00 -5,857,314.00 Total for Other Costs Distributions -3,759,957.00 0.00 0.00 -3,759,957.00 Total indirect Costs -3,473,756.00 0.00 0.00 -3,473,756.00 TOTAL INDIRECT EXPENSES -3,473,756.00 0.00 0.00 -3,473,756.00 TOTAL EXPENDITURES 1,053,753.00 0.00 0.00 1,053,753.00 Comprehensive Agreement - FY 2014 Page: 148 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM/PROJECT Comprehensive Aqreement - FY 2014 / WIC Breastfeedina DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To: 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT ip" Original p Amendment AMENDMENT#0 CITY STATE ZIP CODE Pontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 64,133.00 0.00 0.00 64,133.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 Ail Others (ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 Total Program Expenses 64,133.00 0.00 0.00 64,133.00 TOTAL DIRECT EXPENSES 64,133.00 0.00 0.00 64,133.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 6,068.00 0.00 0.00 6,068.00 Total Indirect Costs 6,068.00 0.00 0.00 6,068.00 TOTAL INDIRECT EXPENSES 6,068.00 0.00 0.00 6,068.00 TOTAL EXPENDITURES 70,201.00 0.00 0.00 70,201.00 Comprehensive Agreement - FY 2014 Page: 149 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 64,133.00 0.00 0.00 64,133.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS-MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 6,068.00 0.00 6,068.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 64,133.00 6,068.00 0.00 70,201.00 Comprehensive Agreement - FY 2014 Page: 150 of 160 Contract# Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual Subcontracting Agency- OLSHA 0.000 0.000 64,133.00 0.00 0.00 64,133.00 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Total Program Expenses 64,133.00 0.00 0.00 64,133.00 TOTAL DIRECT EXPENSES 64,133.00 0.00 0.00 64,133.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 6,068.00 0.00 0.00 6,068.00 Total Indirect Costs 6,068.00 0.00 0.00 6,068.00 TOTAL INDIRECT EXPENSES 6,068.00 0.00 0.00 6,068.00 TOTAL EXPENDITURES 70,201.00 0.00 0.00 70,201.00 Comprehensive Agreement - FY 2014 Page: 151 of 160 Contract # Date: 09/10/2013 1 Program Budget Summary PROGRAM I PROJECT Comprehensive Agreement - FY 2014 / WIC Resident Services CONTRACTOR NAMEOakland County Department of Health and Human Services/ Health Division MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. CITY STATE ZIP CODE DATE PREPARED9/10/2013 BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 BUDGET AGREEMENT 57 Original n Amendment FEDERAL ID NUMBER AMENDMENT#0 Category Amount Cash Inkind Total DIRE¦CT EXPENSES Proqram Expenses 1 Salary & Wages 974,304.00 0.00 0.00 974,304.00 2 Fringe Benefits 737,839.00 0.00 0.00 737,839.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 414,000.00 0.00 0.00 414,000.00 5 Supplies and Materials 44,227.00 0.00 0.00 44,227.00 6 Travel 5,390.00 0.00 0.00 5,390.00 7 Communication • 13,490.00 0.00 0.00 13,490.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 86,798.00 0.00 0.00 86,798.00 10 All Others (ADP, Con. Employees, Misc.) 103,843.00 0.00 0.00 103,843.00 Tote\\ Program Expenses 2,379,891.00 0.00 0.00 2,379,891.00 TOTAL DIRECT EXPENSES 2,379,891.00 0.00 0.00 2,379,891.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 146,048.00 0.00 0.00 146,048.00 2 Other Costs Distributions 264,405.00 0.00 0.00 264,405.00 Total Indirect Costs 410,453.00 0.00 0.00 410,453.00 TOTAL INDIRECT EXPENSES 410,453.00 0.00 0.00 410,453.00 TOTAL EXPENDITURES 2,790,344.00 0.00 0.00 2,790,344.00 Comprehensive Agreement - FY 2014 Page: 152 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 2,525,939.00 0.00 0.00 2,525,939.00 ELPHS - MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS - MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 0.00 0.00 0.00 0.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 264,405.00 0.00 264,405.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 2,525,939.00 264,405.00 0.00 2,790,344.00 Comprehensive Agreement - FY 2014 Page: 153 of 160 Contract # Date: 09/10/2013 3 Program Budget-Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages WIC Staff 1.000 974304.000 VAR 974,304.00 0.00 0.00 974,304.00 2 Fringe Benefits All fringes 0.000 75.730 737,839.00 0.00 0.00 737,839.00 3 Cap. Exp. for Equip & Fac. 4 Contractual Subcontracting Agency- OLSHA to pilot WIC svcs in Oakland Co. 0.000 0.000 414,000.00 0.00 0.00 414,000.00 5 Supplies and Materials Office Supplies 0.000 0.000 . 12,500.00 0.00 0.00 12,500.00 Medical Supplies 0.000 0.000 14,500.00 0.00 0.00 14,500.00 Educational Supplies 0.000 0.000 10,327.00 0.00 0.00 10,327.00 computer supplies 0.000 0.000 150.00 0.00 0.00 150.00 Postage 0.000 0.000 750.00 0.00 0.00 750.00 Printing 0.000 0.000 6,000.00 0.00 0.00 6,000.00 Total for Supplies and Materials 44,227.00 0.00 0.00 44,227.00 6 Travel Mileage Notes : 6000 @ .565 0.000 0.000 3,390.00 0.00 0.00 3,390.00 Conferences 0.000 0.000 2,000.00 0.00 0.00 2,000.00 Total for Travel 5,390.00 0.00 0.00 5,390.00 7 Communication Telephone 0.000 0.000 13,490.00 0.00 0.00 13,490.00 8 County-City Central Services 9 Space Costs Bldg Space Cost Rental 0.000 0.000 86,798.00 0.00 0.00 86,798.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.000 0.000 6,690.00 0.00 0.00 6,690.00 Equipment Repair 0.000 0.000 300.00 0.00 0.00 300.00 Maint Dept Chgs 0.000 0.000 4,025.00 0.00 0.00 4,025.00 Convenience Copier 0.000 0.000 1,000.00 0.00 0.00 1,000.00 IT Operatons 0.000 0.000 66,016.00 0.00 0.00 66,016.00 Comprehensive Agreement - FY 2014 Page: 154 of 160 Contract # Date: 09/10/2013 Line Item Qty Rate UOM Amount Cash Inkind Total Advertising 0.000 0.000 20,692.00 0.00 0.00 20,692.00 StaffTraining 0.000 0.000 1,000.00 0.00 0.00 1,000.00 Prof svcs, interpretation, laundry, etc 0.000 0.000 4,120.00 0.00 0.00 4,120.00 Total for All Others (ADP, Con. Employees, Misc.)103,843.00 0.00 0.00 103,843.00 Total Program Expenses 2,379,891.00 0.00 0.00 2,379,891.00 TOTAL DIRECT EXPENSES 2,379,891.00 0.00 0.00 2,379,891.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Fiscal Year Rate 0.000 14.990 146,048.00 0.00 0.00 146,048.00 2 Other Costs Distributions Health Adm Distribution 0.000 0.000 239,005.00 0.00 0.00 239,005.00 Other Cost Distributions-misc 0.000 0.000 25,400.00 0.00 0.00 25,400.00 Total for Other Costs Distributions 264,405.00 0.00 0.00 264,405.00 Total Indirect Costs 410,453.00 0.00 0.00 410,453.00 TOTAL INDIRECT EXPENSES 410,453.00 0.00 0.00 410,453.00 TOTAL EXPENDITURES 2,790,344.00 0.00 0.00 2,790,344.00 Comprehensive Agreement - FY 2014 Page: 155 of 160 Contract# Date: 09/10/2013 1 Program Budget Summary PROGRAM 1 PROJECT Comprehensive Agreement - FY 2014 / MDEQ Drinking Water DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT AMENDMENT# jv Original f" Amendment 0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 0.00 0.00 0.00 0.00 2 Fringe Benefits 0.00 0.00 0.00 0.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 0.00 0.00 4 Contractual 0.00 0.00 0.00 0.00 5 Supplies and Materials 0.00 0.00 0.00 0.00 6 Travel 0.00 0.00 0.00 0.00 7 Communication 0.00 0.00 0.00 0.00 8 County-City Central Services 0.00 0.00 0.00 0.00 9 Space Costs 0.00 0.00 0.00 0.00 10 All Others {ADP, Con. Employees, Misc.) 0.00 0.00 0.00 0.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 0.00 0.00 2 Other Costs Distributions 759,020.00 0.00 0.00 759,020.00 Total Indirect Costs 759,020.00 0.00 0.00 759,020.00 TOTAL INDIRECT EXPENSES 759,020.00 0.00 0.00 759,020.00 TOTAL EXPENDITURES 759,020.00 0.00 0.00 759,020.00 Comprehensive Agreement - FY 2014 Page: 156 of 160 Contract# Date: 09/10/2013 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDCH)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 0.00 MDCH Comprehensive 0.00 0.00 0.00 0.00 ELPHS-MDCH Hearing 0.00 0.00 0.00 0.00 ELPHS - MDCH Vision 0.00 0.00 0.00 0.00 ELPHS-MDCH Other 0.00 0.00 0.00 0.00 ELPHS-Food 0.00 0.00 0.00 0.00 ELPHS - Drinking Water 495,433.00 0.00 0.00 495,433.00 ELPHS - On-Site Sewage 0.00 0.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 263,587.00 0.00 263,587.00 Inkind Match 0.00 0.00 0.00 0.00 MDCH Fixed Unit Rate Totals 495,433.00 263,587.00 0.00 759,020.00 Comprehensive Agreement - FY 2014 Page: 157 of 160 Contract # Date: 09/10/2013 3 Program Budget - Cost Detail Line Item Qty Rate UOM Amount Cash Inkind Total DIREECT EXPENSES Proqram Expenses 1 Salary & Wages 2 Fringe Benefits 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Other Costs Distributions Environmental Hlth Adm Distribution 0.000 0.000 615,865.00 0.00 0.00 615,865.00 Other Cost Distributions-Misc. Distribution 0.000 0.000 143,155.00 0.00 0.00 143,155.00 Total for Other Costs Distributions 759,020.00 0.00 0.00 759,020.00 Total Indirect Costs 759,020.00 0.00 0.00 759,020.00 TOTAL INDIRECT EXPENSES 759,020.00 0.00 0.00 759,020.00 TOTAL EXPENDITURES 759,020.00 0.00 0.00 759,020.00 Comprehensive Agreement - FY 2014 Page: 158 of 160 Contract # Date: 09/10/2013 Summary of Budget PROGRAM / PROJECT Comprehensive Agreement - FY 2014 / ComprehensiveAqreement - FY 2014 DATE PREPARED9/10/2013 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIODFrom : 10/1/2013 To : 9/30/2014 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. BUDGET AGREEMENT fy Original f Amendment AMENDMENT#0 CITY STATE ZIP CODEPontiac Ml 48341-0432 FEDERAL ID NUMBER38-6004876 Category Amount Cash Inkind Total DIRECT EXPENSES Program Expenses 1 Salary & Wages 12,669,587.00 0.00 0.00 12,669,587.00 2 Fringe Benefits 8,643,406.00 0.00 0.00 8,643,406.00 3 Cap. Exp. for Equip & Fac.26,950.00 0.00 0.00 26,950.00 4 Contractual 636,010.00 0.00 0.00 636,010.00 5 Supplies and Materials 1,531,638.00 0.00 0.00 1,531,638.00 6 Travel 370,334.00 0.00 0.00 370,334.00 7 Communication 222,735.00 0.00 0.00 222,735.00 8 County-City Central Services 1,167,076.00 0.00 0.00 1,167,076.00 9 Space Costs 1,510,930.00 0.00 0.00 1,510,930.00 10 All Others (ADP, Con. Employees, Misc.) 1,799,510.00 0.00 0.00 1,799,510.00 Total Program Expenses 28,578,176.00 0.00 0.00 28,578,176.00 TOTAL DIRECT EXPENSES 28,578,176.00 0.00 0.00 28,578,176.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs -4,112,448.00 0.00 0.00 -4,112,448.00 2 Other Costs Distributions 11,989,564.00 0.00 0.00 11,989,564.00 Total Indirect Costs 7,877,116.00 0.00 0.00 7,877,116.00 TOTAL INDIRECT EXPENSES 7,877,116.00 0.00 0.00 7,877,116.00 TOTAL EXPENDITURES 36,455,292.00 0.00 0.00 36,455,292.00 SOURCE OF FUNDS Category Amount Cash Inkind Total 1 Fees and Collections - 1st and 2nd Party 0.00 2,845,926.00 0.00 2,845,926.00 2 Fees and Collections - 3rd Party 0.00 90,000.00 0.00 90,000.00 3 Federal or State (Non MDCH)0.00 1,881,102.00 0.00 1,881,102.00 Comprehensive Agreement - FY 2014 Page: 159 of 160 i_ 5_ 6_ 7_ 8_ 9_ 10 11 12_ 13_ 14 — 16 17 18 20 21 22 23 £0 £0 £0 £0 ;00 £0 .00 .00 .00 £0 £0 .00 .00 £0 £0 .00 £0 £0 .00 £0 iOof Contract # Federal Cost Based Reimbursement 0.00 0.00 0.00 Federally Provided Vaccines 0.00 2,317,412.00 0.00 Federal Medicaid Outreach 246,386.00 0.00 0.00 Required Match - Local 0.00 246,386.00 0.00 Local Non-ELPHS 0.00 44,501.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 MDCH Non Comprehensive 0.00 0.00 0.00 MDCH Comprehensive 5,093,165.00 0.00 0.00 ELPHS - MDCH Hearing 219,078.00 0.00 0.00 ELPHS-MDCH Vision 213,433.00 0.00 0.00 ELPHS-MDCH Other 2,152,829.00 0.00 0.00 ELPHS-Food 827,691.00 0.00 0.00 ELPHS - Drinking Water 495,433.00 0.00 0.00 ELPHS - On-Site Sewage 358,763.00 0.00 0.00 MCH Funding 321.457.00 0.00 0.00 Local Funds - Other 0.00 18,666,623.00 0.00 Inkind Match 0.00 0.00 54,656.00 MDCH Fixed Unit Rate 380,451.00 0.00 0.00 TOTAL 10,308,686.00 26,091,950.00 54,656.00 Comprehensive Agreement - FY 2014 Version: Comprehensive MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 13/14 AGREEMENT ADDENDUM A 1. This addendum adds the following section to Part I and Renumbers existing 11 Special Certification to 12 and existing 12 Signature Section to 13: Parti 11. Agreement Exceptions and Limitations Notwithstanding any other term or condition in this Agreement including, but not limited to, any provisions related to any services as described in the Annual Action Plan, any Contractor (Oakland County) services provided pursuant to this Agreement, or any limitations upon any Department funding obligations herein, the Parties specifically intend and agree that the Contractor may discontinue, without any penalty or liability whatsoever, any Contractor services or performance obligations under this Agreement when and if it becomes apparent that State or Department funds for any such services will be no longer available. Notwithstanding any other term or condition in this Agreement, the Parties specifically understand and agree that no provision in this Agreement shall operate as a waiver, bar or limitation of any kind, on any legal claim or right the Contractor may have at any time under any Michigan constitutional provision or other legal basis (e.g., any Headlee Amendment limitations) to challenge any State or Department program funding obligations; and, the parties further agree that no term or condition in this Agreement is intended and no such provision shall be argued to state or imply that the Contractor voluntarily assumed or undertook to provide any services as described in the Annual Action Plan, and thereby, waived any rights the Contractor may have had under any legal theory, in law or equity, without regard to whether or not the Contractor continued to perform any services herein after any State or Department funding ends. 2. This addendum modifies the following sections of Part II, General Provisions: Part II I. Responsibilities-Contractor J. Software Compliance. This section will be deleted in its entirety and replaced with the following language: 1 Version: Comprehensive The Michigan Department of Community Health and the County of Oakland will work together to identify and overcome potential data incompatibility problems. 111. Assurances A. Compliance with Applicable Laws. This first sentence of this paragraph will be stricken in its entirety and replace with the following language: The Contractor will comply with applicable Federal and State laws, and lawfully enacted administrative rules or regulations, in carrying out the terms of this agreement. I. Health Insurance Portability and Accountability Act. The provisions in this section shall be deleted in their entirety and replaced with the following language: Contractor agrees that it will comply with the Health Insurance Portability and Accountability Act of 1996, and the lawfully enacted and applicable Regulations promulgated there under. IX. Liability. Paragraph A. will be deleted in its entirety and replaced with the following language. A. Except as otherwise provided by law neither Party shall be obligated to the other, or indemnify the other for any third party claims, demands, costs, or judgments arising out of activities to be carried out pursuant to the obligations of either party under this Contract, nothing herein shall be construed as a waiver of any governmental immunity for either party or its agencies, or officers and employees as provided by statute or modified by court decisions. 2 ATTACHMENT I MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 13/14Comprehensive Agreement INSTRUCTIONS FOR THE ANNUAL BUDGET INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH SERVICES TABLE OF CONTENTS Page I. INTRODUCTION -2 II. MINIMUM BUDGETING REQUIREMENTS ...........2 III. REIMBURSEMENT CHART 3 IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES 13 V. FORM PREPARATION - GENERAL.. 13 VI. FORM PREPARATION - EXPENDITURE CATEGORIES .....13 VII. FORM PREPARATION - SOURCE OF FUNDS 15 VIII. SPECIAL BUDGET INSTRUCTIONS A. Public Health Emergency Preparedness (PHEP) 17 B. WIC 18 C. Family Planning 19 D. Breast and Cervical Cancer 20 E. CSHCS Outreach and Advocacy 22 F. Program Budget - Cost Detail Schedule (DCH-0387) Form Preparation 22 Attachment 1-Annual Budget Forms 24 G. Medicaid Outreach Activities Reimbursement Procedures 28 Attachment 2-Medicaid Outreach Activities Cost Allocation Plan Certification 34 Attachment S-Medicaid Outreach Activities Cost Allocation Plan Sample 35 H. Michigan Colorectal Cancer-Screening Program 38 i. Immunization 317 and VFC Allowable Expenditures 39 MDCH/G&PD FY 13/14 Page 1 of 44 INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH SERVICES I. INTRODUCTION The Annual Budget for Local Health Services is completed on a state fiscal year basis, and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs' funding and Essential Local Public Health Services (ELPHS) (formerly known as the local public health operation's funding) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. II. MINIMUM BUDGETING REQUIREMENTS A. Cost Principles - Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in 2 CFR, Part 225 (OMB Circular A-87), as amended. B. Federal Block Grant Funds - Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (otherthan minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. C. Expenditure and Funding Source Breakdown - For purposes of development, analysis and negotiation activities must be budgeted at the individual expenditure and funding source category level on the Annual Budget for Local Health Services. D. Special Budget Requirements for Certain Categorical Program Elements - The Annual Budget for Local Health Services is completed in the Mi E-Grants System through the application budget to include details for all program elements (excluding Administration and Contractor Support). MDCH/G&PD FY 13/14 Page 2 of 44 E. Local MCH - Local MCH funds can be used for general Maternal Child Health (MCH) activity. These funds are to be budgeted as a funding source under any of the appropriate program element(s) (i.e., Children's Special Health Care Services (CSHCS) Outreach and Advocacy, Child Health, Family Planning, Immunization, Maternal infant Health Program, or a locally defined program which is defined in the LMCH Community Plan). If an agency wants to utilize this funding for another purpose, approval must be obtained from the Division of Family and Community Health. These funding sources cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of expenditures, and evidence is provided that the expenditures satisfy all funding requirements. The MCH activities should address the priorities identified in the community health assessment and improvement process. REIMBURSEMENT CHART A. Program Element/Funding Source The Program Element/Funding Source column provides a listing of all currently funded MDCH programs that are included in the Comprehensive Agreement. When applicable, funding sources are specified. B. Reimbursement Methods The Reimbursement Methods column specifies the type of method used for each of the program element/funding sources. Funding under the Comprehensive Agreement can generally be grouped under four (4) different methods of reimbursement. These methods are defined as follows: 1. Performance Reimbursement - A reimbursement method by which local agencies are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of state funds prior to any utilization of local funds. Performance targets are negotiated starting from the last year's negotiated target and the most recent year's actual numbers except for programs in which caseload targets are directly tied to funding formulas/annual allocations. Other considerations in setting performance targets include changes in state allocations from past years, local fiscal and programmatic factors requiring adjustment of caseloads, etc. Once total performance targets are negotiated, a minimum state funded performance target percentage is applied (typically 90% unless otherwise specified). If local Contractor actual performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation for cost reimbursement will be reduced equivalent to actual performance in relation to the minimum performance. 2. Fixed Unit Rate Reimbursement - A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. 3. ELPHS - A reimbursement method by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required Essential Local Public Health Services (ELPHS), as noted in the current Appropriations Act. 4. Staffing Grant Reimbursement - A reimbursement method by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total state allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable and a source before any local funding requirements unless a special local match condition exists. FY 13/14 Page 3 of44 C. Performance Level If Applicable The Performance Level column specifies the minimum state funded performance target percentage for all program elements/funding sources utilizing the performance reimbursement method (see above). If the program elements/funding source utilizes a reimbursement method other than performance or if a target is not specified, N/A (not-available) appears in the space provided. D. Performance Target Output Measures Performance Target Output Measure column specifies the output indicator that is applicable for the program elements/funding source utilizing the performance reimbursement method. Output measures are based upon counts of services delivered. E. Subrecipient or Vendor Designation The Subrecipient or Vendor Designation column identifies the type of relationship that exists between the Department and the local health department on a program-by-program basis. Federal awards expended as a subrecipient are subject to audit or other requirements of OMB Circular A-133. Payments made to or received as a vendor are not considered Federal awards and are, therefore, not subject to such requirements. 1. Subrecipient A subrecipient is a non-Federal entity that expends Federal awards received from a pass- through entity to carry out a Federal program, but does not include an individual that is a beneficiary of such a program; or is a recipient of other Federal awards directly from a Federal Awarding agency. Subrecipient characteristics include: a. Determines who is eligible to receive what Federal financial assistance; b. Has its performance measured against whether the objectives of the Federal program are met; c. Has responsibility for programmatic decision making; d. Has responsibility for adherence to applicable Federal program compliance requirements; and e. Uses the Federal funds to carry out a program of the organization as compared to providing services for a program of the pass-through entity. 2. Vendor A vendor is a dealer, distributor, merchant, or other seller providing goods or services that are required for conduct of a Federal program. These goods or services may be for an organization's own use or for the use of beneficiaries of the Federal Program. Vendor characteristics include: a. Provides the goods and services within normal business operations; b. Provides similar goods or services to many different purchasers; c. Operates in a competitive environment; d. Provides goods or services that are ancillary to the operation of the Federal program; and e. Is not subject to compliance requirements of the Federal program. F. Type of Project The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, as: MDCH/G&PD FY 13/14 Page 4 of44 Research and development (R&D) means ail research activities, both basic and applied, and all development activities that are performed by a non-Federal entity. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. G. Reimbursement Chart The following Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures for each program/element having a performance reimbursement option. In addition, the chart also provides the subrecipient/vendor designations, as in prior years: REIMBURSEMENT CHART Program Element/ Funding Source(1) Reimbursement Method(2) Performance Level If Applicable^ Performance Target Output Measure Subrecipient or Vendor Designation Adolescent STD Screening Staffing(6)N/A Subrecipient Asthma Control through Education and Environment Staffing^18*N/A Subrecipient Babies Maternal Infant Early Childhood Home Visiting Program(MIECHVP) Healthy Families America Expansion Staffing(6)N/A Subrecipient Bed Bug Surveillance, Education and Outreach Staffi ng(6)N/A Vendor Body Art Fixed Unitt2J N/A Vendor Breast & Cervical Cancer Control Coordination Performance(8)97%# Women Screened for Breast & Cervical Cancer Subrecipient Breastfeeding Support Staffi ng!6)N/A Subrecipient MDCH/G&PD FY 13/14 Page 5 of 44 REIMBURSEMENT CHART Program Element/ Funding Source(i) Reimbursement Method{2) Performance Level If Applicable(3) Performance Target Output Measure Subrecipient or Vendor Designation Comprehensive Cancer Control (CCC) Community Implementation Project Staffing(6)N/A Subrecipient Child Health Staffing^6'N/A Subrecipient CSHCS - Case Management/Care Coordination Fixed Unit Rate<7)N/A Vendor CSHCS Medicaid Outreach Staffing(6)NA Subrecipient CSHCS - Outreach & Advocacy Staffing®N/A Subrecipient Eat Safe Fish Staffing®N/A Subrecipient ELPHS MDCH STAFFING (6))N/A N/A MDA Performance 75%% of Food Service Licensees received required inspections N/A MDEQ STAFFING®N/A N/A Hearing Program Staffing®N/A N/A Vision Program Staffing®N/A N/A Expanded HIV Testing Staffing®N/A Subrecipient Family Planning/BCCCP Joint Project Coordination Staffing®N/A Subrecipient Family Planning Services General Services Performance'5^ ®(13)95%# Unduplicated Clinic Users Served Subrecipient FDA Tobacco Retailer MDCH/G&PD FY 13/14 Page 6 of 44 REIMBURSEMENT CHART Program Element/ Funding Source(i) Reimbursement Method(2) Performance Level If Applicable*3' Performance Target Output Measure Subrecipient or Vendor Designation (A & L) Inspections Staffing(6)N/A Subrecipient FDA Tobacco Retailer (A&L) Inspections Fixed Unit Rate(2)N/A Subrecipient Fetal Alcohol Spectrum Disorder Projects Staffing(6)N/A Subrecipient Fetal/Infant Mortality Review Abstractions Fixed Unit Rate<2)N/A Subrecipient - Health Disparities Capacity Building Phase II Staffing(6>N/A Subrecipient Highly Targeted Community Based HIV Prevention Services Staff ingf6)N/A Subrecipient HIV/AIDS Care MHI Staffing^6'N/A Vendor HIV Prevention Services Categorical Non-Categorical Staffing(6> Fixed Unit Rate ^ N/A N/A Subrecipient Vendor HIV/AIDS Provider Education Staffing'6'N/A Subrecipient HIV Rapid Testing Project Staffing'6'N/A Subrecipient HIV/STD Partner Services Staffing<6)N/A Subrecipient HOPWA Staffing'6'N/A Subrecipient Immunization AFIX Follow-up Site Visit immunization Billing Practice infrastructure Enhancement Field Service Reps Immunization Action Plan Michigan Care Improvement Registry Fixed Unit Rate'7' Staffing'6' Staffing'6' Staffing(6) Staffing'6' N/A N/A N/A N/A Vendor Subrecipient Subrecipient Subrecipient Subrecipient MDCH/G&PD FY 13/14 Page 7 of44 REIMBURSEMENT CHART Program Element/ Funding Source(1, Reimbursement Method(2) Performance Level If Applicable'3* Performance Target Output Measure Subrecipient or Vendor Designation Nurse Education Vaccine Quality Assurance Program VFC/AFIX Site Visit Fixed UnitRate(2)(7) Staffing'6* Fixed UnitRate(2)(7) N/A N/A N/A N/A Vendor Vendor Vendor Informed Consent Fixed UnitRate(2)(7)N/A Vendor Laboratory ServicesPHEP ELC STD Staffing(6) Staffing'6* Staffing (6i N/A N/A N/A Subrecipient Subrecipient Subrecipient Local Health Department SNAP-ED Staffing'6'(18)N/A Subrecipient Local Tobacco Reduction Staffing'6*N/A Subrecipient Maternal Infant Health Program (MIHP) Staffing'6*N/A Subrecipient Michigan Abstinence Program Performance*8*'18*90% Number of unduplicated youth to be served Subrecipient Michigan Colorectal Cancer Screening Program Performance'8*90% Number of women and men that complete a screening test. Subrecipient Michigan Health and Wellness 4X4 Plan Staffing'6*N/A Subrecipient Nurse Family Partnership Services (NFP)Staffing'6*N/A Subrecipient Nurse Family Partnership Medicaid (NFP)Staffing'6*N/A Subrecipient Obesity Prevention Staffing'6*N/A Subrecipient Practices to Reduce infant Mortality through Staffing'6'N/A Subrecipient MDCH/G&PD FY 13/14 Page 8 of44 REIMBURSEMENT CHART Program Element/ Funding Source<1) Reimbursement Method'2' Performance Level If Applicable'3' Performance Target Output Measure Subrecipient or Vendor Designation Equity (PRIME) Local Learning Collaborative Public Health Emergency Preparedness (PHEP) Public Health Emergency Preparedness (PHEP) Staffing(6) (14> (18)N/A Subrecipient Public Health Emergency Preparedness (PHEP) Staffing'61 (15) <18)N/A Subrecipient Public Health Emergency Preparedness (PHEP) Cities of Readiness Initiative (CRI) Staffing^(14)(18)N/A Subrecipient Public Health Emergency Preparedness (PHEP) Cities of Readiness Initiative (CRI) Regional Epidemiology Support Staffing^15'<18> Staffingf6) N/A N/A Subrecipient Subrecipient Sexual Violence Prevention Staffing'6'N/A Subrecipient Sexually Transmitted Disease (STD) Control Staffing<6)N/A Subrecipient Sudden Unexplained Infant Death (SUID) And Other Infant Death Fixed Unit Rate(2)(11)N/A Vendor SEAL! Michigan Dental Sealant Program Staffing'6'N/A Subrecipient TB Control Directly Observed Therapy(DOT)Staffing'6'N/A Vendor i MDCH/G&PD FY 13/14 Page 9 of44 REIMBURSEMENT CHART Program Element/ Funding Source{1) Reimbursement Method*2* Performance Level If Applicable® Performance Target Output Measure Subrecipient or Vendor Designation Taking Pride in Prevention Performance®18'90%Number of undupiicated youth served with intense interventions (at least 14 hours of direct service) Subrecipient Teen Pregnancy Prevention Initiative Performance(8)(18)90%Number of undupiicated youth served with intense interventions (at least 14 hours of direct service) Subrecipient Youth Suicide Prevention Staffing®N/A Subrecipient WIC - Resident Performance w 97%#AverageMonthly Participation Subrecipient WIC - Breastfeeding Staffing®N/A Subrecipient WIC - Migrant Staffing10'N/A Subrecipient MDCH/G&PD FY 13/14 Page 10 of 44 Footnotes: (1) Program element or funding source as applicable. (2) Refer to the master Comprehensive agreement and the program and budget instructions package for further explanation of applicability of these reimbursement methods. (3) Allocation to be reflected in individual programs during budgeting process. (4) Not Applicable. (5) Subject to statewide maintenance of effort requirement for Title X. {6) State funding is first source (after fees and other earmarked sources). (7) Fixed unit rate subject to actual costs. (8) The performance reimbursement target will be the base target caseload established by MDCH. (9) Subject to a match requirement (hard or in-kind) of $1 for each $3 of MDCH agreement funding for coordination. (10) Fixed rate limited to contract amount. (11) Up to 6 visits per family. (12) Non-categoricaliy funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum of $2,000 annually. (13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Quarterly FPAR data will be used to determine total Title X users and Plan First! enrollees. (14) Public Health Emergency Preparedness funding must be expended by June 30,2014and is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) column for this program element. (15) pubijQ Health Emergency Preparedness funding for July 1, 2014- September 30, 2014is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHD's must submit a three-month budget and a quarterly Financial Status Report (FSR) column for this program, element. (16) Project meets the Research and Development Criteria as defined by OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations (17) American Recovery and Reinvestment Act (ARRA) provision applies. See attached appendix for provision. (18) Subject to match requirement as specified in Attachment 111 - Program Assurances and Specific Requirements. MDCH/G&PD FY 13/14 Page 11 of 44 IV.LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATIONPROCEDURES As in past years, no additional accounting system detail is being required beyond local uniform accounting procedures prescribed by the Michigan Department of Treasury, Local Financial Management System requirements, documentation requirements of categorical program funding sources and any local requirements. Some agencies may already have separate cost centers in their accounting system to directly identify costs and related funding of required services, but such breakdowns are not essential to being able to meet minimum reporting requirements if proper allocation procedures are used and adequate documentation is maintained. Ail allocations must have clearly measurable bases that directly apply to the amounts being allocated, must be documented with work papers that will provide an adequate audit trail and must result in a representative reporting of costs and funding for affected programs. More specific guidance can be found in 2 CFR, Part 225 (OMB Circular A-87). V. FORM PREPARATION - GENERAL The Ml E-Grants system on-iine application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Contractor. The system is designed to accommodate any number of local program elements including those unique to a particular local Contractor. Applications, including budget forms, are completed for all program elements, regardless of the reimbursement mechanism, including Agency administration(s) fee for service program elements, categorical program elements, performance based program elements and Medicaid Outreach associated program elements. Budget entry is required for each major expenditure and source of fund categories for which costs/funds are identified. VI. FORM PREPARATION - EXPENDITURE CATEGORIES Budgeted expenditures are to be entered for each program element, project or group of services by applicable major category. A. Salaries and Wages- This category includes the compensation budgeted for all permanent and part- time employees on the payroll of the Contractor and assigned directly to the program. This does not include contractual services, professional fees or personnel hired on a private contract basis. Consulting services, vendor services, professional fees or personnel hired on a private contracting basis shouid be included in "Other Expenses." Contracts with secondary recipient organizations such as cooperating service delivery institutions or delegate agencies should be included in Contractual (Sub-contract) Expenses. B. Fringe Benefits ¦ This category is to include, for at least the specified elements, ail Contractor costs for social security, retirement, insurance and other similar benefits for ail permanent and part-time employees assigned to the specified elements. C. Cap Exp for Eguip & Fac ¦ This category includes expenditures for budgeted stationary and movable equipment used in carrying out the objectives of each program element, project or service group. The cost of a single unit or piece of equipment includes necessary accessories, installation costs, freight and other applicable expenses associated with the purchase of the equipment. Only budgeted equipment items costing $5,000 or more may be reported under this category. Small equipment items costing less than $5,000 are properly classified as Supplies and Materials or Other Expenses. This category also includes capital outlay for purchase or renovation of facilities. D. Contractual (Subcontracts/Sub recipient) - Use for expenditures applicable to written contracts or agreements with secondary recipient organizations such as cooperating service delivery institutions or delegate agencies. Payments to individuals for consulting or contractual services, or for vendor services are to be included under Other Expenses. Specify subcontractor(s) address, amount by subcontractor and total of all subcontractors. MDCH/G&PD FY 13/14 Page 12 of 44 E. Supplies and Materials - Use for all consumable items and materials including equipment-type items costing less than $5,000 each. This includes office, printing, janitorial, postage and educational supplies; medical supplies; contraceptives and vaccines; tape and gauze; prescriptions and other appropriate drugs and chemicals. Federal Provided Vaccine Value should be reported and identified on in Other Cost Distributions category. Do not combine with supplies. F. Travel - Travel costs of permanent and part-time employees assigned to each program element. This includes costs of mileage, per diem, lodging, meals, registration fees and other approved travel costs incurred by the employee. Travel of private, non-employee consultants should be reported under Other Expenses. G. Communication Costs - These are costs for telephone, Internet, telegraph, data lines, websites, fax, email, etc., when related directly to the operation of the program element. H. Countv/Citv Central Services - These are costs associated with central support activities of the local governing unit allocated to the local health department in accordance with 2 CFR, part 225 (OMB Circular A-87). I. Space Costs - These are costs of building space necessary for the operation of the program. J. All Others (Line 11) - These are costs for all other items purchased exclusively for the operation of the program element and not appropriately included in any of the other categories including items such as repairs, janitorial services, consultant services, vendor services, equipment rental, , insurance, Automated Data Processing (ADP) systems, etc. K. Total Direct Expenditures - Ml E-grants sums the direct expenditures budgeted for each program element, project or service grouping and records in the Total Direct Expenditure line of the Budget Summary. L. Admin. O/H Cost Rate - Use to distribute costs of general administrative operations that have not been directly charged to individual programs. The Indirect/Administrative Overhead (O/H) Cost Rate distributes administrative costs to each program element, project or service grouping. Two separate local rates may apply to the agreement period (i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter part. The amount of Admin. O/H should be allocated to all appropriate program elements with the total equivalent amount reflected as a credit or minus in the column(s) for Administration. M. Other Cost Distributions - Use to distribute various contributing activity costs to appropriate program areas based upon activity counts, time study supporting data or other reasonable and equitable means. An example of Other Cost Distributions is nursing supervision. The distribution process permits costs reflected in a single program element to be subsequently distributed, perhaps only in part, to other programs or projects as appropriate. If an allocation is made, the charges must be reflected in the appropriate program columns and the offsetting credit reflected in the program column being distributed. There must be a documented, well-defined rationale and audit trail for any cost distribution or allocation based upon 2 CFR. Part 225 (OMB Circular A-87) cost principles. Federal Provided Vaccine Value should be reported on a separate line and clearly identified. N. Total Direct & Admin. Expenditures - Ml E-grants sums the indirect expenditures program element and records in the Total Indirect Expenditure line of the Budget Summary. O. Total Expenditures ¦ Ml E-grants sums the direct and indirect expenditures and records in the Total Expenditure line of the Budget Summary. VII. FORM PREPARATION - SOURCE OF FUNDS Source of Funds are to be entered for each program element, project or group of services by applicable major category as follows: A. Fees & Collections - Fees 1st & 2nd Party- Funds (1st party) projected to be received from private MDCH/G&PD FY 13/14 Page 13 of 44 payers, including patients, source users and any member of the general population receiving services. Also includes funds (2nd party) received from organizations, private or public, who might reimburse services for a group or under a special plan. B. Fees & Collections - 3rd Party - Third Party Fees - Funds projected to be received from private insurance, Medicaid, Medicare or other applicable titles of the Social Security Act directly related to the cost of providing patient care or other services (e.g., includes Early Periodic Screening, Detection and Treatment [EPSDT] Screening, Family Planning.) C. Federal/State Funding (Non-MDCH) - Funds received directly from the federal government and from any state Contractor other than MDCH, such as the Department of Natural Resources and Environment (MDNRE). This line should also be used to exclude state aid funds such as those provided through the Michigan Department of Treasury under P.A. 264 of 1987 (cigarette tax). D. Federal Cost Based Reimbursement - Funds received for Federal Cost Based Reimbursement which should be budgeted in the program in which they were earned. E. Federally Provided Vaccines - The projected value of federally provided vaccine. F. Federal Medicaid Outreach - (Please note: to be used only for Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership program elements.) Funds projected to be received from the federal government for allowable Medicaid Outreach activities. This amount represents the anticipated 50% federal administrative match of local contributions. G. Required Match - Local - Funds projected to be local contribution for programs that have a match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership, this amount represents the 50%" matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) H. Local Non-ELPHS - Local funds budgeted for the following expenditures: 1. Expenditures for services not designated as required and allowable for ELPHS funding (e.g., medical examiner and inpatient maternity services); expenditures determined not to be reasonable; and, expenditures in excess of the maximum state share of funds available. 2. Any losses arising from uncollectible accounts and other related claims. Under-recovery of reimbursable expenditures from, orfailure to bill, available funding sources that would otherwise result in exclusions from ELPHS funding if recovered. However, no exclusion is required where the local jurisdiction has made and documented a decision to have local funds underwrite: a. the cost of uncollectible accounts or bad debts incurred in support of providing required or allowable health services. An example of this condition would be for services provided to indigents who are billed as a matter of procedure with little chance for receipt of payment. b. potential recoveries or under-recoveries from other sources for the principal purpose of providing required and allowable health services at free or reduced cost to the public served by the Contractor. An example would be keeping fees for services at a reduced level for the benefit of the people served by the Contractor while recognizing that to do so limits recovery from third parties for the same types of services. 3. Contributions to a contingency reserve or any similar provisions for unforeseen events. 4. Charitable contributions and donations. 5. Salaries and other incidental expenditures of the chief executive of a political subdivision (i.e., county executive and mayor). 6. Legislative expenditures; such as, salaries and other incidental expenditures of local governing bodies (i.e., county commissioners and city councils). Do not enter board of health expenses. MDCH/G&PD FY 13/14 Page 14 of 44 7. Expenditures for amusements, social activities and other incidental expenditures related thereto; such as, meals, beverages, lodging, rentals, transportation and gratuities. 8. Fines, penalties and interest on borrowings. 9. Capital Expenditures - Local capital outlay for purchase of facilities and equipment (assets) are excluded from ELPHS funding. I. Other Non- ELPHS - Funds budgeted from sources otherthan state, federal and local appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local substance abuse coordinating Contractor, local area on aging Contractor). J. MDCH - NON-COMPREHENSIVE - Funds budgeted for services provided under separate MDCH agreements. Examples include: funding provided directly by the Community Services for Substance Abuse for community grants, etc. K. MDCH - COMPREHENSIVE - This section includes all funding projected to be due under the Comprehensive agreement from categorical programs and needs to equal the allocation. L. ELPHS - MDCH Hearing - This section includes ail funding projected to be due under Comprehensive agreement specific to the ELPHS MDCH Hearing program and has to equal the MDCH ELPHS Hearing allocation. Additional ELPHS to be budgeted for the Hearing Program must be entered into ELPHS - MDCH Other. Hearing allocations may only be spent on the Hearing Program. M. ELPHS - MDCH Vision - This section includes all funding projected to be due under Comprehensive agreement specific to the ELPHS MDCH Vision program and has to equal the ELPHS MDCH Vision allocation. Additional ELPHS to be budgeted for the Vision Program must be entered into ELPHS - MDCH Other. Vision allocations may only be spent on the Vision Program. N. ELPHS - MDCH Other - This section includes all funding projected to be due under Comprehensive agreement specific to the ELPHS MDCH Other program for eligible program elements. Please note: system validates the ELPHS MDCH Other budgeted funds across the applicable program elements to assure the agreement does exceed the ELPHS — MDCH Other allocation. O. ELPHS - Food ¦ This section includes all funding projected to be due under Comprehensive agreement specific to the ELPHS Food program and has to equal the ELPHS Food allocation. P. ELPHS - Drinking Water - This section includes all funding projected to be due under Comprehensive agreement specific to the ELPHS Drinking Water program and has to equal the ELPHS Drinking Water allocation. Q. ELPHS - On-site Sewage - This section includes all funding projected to be due under Comprehensive agreement specific to the ELPHS On-site Sewage program and has to equal the ELPHS On-site Sewage allocation. R. MCH Funding - This section includes all funding projected to be due under Comprehensive agreement specific to the MCH eligible program elements. Please note: system validates the MCH budgeted funds across applicable program elements to assure the agreement does exceed the MCH allocation. S. Local Funds - Other - Enter all local support in the appropriate element, project or service group column. This may include local property tax, and other local revenues (does not include fees). T. Inkind Match - Enter Local Support from donated time or services. U. MDCH Fixed U nit Rate - Select the type of fee-for-services from the lookup to correspond with the program element VIII. SPECIAL BUDGET INSTRUCTIONS Certain elements are supported by federal or other categorical program funds for which special budgeting MDCH/G&PD FY 13/14 Page 15 of 44 requirements are placed upon grantees and subgrantees. These include: Element Federal or Other Funding Contractor Public Health U.S. Department of Health & Human Services, Centers for Disease Control Emergency Preparedness WIC U.S. Department of Agriculture, Food & Nutrition Service Family Planning U.S. Department of Health & Human Services, Public Health Service Breast and Cervical Cancer U.S. Department of Health & Human Services, Centers for Disease Control CSHCS Outreach & Advocacy Michigan Department of Community Health Medicaid Outreach Activities Centers for Medicare and Medicaid Services In general, subgrantee budgets must provide sufficient budget detail to support grantee budget requests and be in a format consistent with grantor Contractor requirements. Certain types of costs must receive approval of the federal grantor Contractor and/or the grantee prior to being incurred. A. Public Health Emergency Preparedness (PHEP) Special Budget Requirements Local Health Departments will receive the initial FY 13/14 allocation of the CDC Public Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period October 1, 2013 through June 30,2014. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) column for each of the following COMPREHENSIVE program elements: 1. Public Health Emergency Preparedness (PHEP) (October 1, 2013- June 30, 2014) 2. Public Health Emergency Preparedness (PHEP)- Cities of Readiness (October 1, 2013 - June 30, 2014) 3. Bioterrorism - Regional Epidemiology Support (October 1, 2013 - September 30, 2014) 4. Laboratory Services - Bioterrorism (October 1, 2013 - September 30, 2014) B. WIC Special Budget Reguirements 1. Cost/Funding Categories - The following local budget breakdowns are required to fulfill WIC grant application budget requirements each fiscal year: Salaries & Fringe Benefits Automated Management Systems Space Utilization Costs Equipment Supplies Communications & Travel All Other Direct Costs Indirect Costs All Funding Sources By Type The WIC cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget form in the Ml E-Grants system. General instructions for these forms are contained at the end of this section. Agencies receiving WIC-USDA Infrastructure grants must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. Agencies receiving WIC-USDA Breastfeeding Peer Counselor funds must budget these funds MDCH/G&PD FY 13/14 Page 16 of 44 as a separate element. Agencies must track and report expenditures separately on the FSR. And comply with special reporting requirements. 2. Costs Allowable Only With Prior Approval ¦ The following costs are allowable only with prior review/approval of the Michigan Department of Community Health as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR Part 246, and USDA-WIC Administrative Cost Handbook 3/86). Prior approval is accomplished by providing appropriate detail in the budget request approved by MDCH or subsequently in a written request approved in writing by MDCH. A. Automated Information Systems - which are required by a local Contractor except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B. Capital Expenditures of $2.500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C. Management Studies - performed by agencies or departments other than the local Contractor or those performed by outside consultants under contract with the local Contractor. D. Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered bv individuals or organizations, nota partofthe local Contractor, such as: 1. Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Contractor level. F. Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out-of-service training over extended periods of time. G. Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H. Non-Fringe Insurance and Indemnification Costs All charges to WIC must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule, 2 CFR, Part 215 (OMB Circular A-110) and 7 CFR Part 3015. C. Family Planning Special Budget Requirements 1. Cost/Funding Categories ¦ The following local budget breakdowns are required to fulfill Family Planning grant application budget requirements each fiscal year: Salaries & Wages Fringe Benefits Travel Equipment Supplies Contractual Construction MDCH/G&PD FY 13/14 Page 17 of 44 All Other Direct Costs Indirect Costs All Funding Sources By Type The Family Planning cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget in the Ml E-Grants System. General instructions for these forms are contained at the end of this section. 2. Costs Allowable Only With Prior Approval - The following costs are allowable only with prior review/approval of MDCH. Prior approval is accomplished by providing appropriate detail in the budget request approved by MDCH or subsequently in a written request approved in writing by MDCH. A. Alterations and Renovations - to change the interior arrangements or other physical characteristics of existing facilities or installed equipment, to the extent that such changes cost more than $1,000 each. B. Audiovisual Materials and Activities - acquired, produced, presented or disseminated to the general public. C. Consultant Contracts for General Support Services - including equipment and supplies, that will cost in excess of $25,000 or 10% of the total direct cost budget (whichever is greater). D. Equipment - including general purpose and special equipment (e.g., air conditioning) costing $5,000 or more £er unit. E. Insurance - contributions to a reserve for a self-insurance program. F. Public Information Service Costs-for the cost of providing public information services. G. Publication and Printing Costs - for the cost of publications. H. Capital Expenditures - for land or buildings. I. Indemnification Against Third Parties Costs - insurance against potential liabilities. J. Mass Severance Pay - involving grant-supported personnel. K. Organization/Reorganization Costs - allocable to the program. L. Overtime Premium - involving grant-supported personnel. M. Patient Care Costs - rebudgeting out of or reduction in patient care costs (considered a change in scope). N. Professional Services - in connection with Patent/Copyright Infringement Litigation. O. Trailers or Modular Units - for costs of trailers and modular units. P. Transfers Between Construction and Nonconstruction - for approved construction funds. Q. Transfers Between Indirect and Direct Costs - for amounts awarded for indirect costs to absorb increases in direct costs. R. Transfers for Substantive Programmatic Work - to a third party, by contracting or any other means used for the actual performance of substantive programmatic work. All charges to Family Planning must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule and 2 CFR, Part 215 (OMB Circular A-110) D. Breast and Cervical Cancer Control Program Special Budget Requirements MDCH/G&PP FY 13/14 Page 18 of 44 1. The Breast and Cervical Cancer Control Program (BCCCP) budget is to be developed in the following way: The program element, titled "BCCCP Coordination" should be used to budget costs associated with coordination of the program. Only coordination expenses will be reimbursed through the COMPREHENSIVE agreement. All Direct Service claims including Case Management Reimbursement must be billed to the MDCH Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing Direct Service claims to the MDCH Cancer Prevention and Control Section. No Direct Services or Case Management expenses will be reimbursed through the COMPREHENSIVE Agreement. The Coordination amount $97 per woman based on a target caseload established by MDCH. The BCCCP Coordination budget requires the following: a) The BCCCP budget must include BCCCP/WISEWOMAN /MCRCEDP annual meeting travel and related costs for at minimum the BCCCP Coordinator to attend the Wednesday Coordinators' Advisory Committee meeting and the Thursday/Friday sessions; and b) Any remaining balance must be included in the BCCCP budget for outreach and recruitment activities; for example, BCCCP incentives, BCCCP advertising and BCCCP community outreach and recruitment events. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 97% performance requirement for this program. There is no longer a match requirement. Match is recorded by the program and reported to MDCH. For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and Other Program Instructions for the BCCCP and Family Planning/BCCCP Joint Project issued in August of each fiscal year. The above referenced documents are available at www.michiaancancer.ora/BCCCP. 2. The Family Planning (FP)/BCCCP Joint Project budget is to be developed in the following way: The program element, titled "FP/BCCCP Coordination" should be used to budget costs associated with coordination of the program. Only coordination expenses will be reimbursed through the COMPREHENSIVE agreement. All Direct Service claims including Case Management Reimbursement must be billed to the MDCH Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing Direct Service claims to the MDCH Cancer Prevention and Control Section. No Direct Services or Case Management expenses will be reimbursed through the COMPREHENSIVE agreement. The Coordination amount is initially established by MDCH and may be adjusted at the discretion of MDCH through the COMPREHENSIVE amendment process. The Coordination amount will be reimbursed under the staffing grant reimbursement method. There is no performance requirement. There no longer is a match requirement. Match is recorded by the program TPA and reported to MDCH. MDCH/G&PD FY 13/14 Page 19 of 44 For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and Other Program Instructions for the BCCCP and Family Planning/BCCCP Joint Project issued in August of each fiscal year. The above referenced documents are available at www.michiqancancer.orq/BCCCP. E. Children's Special Health Care Services (CSHCS) Outreach and Advocacy - The program element, titled CSHCS Outreach and Advocacy should be used to budget costs associated with this program. F. Program Budget - Online Detail Budget Application Entry Complete the appropriate budget forms contained within the Ml E-Grants application for each program element. An example of this form is attached (see Attachment 1 for reference). 1. Salary and Wages - a. Position Description - Select from the expenditure row look-up all position titles or job descriptions required to staff the program. If the position is missing from the list, please use Other and type in the position in the drop down field provided. b. Positions Required - Enter the number of positions required for the program corresponding to the specific position title or description. This entry may be expressed as a decimal (e.g., Full-Time Equivalent - FTE) when necessary. If other than a full-time position is budgeted, it is necessary to have a basis in terms of time reports to support time charged to the program. c. Amount-Ml E-grants calculates the salary for the position required and records it on the Budget Detail. Enter this amount in the Amount column. d. Total Salary — Ml E-grants totals the amount of all positions required and records it on the Budget Summary. e- Notes - Enter any explanatory information that is necessary for the position description. Include an explanation of the computation of Total Salary in those instances when the computation is not straightforward (i.e., if the employee is limited term and/or does not receive fringe benefits). 2. Fringe Benefits - Select from the expenditure row look-up applicable fringe benefits for staff working in this program. Enter the percentage for each. Ml E-grants updates the total amount for salary and wages in the unit field and calculates the fringe benefit amount. If the composite fringe benefit item is selected from the expenditure row look up, record the applicable fringe benefit items (i.e,. PICA, Life insurance, etc.) in the notes tab. 3. Equipment - Enter a description of the equipment being purchased (including number of units and the unit value), the total by type of equipment and total of all equipment purchases. 4. Contractual - Specify subcontractor(s)/subrecipient(s) working on this program, including the subcontractor's/subrecipient's address, amount by subcontractor/subrecipient and total of all subcontractor(s)/Subrecipient(s). Multiple small subcontracts can be grouped (e.g., various worksite subcontracts). 5. Supplies and Materials - Enter amount by category. A description is required if the budget category exceeds 10% of total expenditures. 6. Travel - Enter amount by category. A description is required if the budget category MDCH/G&PD FY 13/14 Page 20 of 44 exceeds 10% of total expenditures. 7. Communication - Enter amount by category. A description is required if the budget category exceeds 10% of total expenditures. 8. Countv-Citv Central Services - Enter amount by category and total for all categories. 9. Space Costs - Enter amount by category and total for all categories. 10. Other Expenses - Enter amount by category and total for all categories. A description is required if the budget category exceeds 10% of total expenditures. 11. Indirect Cost Calculation - Enter the base(s), rate(s) and amount(s). 12. Other Cost Distributions - Enter a description of the cost, percent distributed to this program and the amount distributed. 13. Total Exp. - Ml E-grants totals the amount of all positions required and records it on the Budget Summary. MDCH/G&PD FY 13/14 Page 21 of 44 Attachment B1 Attachment B1-Program Budget Summary OKECT1XPEMSES . Program Expanses Salary & Wsgss Flings Eensfts Cap. Bcp. for Equip & Fac. Contrsotual Sup-pliss ana Matsrials Tiavi\ Coinrnunijstion County-City Centra! Seivicss Siscs Costs AiS Others (AQP, Can. Employ Total Program Expenses TOTAL DIRECT EXPENSES FEXPENSES ' indirect Costs indirect Costs Othef Casts Dlsiribuliona Totai tixSrect Costs TOTAL ttJCHRECr EXPENSES TOTAL EXPENDITURES MDCH/G&PD FY 13/14 Page 22 of 44 moez 36Bd mzi Adad^s/Hoaw roc- o m : :0 i:(>b;o ;jgl: 'iQOSvg'rt- S: pi:Q ;S; lios-o 7 'M iiq-o );ec & . CC-'C ' icox ; c6"c itoo gOO'O iioo'o : aci d lleb'o bl steasiun p®*lj HDQW pup^ui jayjo-spufid fsooi EuiCundHOI-'i s;!S-U0-SHdT3 :®Buwuya-SHdl3 m joq'tt. •gj tWp ip- |M] p m. . gg ; CC'C i bo" o" I ab:o" iOC'Cf Iwcis's?" 'is. ;;coo l;oo:b iboo. jlod^" i^CO'CS |:co"o" CiTO liGO'O jfocfo* JiOCfO iiOO'O IjOO'O ;co"G :bc:c" coc BOOd-SHd13 JsmoHoaw-SHdia .. uorsKHOQW-SHdli 6uu28HHOOM-SHdl3 9A)SU9l|5irfUUOO HDai'i SNSuauajdujoo UOM HOQH SHdl3-U0NJaxao SHcTQ-UON ^30-| ¦ m; i.csrc gl: gj ;!CC'a ^ i;oc'gos:6r m ilsc's g3 |;ee;oboir libc-'c liOO'O - - ijo^o" i!ob:o^ lioo'F ilocro- 00 c ' OQ'C iiOO'O !3fl'00c's9 ;G0'G CCD SHdia-uOMlKiOI.; 18301- UOISVi D9Jin&3y: tpESJino pieajpsiiiejaoad: sayoasf, pspROJd^lieKpaj ;uaiu3sjnqai;sypasegisoo iejspsj (nogik "on) 91s4s ja isjepa j illEci pj; - suopsailoo PUB 398^ -tved puscue jsi -suoiksiioo cue 3334 SpMjJOaDJDOS S3aniKIH3dX3 IViOi aaji mck^s ^idOD'ajij dad i i WJpijeA . spullijo 33jnOS > »*b-s a [ i sabs a; rspii) | snoat/riisosi^j | isEong | sudiiBogiyao is;u9amsoGJscys KK02 Ai-iasiassjCv sAtsusyaidtuoo' : iusj50jd aidWVS ssouussCuiuusidiliuuEi :uGneaiiddy tueiifliedaa miesH oev feusov it i:oi4e3«:adv spunj jo eojnos n fflicBigan.gou a tits .f B2 Attachment B2-Proqram Budget Cost Detail ABC Health Department Appiicatior,: FamiiyPianning Sercices SAMPLE PrcFgram" COiripreiiensive Agreemer,! - FY 20 XX raccsheet 5 Certificaliefis f .gudgsS MisceBarteous j Ir.ds* | B Sajs |! 8 Savs «• [ I M Validate 11 1 PDF [j la Copy Program Expenses -Salary 6 Wages ClassiffcalionSeq.: 1 li'Pe; Su&Tsee: ibln £ Show Tree | (7) (*) Narrafejg: 1 ISelectH^oostfian descrisKon. benrifytTe quaniitya Id^rtiry tr^e rate ss ffversge t i-] ^ il^uise Pracmioner Q ^ iPaSlicHeaiU-.Nurse PI ^ :Coo;din3ior G ^ iCienc 1R[Oisf'3493l43C;?TE :0! 1^Q69i3| 1W53^; 0 41 J 33 3 0° 20 ^ 1 11d . -£3 2 C - E _~] 2i 0 J 11.30 U.fM-S-. 1 u.au IXUt!:fe j iv an o.no;£¦7, i o.oo:o.oc-0^ ! fe Show Tree |»(0I Saee i B Savs <• ' E S PDF ll^ Copy Catagory: ;Program Spensas - Cap. Exp. aassificaaon Seg.: 'h | Ifljs:iExperalRure Sub Type .: iDired Narrafes: ®.- liofis:'¦tfir&i as tn? cost of a asrcle ts<n >;aluei st $5,300 or mcr; and wftha lisefti! life of moretoan oni-ysa.'. Costs should iidude the Setn snd fnye.isss sucnas iTs^ilatior costs. fssBfeiancsfess.etc. teras costrij ess tfieii 55,200 stoua RemsfsS tea supples tm raisrialsfris. IB!10! I B Save B Sate *;: Vaiidate i I tl Sifr >¦;.! PDF i 1%; Copy Cstegofy: ClassifiC3tionSeq. •Frogrsfn Expenses -.Ccntradusl h Type: _ ¦ ¦: , Su6 Type: ;Dired IJarrstrve: iCantractja) refers Is sresndaryrecipteitorgariiraticns only. Rssse enter the coolactinft iCorisuSs'nisariflsuspsSfcigserwoe'iubccr.iracss-tioLilS be BiSgKei unfler the other exoense l:ne. S Show Tree | (7) (T) Category; ClassificaCon Seq. senses - Supplies and Materials Level: S'Line Item OcategoiV Type: iEtperditire Sub Type: iDirett Natrative: H D " IPfinfing ^ iPostage QT 'ibo.oo| loeiQi! .0: 7otmi; 700/30;: [ 8 Save i l B Save «I [Eif Validate I ! PDF i I ^ Copy fe Show Tree ! ClsssifiafenSeq.::1 Leva!:<*; .Line Item 0 Category SubType: jDlrect : Nsirativs: S 1 instmcfions: ; : Q X jfnileage Q ^ -Conferences MDCH/G&PD FY 13/14 Page 24 of 44 B Save I | B Save*-! 11^ Validate I I PDF I j I®Copy 's Show Treel ij) (T) Cstegoo': iPfosjainEjpenses-Oorrimuflicatran CJassificationSeq.: ;i Leve!: sS/Uneitsm OCategor/ Typs: Sspenaitae SutT>pa; Direct ! instojcSons: [j y- |0!her IB! 7,232.001 Iptionas and IT lines ! B Sa»e 11 B Sare o ! I El Validate ! [ hj -"fo1;<; [ Ijp PDF ] j%i Copt *e Show Tree j (*) (_ÿ) Cstegory;jProgram Expenses - County-City Central Setvicas |lyps: ClasslucaSion Seci.:¦i Level: yvUneiSem OOategor/Sub Type: -uirer.::Narrativs:b3 instructions; > Reri > iliiifies 'Qi £92333 e i B Sate |: B SaYC« j Validate ^PfF , 1^ Copy S ihow Tree 1 (• Categary; ClassrO cation Seq : R Level:®Line!tgm C'Categoiy B^e: SufiTyca lEgsandiUira iDired Narrative.0 instructions • y > n ? 1B' 2,2?9.0t)jIB i ••• ^ ^nn mi! _2.279,aiy idii.on- c.cci J-OQ: "i"c.cfr 0.00! *1 n tifii: n fin- 91 ' Validate j | gj ir;c.-:s- | j^PDF i j%Copt 'S 'show Tree 1 H/ ÿ) fi: ¦Incfirect Costs -IndiredCosls '3 SubTYpe: iinflirea Nsrratiue: -SsL i ClasslficaSBnSeq.: Q > TiDisliiCuiop> : =— MDCH/G&PD FY 13/14 Page 25 of 44 G. Medicaid Outreach Activities Reimbursement Procedures Medicaid Outreach Activities that are funded by local dollars and meet federal requirements are eligible for reimbursement at a 50% federal administrative match rate. Local Health Departments seeking reimbursement for the provision of locally funded allowable outreach activities specific to the Medicaid program may do so by submitting appropriate documentation to MDCH in accordance with the instructions listed below. Medicaid Outreach Activities funding is a subrecipient relationship. 1. Budget Preparation A. Complete the Ml E-Grants application and budget forms for the application Medicaid Outreach Activities that occur during the fiscal year: 10/1/xx-09/30/xx, Reimbursable activities included in the budget must conform to the requirements as specified in the MSA bulletin for Local Health Department Outreach Activities. Complete the Ml E-Grants application and budget forms for this program. 1. Medicaid Outreach Activities: 10/01/xx-09/30/xx a. Expenditure Category Tab Enter the expenditures budgeted for the fiscal year: 10/01/xx-09/30/xx. Expenses budgeted for each of the listed expenditure categories are allowable and must be specific to the Medicaid program as described in the MSA bulletin for Local Health Department Outreach Activities. Outreach activities must not be part of direct service. Expenditures must be reflected in the cost allocation plan. b. Source of Funds Tab Budget the amount expected from the federal government for allowable Medicaid Outreach activities. Federal Medicaid Outreach represents the anticipated 50% federal administrative match of local contributions. Budget the local contribution. Required Match - Local represents the 50% matching local contribution for Medicaid Outreach activities. These two amounts should match. c. Sources of Local Funds Types Local health departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the health department as a source for matching funds. Other state and/or federal grant awards for Medicaid Outreach must be recorded on the appropriate line as indicated in the Comprehensive Budget Instructions - Attachment I. (Please specify the source of funds as shown in the example.) B. Complete the Ml E-Grants application and budget forms for the application titled CSHCS Medicaid Outreach for the timeframe: 10/01/xx-09/30/xx. 1- CSHCS Expenditures related to CSHCS Outreach and Advocacy should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1 /xx-09/3Q/xx. a. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD CSHCS program has been applied. A table containing each health MDCH/G&PD FY 13/14 Page 26 of 44 jurisdiction Medicaid Participation Rate is located in the Ml E-Grants site. The formula for calculating the federal funding is as follows: Federal funding - (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) b. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution. Federal Medicaid Outreach and Required Match - Local should equal each other. Additional local contribution that is not eligible for the 50% federal match should be reported on the Local Funds - Other line. c. Sources of Local Fund Types Local health departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the health department as a source for matching funds. d. Comprehensive Outreach and Advocacy and Care Coordination Funds Should be reported in a separate program element. C. Complete the Ml E-Grants application and budget forms for the application titled Nurse Family Partnership for the timeframe: 10/01 /xx-09/30/xx. Complete the MI E-Grants application and budget forms for this program. - — 1. Nurse Family Partnership Outreach (applicable only for Berrien, Calhoun, Kalamazoo. Oakland and Kent) Expenditures related to Nurse Family Partnership Outreach should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the COMPREHENSIVE Budget Instructions-Attachment I. The budget should reflect the entire fiscal year period: 10/1 /13-09/30/14. a. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD Nurse Family Partnership program has been applied. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) b. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution in Required Match - Local. Federal Medicaid Outreach and Required Match - Local should equal each other. Additional local contribution related to service provision for non-Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. c. Sources of Local Fund Types Local health departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the health department as a source for matching funds. MDCH/G&PD FY 13/14 Page 27 of 44 D. Cost Distributions Record costs distributions in the Indirect Costs - Other Costs Distribution on the Application budget if costs associated with allowable Medicaid Outreach activities conducted in other Comprehensive programs (i.e., WIC, Family Planning, Immunization, etc.) are to be distributed. This may require a budget modification in the related program(s) to reflect the cost distribution movement. 2. Cost Allocation Certification This certification remains on file with the Department until no longer valid (see Attachment 2). 3. Cost Allocation Plan for Medicaid Outreach Activities LHDs seeking Medicaid Outreach reimbursement must keep on file a current cost allocation plan that reflects actual costs associated with Medicaid Outreach Activities, CSHCS Outreach and Advocacy and Nurse Family Partnership (see Attachment 3). The cost allocation plan must be supported by appropriate documentation, such as a time study, or other federally approved methodology for allocating costs, in accordance with 2 CFR, Part 225 (OMB Circular A-87). At a minimum, the cost allocation plan should contain both a narrative section and an allocation methodology section for both Medicaid Outreach activities and CSHCS Outreach and Advocacy forthe fiscal year. The narrative section should briefly describe each program for which Medicaid Outreach activity expenditures are distributed and list the expenditure categories utilized. Non-reimbursable costs should be identified. The narrative section should also state the methodology utilized for distributing costs. -The allocation methodology section provides the detailed calculations for how costs are determined. A. Medicaid Outreach Activities In the example provided (see Attachment 3), costs associated with providing Medicaid Outreach activities are incurred both through dedicated staff for conducting outreach activities and through the WIC program. In the Medicaid Outreach program, staff time, fringe benefits, supplies, materials, travel, other expenses, indirect and supervision associated with providing a Medicaid Outreach program are calculated forthe time period at a cost of $89,074. In addition, through a time-study conducted in the WIC clinic on a quarterly basis, it was determined that, on the average, seven minutes of each certification and re-certification appointment is spent performing Medicaid Outreach activities. Time spent conducting outreach activities is multiplied by the number of encounters to determine the total number of hours spent on Medicaid Outreach. Number of hours is multiplied by the averaged hourly wage to determine the total outreach salary costs. Fringe costs and indirect costs associated with outreach salary costs are also added for a total of $47,532. Total for Medicaid Outreach Activity expenses = $136,606. Non-reimbursable costs are subtracted from this amount. Total amount of local contribution spent for Medicaid Outreach Activities = $77,606 and the 50% federal administrative match is $38,803. B. CSHCS Outreach and Advocacy Program/Nurse Family Partnership Medicaid Outreach In the example provided (see Attachment 3), costs associated with providing Medicaid Outreach activities through the CSHCS Outreach and Advocacy program or the Nurse Family Partnership Outreach are incurred through dedicated staff responsible for delivering the program. Staff time, fringe benefits, supplies, materials, travel, other expenses, indirect and supervision associated with providing these programs are calculated for the time period at a cost of $210,912. in this example, Comprehensive Grant funding for the period is subtracted from the program's total cost to determine the MDCH/G&PD FY 13/14 Page 28 of 44 local contribution. This amount is multiplied by the program's Medicaid participation rate at 35%, which equals $38,819. The 50% federal administrative match is $19,410. 4. Financial Status Report (FSR) - LHDs seeking 50% federal administrative match should request reimbursement by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through Ml E-Grants. A. Medicaid Outreach Activities 1. Quarterly FSRs and Final FSR For quarters 1-3, LHDs must reflect the actual Medicaid Outreach expenses incurred in a separate program element titled Medicaid Outreach. Actual expenses incurred for each of the listed expenditure categories are allowable, but must be specific to Medicaid Outreach as defined by the MSA bulletin for Local Health Department Outreach Activities and not part of a direct service. Expenses should be supported by a time study or other federally approved methodology. a. Federal Medicaid Outreach Should be used to request the 50% federal administrative match for Medicaid Outreach. b. Required Match - Local Should be used to report the remaining portion of the local contribution of the Medicaid Outreach Match. Both amounts should equal. c. Other Source of Funds Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDCH grants, etc.) should be reported on the appropriate line has indicated in the COMPREHENSIVE Budget Instructions - Attachment I. Total Source of Funds should equal Total Expenditures. B. CSHCS Outreach and Advocacy CSHCS Outreach and Advocacy billing should occur on the final FSR through Mi E- Grants after Comprehensive Agreement funds have been expended. 1. Billing should occur as follows: a. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the % of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. b. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Additional local contribution that is not eligible for the 50% federal match should be reported in Local Funds - Other. c. Local Funds - Other Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDCH grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I. d. Comprehensive Outreach and Advocacy and Care Coordination MDCH/G&PD FY 13/14 Page 29 of 44 Should be billed as separate program element. C. Nurse Family Partnership Outreach Reimbursement for Nurse Family Partnership Outreach should be requested by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through Ml E-Grants. Should occur on the final FSR after Comprehensive funds have been expended. 1. Billing should occur as follows: a. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the %of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. b. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Both lines should equal. Additional local contribution related to service provision for non-Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. c. Local Funds - Other Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDCH grants, etc.) should be reported on the appropriate line has indicated in the COMPREHENSIVE Budget instructions - Attachment I. 5. Comprehensive Agreement Obligation Report - filed in September 20xx. The Obligation report is used to estimate the payable amount due to local health departments from MDCH for each program element. A. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach Activities to be earned from Medicaid Outreach on the Federal Medicaid Outreach row. B. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach activities to be earned from CSHSC-Medicaid Outreach. This should reflect the local contribution multiplied by the Medicaid enrollment participation rate x 50% federal match rate. C. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach activities to be earned from Nurse Family Partnership Outreach. This should reflect the local contribution multiplied by the Medicaid enrollment participation rate x 50% federal match rate. Note: CSHCS Outreach and Advocacy and CSHCS Care Coordination activities funded through the Comprehensive Agreement are recorded as separate program elements. MDCH/G&PD FY 13/14 Page30of44 Attachment 2 (Name of Health Department) MEDICAID OUTREACH ACTIVITIES COST ALLOCATION PLAN Certification by the Responsible Health Department Official This is to certify that I have reviewed the cost allocation plan and to the best of my knowledge and belief: 1. All costs included in this proposal to establish cost allocations or billings for Medicaid Outreach Activities are allowable in accordance with the requirements of 2 CFR Part 225 (OMB Circular A-87), "Cost Principles for State and Local Governments," and the Federal award(s) to which they apply. Unallowable costs have been adjusted for in allocating costs as indicated in the cost allocation plan. 2. All costs included in this proposal are properly allocable to the Medicaid Outreach Activities Administration award on a basis of a beneficial casual relationship between the expenses incurred and the Medicaid Outreach Administration award to which they are allocated in accordance with applicable requirements. Further, the same costs that have been treated as indirect costs have not been claimed as direct costs. Similar types of costs have been accounted for consistently. 3. This certification will be resubmitted if a significant change occurs that impacts the Medicaid Outreach activities or upon a Department review that results in a finding of non-compliance. If neither of these conditions exists the certification remains valid in subsequent fiscal years. I, as the responsible Health Department Official, declare that the foregoing is true and correct. (Name of Health Department) Signature: Name of Official: Title: Date: MDCH/G&PD FY 13/14 Page 31 of 44 Attachment 3 GREEN COUNTY HEALTH DEPARTMENT MEDICAID OUTREACH ACTIVITIES COST ALLOCATION PLAN OCTOBER 1, 20XX TO SEPTEMBER 30, 20XX MDCH/G&PD FY 13/14 Page 32 of 44 Green County Health Department Cost Allocation Methodology For Medicaid Outreach Activities The Green County Health Department has a specific staff person assigned to qualified Medicaid Outreach Activities. The actual costs of this position have been charged to the Medicaid Outreach Activities cost center. These costs are Salary, Fringe Benefits, Supplies & Materials, Communications, Space Cost, Other Misc., Indirect Costs and Nursing Supervision. Non-reimbursable costs have been deducted from these costs as an Exclusion Item (grant funding). The WIC program includes qualified Medicaid Outreach Activities in the initial and bi-annual recertification process. The cost of the Medicaid Outreach Activities included in the WIC Cost Center was determined by using a one-week time study (which will be repeated periodically). The result of the time study is the average number of minutes per certification or recertification involved in Medicaid Outreach Activities. The average time multiplied by the number of certifications and recertifications was converted into hours providing qualified activities. Total hours were multiplied by the average hourly salary of outreach staff to arrive at the salary costs of providing the outreach activities. Fringe benefit costs were calculated using the staff's fringe benefit/salary ratio and the indirect cost was calculated using the health department's standard indirect costs distribution allocation process. MDCH/G&PD FY 13/14 Page 33 of 44 GREEN COUNTY HEALTH DEPARTMENT BUDGETED COSTS FOR MEDiCAED OUTREACH ACTIVITIES BUDGETED FOR 10/1/05 -9/30/06 COSTS OF STAFF ASSIGNED TO MEDICAID Salary Fringe Benefits @ 48.% Supplies &. Materials Travel Communications Space Cost Other Misc. Indirect @37.63% Nursing Supervision Total $09 ,074 ^Indirect Cost)) $38 ,200 $18,350 $1 ,ÿÿÿ$500$500 S440 $21 ,287 SB .797 SS9 .074 COSTS OF STAFF ASSIGNED TO WIC Average time per certification or recertification (minutes) Number projected Total WIC Medicaid Outreach Activity time (minutes) Total in Hours Average Salary for positions providing outreach Total outreach salary cost Fringe at 48% Indirect Cost @ 37.63% Total Cost of WIC Medicaid Outreach Activities to be Distributed From WIC • to Medicaid Outreach Total Budgeted Cost for 7/1/05 - 9/30/05 Less Federal funded grant Total Medicaid Outreach Activity Qualified Matchable Cost Projected for July 1 - Sept 30,2005 7 9.200 64 ,400 1 ,073 $21.74 $23 .336 $1 1 ,201 $12,995 $47 ,532 $47,532 $136,606 $59 .ODD $77.60S Anticipated Federal Medicaid Match at 50'$38,803 MDCH/G&PD FY 13/14 Page 34 of 44 H. Michigan Colorectal Cancer Screening Program - The Michigan Colorectal Cancer Early Detection program (MCRCEDP) budget is to be developed in the following ways: 1. This budget is intended to cover all staffing and coordination for the program. All allowable expenses will be reimbursed through the Comprehensive agreement. 2. Ali direct service claims must be billed through the Third Party Administrator. The LHD and/or direct service providers with contracts or letters of agreement with the LHD will be responsible for billing. 3. The staffing, coordination and direct service total amount is $105 per woman or man based on a target caseload established by MDCH. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 90% performance requirement for this program. The performance target output measure is the number of women and men that complete a screening test for colorectal cancer. 4. For specific program requirements, including current direct service reimbursement rates and other documentation refer to the most current MCRCEDP manual. MDCH/G&PD FY 13/14 Page 35 of 44 Immunization Allowable Expenditures with 317 and Vaccine for Children (VFC) Financial Assistance (FA) Operations Funds FOB developed the followmg tables to assist grantees in.preparing budgets that are in compliance with federal grants policies. Th tables were developed using a combination of the OMB Circular A-S7, PHS Grants Policy Statement 3505, arid POB-ideutafied pic-gram prioritiea. I September 7,2011 Chapter 0—The Basics p.24 Excerpt from "Immunization Proyram Operation Manual (IPOM) Chapter Zero" htto://'a^ww.cdc.gQv/vaccmes/vac-gstVpolicies/ip&nVciefault.htm Budget Category/Expenses Allowablewith 317 operations funds Allowable with VJ'C operations fluids Allowable with VFC ordering fluids AUowable with VTC/AFK funds Allowable with Paii Elu funds Perinatal hospital record reviews V Equipment* Fax machines for vaccine ordering V V V V accine storage equpment for VFC vaccine V V Personal computers / Laptops ' i V V V V Copy machines V V <V '^Equipment: an article of tangible nonexpendable personal property havmg useful life of m ore than one year and an acquistion cost of $5,000 or more per unit. Supplies Vaccine admnistration supplies (including, but not limited to, nasal pharyngeal swabs, syringes for emergency vaccination clinics and other medical supplies for disease surveillance) V Office supplies-computers, general office (penSj paper, paper clips, etc.), ink cartridges, calculators V V V V .V Pink Books, Red Books, Yellow Books V Printers V V V V V Laboratory supplies (influenza cultures and PCRs> cultures and molecular, lab media serotyping) V Temperature monitors/Thermometers/Data Loggers V V Contractual September 7,2011 Chapter 0—The Basics p.25 I sf^ Ph a ¦7-"T- "7=- -T £ u s-A b 5 cc?! > *-tf "5§ - 58 8a S SS «m™ I §• ¦>->->--r •>">••-?" •5 t fii« iH © wig w "45 ¦©1111 ">¦>•"7-¦?*¦>* 5^t5 «U13bd*«S- w S2 ©| ¦•£ s so S^-gU) ov u2 ca tfooh5* V tfl ^-V -u aoo aa --c «2' =5. u u GL. ^w «^ Os 'S-j -wo 3Ss.a » oo-'wj « •J3 CA «^ 'So £. . 41fl w »V *75 ctf * 3 ** 'J Ow o < •-S ¦is-' "I s'$ a•£ -a< -fa : Cu'3. •ca &0c•J3 s13w g. '3s '¦& •a il m oO oO P- PQ o U o<N r- U•u MDCH/G&PDFY 13/14 Page 38 of 44 Budget Category/Expmses Allowable Allowable Allowable Allowable Allowable with 317 ¦with VFC with VF C with with Fan operatiotis funds operations funds ordering funds VFC/AFIX funds Flu funds transmittal^ messengerj postage, local and long distance telephone) V V V V; Consumer information activities V V V Consumer / provider board participation (travel reimbursement)V Data processing V V V V Laboratory services (tests conducted for immunization programs)V Local service delivery activities V Maintenance operation'repairs V Malpractice insurance for volunteers V Memberships/subscriptions V NTS Oversampling V Pagers/cell phones V V V V Perinatal Hep B incentives V Printing of vaccine accountability forms V Professional service costs (limited term staff). Attorney General Office services V Promotional materials (NITW)V Public relations V Publication/printing costs (all other immunization related publication and printing expenses) V V V V Rent V V Shipping (other than vaccine)V V Software license/Renewals (ORACLEf etc.)V Stipend Reimbursements V September 7^ 2011 Chapter 0-1—The Basics p.27 Budget Category/Expenses Allowable with 317 operations ftmds Allowable with VFC operations fimds Allowable with VFC ordering funds Allowable widi VFC/AFIX ftmds Allowable with Pan Flu funds Toll-fi-ee phone lines for vaccine ordering V A Training costs - Statewide, staff, providers V ;V V Translations (translating materials)4 Vehicle lease (restricted to grantees with policies that prohibit local travel reimbursement) ¦i VFC promotional and recruitment materials ¦4 < VFC provider feedback surveys V < VIS camera-ready copies V September1,2011 Chapter 0—The Basics p.28 NON-ALLOWABLE EXPENSES WITH 317 AND \TC EA OPERATIONS FUNDS Expense NOT NOT allowable allowable with 317 with VI C fimds funds Honoraria V V Advertising costs (conventions, displays, exhibits, meetings,V V memorabilia, gifts, souvenirs) Alcoholic beverages V V Building purchases;, construction, capital improvements V V Land purchases V V Legislative/lobbying activities V 4 Bonding V 4 Depreciation on use charges V 4 Research V 4 Fundraising 1 V 4 Interest on loans for the acquisition and/or modernization of an V 4 existing building Clinical care (non-immunization services)V 4 Entertainment V 4 Payment of bad debt 4 4 Dry cleaning V 4 Other restrictions which must be taken into account while writing the budget: September 7,2011 Chapter 0—The Basics p.29 ATTACHMENT II GUIDANCE TO STATE AGENCIES REGARDING THE USE OF FUNDS RECEIVED UNDER THE AMERICAN RECOVERY AND REINVESTMENT ACT (ARRA) Table of Contents BACKGROUND 4 PURPOSE — 4 INTRODUCTION. - - -5 SECTION 1 - CONTRACT AND GRANT TERMS AND REQUIREMENTS 6 1.1 - Buy Michigan Preference -6 1.2- Buy American Requirement - - 6 1.3 - Whistteblower Protections - 7 14 - Wage Requirements. ? 1.5 - Publicizing Contract Actions - 7 1.6 - Reporting Requirements -7 1.7- inspection of Records ® 1.8 - Availability of Funding 8 1.9 - Non-Discrimination * 1.10 - Prohibition on Use of Funds - —- 8 1.11- Publications 1.12- False Claims Act 8 1.13- Conflicting Requirement —9 1.14 - Sub-Recipient Requirements 9 1.15- Competitive Fixed Price Contracts - 9 1.16- Segregation of Funds - - - 9 1.17 - Job Opportunity Posting Requirements 9 SECTION 2 - COMPLIANCE AND CONTRACT MANAGEMENT 10 2.1 - General Planning and Process 2.2 - Determination of Responsibility 10 2.3 - Delegated Authority ^1 2.4 - Contract Surveillance/Administration 11 2.5 - Emergency Purchases.... 2.6 - Reporting - - ¦ .-12 2.7 - Segregation of Costs - 13 2.8 - Government Accountability Office/inspector General Access 13 2.9-Ethics......... 14 2.10 - Michigan Economic Recovery Office Notification 14 2.11 - Notice Requirements under PA 7 of 2009 14 Guidance to State Agencies Regarding Funds Received AprU 16, 2009 Under the American Recovery and Reinvestment Act (ARRA) 2.12 Fraud Prevention 14 2^13 - Grant and Cooperative Agreements 15 2.14 - Risk Considerations - 18 2.15 - Buy American Requirement Applicable to State Agencies .18 2.16 - WhistleBIower Protection 20 2.17 - Internet Sites.... - 20 SECTION 3 - ACCOUNTING AND FINANCIAL REPORTING GUIDANCE..... .21 3.1 - General R*Stars Coding Requirements 21 3.2 - Profile Creation And Submission - 21 3.3 - D39 Profile Structure ....21 3.4 - D53 Profile Structure 22 3.5 - Budgetary Transaction Procedures ....22 3.6 - Agency Receiving ARRA Revenue from another Agency 22 3.7 - Federal Reporting 22 SECTION 4 - APPENDICES - - - 23 4.1 - AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 (TITLE XV & XVi)23 TITLE XV-ACCOUNTABILITY AND TRANSPARENCY...... 23 Sec. 1501. Definitions - 23 SUBTITLE A—TRANSPARENCY AND OVERSIGHT REQUIREMENTS .....23 Sec. 1511. Certifications 23 Sec. 1512. Reports On Use Of Funds 23 Sec. 1513. Reports Of The Council Of Economic Advisers. 24 Sec. 1514. inspector General Reviews 25 Sec. 1515. Access Of Offices Of Inspector General To Certain Records And Empfoyees 25 SUBTITLE B-RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD.....25 Sec. 1521. Establishment Of The Recovery Accountability And Transparency Board.26 Sec. 1522. Composition Of Board 26 Sec. 1523. Functions Of The Board.. 26 Sec. 1524. Powers Of The Board 28 Sec. 1525. Empioyment, Personnel, And Related Authorities 28 Sec. 1526. Board Website. 29 Guidance to State Agencies Regarding Funds Received Under the American Recovery and Reinvestment Act (ARRA) April 16.2009 2 Sec. 1527. Independence Of Inspectors General. Sec. 1528. Coordination With The Comptroller Genera! And State Auditors. 31 Sec. 1529. Authorization Of Appropriations 31 Sec. 1530. Termination Of The Board - - - .......31 SUBTITLE C-RECOVERY INDEPENDENT ADVISORY PANEL 31 Sec. 1541. Establishment Of Recovery independent Advisory Panel 31 Sec. 1542. Duties Of The Panel 32 Sec. 1543. Powers Of The Panel - 32 Sec. 1544. Panel Personnel Matters 32 Sec. 1545. Termination Of The Panel 33 Sec. 1546. Authorization Of Appropriations 33 SUBTITLE D-ADDITIONAL ACCOUNTABILITY AND TRANSPARENCY REQUIREMENTS - --33 Sec. 1551. Authority To Establish Separate Funding Accounts 33 Sec. 1552. Set-Aside For State And Locai Government Reporting And Recordkeeping..... — 33 Sec. 1553. Protecting State And Local Government And Contractor Whistieblowers. ••-•34 Sec. 1554. Special Contracting Provisions 39 TITLE XVI-GENERAL PROVISIONS-THIS ACT..... .................39 Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 3 BACKGROUND On Tuesday, February 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act of 2009, Pub. L 111-5 (ARRA). This Act provided $787 bUiion of federally financed economic stimulus funding through a combination of spending programs and reductions in business and individual taxes. The ARRA funds are provided for purposes which include preserving and creating jobs and promoting economic recovery; assisting those most impacted by the recession; investing in transportation, environmental protection, and other infrastructure to provide long-term economic benefits; and stabilizing state and local government budgets. The State of Michigan will receive hundreds of millions of dollars of ARRA funds. Governor Granholm has identified five key priorities for spending Michigan's share of the economic recovery dollars. We will: • Create new jobs and jumpstart Michigan's economy; • Train Michigan workers and educate Michigan students for the good jobs here today, and the new jobs we create tomorrow; • Rebuild Michigan infrastructure—roads, bridges, water and sewer systems, mass transit broadband, health information technology, and schools; e Provide assistance for struggling Michigan families, helping them make ends meet; and • Invest in energy efficiency and renewable energy technologies to create jobs, save money, and reduce our reliance on fossil fuels. Michigan has been selected as one of sixteen states to be part of a core group of states that will be monitored over the next three years to provide an analysis of the use of funds under the ARRA. PURPOSEThe purpose of this correspondence is to give some preliminary guidance to State Agencies regarding the use of ARRA funds, including contractual and grant requirements and accounting and financial reporting requirements. State agencies will continue to adhere to the existing state procurement guidelines including the Public Acts, Executive Directives, Administrative Guides, and the Financial Management Guide. These requirements and considerations also apply to those contract types which are currently handled by the agency through statutory authority or Administrative Guide delegation (i.e. grants, direct human services, medical services, construction, MOOT, DNR leases, etc.). in addition, the ARRA has some specific contractual, grant, and reporting requirements that are outlined in Title XV Accountabifity and Transparency & Title XVi General Provisions' of the Act This document will be updated as necessary. Guidance provided herein is not intended to be exhaustive and the agency will have responsibility to research these two titles for complete detail. Guidance to State Agencies Regarding Funds Received Aprii 16, 2009 Under the American Recovery and Reinvestment Act {ARRA) 4 All contracts and grants involving the use of funds made available under the American Recovery and Reinvestment Act (ARRA) must include provisions described in the ARRA, in addition to the standard terms and conditions typically used by state agencies for contracts, grants, and other types of agreements involving the use of federal funds. Our task will be to administer contracts that include the reporting tools, monitoring procedures, and accountability requirements that will help prevent fraud, waste, and abuse of these funds. Aqencies should put in place the internal controls that will support the requirements of ensuring that the ARRA funds are spent properly, efficiently, and effectively, and are meeting the intended goal. This will require that these contracts are overseen by an adequate number of trained purchasing and grant personnel. In light of the Administration's commitment to high levels of accountability and transparency, special attention should be given to maintaining strong internal controls over ARRA program funds. The high risk associated with the award and expenditure of ARRA program funds merits increased oversight by the agency. Much of the guidance provided herein comes from the Federal Office of Management and Budget guidance and requirements to Federal Agencies (M-09-15, April 3, 2009) and the Federal Registry Vol. 74 Rules and Regulations (March 31, 2009 pages 14622-14651). We expect that Federal guidance and requirements to federal agencies will trickle down to first tier recipients of the ARRA funds. We encourage State Agencies to become familiar with the details of these requirements. Guidance to State Agencies Regarding Funds Received April 16, 2009 Under the American Recovery and Reinvestment Act (ARRA) 5 SECTION 1 - CONTRACT AND GRANT TERMS AND REQUIREMENTS Aii contracts, both new and existing, involving the use of ARRA funds must include provisions iike those set forth in this Section. As used in this Section, "Recipient refers to the recipient of ARRA funds from the State of Michigan (i.e. the contractor or grantee). 1.1 - Buy Michigan PreferenceA preference is given to products manufactured or services offered by Michigan- based firms if all other things are equal and if not inconsistent with federal statute (see MCL 18.1261). 1.2 - Buy American Requirement The Buy American provision in Section 1605 of Division A, Title XVi of the ARRA requires that all "iron, steel and manufactured goods used in the construction, alteration, maintenance or repair of a "public buiiding or public work funded in whole or in part by funds made avaiiabfe under the ARRA be "produced in the United States," unless this requirement is waived by the appropriate federal agency. Iron and steel are "produced in the United States" if all of the manufacturing processes, except metaliurgic processes involving refinement of steel additives, take place in the United States. Iron or steel used as components or subcomponents of manufactured goods used in an ARRA-funded project, however, do not have to be "produced in the United States." Manufactured goods are "produced in the United States" if the manufacturing occurs in the United States (there is no requirement about the origin of the components or subcomponents of the manufactured goods). The Buy American requirement may be waived by federal agencies in the following circumstances only: (1) application of the Buy American requirement would be inconsistent with the public interest; (2) iron, steel and the relevant manufactured goods are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality; (3) or inclusion of iron, steel or manufactured goods produced in the United States will increase the cost of the overall project by more than 25 percent. As used in this Section, "steel" means any alloy that includes at least 50 percent iron, between .02 and 2 percent carbon, and may include other elements. "Manufactured good" means a good brought to the construction site for incorporation into the building or work that has been — (1) processed into a specific form and shape; or (2) combined with other raw material that has different properties than the properties of individual raw materials. "Public building or public work" means a public building of, and a public work of, the United States; the District of Columbia; commonwealths, territories, and minor outlying islands of the United States; State and local governments; and multi-State regional or interstate entities which have governmental functions). Guidance to Stale Agencies Regarding Funds Received Aprii 16,2009 tinder the American Recovery and Reinvestment Ad (ARRA) 6 1.3 - Whistleblower Protections fSection 1553 of Title XV of Division A of the ARRA prohibits all non-federal recipients of ARRA funds, including the State of Michigan, and all contractors and grantees of the State of Michigan, from discharging, demoting or otherwise discriminating against an employee for disclosures by the employee that the employee reasonably believes are evidence ,of (1) gross mismanagement of a contract or grant relating to ARRA funds; (2) a gross waste of ARRA funds; (3) a substantial and specific danger to public health or safety related to the implementation or use of ARRA funds; (4) an abuse of authority related to implementation or use of ARRA funds; or (5) a violation of law, rule, or regulation related to an agency contract (including the competition for or negotiation of a contract) or grant, awarded or issued relating to ARRA funds. The Recipient must post notice of the rights and remedies available to employees under Section 1553 of Title XV of Division A of the ARRA. This term must be included in all subcontracts or sub-grants involving the use of funds made available under the ARRA. 1.4 - Wage Requirements ,All laborers and mechanics employed by contractors and subcontractors on projects funded in whole or in part with funds available under the ARRA shall be paid wages at rates not less than those prevailing on projects of a character similar in the locality, as determined by the United States Secretary of Labor in accordance with subchapter IV of chapter 31 of title 40 of the United States Code. (See ARRA Sec, 1606 & RFP Section 2.204 Prevailing Wage). The Secretary of Labor's determination regarding the prevailing wages applicable in Michigan is available at httD://www.qpo.aov/davisbacon/mi.htmi. 1.5-Publicizing Contract ActionsAll contract solicitations funded in whole or in part with ARRA funds will be posted on the www.bid4michiaan.com website. All contracts resulting from the ARRA will be published on the State of Michigan's Recovery Web site, www.michioan.Qov/recoverv. 1.6 - Reporting RequirementsNot later than ten calendar days after the end of each calendar quarter, the State must submit a report that, at a minimum, contains the information specified in Section 1512 of Division A, Title XV of the ARRA. It is imperative all contracts involving the use of ARRA funds include requirements mat the Vendor supply the State with the necessary information to submit these reports to the federal government (see RFP Section 1.042 Reports) in a timely manner. More detail will follow regarding the timing and submission of reports. The Recipient's failure to provide complete, accurate, and timely reports shall constitute an "Event of Default". Upon the occurrence of an Event of Default, the Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 7 state department or agency may terminate this contract upon 30 days prior written notice if the default remains uncured within five calendar days following the last day of the calendar quarter, in addition to any other remedy available to the state department or agency in law or equity. 1.7 - Inspection of Records The Recipient shall permit the United States Comptroller General or his representative or the appropriate inspector general appointed under section 3 or 8G of the Inspector General Act of 1998 or his representative (1) to examine any records that directly pertain to, and involve transactions relating to, this contract; and (2) to interview any officer or employee of the Recipient or any of its subcontractors/subgrantees regarding the activities funded with funds appropriated or otherwise made available by the ARRA. 1.8 - Availability of Funding The Recipient acknowledges that the programs supported with temporary federal funds made available by the American Recovery and Reinvestment Act of 2009, Pub. L 111-5, will not be continued with state financed appropriations once the temporary federal funds are expended. 1.9 - Non-Discrimination The Recipient shall comply with Title VI of the Civii Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, and other civil rights laws applicable to recipients of Federal financial assistance (see RFP Section 2.201 Non-Discrimination). 1.10 - Prohibition on Use of Funds None of the funds made available under this contract may be used for any casino or other gambling establishment, aquarium, zoo, golf course, swimming pools, or similar projects. 1.11 - Publications Recipient shall include the Michigan Recovery logo on all signage or other publications in connection with the activities funded by the state of Michigan through funds made available by the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5. 1.12 - False Claims Act The Recipient shall promptly refer to an appropriate federal inspector general any credible evidence that a principal, employee, agent, contractor, sub-grantee, subcontractor or other person has committed a false claim under the False Claims Act or has committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving those funds. Guidance to State Agencies Regarding Funds Received April 16,2003 Under the American Recovery and Reinvestment Act (ARRA) S 1.13-Conflicting RequirementIf the ARRA requirements conflict with State of Michigan requirements, then ARRA requirements control, 1.14-Sub-Recipient RequirementsRecipient shall include these terms, including this requirement, in any ot its subcontracts or subgrants in connection with projects funded in whole or tn partwsth funds available under the American Recovery and Reinvestment Act of 2009, Pud. L 111-5. 1.15-Competitive Fixed Price Contracts .Recipient, to the maximum extent possible, shall award any subcontracts funded, in whole or in part, with Recovery Act funds as fixed-price contracts through the use ot competitive procedures. 1.16 - Segregation of FundsRecipient shall segregate obligations and expenditures of Recovery Act funds from other funding. No part of funds made available under the American Recovery and Reinvestment Act of 2009, Pub. L 111-5, may be comingled with any other funds or used for a purpose other than that of making payments for costs allowable under the ARRA. 1.17«Job Opportunity Posting Requirements _Recipient shall post notice of Job opportunities created in connection with activities funded in whole or in part with ARRA fends in the Michigan Talent Bank, www.michworks.orq/mtb. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the Afnerican Recovery and Reinvestrrient Act (ARRA) 9 SECTION 2 - COMPLIANCE AND CONTRACT MANAGEMENT: This Section provides guidance to state agencies on Compliance and Contract Management in connection with funds made available under the ARRA. As used in this Section, "Recipienf refers to the recipient of ARRA funds from the State of Michigan (i.e. the contractor or grantee). 2.1 ¦ General Planning and ProcessIn addition to any appiicable state or federal procurement requirements, state agencies and Recipients, to the maximum extent possible, shall award any contracts funded, in whole or in part, with ARRA funds with the following provisions: 1. Fixed-price contracts whenever possible. Fixed price contracts can accommodate market fluctuations when appropriate, when tied to economic index price adjustments. 2. Competitive bidding with fair and open competition. Agencies are expected to follow the same taws, principles, policy, and procedures in awarding ARRA contracts as they do in awarding with other funds. (See PA 431 -18.1261 (3), Administrative Guide 0510.02 & 0510.32, and Executive Directive 2005-3.) 3. A summary of any contract or order (or modification to an existing contract or order), including a description of the required products and services, using such funds may be posted in a special section of the Web site Recovery.gov or Michigan.gov/recovery unless the contract or order is both fixed-price and competitively awarded (see item 1 & 2 above). 4. State agencies and sub-recipients of ARRA funds shait use ARRA funds in a manner that maximizes job creation and economic growth. 5. Statement of Work development should ensure that performance measures are meaningftjl, measurable, time bound, results-oriented, and consistent with agency plans and the goals of the ARRA. 6. Contract terms should address the failure to complete the project, meet milestones or deliver the deliverables. T. Planning should involve mitigating schedule, cost, and performance risk (see Risk Assessment Report & Worksheet in the DMB Purchasing Operations intranet ARRA toolkit), 8. If applicable, terms should include special Buy American requirements (see Division A, Title XVI, Section 1605 of the ARRA). 9. Requirements should assure that ail sub-recipients of ARRA funds can report essential information as may be required under the ARRA. 2.2 - Determination of ResponsibilityThe award of a contract based solely on lowest evaluated price can produce a false economy, thus increasing performance, cost, and schedule risk. The general standards for responsibility include that the prospective contractor have: 1. Adequate financial resources to perform the contract or the ability to obtain them; Outdance to State Agencies Regarding Funds Received April 16,2009 Under the Amencan Recovery and Reinvestment Act (ARRA) 10 2. The ability to comply with the required or proposed delivery or perfomiance schedule, taking into consideration all existing commercial and governmental business commitments;3 A satisfactory record of past performance, integrity, and business ethics, 4 The necessary organization, experience, accounting and operational controls, and technical skills, or the ability to obtain them; and 5. The necessary production, construction, and technicai equipment ana facilities, or the ability to obtain them. 2 3Ttoef^tn>e no^elegated Authority" (to SOM agencies) for ARRA-re!ated contracts. Regardless of value, ail purchase requests must be submrtted to the DMB Purchasing Operations. There will be restrictions on the use ^of vouchers, and other controls will be in place to ensure that a!! ARRA-reiated payments can be "identified" to ARRA contracts. Requests for direct vouchers must be preapproved by DMB Purchasing Operations. There will be monitoring of SOM agencies ADPICS transactions for potential ARRA-related payments on contracts not previously approved by DMB Purchasing Operations/State Administrative Board. More details on the process and procedures will be forthcoming. This restriction does not apply to those contract types which are currently handled by the agency through statutory authority or Administrative Guide delegation (i.e. grants, direct human services, medical services, construction, MOOT, DNK leases, etc.). 2.4 - Contract Surveillance/AdministrationContract surveillance and administration will be a critical component to the successful tracking of ARRA expenditures and monitoring of deliverables. The DMB buyer will continue to fill the role of Contract Administrator for DMB contracts. The Aqency appointed Contract Compliance Inspectors (CCI) should be carefully chosen for their knowledge of the program, proximity to the deliverables and experience with the project. The CCI will play an important role in the day-to-day surveillance and supervision of the contract including: 1. Approving payments, 2. Documenting timely vendor performance issues, 3. Monitoring contract compliance, cost, schedules and deliverables, 4. Completing a vendor rating and contract doseout, 5. Documenting timely inspections and acceptance of deliverables, 6. identify and help remedy deficiencies identified related to contract performance. The agency should ensure that these persons have clear guidance as to their roles and responsibilities and that there is adequate training before assigning these roles. You will find the following tools on the DMB intranet, in the ARRA toolkit, to assist with contract administration and contract monitoring: Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 11 1. Risk Assessment Report & Worksheet 2. Kick-Off Meeting Record 3. Contract Compliance Report 4. Vendor Scorecard 5. Contract Closeout Report 2.5 - Emergency PurchasesAgencies are cautioned that the ARRA does not independently trigger use of emergency procurement authorities in Administrative Guide 0510.38. These authorities are triggered in limited, statutorily identified, circumstances. Uniess one of these circumstances exists, the special emergency authorities shall not be used. Procurement officers will need to be abie to report data and statistics on the following:1. All competitively bid contracts 2. Non-competitive contract awards 3. Contract types & type of projects 4. The recipients of contracts 5. Amount of awards Section 1512 of the ARRA requires reporting on the following: 1. The total amount of ARRA funds received by the Recipient/Contractor/Grantee during the Reporting Period; 2. The amount of ARRA funds that were expended or obligated during the Reporting Period;3. A detailed list of all projects or activities for which ARRA funds were expending or obligated, including: a) the name of the project or activity; b) a description of the project or activity; c) an evaluation of the completion status of the project or activity; and d) an estimate of the number of jobs created and the number of jobs retained by the project or activity;4. For any subcontracts or subgrants equal to or greater than $25,000: a) The name of the entity receiving the subaward; b) The amount of the subaward; c) The transaction type;d) The North American Industry Classification System (NAICS) code or Catalog of Federal Domestic Assistance (CFDA) number; e) Program source;f) An award title descriptive of the purpose of each funding action; g) The location of the entity receiving the subaward; h) The primary location of the subaward, including the city, state, congressional district and country; andi) A unique identifier of the entity receiving the subaward and the parent entity of the recipient, should the entity be owned by another. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 12 5 For any subcontracts or subgrants of less than $25,000 or to individuals, the* information required in (4) (a)-0) may be reported in the aggregate. a) The certification of an authorized officer of the Recipient/Contractor/Grantee that the information contained in the report is accurate; and ^ .6. Any other information reasonably requested by the Contract Manager/Grant Manager or required by state or federal law or regulation. Besides these reports, the Government Accountability Office (GOA) is required to conduct bimonthly reviews and prepare reports on such reviews on the useby selected states and localities of funds made available in the ARRA. The ARRA does not specify the criteria by which the states and localities will be selected. The reports are to be available online. For additional details about the 'Reporting' requirements, see the Section 1512 of the ARRA and Federal Register, Volume 74, Number 61 available at hftp://www.fta.dot.qov/documents/Q40409 OMB Cmt Request 1512 data SP^C^' ).pdf. Further guidance regarding the specific data element as well as the method for submission of the information will be provided as soon as it becomes available. 2.7 - Segregation of Costs x, ,Obliqations and expenditures of ARRA funds must be segregated from other funding. No part of ARRA funds may be comingled with any other funds or used for a purpose other than that of making payments for costs allowable under the ARRA. Refer to section 3 for specific guidance on accounting and financial reporting requirements. The Purchase Request Form (FRF) and the Administrative Bid Tab will have a check box added to designate which contracts are using ARRA funds, in whole or in part. These ARRA-funded projects that must receive State Administrative Board approval will be considered on a separate State Administrative Board agenda. 2.8 - Government Accountability Office/Inspector General AccessThe Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) are issuing an Interim rule amending the Federal Acquisition Requlation (FAR) to implement Sections 902,1514, and 1515 of the Amencan Recovery and Reinvestment Act of 2009. Collectively, these Sections provide for the audrt and review of both contracts and subcontracts, and the ability to interview such contractor and subcontractor personnel under contracts containing Recovery Act funds. For the Comptroller General these alternate clauses provide specific authority to audit contracts and subcontracts and to interview contractor and subcontractor employees under contracts using Recovery Act funds. Agency inspector generals receive the same authorises, with the exception of interviewing subcontractor employees. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 13 For full details of the 'Government Accountability Office & Inspector Genera! Access3 requirements, see the Federal Registry Vol. 74 Rules and Regulations (March 31, 2009, pages 14646-14649). 2.9 - EthicsIt is critical that transparency and integrity are a cornerstone of this process. The risk of fraud and abuse grows when the distribution of millions of dollars is mixed with new programs, new requirements, and new staffing. DMB Purchasing Operations has reformatted the Confidentiality Statement and the Conflict of Interest and Disclosure Forms to add more accountability. 2.10 - Michigan Economic Recovery Office Notification Agencies should forward all Requests for Proposals (RFP), Invitations to Bid (ITB), or similar solicitations to the Michigan Economic Recovery Office for review at least three days prior to releasing them to the pubic. Agencies may go ahead and release/post the document if they have not heard back from the Michigan Economic Recovery Office on the third day after notification. 2.11 - Notice Requirements under PA 7 of 2009 Section 203 of the bill provides for an automatic appropriation of any additional Recovery Act funds available to the state through the redistribution provisions of the Recovery Act If your department receives additional funds under the Recovery Act as a result of these redistribution provisions, the department must report to the senate and house standing committees on appropriations subcommittee, senate and house fiscal agencies, state budget director and the Governor on the amount of the Hinds received and the purposes for which they will be spent within 30 days of receiving the funds. If your department is distributing funds received under the Recovery Act through a competitive grant process, you must notify the senate and house of representatives standing committees on appropriations, senate and house fiscal agencies, and state budget office at least one day prior to the issuance of the request for proposals. Please include the Michigan Economic Recovery Office on this notice. 2.12 Fraud PreventionBy establishing an effective fraud prevention program, agencies can provide reasonable assurance that ARRA funds benefit intended recipients. A well-designed fraud prevention program will minimize waste and abuse and should consist of preventive controls, detection, monitoring, investigations, and prosecutions. These controls prevent ineligible individuals and questionable firms from gaining access to government funds in the first place. Most recently, in February 2009, the National Procurement Fraud Task Force (NPFTF) published a white paper (A Guide to Grant Oversight and Best Practices for Combating Grant Fraud, Washington, D.C.: February, 2009) that identified best practices and made recommendations for agencies to consider in preventing fraud, Guidance to State Agendes Regarding Funds Received Under the American Recovery and Reinvestment Act (ARRA) April 16,2009 14 waste, and abuse in grants they administer. These recommendations included enhanced certmcations, increased training, improved communications with grant recipients, increased information sharing concerning potential fraud, and rigorous oversight of how grant dollars are spent after they are awarded. We recommend you access and read that report. 2.13 - Grant and Cooperative Agreements /A„.,The passage of the American Recovery and Reinvestment Ad of 2009 (ARRA) changed the way the State of Michigan will report information to the Federal Government related to grants. As a result, grant agreements must require recipients and sub-recipients to: .1. Maintain current registrations in the Central Contractor Registration (CCR) database, http://www.ccr.gov/2. Report quarterly on project activity status (further defined in Section *.7), in addition to any reporting requirements that currently apply to recipients of federal funds; . ....3. Follow Buy American guidelines (section 1605 of ARRA and section 1.10 of this document) _ , ±. . _4. Implement wage rate requirements (section 1606 of ARRA and section 1.5 of this document) . ...5. Ensure proper accounting and reporting of ARRA expenditures in Single Audits Grant agreements must also include any terms needed to imptement agency/program specific provisions and general provisions of ARRA- For complete details of the "Grants and Cooperative Agreements" requirements, see the Federal Office of Management & Budget guidance letter of Apni 3, 2009 (M- 09-15), Section 5 and Appendix 9. http://www.recoverv.gov/sites/default/files/m09- 15.pdf We have included some excerpts pertinent to grant requirements: "5.1 Are there actions, beyond standard practice, that agencies must take while planning for competitive and formula grant awards under Recovery Act? Yes.(1) Determining Grant Objectives and Evaluation Criteria for Award Agencies should structure grants to result in meaningful and measurable outcomes that are consistent with agency plans and that promote the goals of the Recovery Act. The evaluation criteria for award should include those that bear on the measurement and likelihood of achieving these outcomes, such as jobs creation and preservation. (2) CompetitionAlthough the Recovery Act calls on agencies to commence expenditures and activities as quickly as possible consistent with prudent management, this Guidance to State Agencies Regarding Funds Received April 16, 2009 Under me American Recovery and Reinvestment Act (ARRA) 15 statement, by itself, does not constitute a sufficient justification to support award of a federal grant on a non-competitive basis. Agencies are expected to foliow the same laws, principles, procedures, and practices in awarding discretionary grants with Recovery Act funds as they do with other funds. Agencies should review their internal policies with a goal towards promoting competition to the maximum extent practicable. !n conducting this review, agencies may want to consider the appropriateness of limited competitions among existing high- performing projects versus full and open competitions. (3) Existing Grants .Ultimately, agencies must determine what award method(s) will allow recipients to commence expenditures and activities as quickly as possible consistent with prudent management and statutory requirements. Agencies may consider obligating funds provided under the Recovery Act on an existing grant, including, but not limited to, a continuation or renewal grant Because Recovery Act funds must be tracked and accounted for separately, supplements to existing agreements are not recommended as there is a greater risk that the grant recipient will be unable to track and report Recovery Act funds separately. Also, agreements must spell out the assignment of agency roles and responsibilities to fulfill the unique requirements of the Recovery Act. These include, but are not limited to, report development and submission, accurate and timely data reporting,' and special posting requirements to agency Web sites and Recovery.gov. (4) Timeliness of AwardsAgencies need to assess existing processes for awarding formuia allocations and announcing, evaluating and awarding discretionary grant opportunities to comport with the objective to make awards timely. 5.4 Are Federal agencies expected to initiate additional oversight requirements for grants, such as mandatory field visits or additional case examinations for error measurements, to comply with grant rules and regulations? Yes.Agencies must take steps, beyond standard practice, to initiate additional oversight mechanisms in order to mitigate the unique implementation risks of the Recovery Act At a minimum, agencies should be prepared to evaluate and demonstrate the effectiveness of standard monitoring and oversight practices. (1) Performance Management and Accountability Agencies must adapt current performance evaluation and review processes to include the ability to report periodically on completion status of the program or activity, and program and economic outcomes, consistent with Recovery Act requirements. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 16 Aqencies, in consultation with the Inspectors Genera!, shall establish procedures to validate the accuracy of information submitted on a statistical basis and/or nsK based approach as approved by OMB. (2) Internal Controls Assessment tConsistent with normal practices, agencies must use appropnate interna contra assessments to assess the risk of program waste, fraud, and/or abuse. Using the aforementioned risk assessments, agencies must have defined strategies, developed with input from the Inspector General for the agency, to prevent or timely detect waste, fraud, or abuse. Also, consistent with Section 3 of this Guidance, agencies should initiate additional measures, as appropriate, to address higher risk areas. 5 9 Are there terms ami conditions, beyond standard practice, that must be included in competitive and formula grant agreements under the Recovery Act? Aqencies must: " V. ,* Use the agency's standard award terms and conditions on award notices, where applicable, unless they conflict with the requirements of the Recovery Act In the case where the Recovery Act requirement conflicts with an agency's standard award term or condition, the agency's award term or condition should be modified, as necessary, to ensure compliance with the Recovery Act requirement. * Ensure other award terms needed to implement the agency/program-specific provisions and general provisions of the Recovery Act are included on awards Note that OMB has issued standard award terms for agencies to use in implementing Sections 1512,1605 and 1606 for grants, cooperative agreements, and loans. Agencies must ensure that they use any terms and conditions that implement other Recovery Act provisions, where applicable and as appropriate, such provisions in Sections 1511,1515,1553,1604, and 1609. * Ensure that there is an award term or condition requiring first tier sub- awardees to begin planning activities, including obtaining a DUNS number (or updating the existing DUNS record), and registering with the Central Contractor Registration (CCR). Prime recipients and Federal agencies must establish mechanisms to meet Recovery Act data collection requirements. Agencies should work with prime recipients to ensure that DUNS and CCR requirements for first tier sub-awardees are met no later than the first time Recovery Act data requirements are due. * Make clear that that any funding provided through the Recovery Act is one¬ time funding. Guidance to State Agencies Regarding Funds Received AprS 16, 2009 Under the American Recovery and Reinvestment Act (ARRA) 17 • include the requirement that each grantee or sub-grantee awarded funds made available under the Recovery Act sbali promptly refer to an appropriate inspector general any credible evidence that a principal, employee, agent, contractor, sub-grantee, subcontractor, or other person has submitted a false claim under the False Claims Act or has committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving those funds." 2.14-Risk ConsiderationsRisk identification and mitigation is a critical component to the contract process, f-or complete details of the 'Governance, Risk Management and Program Integrity requirements, see the Federal Office of Management & Budget guidance letter of April 3, 2009 (M-09-15), Section 3 and Appendix 4. We encourage you to read the entire context of those sections to learn how to better identify and mitigate risks associated with grant funds. The following acquisition process questions should prove helpful. „ x. ... .. . .1. Do new Requests for Proposals issued under Recovery Act initiatives contain the necessary language to satisfy the requirements of the Recowy Act? 2. Are contracts awarded in a prompt, fair, and reasonable manner? 3. Do new contracts using Recovery Act funds have the specific terms required. 4. Are contracts awarded using Recovery Act funds transparent to the public. Are the public benefits of the funds used under these contracts reported clearly, accurately and in a timely manner? 5. Are funds used for authorized purposes and the potential for fraud, waste, error, and abuse minimized and/or mitigated?6. Do projects funded under the Recovery Act avoid unnecessary delays and cost overruns?7. Are there any performance issues identified with regard to (potentia!) contractor? Are there follow up actions to address the performance issues? 2.15-Buy American Requirement Applicable to State Agencies The Buy American provision in Section 1605 of Division A, Title XVI of the ARRA requires that all "iron, steel and manufactured goods used in the construction, alteration, maintenance or repair of a "public building or public work funded in whole or in part by funds made available under the ARRA be "produced in the United States," unless this requirement is waived by the appropriate federal agency. Iron and steel are "produced in the United States" if all of the manufacturing processes, except metaliurgic processes involving refinement of steel additives, take place in the United States, iron or steel used as components or subcomponents ot manufactured goods used in an ARRA-funded project, however, do not have to be "produced in the United States." Manufactured goods are "produced in me United States" if the manufacturing occurs in the United States (there is no requirement about the origin of the components or subcomponents of the manufactured goods). Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 18 The ARRA also provides that the Buy American requirement in Section 1605 shai! be appiied in a manner consistent with United States obligations under intemaiiona agreements" As a practical matter, this means that, for procurement under state construction contracts valued at $7,443,000 or more, iron, steel and manufactured goods may be purchased if they are produced in the United States or produced in any of the foilowing countries: Aruba, Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea (Repub ic of), Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spam, Sweden, Switzerland, United Kingdom, Australia, or Chile. The "exception" to the Buy American requirement for obligations under international agreements does not apply to dredging, the restrictions attached to federal ^ states for mass transit and highway projects, or the purchase of construction grad steel motor vehicles or coal. Consequently, if using ARRA funds in connection with these activities or for construction grade steel, motor vehicles or coal, only items produced in the United States may be procured. The Buy American requirement may be waived by Federal agencies in the following circumstances only: (1) application of the Buy American requirement would be inconsistent with the public interest; (2) iron, steel and the relevant manufactured noods are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality; (3) or inclusion of iron, steel or manufactured goods produced in the United States will increase the costof the overall project by more than 25 percent. Requests for waivers must be submitted before funds are awarded by a federal agency or obligated by the state. The process for requesting a waiver of the Buy American requirements, including information that must be provided to federal agencies in support of a request for a waiver 's ^esenbedon pages 139-141 of the federal Office of Management and Budget's April 3,2009 guidance. As used in this Section, "steel" means any alloy that includes at least 50 percent iron between .02 and 2 percent carbon, and may include other elements. "Manufactured good" means a good brought to the construction site for incorporation into the building or work that has been - (1) processed into a specific form and shape- or (2) combined with other raw material that has different properties than the properties of individual raw materials. "Public building or public work" means a _ public building of, and a public work of, the United States; the District of Columbia, commonwealths, territories, and minor outlying islands of the United States; btate and local governments; and multi-State regional or interstate entities which have governmental functions). Guidance to State Agencies RegarcBng Funds Received Under the American Recovefy and Reinvestment Act (ARRA) April 16, 2009 19 2.16 - WhfstleBlower Protection All state agencies must post notice of the rights and remedies available to employees under Section 1553 of the ARRA. {For the Michigan CM! Service Whistle Blowers Ruie 2-10 link to: http://www,michiqan.aov/mdcs/0.1807.7-147-6877 8155-72500-,00-html) 2.17 - internet Sites The following links may be heipful to your staff: The fastest and easiest way to obtain copies of GAO documents at no cost is through GAO's Web site fwww.qao.gov). Each weekday afternoon, GAO posts on its Web site newly released reports, testimony, and correspondence. To have GAO e-mail you a list of newly posted products, go to www.gao.gov and select "E-mail Updates." Michigan Recovery site - http://www.michiqan.qov/recoverv Federal Recovery site - http://www.recoverv.qov/ NASPO Recovery site - http://www.naspo.orq/content.cfm/id/stimutus Council of State Governments ARRA Web site - http://www.staterecoverv.orq/ The American Recovery and Reinvestment Act - http://www.recoverv.oov/7a-content/act OMB Guidance Memo (2/17/2009): http://www.naspo.orq/documents/rnitia) omb guidance 090218.pdf OMB Guidance Memo (04/03/2009): http://www.whrtehouse.qov/omb/assets/mernoranda fv2009/m09-15.pdf Access to the Federal Register - http://www.qpoaccess.qov/fr/ DMB intranet site - http://connect.mfchiqan.qov/portal/site/dmb/ Guidance Jo State Agencfes Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 20 SECTION 3 -ACCOUNTING AND FINANCIAL REPORTING GUIDANCE No part of ARRA funds may be comingted with any other funds or usedJor a purpose other than that of making payments for costs allowable u^^e To assist in tracking and keeping ARRA funds separate from non-ARRA funds, the following steps will be taken. 3.1 - General R*Stars Coding RequirementsIn order to meet specific ARRA reporting guidelines, it is necessary to track all federal ARRA revenues separately from existing federal program re'wmue. Ea ARRA-related line item appropriation will require unique appropriation (2U proriiej and fund (D23 profile) numbers. 3.2 - Profile Creation And SubmissionDepartments will submit new profile requests for 20s and D23s to the^ate Budg Office (SBO) for approval. SBO approved profiles will be sent to the Office ot Rnancial Management (OFM) for final approval and entry AH profiles must have the acronym ARRA in the title. The AR/^nfund^w^1 ® to like fund sources through the use of the State Fund Group (D39 profile) and Finance Source (D53 profile) fields located on the D23 profile. These* two.coding elements will be created by SBO, Office of Budget Development (OBD) and OFM and entered on the agency submitted D23 profiles. 3.3 - 039 Profile StructureThe D39 values established to track ARRA revenue will use each of the four place holders of the profile to identify funds at multiple levels. The placeholders will be defined by SBO and OFM.1. The first indicator identifies ARRA-related revenues and expenditures 2. The second indicator identifies a group of programs 3. The third indicator identifies major programs within a group 4. The fourth indicator identifies sub-programs (if needed) The groups have been defined as follows: 1. 90XX ~ Fiscal Stabilization 2. g-fXX - Health & Human Services 3. 92XX — Education 4. 93XX-Transportation 5. 94XX" Energy 6. 95XX - Economic Development 7. 96XX - Natural Resources & Environmental 8. 97XX- Justice 9. 98XX-Labor 10. 99XX - Miscellaneous Guidance to State Agendes Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 21 3.4 - D53 Profile Structure The D53 values estabtished to track ARRA revenues will use two values to distinguish between competitive and formula driven grants. 1. 70 - ARRA Funding/Expenditures - Competitive 2. 80 - ARRA Funding/Expenditures - Formula Driven 3. 3.5 - Budgetary Transaction ProceduresDepartments wili follow the same budgetary transaction procedures for supplemental appropriations as established by the SBO-OBD. The instructions are available electronically on the SBO intranet at http://connect.michiqan.aov/budqet 3.6 - Agency Receiving ARRA Revenue from another Agency If an Agency plans to receive ARRA funds from another Agency, the recipient agency should contact their OFM Accounting Liaison for guidance related to profile establishment and transaction processing. 3.7 - Federal Reporting On April 1,2009, the Office of Management and Budget (OMB) issued federal reporting guidance related to ARRA revenue. The guidance contains standard data elements that agencies will be responsible for in order to comply with the reporting requirements under section 1512 of the American Recovery and Reinvestment Act of 2009 (Public Law 111 - 5). The data elements are listed in detail within the Federal Register, Volume 74, Number 61. A copy of those reporting data elements can be found at: httP"//www.fta.dot.qov/documents/04Q4Q9 OMB Cmt Request 1512 data specsd ifidf Further guidance regarding the specific data element as well as the method for submission of the information will be provided as soon as it becomes available. Guidance to State Agendas Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 22 SECTION 4 - APPENDICES 4.1 - AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 (TITLE XV & XVI) TITLE XV~ACCOUNTABILITY AND TRANSPARENCY Sec. 1501. Definitions. In this title: . . , ^(1) AGENCY - The term 'agency1 has the meaning given under section 551 of title 5, United States Code.(2) BOARD - The term "Board* means the Recovery Accountability and Transparency Board established in section 1521. (3) CHAIRPERSON - The term 'Chairperson* means the Chairperson of the Board,(4) COVERED FUNDS - The term 'covered funds' means any funds that are expended or obligated from appropriations made under this Act. (5) PANEL - The term 'Panel' means the Recovery Independent Advisory Pane! established in section 1541. SUBTITLE A-TRANSPARENCY AND OVERSIGHT REQUIREMENTS Sec. 1511. Certifications. ^ .With respect to covered funds made available to State or local governments for rnfrastructure investments, the Governor, mayor, or other chief executive, as appropriate, shall certify that the infrastructure investment has received the full review and vetting required by law and that the chief executive accepts responsibility that the infrastructure investment is an appropriate use of taxpayer dollars. Such certification shall include a description of the investment, the estimated total cost, and the amount of covered funds to be used, and shall be posted on a website and linked to the website established by section 1528. A State or local agency may not receive infrastructure investment funding from funds made available in this Act unless this certification is made and posted. Sec. 1512. Reports On Use Of Funds.(a) Short Title - This section may be cited as the Jobs Accountability Act. (b) Definitions - In this section:(1) RECIPIENT - The term 'recipient'- (A) means any entity that receives recovery funds directly from the Federal Government {including recovery funds received through grant, loan, or contract) other than an individual; and (B) includes a State that receives recovery funds. (2) RECOVERY FUNDS - The term vrecovery funds* means any funds that are made available from appropriations made under this Act. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 23 (c) Recipient Reports - Not later than 10 days after the end of each calendar quarter, each rectpient that received recovery funds from a Federal agency shaft submit a report to that agency that contains- (1) the total amount of recovery funds received from that agency; {2) the amount of recovery funds received that were expended or obligated to projects or activities; and (3) a detailed list of all projects or activities for which recovery funds were expended or obligated, induding-- (A) the name of the project or activity; (B) a description of the project or activity; (C) an evaluation of the completion status of the project or activity; (D) an estimate of the number of jobs created and the number of jobs retained by the project or activity; and (E) for infrastructure investments made by State and local governments, the purpose, total cost, and rationale of the agency for funding the infrastructure investment with funds made available under this Act, and name of the person to contact at the agency if there are concerns with the infrastructure investment. (4) Detailed information on any subcontracts or subgrants awarded by the recipient to include the data elements required to comply with the Federal Funding Accountability and Transparency Act of 2006 {Public Law 109- 282), allowing aggregate reporting on awards below $25,000 or to individuals, as prescribed by the Director of the Office of Management and Budget. (d) Agency Reports - Not later than 30 days after the end of each calendar quarter, each agency that made recovery funds available to any recipient shall make the information in reports submitted under subsection (c) publicly available by posting the information on a website. (e) Other Reports - The Congressional Budget Office and the Government Accountability Office shall comment on the information described in subsection (c) (3) (D) for any reports submitted under subsection (c). Such comments shall be due within 45 days after such reports are submitted. (f) COMPLIANCE - Within 180 days of enactment as a condition of receipt of funds under this Act, Federal agencies shall require any recipient of such funds to provide the information required under subsection (c). (g) GUIDANCE - Federal agencies, in coordination with the Director of the Office of Management and Budget, shall provide for user-friendly means for recipients of covered funds to meet the requirements of this section. (h) REGISTRATION - Funding recipients required to report information per subsection (c) (4) must register with the Centra? Contractor Registration database or complete other registration requirements as determined by the Director of the Office of Management and Budget. Sec. 1513. Reports Of The Council Of Economic Advisers. (a) In General - In consultation with the Director of the Office of Management and Budget and the Secretary of the Treasury, the Chairperson of the Council of Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 24 Economic Advisers shall submit quarterly reports to the Committees on Appropriations of the Senate and House of Representatives that detail the impact of programs funded through covered funds on employment, estimated economic growth, and other key economic indicators. (b) Submission of Reports-\ first REPORT - The first report submitted under subsection (a) snail be submitted not later than 45 days after the end of the first full quarter following the date of enactment of this Act.(2) LAST REPORT - The last report required to be submitted under subsection (a) shall apply to the quarter in which the Board terminates under section 1530. Sec, 1514. Inspector General Reviews.(a) Reviews - Any inspector general of a Federal department or executive agency shall review, as appropriate, any concerns raised by the public about specific investments using funds made available in this Act Any findings of such reviews not related to an ongoing criminal proceeding shall be relayed immediately to the head of the department or agency concerned. In addition, the findings of such reviews, along with any audits conducted by any inspector general of funds made available in this Act, shall be posted on the inspector general's website and linked to the website established by section 1526, except that portions of reports may be redacted to the extent the portions would disclose information that is protected from public disclosure under sections 552 and 552a of title 5, United States Code. Sec. 1515^ Access Of Offices Of inspector General To Certain Records And Employees. , , . ^ r ^(a) Access - With respect to each contract or grant awarded using covered funds, any representative of an appropriate inspector general appointed under section 3 or 8G of the Inspector General Act of 1978 (5 U.S.C. App.}, is authorized- (1) to examine any records of the contractor or grantee, any of its ^ subcontractors or subgrantees, or any State or local agency administering such contract, that pertain to, and involve transactions relating to, the contract, subcontract, grant, or subgrant; and (2) to interview any officer or employee of the contractor, grantee, subgrantee, or agency regarding such transactions. (b) Relationship to Existing Authority - Nothing in this section shall be interpreted to limit or restrict in any way any existing authority of an inspector general. SUBTITLE B-RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD Guidance to State Agencies Regarding Funds Received April 18,2008 Under the American Recovery and Reinvestment Act (ARRA) 25 Sec. 1521. Establishment Of The Recovery Accountability And Transparency Board.There is estabtished the Recovery Accountabiiity and Transparency Board to coordinate and conduct oversight of covered funds to prevent fraud, waste, and abuse- Sec. 1522. Composition Of Board. (a) Chairperson-(1) DESIGNATION OR APPOINTMENT - The President shal!- (A) designate the Deputy Director for Management of the Office of Management and Budget to serve as Chairperson of the Board; (B) designate another Federal officer who was appointed by the President to a position that required the advice and consent of the Senate, to serve as Chairperson of the Board; or (C) appoint an individuaJ as the Chairperson of the Board, by and with tine advice and consent of the Senate. (2) COMPENSATION-(A) DESIGNATION OF FEDERAL OFFICER - If the President designates a Federai officer under paragraph (t) (A) or (B) to serve as Chairperson, that Federal officer may not receive additional compensation for services performed as Chairperson.(B) APPOINTMENT OF NON-FEDERAL OFFICER - If the President appoints an individual as Chairperson under paragraph (1 )(C)( that individual shaii be compensated at the rate of basic pay prescribed for level IV of the Executive Schedule under section 5315 of title 5, United States Code. (b) Members - The members of the Board shall incfude- (1) the Inspectors General of the Departments of Agiiculture, Commerce, Education, Energy, Health and Human Services, Homeland Security, Justice, Transportation, Treasury, and the Treasury Inspector General for Tax Administration; and (2) any other Inspector General as designated by the President from any agency that expends or obligates covered funds. Sec. 1523. Functions Of The Board. (a) Functions-(1) IN GENERAL - The Board shad coordinate and conduct oversight of covered funds in order to prevent fraud, waste, and abuse. (2) SPECIFIC FUNCTIONS - The functions of the Board shall include- (A) reviewing whether ihe reporting of contracts and grants using covered funds meets applicable standards and specifies tie purpose of the contract or grant and measures of performance; (B) reviewing whether competition requirements applicable to contracts and grants using covered funds have been satisfied; (C) auditing or reviewing covered funds to determine whether wasteful spending, poor contract or grant management, or other Guidance to State Agencies Regarding Funds Received Aprif 16,2009 Under the American Recovery and Reinvestment Act (ARRA) abuses are occurring and referring matters it considers appropriate for investigation to the inspector general for the agency that disbursed the covered funds; (D) reviewing whether there are sufficient qualified acquisition and grant personnel overseeing covered funds; (E) reviewing whether personnel whose duties involve acquisitions or grants made with covered funds receive adequate training; and (F) reviewing whether there are appropriate mechanisms for interagency collaboration relating to covered funds, including coordinating- and collaborating to the extent practicable with the Inspectors General Council on Integrity and Efficiency established by the Inspector General Reform Act of 2008 {Public Law 110-409). (b) Reports- , ^ t .(1) FLASH AND OTHER REPORTS - The Board shail submit to the President and Congress, including the Committees on Appropriations of the Senate and House of Representatives, reports, to be known as 'flash reports', on potential management and funding problems that require immediate attention. The Board also shall submit to Congress such other reports as the Board considers appropriate on the use and benefits of funds made available in this Act.(2) QUARTERLY REPORTS - The Board shall submit quarterly reports to the President and Congress, including the Committees on Appropriations of the Senate and House of Representatives, summarizing the findings of the Board and the findings of inspectors general of agencies. The Board may submit additional reports as appropriate.(3) ANNUAL REPORTS - The Board shall submrt annual reports to the President and Congress, including the Committees on Appropriations of the Senate and House of Representatives, consolidating applicable quarterly reports on the use of covered funds. (4) PUBLIC AVAILABlLITY-(A) IN GENERAL - AW reports submitted under this subsection shall be made publicly available and posted on the website established by section 1526.(B) REDACTIONS - Any portion of a report submitted under this subsection may be redacted when made publicly available, if that portion would disclose information that is not subject to disclosure under sections 552 and 552a of title 5, United States Code. (c) Recommendattons-(1) IN GENERAL - The Board shall make recommendations to agencies on measures to prevent fraud, waste, and abuse relating to covered tads. (2) RESPONSIVE REPORTS - Not later than 30 days after receipt of a recommendation under paragraph (1), an agency shall submit a report to the President the congressional committees of jurisdiction, induding the Committees on Appropriations of the Senate and House of Representatives, and the Board on-- Gukfance to State Agencies Regarding Funds Received Aprii 16.2009 Under the American Recovery and Reinvestment Act (ARRA) 27 (A) whether the agency agrees or disagrees with the recommendations; and (B) any actions the agency will take to implement the recommendations. Sec. 1524. Powers Of The Board. (a) In General - The Board shall conduct audits and reviews of spending of < covered funds and coordinate on such activities with the inspectors general of the relevant agency to avoid duplication and overlap of work. (b) Audits and Reviews - The Board may™ (1) conduct its own independent audits and reviews relating to covered funds; and{2) collaborate on audits and reviews relating to covered funds with any inspector general of an agency. (c) Authorities-(1) AUDITS AND REVIEWS - In conducting audits and reviews, the Board shall have the authorities provided under section 6 of the Inspector General Act of 1978 (5 U.S.C. App.). Additionally, the Board may issue subpoenas to compel the testimony of persons who are not Federal officers or employees and may enforce such subpoenas in the same manner as provided for inspector general subpoenas under section 6 of the Inspector General Act of 1978 (5 U.S.C. App.).(2) STANDARDS AND GUIDELINES - The Board shall carry out the powers under subsections (a) and (b) in accordance with section 4(b)(1) of the Inspector General Act of 1978 (5 U.S.C. App.). (d) Public Hearings - The Board may hold public hearings and Board personnel may conduct necessary inquiries. The head of each agency shall make all officers and empioyees of that agency avaitabie to provide testimony to the Board and Board personnel. The Board may issue subpoenas to compel the testimony of persons who are not Federal officers or employees at such public hearings. Any such subpoenas may be enforced in the same manner as provided for inspector general subpoenas under section 6 of the Inspector Genera! Act of 1978 (5 U.S.C. App.).(e) Contracts - The Board may enter into contracts to enable the Board to discharge its duties under this subtitle, including contracts and other arrangements for audits, studies, analyses, and other services with public agencies and with private persons, and make such payments as may be necessary to carry out the duties of the Board. (f) Transfer of Funds - The Board may transfer funds appropriated to the Board for expenses to support administrative support services and audits, reviews, or other activities related to oversight by the Board of covered funds to any office of inspector general, the Office of Management and Budget, the General Services Administration, and the Panel Sec. 1525. Employment, Personnel, And Related Authorities. (a) Employment and Personnel Authorities- Guidance to Stale Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 28 (1) IN ^^^ORjT|ES _ gybject to paragraph (2), the Boarti may exercise the authorities of subsections (b) through (i) of se^on 3161 of title 5, United States Code (without regard to subsection (a) of that section). . . .../g) APPLiCATfON - For purposes of exercising the autnonties described under subparagraph (A), the term 'Chairperson of the Board' shall be substituted for the term 'head of a temporary rc) CONSULTATION - In exercising the authorities described under subparagraph (A), the Chairperson shall consult with members of the Board. _(2) EMPLOYMENT AUTHORITIES - in exercising the emp oyment authorities under subsection (b) of section 3161 of title 5, United Stages Code, as provided under paragraph (1) of this subsection--(A) paragraph (2) of subsection (b) of section 3161 of that title (relating to periods of appointments) shall not apply; and (B) no period of appointment may exceed the date on which the Board terminates under section 1530. Information and Assistance- . .(1) IN GENERAL - Upon request of the Board for information or assistance from any agency or other entity of the Federal Government the head of such entity shall, insofar as is practicable and not in of any existing law, furnish such information or assistance to the Board, or an authorized designee.(2) REPORT OF REFUSALS - Whenever information or assistance requested by the Board is, in the judgment of the Board, unreasonably reused or not provided, the Board shall report the circumstances to the congressional committees of jurisdiction, including the Committees on Appropriations of the Senate and House of Representatives, withou (c) AdmWstrative Support - The General Services Administration shall provide the Board with administrative support services, including the provis.on of office space and facilities. Sec.1 ^afE^tabfeiTment^Thg Board shail establish and maintain, no later than 30 days iter enacSent of this Act, a user-friendly, public-facing website to foster greater accountabiiity and transparency in the use of covered funds.(b) Purpose- The website established and maintained under subsection (a) shall be a portal or gateway to key information relating to this Act and provide connections to other Government websites with related . (c) Content and Function - In establishing the website established and maintained under subsection (a), the Board shall ensure the fo lowing: (1) The websHe shall provide materials explaining what this Act means for citizens The materials shall be easy to understand and regularly updated. Guidance to Stale Agencies Regarding Funds Received Apnt 16.2009 Under the American Recovery and Reinvestment Act (ARRA) 29 (2) The website shall provide accountability information, inciuding findings from audits, inspectors general, and the Government Accountabifity Office. (3) The website shall provide data on relevant economic, financial, grant, and contract information in user-friendiy visual presentations to enhance public awareness of the use of covered funds. (4) The website shall provide detailed data on contracts awarded by the Federal Government that expend covered funds, including information about the competitiveness of the contracting process, information about the process that was used for the award of contracts, and for contracts over $500,000 a summary of the contract. (5) The website shall include printable reports on covered funds obligated by month to each State and congressional district. (6) The website shall provide a means for the public to give feedback on the performance of contracts that expend covered funds. {7) The website shall include detailed information on Federal Government contracts and grants that expend covered funds, to include the data elements required to comply with the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109-282), allowing aggregate reporting on awards below $25,000 or to individuals, as prescribed by the Director of the Office of Management and Budget £8) The website shall provide a link to estimates of the jobs sustained or created by the Act (9) The website shall provide a fink to information about announcements of grant competitions and solicitations for contracts to be awarded. (10) The website shall include appropriate links to other government websites with information concerning covered funds, including Federal agency and State websites.(11) The website shall include a plan from each Federal agency for using funds made available in this Act to the agency. (12) The website shall provide information on Federal allocations of formula grants and awards of competitive grants using covered funds. (13) The website shall provide information on Federal allocations of mandatory and other entitlement programs by State, county, or other appropriate geographical unit. (14) To the extent practical, the website shall provide, organized by the location of the job opportunities involved, links to and information about how to access job opportunities, including, if possible, links to or information about local employment agencies, job banks operated by State workforce agencies, the Department of Labor's CareerOneStop website, State, local and other public agencies receiving Federal funding, and private firms contracted to perform work with Federal funding, in order to direct job seekers to job opportunities created by this Act (15) The website shall be enhanced and updated as necessary to carry out the purposes of this subtitle. (d) Waiver - The Board may exclude posting contractual or other information on the website on a case-by-case basis when necessary to protect national security Guidance to State Agencies Regarding Funds Received April 16.2009 Under the American Recovery and Reinvestment Act (ARRA) 30 or to protect information that is not subject to disclosure under sections 552 and 552a of title 5, United States Code. Sec. 1527. Independence Of Inspectors General.(a) Independent Authority - Nothing in this subtitle shall affect the independent authority of an inspector general to determine whether to conduct an audit or investigation of covered funds.(b) Requests by Board - If the Board requests that an inspector general conduct or refrain from conducting an audit or Investigation and the inspector general rejects the request in whole or in part, the inspector general shail, nolMater ten 30 days after rejecting the request, submit a report to the Board, the head of me applicable agency, and the congressional committees of jurisdiction, inciudEng the Committees on Appropriations of the Senate and House of Representatives. The report shaf! state the reasons that the inspector genera! has rejected the request in whole or in part. The inspector general's decision shal! be final. Sec 1528. Coordination With The Comptrolier Genera! And State Auditors. The Board shall coordinate its oversight activities with the Comptrolier General of the United States and State auditors. Sec. 1529. Authorization Of Appropriations.There are authorized to be appropriated such sums as necessary to carry out this subtitie. Sec, 1530. Termination Of The Board. The Board shall terminate on September 30, 2013. SUBTITLE C-RECOVERY INDEPENDENT ADVISORY PANEL Sec 1541. Establishment Of Recovery Independent Advisory Panel. (a) Establishment - There is established the Recovery Independent Advisory ^Membership ~ The Panel shall be composed of 5 members who shall be appointed by the President. .(c) Qualifications - Members shall be appointed on the basis of expertise in economics, public finance, contracting, accounting, or any other relevant field. (d) Initial Meeting - Not later than 30 days after the date on which all members of the Panel have been appointed, the Panel shall hold its first meeting. (e) Meetings - The Pane! shall meet at the call of the Chairperson of the Panel. (f) Quorum - A majority of the members of the Panel shall constitute a quorum, but a lesser number of members may hold hearings. (g) Chairperson and Vice Chairperson - The Panel shall select a Chairperson and Vice Chairperson from among its members. Guidance to State Agencies Regarding Funds Received Apnl 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 31 Sec, 1542. Duties Of The Panel.The Panel shall make recommendations to the Board on actions the Board could take to prevent fraud, waste, and abuse relating to covered funds. Sec. 1543. Powers Of The Panel. (a) Hearings - The Panel may hold such hearings, sit and act at such times and pfaces, take such testimony, and receive such evidence as the Panel considers advisable to carry out this subtitle. (b) Information From Federal Agencies - The Panel may secure directly from any agency such information as the Pane! considers necessary to carry out this subtitle. Upon request of the Chairperson of the Panel, the head of such agency shall furnish such information to the Panel.(c) Postal Services - The Panei may use the United States mails in the same manner ancJ under the same conditions as agencies of the Federal Government. (d) Gifts - The Pane! may accept, use, and dispose of gifts or donations of services or property. Sec. 1544. Panel Personnel Matters. (a) Compensation of Members - Each member of the Panel who is not an officer or employee of the Federal Government shall be compensated at a rate equal to the daily equivalent of the annual rate of basic pay prescribed for level IV of the Executive Schedule under section 5315 of title 5, United States Code, for each day (including travel time) during which such member is engaged in the performance of the duties of the Panel. Al! members of the Panel who are officers or employees of the United States shall serve without compensation in addition to that received for their services as officers or employees of the United States. (b) Travel Expenses - The members of the Panel shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of chapter 57 of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Panel. (c) Staff-(1) IN GENERAL - The Chairperson of the Panel may, without regard to the civi! service laws and regulations, appoint and terminate an executive director and such other additional personnel as may be necessary to enable the Panel to perform its duties. The employment of an executive director shall be subject to confirmation by the Panel. (2) COMPENSATION - The Chairperson of the Panei may fix the compensation of the executive director and other personnel without regard to chapter 51 and subchapter HI of chapter 53 of title 5, United States Code, relating to classification of positions and General Schedule pay rates, except that the rate of pay for the executive director and other personnel may not exceed the rate payable for level V of the Executive Schedule under section 5316 of such title. (3) PERSONNEL AS FEDERAL EMPLOYEES- Guidance io State Agencies Regarding Funds Received April 15.2009 Under the American Recovery and Reinvesfenent Act (ARRA) 32 (A) IN GENERAL - The executive director and any personnel of the Pane! who are employees shall be employees under section 2105 of title 5, United States Code, for purposes of chapters 63, 81, 83, 84, 85, 87,89, 89A, 89B, and 90 of that title.(B) MEMBERS OF PANEL - Subparagraph (A) shall not be construed to apply to members of the Panel. (d) Detail of Government Employees - Any Federal Government be detailed to the Panel without reimbursement, and such detail shall be without interruption or loss of civil service status of privilege. ^(e) Procurement of Temporary and intermittent Services - The Chairperson of the Panel may procure temporary and intermittent services under section 3109(b) ot title 5 United States Code, at rates for indMduafs which do not exceed the daily equivalent of the annual rate of basic pay prescribed for level V of the Executive Schedule under section 5316 of such title. (f) Administrative Support - The General Services Administration shall provide the Panel with administrative support services, including the provision of office space and facilities. Sec. 1545. Termination Of The Panel. The Panel shall terminate on September 30,2013. Sec. 1548. Authorization Of Appropriations. There are authorized to be appropriated such sums as necessary to carry out this subtitle. SUBTITLE D-"ADDITIONAL ACCOUNTABILITY AND TRANSPARENCYREQUIREMENTS Sec. 1551. Authority To Establish Separate Funding Accounts. Although this Act provides supplemental appropriations for programs, projects, and activities in existing Treasury accounts, to facilitate tracking through Treasury and agency accounting systems, the Secretary of the Treasury shall ensure that all funds appropriated in this Act shall be established in separate Treasury accounts, unless a waiver from this provision is approved by the Director of the Office of Management and Budget. Sec. 1552. Set-Aside For State And Local Government Reporting And Recordkeeping. ^ r ,, , ..Federal agencies receiving funds under this Act, may, after following the notice and comment rulemaking requirements under the Administrative Procedures Act (5 U.S.C. 500), reasonably adjust applicable limits on administrative expenditures for Federal awards to help award recipients defray the costs of data collection requirements initiated pursuant to this Act. Guidance to State Agencies Regarding Funds Received Aprii 16,2009 Under the American Recovery and Reinvesiment Act (ARRA) 33 Sec. 1553. Protecting State And Local Government And Contractor Whistleblowers. (a) Prohibition of Reprisals - An employee of any non-Federal employer receiving covered funds may not be discharged, demoted, or otherwise discriminated against as a reprisal for disclosing, including a disclosure made in the ordinary course of an employee's duties, to the Board, an inspector general, the Gomptroiler General, a member of Congress, a State or Federal regulatory or law enforcement agency, a person with supervisory authority over the employee (or such other person working for the employer who has the authority to investigate, discover, or terminate misconduct), a court or grand jury, the head of a Federal agency, or their representatives, information that the employee reasonably believes is evidence of-(1) gross mismanagement of an agency contract or grant relating to covered funds; (2) a gross waste of covered funds;(3) a substantial and specific danger to public health or safety related to the implementation or use of covered funds;(4) an abuse of authority related to the impiementatEon or use of covered tods; or (5) a violation of law, rule, or regulation related to an agency contract (including the competition for or negotiation of a contract) or grant, awarded or issued relating to covered funds. (b) Investigation of Complaints-(1) IN GENERAL - A person who believes that the person has been subjected to a reprisal prohibited by subsection (a) may submit a complaint regarding the reprisal to the appropriate inspector general. Except as provided under paragraph (3), unless the inspector general determines that the complaint is frivolous, does not relate to covered funds, or another Federal or State judicial or administrative proceeding has previously been invoked to resolve such complaint, the inspector general shall investigate the complaint and, upon completion of such investigation, submit a report of the findings of the investigation to the person, the person's employer, the head of the appropriate agency, and the Board.(2) TIME LIMITATIONS FOR ACTIONS- (A) IN GENERAL - Except as provided under subparagraph (B)r the inspector general shall, not later than 180 days after receiving a complaint under paragraph (1 )~ 0) make a determination that the complaint is frivolous, does not relate to covered funds, or another Federal or State judicial or administrative proceeding has previously been invoked to resolve such complaint; or (ii) submit a report under paragraph (1). (B) EXTENSIONS-(i) VOLUNTARY EXTENSION AGREED TO BETWEEN INSPECTOR GENERAL AND COMPLAINANT - if the Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 34 inspector genera! is unable to compiete an investigation under this section in time to submit a report within the 180- day period specified under subparagraph (A) and the person submHting the complaint agrees to an extension of time, the inspector general shall submit a report under paragraph (1) within such additional period of time as shall be agreed upon between the inspector general and the person submitting the ©ECTENSION GRANTED BY INSPECTOR GENERAL. - If the Inspector general is unable to complete an investigation under this section in time to submit a report within the 180- day period specified under subparagraph (A), the inspector general may extend the period for not more than 180 days without agreeing with the person submitting the complain, to such extension, provided that the inspector general provides a written explanation (subject to the authority to exclude information under paragraph (4)(C5) for the decision, which - shall be provided to both the person submitting the compfamt and the non-Federal employer.(ni) SEMi-ANNUAL REPORT ON EXTENSIONS - The inspector general shall include in semi-annuaf reports to Congress a list of those investigations for which the inspector genera! received an extension. (3) DISCRETION NOT TO INVESTIGATE COMPLAINTS- (A) IN GENERAL - The inspector general may decide not to conduct or continue an investigation under this section upon providing to the person submitting the complaint and the non- Federal employer a written explanation (subject to the authority to exclude information under paragraph (4)(C)5 for such decision.(B) ASSUMPTION OF RIGHTS TO CIVIL REMEDY - Upon receipt of an explanation of a decision not to conduct or continue an investigation under subparagraph (A), the person submitting a complaint shall immediately assume the right to a civil remedy under subsection (c)(3) as if the 210-day period specified under such subsection has already passed.(C) SEMI-ANNUAL REPORT - The inspector general shall include in semi-annual reports to Congress a list of those investigations the inspector general decided not to conduct or continue under this (4) ACCEsI TO INVESTIGATIVE FILE OF INSPECTOR GENERAL- (A) IN GENERAL - The person alleging a reprisal under this section shall have access to the investigation file of the appropriate inspector general in accordance with section 552a of title 5, United States Code (commonly referred to as the 'Privacy Act*). The investigation of the inspector general shall be deemed dosed tor Outdance to State Agencies Regarding Funds Received Aprii 16, 2009 Under the American Recovery and Reinvestment Act (ARRA) 35 purposes of disclosure under such section when an employee files an appeal to an agency head or a court of competent jurisdiction. (B) CIVIL ACTION - In the event the person alleging the reprisal brings suit under subsection (c){3}, the person alleging the reprisal and the non-Federal employer shail have access to the investigative file of the inspector genera! in accordance with the Privacy Act.(C) EXCEPTION - The inspector general may exclude from disclosure- (i) information protected from disclosure by a provision of law; and (ii) any additional information the inspector general determines disclosure of which would impede a continuing investigation, provided that such information is disclosed once such disclosure would no longer impede such investigation, unless the inspector general determines that disclosure of law enforcement techniques, procedures, or information could reasonably be expeded to risk circumvention of the Saw or disclose the identity of a confidential source. (5) PRIVACY OF INFORMATION - An inspector general investigating an alleged reprisal under this section may not respond to any inquiry or disclose any information from or about any person alleging such reprisal, except in accordance with One provisions of section 552a of title 5, United States Code, or as required by any other applicable Federal law. (c) Remedy and EnforcementAuthority-(1) BURDEN OF PROOF-(A) DISCLOSURE AS CONTRIBUTING FACTOR IN REPRISAL- (i) IN GENERAL - A person alleging a reprisal under this section shall be deemed to have affirmatively established the occurrence of the reprisal if the person demonstrates that a disclosure described in subsection (a) was a contributing factor in the reprisal.(ii) USE OF CIRCUMSTANTIAL EVIDENCE - A disclosure may be demonstrated as a-contributing factor in a reprisal for purposes of this paragraph by circumstantial evidence, induding- (i) evidence that the official undertaking the reprisal knew of the disclosure; or (II) evidence that the reprisal occurred within a period of time after the disclosure such that a reasonable person could conclude that the disclosure was a contributing factor in the reprisal (B) OPPORTUNITY FOR REBUTTAL - The head of an agency may not find the occurrence of a reprisal with respect to a reprisal that is affirmatively established under subparagraph (A) if the non- Guidance to State Agencies Regarding Funds Received April 16.2009 Under the American Recovery and Reinvestment Act (ARRA) 3S Federal employer demonstrates by dear and convincing evidence that the non-Federai employer would have taken the action constitutrng the reprisal in the absence of the disclosure. (2) AGENCY ACTION - Not later than 30 days after receiving an inspector general report under subsection (b), the head of the agency concerned shall determine whether there is sufficient basis to conclude that the non- Federal employer has subjected the complainant to a reprisal prohibited by subsection (a) and shaft either issue an order denying relief in whole or in part or shall take 1 or more of the following actions; (A) Order the employer to take affirmative action to abate the reprisal.(B) Order the employer to reinstate the person to the positron that the person held before the reprisal, together with the compensation (including back pay), compensatory damages, employment benefits, and other terms and conditions of employment that would apply to the person in that position if the reprisal had not been taken(C) Order the employer to pay the complainant an amount equal to the aggregate amount of afl costs and expenses (including attorneys' fees and expert witnesses' fees) that were reasonably incurred by the complainant for, or in connection with, bringing the complaint regarding the reprisal, as determined by the head of the agency or a court of competent jurisdiction.(3) CIVIL ACTION - If the head of an agency issues an order denying relief in whole or in part under paragraph (1), has not issued an order within 210 days after the submission of a complaint under subsection (b), or in the case of an extension of time under subsection (b)(2XBXi), within 30 days after the expiration of the extension of time, or decides under subsection (b)(3) not to investigate or to discontinue an investigation, and there is no showing that such delay or decision is due to the bad faith of the complainant, the complainant shall be deemed to have exhausted all administrative remedies with respect to the complaint, and the complainant may bring a de novo action at faw or equity against the employer to seek compensatory damages and other relief available under this section in the appropriate district court of the United States, which shall have jurisdiction over such an action without regard to the amount in controversy. Such an action shall, at the request of either party to the action, be tried by the court with a jury.(4) JUDICIAL ENFORCEMENT OF ORDER - Whenever a person fails to comply with an order issued under paragraph (2), the head of the agency shall file an action for enforcement of such order in the United States district court for a district in which the reprisal was found to have occurred. In any action brought under this paragraph, the court may grant appropriate relief, including injunctive relief, compensatory and exemplary damages, and attorney's fees and costs. Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 37 (5) JUDICIAL REVIEW - Any person adversely affected or aggrieved by an order issued under paragraph (2) may obtain review of the orders conformance with this subsection, and any regulations issued to carry out this section, in the United States court of appeals for a circuit in which the reprisal is alleged in the order to have occurred. No petition seeking such review may be filed more than 60 days after issuance of the order by the head of the agency. Review shaf! conform to chapter 7 of trtie 5, United States Code.(d) Nonenforceabiiity of Certain Provisions Waiving Rights and Remedies or Requiring Arbitration of Disputes-(1) WAiVER OF RIGHTS AND REMEDIES - Except as provided under paragraph (3), the rights and remedies provided for in this section may not be waived by any agreement policy, form, or condition of empioyment, including by any predispute arbitration agreement(2) PREDISPUTE ARBiTRATiON AGREEMENTS - Except as provided under paragraph (3), no predispute arbitration agreement shafi be valid or enforceable if it requires arbitration of a dispute arising under this section. (3) EXCEPTION FOR COLLECTIVE BARGAINING AGREEMENTS - Notwithstanding paragraphs (1) and (2), an arbitration provision in a collective bargaining agreement shall be enforceable as to disputes arising under the collective bargaining agreement.(e) Requirement to Post Notice of Rights and Remedies - Any employer receiving covered funds shall post notice of the rights and remedies provided under this section. (f) Rules of Construction- ^^r-r^r-r,(1) NO IMPLIED AUTHORITY TO RETALIATE FOR NON-PROTECTED DISCLOSURES - Nothing in this section may be construed to authorize the discharge of, demotion of, or discrimination against an employee for a disclosure other than a disclosure protected by subsection (a) or to modify or derogate from a right or remedy otherwise available to the employee. (2) RELATIONSHIP TO STATE LAWS - Nothing In this section may be construed to preempt preclude, or limit the protections provided for public or private employees under State whistlebiower laws. (q) Definitions - In this section:(1) ABUSE OF AUTHORITY - The term 'abuse of authority means an arbitrary and capricious exercise of authority by a contracting official or employee that adversely affects the rights of any person, or that results in personal gain or advantage to the official or employee or to preferred other persons. , .(2) COVERED FUNDS - The term covered funds means any contract, grant, or other payment received by any non-Federal employer if~ (A) the Federal Government provides any portion of the money or property that is provided, requested, or demanded; and (B) at least some of the funds are appropriated or otherwise made available by this Act(3) EMPLOYEE - The term 'employee'- Guidance to State Agencies Regarding Funds Received April 16.2009 Under toe American Recovery and Reinvestment Act (ARRA) 38 (A) except as provided under subparagraph (8), means an individual performing services on behalf of an employer, and (8) does not include any Federal empioyee or member of the uniformed services (as that term is defined in section 101 (a)(5) of title 10, United States Code).(4) NON-FEDERAL EMPLOYER - The term 'non-Federal employer*- (A) means any employer-(i) with respect to covered funds- (i) the contractor, subcontractor, grantee, or recipient, as the case may be, if the contractor, subcontractor, grantee, or recipient is an employer; and (H) any professional membership organization, certification or other professional body, any agent or licensee of the Federal government, or any person acting directly or indirectly in the interest of an employer receiving covered funds; or (ii) with respect to covered funds received by a State or loca! government, the State or loca! government receiving the funds and any contractor or subcontractor of the State or local government; and (B) does not mean any department, agency, or other entity of the Federal Government(5) STATE OR LOCAL GOVERNMENT - The term 'State or local government' means- „(A) the government of each of the several States, the Dtstnct or Columbia, the Commonwealth of Puerto Rico, Guam, American Samoa, the Virgin islands, the Commonwealth of the Northern Mariana islands, or any other territory or possession of the United States* or (B) the government of any political subdivision of a government listed in subparagraph (A). Sec. 1554. Special Contracting Provisions.To the maximum extent possible, contracts funded under this Act shall be awarded as fixed-price contracts through the use of competitive procedures. A summary of any contract awarded w!th such funds that is not fixed-price and not awarded using competitive procedures shall be posted in a special section of the website established in section 1526. TITLE XVI-GENERAL PROVISIONS-THIS ACT RELATIONSHIP TO OTHER APPROPRIATIONS Sec, 1601. Each amount appropriated or made available In this Act is in addition to amounts otherwise appropriated for the fiscal year involved. Enactment of this Guidance to State Agencies Regarding Funds Received April 16,2009 Under ifie American Recovery and Reinvestment Act {ARRA) 39 Act shall have no effect on the availability of amounts under the Continuing Appropriations Resolution, 2009 (division A of Public Law 110-329). PREFERENCE FOR QUICK-START ACTiVlTIES SEC. 1602. In using funds made available in this Act for infrastructure investment, recipients shall give preference to activities that can be started and completed expedftiously, inciuding a goat of using at least 50 percent of the funds for activities that can be initiated not later than 120 days after the date of the enactment of this Act. Recipients shall also use grant funds in a manner that maximizes job creation and economic benefit. PERIOD OF AVAILABIUTYSEC. 1603. Ail funds appropriated in this Act shall remain available for obligation until September 30,2010, unless expressly provided otherwise in this Act. LIMIT ON FUNDSSEC. 1604. None of the funds appropriated or otherwise made available sn this Act may be used by any State or local government, or any private entity, for any casino or other gambling establishment, aquarium, zoo, golf course, or swimming pool. BUY AMERICAN ,vmSec. 1605. Use of American Iron, Steel, and Manufactured Goods, (a) None ot the funds appropriated or otherwise made available by this Act may be used for a project for the construction, alteration, maintenance, or repair of a public building or public work unless all of the iron, steel, and manufactured goods used in the project are produced in the United States. (b) Subsection (a) shall not apply in any case or category of cases in which the head of the Federal department or agency involved finds that- (1) applying subsection (a) would be inconsistent with the public interest, (2) iron, steel, and the relevant manufactured goods are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality; or(3) inclusion of iron, steel, and manufactured goods produced in the United States will increase the cost of the overall project by more than 25 percent(c) If the head of a Federal department or agency determines that it is necessary to waive the application of subsection (a) based on a finding under subsection (b), the head of the department or agency shall publish in the Federal Register a detailed written justification as to why the provision is being waived. (d) This section shall be applied in a manner consistent with United States obligations under international agreements. WAGE RATE REQUIREMENTSSEC. 1606. Notwithstanding any other provision of law and in a manner consistent with other provisions in this Act, all laborers and mechanics employed Guidance to State Agencies Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 40 by contractors and subcontractors on projects funded directly by or assisted in whole or in part by and through the Federal Government pursuant to this Act shall be paid wages at rates not less than those prevailing on projects of a character similar in the locality as determined by the Secretary of Labor m accordance with subchapter IV of chapter 31 of title 40, United States Code. With respect to the labor standards specified in this section, the Secretary of Labor shall have the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (64 Stat. 1267; 5 U.S.C. App.) and section 3145 of title 40, United States Code. ADDITIONAL FUNDING DISTRIBUTION AND ASSURANCE OF APPROPRIATE USE SEC. 1607. (a) Certification by Governor - Not later than 45 days afterthe date of enactment of this Act, for funds provided to any State or agency thereof, the Governor of the State shal! certify that: (1) the State will request and use funds provided by this Act; and (2) the funds will be used to create jobs and promote economic growth. .(b) Acceptance by State Legislature- If funds provided to any State in any division of this Act are not accepted for use by the Governor, then acceptance by the State legislature, by means of the adoption of a concurrent resolution, shall be sufficient to provide funding to such State. (c) Distribution - After the adoption of a State legislature's concurrent resolution, funding to the State will be for distribution to local governments, councils of government, public entities, and public-private entities within the State either by formula or at the State's discretion. ECONOMIC STABILIZATION CONTRACTINGSEC. 1608. REFORM OF CONTRACTING PROCEDURES UNDER EESA. Section 107(b) of the Emergency Economic Stabilization Act of 2008 (12 U.S.C. 5217(b)) is amended by inserting 'and individuals with disabilities and businesses owned by individuals with disabilities (for purposes of this subsection the term "individual with disability' has the same meaning as the term 'handicapped individual' as that term is defined in section 3(f) of the Small Business Act (15 U.S.C. 632(f))/ after '(12 U.S.C. 1441a£rX4)),'. SEC. 1609. (a) FINDINGS-(1) The National Environmental Policy Act protects public health, safety and environmental quality: by ensuring transparency, accountability and public involvement in federal actions and in the use of public funds; (2) When President Nixon signed the National Environmental Policy Act into law on January 1,1970, he said that the Act provided the ^direction' ^ for the country to 'regain a productive harmony between man and nature'; (3) The National Environmental Policy Act helps to provide an orderly process for considering federal actions and funding decisions and prevents ligation and delay that would otherwise be inevitable and existed prior to the establishment of the National Environmental Policy Act. Guidance to State Agendes Regarding Funds Received April 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 41 (b) Adequate resources w'rthin this bill must be devoted to ensuring that applicable environmental reviews under the National Environmental Policy Act are completed on an expeditious basis and that the shortest existing applicable process under the National Environmental Policy Act shall be utilized. (c) The President shall report to the Senate Environment and Public Works Committee and the House Natural Resources Committee every 90 days foliowing the date of enactment until September 30, 2011 on the status and progress of projects and activities funded by this Act with respect to compliance with National Environmental Policy Act requirements and documentation. SEC. 1610. (a) None of the funds appropriated or otherwise made available by this Act, for projects initiated after the effective date of this Act, may be used by an executive agency to enter into any Federal contract unless such contract is entered into in accordance with the Federal Property and Administrative Services Act (41 U.S.C. 253) or chapter 137 of title 10, United States Code, and the Federal Acquisition Regulation, unless such contract is otherwise authorized by statute to be entered into without regard to the above referenced statutes. (b> All projects to be conducted under the authority of the Indian Self- Determination and Education Assistance Act, the Tribaily-Controiled Schools Act, the Sanitation and Facilities Act, the Native American Housing and Self- Determination Assistance Act and the Buy-Indian Act shall be identified by the appropriate Secretary and the appropriate Secretary shall incorporate provisions to ensure that the agreement conforms with the provisions of this Act regarding the timing for use of funds and transparency, oversight, reporting, and accountability, including review by the inspectors General, the Accountability and Transparency Board, and Government Accountability Office, consistent with the objectives of this Act. Sec. 1611. Hiring American Workers in Companies Receiving TARP Funding, (a) SHORT TITLE - This section may be cited as the 'Employ American Workers Act'(b) PROHIBITfON-(1) IN GENERAL - Notwithstanding any other provision of law, it shall be unlawful for any recipient of funding under title I of the Emergency Economic Stabilization Act of 2008 (Public Law 110-343} or section 13 of the Federal Reserve Act (12 U.S.C. 342 et seq.) to hire any nonimmigrant described in section 101(a)(15)(h)(i)(b) of the immigration and Nationality Act (8 U.S.C. 1101 (a)(15)(h}(i)(b)) unless the recipient is in compliance with the requirements for an H-1B dependent employer (as defined in section 212(n)(3) of such Act (8 U.S.C. 1182(n)(3))), except that the second sentence of section 212(n)(1 )(E)(ii) of such Act shall not apply.(2) DEFINED TERM - In this subsection, the term 'hire* means to permit a new employee to commence a period of employment. (c) Sunset Provision - This section shall be effective during the 2-year period beginning on the date of the enactment of this Act. SEC. 1612. During the current fiscal year not to exceed 1 percent of any appropriation made available by this Act may be transferred by an agency head between such appropriations funded in this Act of that department or agency: Guidance to State Agencies Regarding Funds Received Apn! 16,2009 Under the American Recovery and Reinvestment Act (ARRA) 42 Provided That such appropriations shall be merged with and available for the same ourposes and for the same time period, as the appropnatron to which transferred: Pmvided further, That the agency head on ADDrooriations of the Senate and House of Representatives of the transte days^n advance: Provided further. That notice of any transfer made pursuant to this authority be posted on the website established by the Recovery Act Accountability and Transparency Board 15 days followingi sueti trans^ further, That the authority contained in this section is in addition authorities otherwise available under current law: Provided further. That the authority provided in this section shall not apply to any appropriation that is subject to transfer provisions included elsewhere in this Act. Guidance to State Agencies Regarding Funds Received Under the American Recovery and Reinvestment Act (ARRA) April 16, 2009 43 ATTACHMENT II! MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 13/14 COMPREHENSIVE AGREEMENT PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Contractor and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on-site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Many program specific assurances and other requirements are defined within the referenced documents including Minimum Program Requirements established for the following program elements as of October 1,2006: A.Breast and Cervical Cancer Control I.Immunization - (Essential Local Public Health B.Clinical Laboratory Services & Categorical) C.Family Planning J.LHD/CSHCS D.Food Service Sanitation K.Michigan Care Improvement Registry E.General Communicable Disease Control L.On-Site Sewage F.Healthy Homes and Lead Poisoning M.Private/Type II Water Supplies G.Hearing N.Vision H.HIV/STD Prevention & Treatment 0.WiC MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 1 of 87 For FY 13/14, special requirements are applicable for the remaining program elements listed in the attached pages. Adolescent STD Screening Asthma Control through Education and Environment (ACE) Babies MIECHVP Healthy Families America Expansion Body Art Facility Licensing Bioterrorism - Regional Epidemiology Support Breast and Cervical Cancer Control Program (BCCCP) Centralized Access Home Visiting Hub Children's Special Health Care Services (CSHCS) Eat Safe FishEssential Local Public Health Services (ELPHS) Family Planning/BCCCP Joint Project Family Planning-Pregnancy Prevention FDA Tobacco Retailer (A & L) Inspections Fetal Alcohol Spectrum Disorder Projects Fetal Infant Mortality Review (FIMR) Case Abstractions HIV Ryan White Part B HIV Expanded Testing Dental HIV Prevention Services HIV Rapid Testing HIV/STD Partner Services HOPWA (Housing Opportunities for Persons Living with HIV/AIDS) Immunization Action Plan Immunization Assessment Feedback Incentive Exchange (AFIX) Follow-up Site Visit Immunization - Field Service Representatives Immunizations MCIR Regions Immunization - Nurse Education Reimbursement Immunization - Vaccine Quality Assurance Program Immunization - VFC/AFIX Site Visit Infant Safe Sleep Informed Consent Laboratory Services Bioterrorism Laboratory Services Epidemiology Laboratory Capacity (ELC) Laboratory Services STD Local Maternal and Child Health (MCH) Local Health Department Project SNAP-Ed Local Tobacco Reduction Michigan Abstinence Program Michigan Care Improvement Registry Michigan Colorectal Cancer Early Detection Program Michigan Health and Wellness 4X4 Plan Nurse Family Partnership Services Nurse Family Partnership Services MIECHV Practices to Reduce Infant Mortality through Equity (PRIME) Local Learning Collaborative Public Health Emergency Preparedness (PHEP) Sexual Violence Prevention Sexually Transmitted Disease (STD) Control Sudden Unexplained Infant Death SUIDS SEAL! Michigan Dental Sealant Program TB Control and Elimination Taking Pride in Prevention (TPIP) Teen Pregnancy Prevention Initiative WIC Breastfeeding WIC Services MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 2 of 87 WISEWOMAN Coordination Page 3 of 87MDCH/G&PD FY 13/14 ATTACHMENT III8/1/13 FORMAT fPROGRAM/ELEMEN-n SPECIAL REQUIREMENTS I. Budget and Agreement Requirements - Lists those special funding and agreement requirements applicable to the program/element as a whole. II. Contractor Requirements - Lists those special requirements applicable to ail agencies administering the program element. III. Department Requirements - Lists those special requirements applicable to the Department IV. Contractor Specific Requirements - Lists those unique requirements applicable only to the single Contractor covered by this agreement. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 4 of 87 ADOLESCENT SEXUALLY TRANSMITTED DISEASE (STD) SCREENINGSPECIAL REQUIREMENTS (OAKLAND COUNTY HEALTH DIVISION) OCTOBER 1, 2013- December 31, 2013 Contractor Requirements Project Summary: Individuals 15-24 years of age will be screened for chlamydia and gonorrhea at the following Oakland County sites: 1. Oakland County Children's Village Detention 2. Oakland County Children's Village Shelter Care 3. Oakland County Main Jail 4. Oakland County Utilizing the identified project sites: 1. Test at least 100 adolescents and young adults per month, using NAAT tests for gonorrhea and chlamydia. 2. Collect race, gender, age, test result, and treatment date for all tests. 3. Refer clients for further health evaluation if indicated. 4. Provide client centered risk reduction plan, promoting abstinence. 5. Treat all positives on site if possible. 6. Contact positive clients that are released prior to treatment with treatment options in community. 7. Promote self-notification of partners. 8. Analyze and forward data to MDCH every quarter. 9. Develop one annual slide set highlighting year end data by demographic variable including trend data. 10. Continue to promote awareness of prevalence of STDS within adolescent and young adult populations. 11. Participate in quarterly Michigan Infertility Prevention Project meetings; providing quarterly screening project data. ASTHMA CONTROL THROUGH EDUCATION AND ENVIRONMENT (ACE) SPECIAL REQUIREMENTS (INGHAM COUNTY HEALTH DEPARTMENT) Ingham County Health Department will provide Certified Asthma Educators to conduct asthma and healthy homes education with at least 60 families. At least one representative will attend quarterly ACE Consortium Meetings as well as provide training to residents and maintenance staff on Asthma Trigger and Injury Prevention. Additionally, they will provide training and resources for smoking cessation and referrals for Quit-Tobacco Workshops. Contractor Requirements The ACE project will promote cost-effective, preventative measures to correct multiple safety and health hazards in the home environment that produce serious diseases in children in low-income families, specifically targeting families with asthmatic children in multifamily public and assisted housing within the City of Lansing. Ingham County Health Department will support ACE by: MDCH/G&PD FY 13/148/1/13 ATTACHMENT ill Page 5 of 87 1. Providing a certified asthma educator to conduct asthma and healthy homes assessment and education to at least 60 families living in public or assisted multifamily housing using the MATCH program methodology, which includes the following: a. Up to 6 in home asthma case management visits, including one primary care physician visit, one school/work visits and a social worker visit when necessary. b. Foilow-up environmental assessments will be conducted at the discharge visit by the Certified Asthma Educator. 2. Conducting education and outreach to the community on healthy homes related issues, including asthma triggers and childhood injury control in the home. 3. Providing training to housing staff on healthy homes and asthma related issues through seminar style exercises. 4. Providing smoking cessation training to ACE and housing staff. 5. Conducting education and outreach to eligible ACE families referred to Quit-Tobacco Workshops. 6. Assigning an ICHD representative to attend the 12 quarterly ACE Consortium Meetings. 7. Providing in-kind match of 82%. This leveraged funding should be on the budget. BABIES MATERNAL INFANT EARLY CHILDHOOD HOME VISITING PROGRAM (MiECHVP) HEALTHY FAMILIES AMERICA EXPANSION SPECIAL REQUIREMENTS(WAYNE COUNTY HEALTH DEPARTMENT) Maintain Fidelity to the Model: 1. Adhere to the Healthy Families America (HFA) program standards and operate the program with fidelity to the requirements of the HFA National Office—Prevent Child Abuse America and MDCH implementation plan. A. Ensure model standards (12 Critical Elements) are being met B. Address challenges to maintaining program quality and fidelity. 1. Develop a strategy to handle additional stressors caused by: retraining staff, learning program model, additional work load requirements. Staffing: 2. Current Wayne County Babies HFA staffing will be retained (one supervisor, one supervisor/home visitor, one home visitor). One additional home visitor will be hired. Required HFA staff/client ratios will be maintained at ail times. A. Charge appropriate staff time to grant. B. Amend contract with SEMHA for HR services. C. Obtain necessary training, curriculum and supplies for new staff. Target Population: 3. The Wayne County Babies HFA Program will expand to serve an additional 25 families who are pregnant and/or parenting African American women, through the age of 24, living in the cities of Highland Park, Inkster, Hamtramckand Redford. A. Develop and implement a joint recruitment plan or memorandum of understanding with Spaulding for Children. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 6 of 87 B. HFA Participants will be identified and recruited in a joint effort with the Spaulding for Children HFA program. 1. Continue collaboration with DHS, physician offices, community event organizers, WIC, etc. for referrals. 2. C. Attrition rates for participants will be minimized. 1. Participants will sign Pledge Forms. 2. Supplemental services and incentives will be provided to participants (as outlined in the implementation plan). Program Monitoring. Assessment Support and Technical Assistance (TA): 4. Fully participate with the HFA National Office and MDCH with respect to program monitoring, assessment, support and technical assistance services. Professional Development and Training: 5. Ensure ail training and technical assistance requirements are met. A. All Wayne County Babies HFA program staff will participate in: 1. Professional development and training activities, as required by HFA or the Growing Great Kids (GGK) curriculum owner—Great Kids, Inc. 2. Home visiting learning communities and/or other learning opportunities offered by the state. 3. Workforce development opportunities. Engage the Local Community: 6. Participate in a broad-based community advisory committee that is providing oversight for HFA and other home visiting efforts. This will occur collaboratively with other early childhood committees or advisory bodies, or the Local Leadership Group established to work with the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program as listed below. Money may not be used fora separate advisory for Wayne County Babies or HFA. Coordinate with Appropriate Entities/Programs: 7. Build upon and maintain diverse community and target population collaboration and support. 8. Participate in the Local Leadership Group (LLG) that has been designated to work with the Michigan MIECHV Program, to effectively link HFA with other home visiting programs and services offered in the community, and to represent HFA in Continuous Quality Improvement (CQI) efforts that assess the impact of the overall home visiting effort in the community. Data Collection: 9. Collect and report data for all eligible families who receive services funded with the MIECHV Program, as outlined in the implementation plan. A. Comply with all HFA data collection requirements. B. Work with the MIECHV Evaluation contractor to develop a plan to collect and report additional data beyond that required for HFA. C. Provide all MIECHV evaluation data in accordance with the evaluation plan. Continuous Quality Improvement (CQI): 10. Participate in all HFA quality initiatives including: research, evaluation and continuous quality MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 7 of 87 improvement. 11. Participate in all local CQI team (established by the Local Leadership Group) initiatives, as well as those required by the State CQI team. A. Review data to identify quality issues and gaps to be addressed. B. Use data to identify strengths and challenges in program implementation. C. Local teams will set targets and monitor progress toward these targets. D. Utilize a Plan-Do-Study-Act (PDSA) approach to CQI. E. Monitor progress toward the Home Visiting Program Objectives. F. Use data to identify opportunities for improvement and develop improvement strategies. G. Participate in necessary trainings and technical assistance provided by the State CQI team. H. Participate in all reporting and evaluation activities required by the state. Reporting Requirements 12. The contractor shall adhere to the HFA National Office program reporting requirements. 13. Submit all required reports in accordance with the MDCH reporting requirements. 14. Reports and information shall be submitted to: Penny Eisfelder Division of Family and Community Health Michigan Department of Community Health P.O. Box 30195 Lansing, Michigan 48909 or eisfelderp@michiaan.aov (put "Healthy Families America Reports FY 12" in the subject line) BODY ART FACILITY LICENSING SPECIAL REQUIREMENTS Budget and Agreement Requirements This agreement is intended to establish a payment schedule to the Local Entity, following notification of a completed inspection and recommendation for issuance of license. The intent is to help offset costs related to the licensing of a body art facility, when fees are collected from the respective Local Entity's jurisdiction in accordance with Section-13101-13111 of the Public Health Code, Public Act 149 of 2007, which was updated on December 22,2010 and is now Public Act 375. The State will reimburse the Local Entity on a quarterly basis according to the following criteria: $250 $125 $112.50 $250 $375 $25 Initial annual license for a Body Art Facility prior to July 1 50% of state fee Initial annual license for a Body Art Facility on or after July 1 50% of state fee Issue a temporary license for a Body Art Facility 75% of state fee License renewal prior to December 1 50% of state fee License renewal after December 1 50% of state fee + 50% of penalty Duplicate License 50% of state fee Page 8 of 87 MDCH/G&PD FY 13/14 ATTACHMENT III8/1/13 Payment will be made for those body art facilities that have applied and paid in full to the State after the signing of PA 375 (December 22,2010), following notification of a completed inspection and recommendation for issuance of license. Local Entity Requirements The Local Entity is authorized to enforce PA 375 and conduct an inspection of all body art facilities under its jurisdiction, investigate complaints, and enforce licensing regulations and requirements. The Local Entity must complete a Body Art Facility Inspection Report [DCH-1468 {07-09)3, as provided by the State, or other report form approved by the State that meets, at minimum, all standards of the state inspection report. Only body art facilities that have applied for licensure should be inspected. All body art facilities must be inspected annually. Licenses will only be released from the State following notification of a completed inspection and upon recommendation by the Local Entity. Completed inspection reports should be signed by the facility owner and recommendation for licensure should be forwarded to the State within two to four weeks following the inspection. Reports should be entered via the online interface or can be sent to: HIV/STD/VH/TB Epidemiology Section, Division of Communicable Diseases, 201 Townsend Rd, 5th Floor, Lansing, Michigan 48913. The contact person is Mr. Michael Kucab, who can be reached at 517-335-8168 or by e-mail at kucabm@michiaan.aov. State Requirements The State will notify the local entity by email when an applicant has paid for licensure or renewal. This will serve as the request to the Local Entity to perform an inspection. The State will issue a license to an applicant upon the recommendation of the Local Entity performing the inspection. The State will reimburse the Local Entity according to this payment schedule to help offset the costs related to the licensing of the body art facility. Payments will be released quarterly based on the FSR submitted. The State will provide a reporting template to be attached to the FSR. BIOTERRORISM REGIONAL EPIDEMIOLOGY SUPPORT SPECIAL EQUIREMENTS Regional Epidemiology Support 1. For those local health departments receiving additional funds to provide workspace for Regional Epidemiologists, the contractor must provide adequate office space, telephone connections, and high-speed Internet access. The position must also have access to fax and photocopiers. 2. These funds must be tracked separately from the Base Bioterrorism funding and not included within that budget. BREAST AND CERVICAL CANCER CONTROL PROGRAM fBCCCP) SPECIAL REQUIREMENTS Contractor Reguirements The BCCCP (Breast and Cervical Cancer Control Program) is a program designed to provide comprehensive breast and cervical cancer screening and diagnostic services to low-income women between the ages of 40-64. Although the BCCCP serves all income eligible women between the ages of 40-64, recruitment efforts are focused on hard to reach populations, such as minorities, particularly African American and Native American women, and women aged 50-64, as well as women who have never before been screened for either breast of cervical cancer. For specific BCCCP requirements, refer to the most current BCCCP Policies and Procedures Manual. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 9 of 87 CENTRALIZED ACCESS HOME VISITING HUB SPECIAL REQUIREMENTS(GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT AND ST. CLAIR COUNTY HEALTH DEPARTMENT Purpose: To carry out the activities outlined in the agency's Home Visiting Hub Work Plan, as developed and submitted to the Michigan Department of Community Health (MDCH). Funding Requirements: This funding MUST be used to carry out the specific activities outline in each agency's respective Home Visiting Hub Work Plan, for the purposes of working toward the establishment of a Home Visiting Hub within each community. Any changes to the approved work plan, or associated budget, must have MDCH approval. These funds should be fully expended by September 30, 2014 and there will be no opportunity for carryover of the funds beyond that date. CHILDREN'S SPECIAL HEALTH CARE SERVICES fCSHCS) SPECIAL REQUIREMENTS Program Management: 1. Reporting Requirements A. The contractor shall submit: i. Annual Narrative Progress Report 1. A brief annual narrative report is due by November 15 following the end of the fiscal year. The reporting period is October 1, 2013 — September 30, 2014. The annual report will be submitted to the Department and shall include: a. Summary of CSHCS successes and challenges b. Technical assistance needs the LHD is requesting the State to address c. Brief description of how any local MCH funds allocated to CSHCS were used (e.g., CSHCS salaries, outreach materials, mailing costs, etc.) (if applicable) d. The duplicated number of clients referred for diagnostic evaluations e. The unduplicated number of CSHCS eligible clients assisted with CSHCS enrollment f. The unduplicated number of CSHCS clients in the CSHCS renewal process. Duplicated Number of Clients Referred for Diagnostic Evaluation is defined as: Number of individuals the local health department (LHD) referred for and/or assisted in obtaining a diagnostic evaluations during the fiscal year. Those eligible for this service must have symptoms and medical history indicating the information. Individuals currently enrolled in a commercial Health Maintenance Organization (HMO), Medicaid Health Plan (MHP) or with other commercial insurance coverage must seek an evaluation by an appropriate physician sub-specialist through their respective health insurer. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 10 of 87 A diagnostic may be issued for insured persons to cover the cost of the evaluation that is by policy not covered by the health insurance (e.g. co-pay, deductible). Undupiicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment is defined as: Number of CSHCS eligible clients the LHD assisted in the CSHCS enrollment process during the fiscal year. This assistance includes but is not limited to helping the family obtain necessary medical reports to determine clinical eligibility, completing the CSHCS Application for Services, completing the CSHCS financial assessment forms, etc. "Assisted" refers to help provided either over the telephone or in person with the client. Undupiicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process is defined as: Number of CSHCS enroilees the LHD assisted in the completion and/or submission of the documents required for MDCH to make a determination whether to continue/renew CSHCS coverage during the fiscal year. "Assisted" refers to help provided either over the telephone or in person with the client. ii. Quarterly Care Coordination and Case Management Logs 1. Submit the Care Coordination and Case Management Logs electronically in an encrypted manner to the Contract Manager. The quarterly logs will be submitted in coordination with the FSRs no later than thirty (30) days after the close of the quarter. Reporting Time Period Quarterly Logs Due October 1, 2013 - December 31, 2013 January 30, 2014 January 1, 2014- March 31, 2014 April 30, 2014 April 1, 2014 - June 30, 2014 July30,2014 July 1, 2014-September30, 2014 October30, 2014 B. Unless otherwise stated, all reports and information shall be submitted electronically or via US mail to: Courtney Lawler Quality and Program Services Section Children's Special Health Care Services Michigan Department of Community Health Lewis Cass Building, 6th Floor 320 S. Walnut Lansing, Michigan 48933 Phone: (517) 241-7182 Fax: (517) 241-8970 C. The Contract Manager shall evaluate the reports submitted as described in A above, for their completeness and adequacy. The Contract Manager will conduct case management and care coordination log audits on a quarterly basis. Relationship between Local Public Health Departments and Medicaid Health Plans: The Local Health Department (LHD) must enter into agreements with all Medicaid Health Plans for CSHCS enroilees in the LHD service area. Local Health Departments and the Contractor may share enrollee information to facilitate coordination of care without specific, signed authorization from the enrollee. The enrollee has given consent to share information for purposes of payment, treatment and operations as part of the Medicaid Beneficiary Application. The agreement must address all of the following topics: • Data sharing • Communication on development of Care Coordination Plan MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 11 of 87 • Reporting requirements « Quality assurance coordination « Grievance and appeal resolution ® Dispute resolution • Transition planning for youth The agreement shall be in place by January 1, 2014 and will take effect for FY14. A copy of the agreements should be sent to: CSHCS Attn: Orlene Christie Lewis Cass Building 320 S. Walnut Street 6th Floor Lansing, Michigan 48913 EAT SAFE FISH SPECIAL REQUIREMENTS(BAY COUNTY HEALTH DEPARTMENT) For the project period of October 1, 2013 to September 30, 2014, the Bay County Health Department will collaborate with the Department of Community Health and the EPA Region V Saginaw Community Information Office to deliver a uniform message for the Saginaw River and connected waters regarding the fish and wild game consumption advisories within their jurisdictions. Bay County Health Department (BCHD) will develop a plan to distribute that message using existing health department programs, the medical community, special events, and community service providers to communicate with the at-risk population. BCHD will get approval from MDCH program manager and for any changes to the Saginaw and Bay County Cooperative Agreement Scope of Work including budget and budget narratives. Contractor Requirements: The Bay County Health Department (BCHD) will provide appropriate staff to fulfill the following objectives and outputs as detailed below. 1) Comply with the Saginaw and Bay County Cooperative Agreement budget and budget narratives as describe in the scopes of work provided to the BCHD program manager as applicable from 10/1/2013 to 9/30/2014. 2) Provide 30 hours of health education and community outreach per week. A. Conduct health education and community outreach in Saginaw, Midland, and Bay Counties. Activities will include, but not be limited to, internal BCHD distribution, health care provider outreach, and key event participation. B. Track hours to comply with cost recovery requirements. 3) Development, Printing, and Distribution of Outreach Materials and implementation of Display Booth A. Identify, track, and record of materials distributed at additional locations within Midland, Bay, and Saginaw Counties. B. Make payment for the replacement of signage on the Tittabawasse and Saginaw Rivers. 4) Conduct Capacity Building in Saginaw, Midland and Bay Counties A. Actively seek out new community partners in Saginaw, Midland and Bay Counties. 5) Participate in monthly SBCA teleconference. 6) Track and report output measures. 7) Write and Submit quarterly reports and an annual report to MDCH. A. Submit draft quarterly reports within 15 days after the end of each quarter. B. Annual reports upon request. MDCH/G&PD FY 13/148/1/13 ATTACHMENT ill Page 12 of 87 8) Provide Presentation of display booth at select community events in coordination with EPA Region V Saginaw Community Information Office. 9) Conduct Outreach though existing BCHD Programs such as WIC, Immunizations, programs for young mothers, or other programs reaching the target population. 10) Assist the EPA Region V Saginaw Community Information Office with community outreach. 11) Outreach to Health Care Providers. ESSENTIAL LOCAL PUBLIC HEALTH SERVICES fELPHS) SPECIAL REQUIREMENTS Budget and Agreement Requirements 1. State funding for ELPHS shall support and the agency shall provide for all of the following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act No. 336, of 1998 Section 909. Drinking Water Supply Immunization Food Service Sanitation On-Site Sewage Treatment Management Infectious/Communicable Disease Control Sexually Transmitted Disease Hearing Vision State funding for ELPHS can support administrative cost for the eight required services including allowable indirect cost, or an agency's cost allocation plan. 2. ELPHS funding can also be used to fund other core health functions including: Community Health Assessment & Improvement, Public Policy Development, Health Services Administration, Quality Assurance, Creating & Maintaining a Competent Work Force and Local Public Health Accreditation. These services may be budgeted separately as part of the Administrative Budget element. 3. Net allowable expenditures are the authorized actual/allowable expenditures (total costs less specified exclusions). Available funding is also limited by state appropriations. 4. First and second party fees earned in each required service program may be used only in that required service program. 5. State ELPHS funding is subject to local maintenance of effort compliance distribution of state ELPHS funds shall only be made to agencies with total local general fund public health services spending in FY 13/14 of at least the amount expended in FY 92/93. To be eligible for any of the State funding increases from FY 94/95 through FY 13/14, the FY 92/93 Local Maintenance of Effort Level must be met. 6. A final statewide cost settlement will be performed to assure that all available ELPHS funds are fully distributed and applied for required services. Contractor Reguirements 1. Assure the availability and accessibility of services for the following basic health services: Prenatal Care; Immunizations; Communicable Disease Control; STD Disease Control; Tuberculosis Control; Health/Medical Annex of Emergency Preparedness Plan. 2. Fully comply with the Minimum Program Requirements for each of the required services. 3. Contractor will be held to accreditation standards and follow the accreditation process and schedule established by the Department for the required services to achieve full accreditation status. Agencies designated as "not accredited" may have their Department allocations reduced for Departmental costs incurred in the assurance of service delivery. The accreditation process is based upon the Minimum Program Standards and scheduled on a three-year cycle. The Minimum Program Standards include the majority of the required Department reviews. Some additional reviews, as mandated by the funding agency, may not be included in the Program Standards and may need to be scheduled at other timesA MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 13 of 87 Department Requirements 1. Whenever the Department delivers direct services within the Contractor's area, it shall give prior notification and provide summary reports of those activities upon the request of the local health officer. Contractor Specific Requirements - Food Service Sanitation Budget and Agreement Requirements MDA Agrees to: Food Service Establishment Licensing 1. Furnish pre-printed food service establishment license applications and pre-printed licenses to the local health department for each licensing year (May 1 through April 30) using previous year active license data. 2. Provide a count of ail licenses sent to the local health department titled "Record of Licenses Received." 3. Reprint any licenses requiring correction and send corrected copies to the local health department. 4. Bill the local health department for state fees_upon notification by the local health department that the license has been approved and issued. Temporary Food Service Establishment Licensing 1. Furnish blank temporary food service license application forms (forms FI-231, FI-231 A) and blank Combined License/Inspection forms (Fl-229) upon request from the local health department. A. Furnish a "Record of Licenses Received" with each order of Combined Licenses/Inspection forms. B. Periodically reconcile temporary food service establishment licenses sent to the local health department with the licenses that have been issued (copy returned to MDA). C. Bill the local health department for state fees upon notification by the local health department that the license has been approved and issued. Contractor Reguirements The local health department agrees to: Food Service Establishment Licensing 1. Accept responsibility for all licenses specified in the "Record of Licenses Received." 2. Issue licenses in accordance with the Michigan Food Law 2000, as amended. 3. Provide updates to MDA on the 1st and 15th of each month, as necessary to: A. Provide a list of food service establishments approved for licensure/license issued. B. Provide a list of food service establishment licenses that have not been approved for licensure and are considered voided or deleted. C. Return the actual licenses to MDA that are to be voided or deleted. D. Return renewal license applications and licenses that require correction. Mark the corrections on the renewal application. Temporary Food Establishment Licensing 1. Upon receipt, sign and return the "Record of Licenses Received" to MDA. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 14 of 87 2. Issue licenses in accordance with the Michigan Food Law 2000, as amended. 3. Make every effort to issue temporary food establishment licenses in numerical order. 4. Provide updates to MDAon the 1st and 15th of each month, as necessary, to provide: A. A copy of each temporary food establishment license issued. B. A list of lost or voided licenses by license number. Contractor Specific Requirements - Private and Type 111 Drinking Water Supply Requirements The local health department shall perform the following services including but not limited to: 1. Perform water well permitting activities, pre-driliing site reviews and water supply system inspections for code compliance purposes with qualified individuals classified as sanitarians or equivalent. 2. Assign one individual to be responsible for quarterly reporting of the data and to coordinate communication with the assigned State staff. Reports shall be submitted no later than fifteen (15) days following the end of the quarter on forms provided by the State. The report form EQP 2057(3) is available on the MDEQ website. All quarterly reports are submitted directly to the MDEQ address noted on the form. 3. Perform the activities described in items 5 through 8 of the attached Minimum Program Requirements (MPRs), Drinking Water Supply, dated October 1,1996, the associated performance indicators, and use the "Guidance Manual for the Private and Type III Drinking Water Supply Program," October 2002,1/2007, as furnished by the State to implement the MPR provisions. The guidance manual is available online at www.michiqan.aov/documents/dea/deQ-wb-dwehs-wcu- auidancemanual 221342 7.pdf Contractor Specific Requirements - Private On-Site Sewage Treatment Management Program Requirements The local health department shall perform the following services for private single- and two-family homes and other establishments that generate less than 10,000 gallons per day of sanitary sewage: 1. Maintain an up-to-date regulation for on-site sewage treatment and disposal systems (Systems). The regulation shall be supplemented by established internal policies and procedures. Technical guidance for staff that defines site suitability requirements, the basis for permit approval and/or denial, and issues not specifically addressed by the regulation shall be provided. 2. Evaluate all parcels to determine the suitability of the site for the installation of initial and replacement Systems in accordance with applicable regulation(s). These evaluations shall be conducted by a trained sanitarian or equivalent and shall consist of a review of the permit application for the installation of a System and a physical evaluation of the site to determine suitability. 3. Accurately record on the permit to install the initial or replacement System or on an attachment to the permit the site conditions for each parcel evaluated including soil profile data, seasonal high water table, topography, isolation distances, and the available area and location for initial and replacement Systems. The requirement for identifying a replacement System applies to issuance of new construction permits only. 4. Issue a permit, prior to construction, in accord with applicable regulation(s) for those sites that meet the criteria for the installation of a System. The permit shall include a detailed plan and/or specifications that accurately define the location of the initial or replacement System, System size, other pertinent construction details, and any documented variances. 5. Provide and keep on file formal written denials, stating the reason for denial, for those applications where site conditions are found to be unsuitable. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 15 of 87 6. Conduct a construction inspection prior to covering each System to confirm that the completed System complies with the requirements of the permit that has been issued. Maintain, on file, an accurate individual record of each inspection conducted during construction of each system. In limited circumstances where constraints prohibit staff from completing the required construction inspection in a timely manner, an effective alternate method to confirm the adequacy of the completed System shall be established. The effective alternative method shall be utilized for no more than 10 percent of the total number of final inspections unless specific authorization has been granted by the State for other percentage. The results of all such inspections or an alternate method shall be clearly documented. 7. Maintain an organized filing system with retrievable information that includes documentation regarding all site evaluations, permits issued or denied, final inspection documentation, and the results of any appeals. 8. Conduct review and approval or rejection of proposed subdivisions, site condominiums and also land divisions under one acre in size for site suitability according to the statutes and Administrative Rules of the Michigan Department of Environmental Quality (DEQ). 9. Utilize the State's "Michigan Criteria for Subsurface Sewage Disposal" (Criteria) for Systems other than private single- and two-family homes that generate less than 10,000 gallons per day. Systems treating less than 1,000 gallons per day may be approved in accordance with the Local Entity's regulation. Advise the State prior to issuance of a variance from the Criteria. Variances are only to be issued by the Director of Environmental Health of the Local Entity after consultation with the State. Appeals of any decision of the Local Entity pursuant to the Criteria including systems treating less than 1000 gallons evaluated in accordance with the Local Entity's regulation shall only be made to the State. 10. Maintain quarterly reports that summarize the total number of parcels evaluated, permits issued, alternative or engineered plans reviewed, and number of appeals, number of inspections during construction, number of failed systems evaluated, and number of sewage complaints received and investigated. The report form EQP 2057a is available on the DEQ website. All quarterly reports are to be submitted directly to DEQ to the address noted on the form within 15 days following the end of each quarter to the address noted on the form. 11. Review all engineered or alternative System plans. Conduct adequate inspections during the various phases of construction to ensure proper installation. 12. Collect data at the time of permit issuance when a System has failed to document the System age, design, site conditions, and other pertinent factors that may have contributed to the failure of the original System. Evaluations shall record information indicated on the DEQ Residential and Non- Residential Failed System Data Collection forms. The results for all failed Systems evaluated shall be maintained in a retrievable file or database and summarized in an annual calendar year data report. Annual summaries of failed system data shall be provided to the DEQ for input into the state-wide failed system database. DEQ Failed System Data Submission Forms (Non Residential and Residential) shall be provided to the State no later than February 1 st of the year following the calendar year for which the data has been collected. 13. Provide training for staff involved in the Program as necessary to maintain knowledge of current regulations and internal policies and procedures and to keep staff informed of technological improvements and advancements in Systems. 14. Establish and maintain an enforcement process that is utilized to resolve violations of the Local Entity and/or State's rules and regulations. 15. Maintain complaint forms and a filing system containing results of complaint investigations and documentation of final resolution. Investigate and respond to all complaints related to Systems in a timely manner. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 16 of 87 FAMILY PLANNING/BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCCP) JOINT PROJECT SPECIAL REQUIREMENTS Contractor Requirements The FP/BCCCP Demonstration Project is a joint program between Family Planning and BCCCP designed to provide diagnostic services to Title X (Family Planning) clients who have Pap tests indicating possible cervical cancer. Extensive data is required by the Center for Disease Control and Prevention (CDC) for each woman served by federal funds. Dates of service and results of testing are required prior to authorizing reimbursement to providers. Therefore, data about the abnormal Pap smear will have to be transmitted from the Family Planning program to the designated BCCCP agency prior to arranging diagnostic services. 1. Women eligible for this program will be Title X clients, be uninsured or underinsured, and with income under 250% of poverty. A Family Planning client meeting these eligibility criteria will sign a release form to allow her data to be provided to the BCCCP. Forms will be provided to the Family Planning agencies for recording data required for referral to a BCCCP agency. All data required for enrollment in the BCCCP will be collected by the BCCCP agency. 2. Each delegate agencies must serve a minimum of 95% of proposed Title X users to access its total amount of allocated funds. In addition, each delegate agency must work with the Department to jointly establish and achieve a minimum target for Plan First! caseload enrollment. Quarterly FPAR data will be used to determine total Title X users and Plan First! enrollees. 3. Dates and results of all diagnostic procedures must be recorded in the Michigan Breast and Cervical Cancer Information System (MBCIS) by the BCCCP agency before reimbursement can be approved. 4. The data must indicate the outcome of testing with a final diagnosis of cancer/not cancer and, if cancer, the stage and date of treatment initiation, as well as the type of treatment. It is expected that there will be extensive communication between the referring Title X agency and the BCCCP agency managing the diagnostic process, so that the woman will proceed seamlessly through the medical system(s). 5. The BCCCP agency must provide results of diagnostic evaluation to the referring Family Planning agency upon request, and upon completion of the diagnostic process. 6. If cancer is diagnosed the woman will have access to the BCCCP treatment network, and the BCCCP agency must make every effort to ensure the woman receives proper treatment. Women diagnosed with cervical cancer or pre-cancer (CIN 2) in the FP/BCCCP Joint Project are eligible to apply for Medicaid to pay for treatment. FAMILY PLANNING - PREGNANCY PREVENTION SPECIAL REQUIREMENTS Contractor Requirements 1. The funds appropriated in the current State Public Health Appropriations Act for pregnancy prevention programs shall not be used to provide abortion counseling, referrals or services, unless contradicts Title X Federal Law (Title X of the Public Health Service Act). 2. Each delegate agencies must serve a minimum of 95% of proposed Title X users, to access its total amount of allocated funds. In addition, each delegate agency must work with the Department to jointly establish and achieve a minimum target for Plan First! caseload enrollment. Biannual FPAR data will be used to determine total Title X users and Plan First! enrollees. 3. Title X Family Planning agencies must collect Medicaid and Plan First! User data. The information must be reported on the Michigan Table 15, as provided by program, and must be submitted MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 17 of 87 biannually along with Family Planning Annual Report (FPAR) in an electronic reporting format as prescribed by the Department. Reporting Requirements The contractor shall submit Family Planning Annual Reports (FPAR): Period covered Due to MDCH Mid-Year Report (Jan.-June) July 15, 2014 Annual Report (Jan-Dec) January 10, 2014 FDA TOBACCO RETAILER (A&U INSPECTIONS SPECIAL REQUIREMENTS (CITY OF DETROIT HEALTH AND WELLNESS, DISTRICT HEALTH DEPARTMENT #4, GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, JACKSONCOUNTY HEALTH DEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT, MIDLAND COUNTY HEALTH DEPARTMENT, MONROE COUNTY HEALTH DEPARTMENT,WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT, WAYNE COUNTY HEALTHDEPARTMENT) 1. One local health department staff person to be commissioned by FDA to carry out FDA Advertising and Labeling Inspections and related activities. 2. Participate in all FDA Program Training, annual refresher training/courses and other related MDCH/FDA meetings and site visits. 3. Conduct and document the agreed upon number of routine, compliance and complaint follow-up Advertising and Labeling Inspections, including all follow-up activities, utilizing FDA report forms and protocol. 4. Provide written affidavits and/or in-person testimony for FDA-specified A&L Tobacco Control Act violations upon request. 5. On a daily basis (i.e., when conducting FDA-related activities), provide documentation of all FDA activities by utilizing either the MDCH Activity Log or other similar form. 6. Submit quarterly and year-end reports to MDCH utilizing the template provided. Quarterly report due dates: 11/30/13,2/28/2014, 5/28/14, and 8/15/14. The August 15,2014 report will serve as a quarterly/year-end report. FDA TOBACCO RETAILER (A&L) INSPECTIONS SPECIAL REQUIREMENTS(OAKLAND COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES/HEALTH DIVISION) 1. One local health department staff person to be commissioned by FDA to carry out FDA Advertising and Labeling Inspections and related activities. 2. Participate in all FDA Program Training, annual refresher training/courses and other related MDCH/FDA meetings and site visits. 3. Conduct and document up to 123 new Routine Compliance Inspections as assigned through the FDA TIMS system, as well as complete all follow-up activities utilizing FDA report forms and protocol. 4. Conduct and document assigned Compliance Follow-up, Complaint Follow-up and Recheck Inspections as assigned through the FDA TIMS system, as well as complete all follow-up activities utilizing FDA report forms and protocol. 5. Provide written affidavits and/or in-person testimony for FDA-specified A&L Tobacco Control Act violations upon request. 6. Submit quarterly and year-end reports to MDCH utilizing the template provided. Quarterly report due dates: 11/30/13, 2/28/2014, 5/28/14, and 8/15/14. The August 15,2014 report will serve as a quarterly/year-end report. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 18 of 87 FDA TOBACCO RETAILER (A&U INSPECTIONS SPECIAL REQUIREMENTS(CITY OF DETROIT HEALTH AND WELLNESS) 1. One staff person to be commissioned by FDA to carry out FDA Advertising and Labeling Inspections and related activities. 2. Agency will subcontract with up to three additional commissioned FDA Inspectors to conduct inspections on an as-needed basis statewide. 3. Participate in all FDA Program Training, annual refresher training/courses and other related MDCH/FDA meetings and site visits. 4. Conduct and document up to 120 new Routine Compliance Inspections, as assigned through the FDA TIMS system, as well as complete all Recheck and Compliance Follow-up Inspections utilizing FDA report forms and protocol. 5. Provide written affidavits and/or in-person testimony for FDA-specified A&L Tobacco Control Act violations upon request. 6. Submit quarterly and year-end reports to MDCH utilizing the template provided. Quarterly report due dates: 5/28/2014 and 8/15/14. The August 15, 2014 report will serve as a quarterly/year-end report. FETAL ALCOHOL SPECTRUM DISORDER PROJECTS - SPECIAL REQUIREMENTS(CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT AND PUBLIC HEALTH, DELTA-MENOMINEE COUNTIES) Objective: For the project period of October 1, 2013 to September 30, 2014, the Delta-Menominee and Central Michigan County Health Departments will collaborate with the Department of Community Health to to assist local communities with evidence-based activities identified in the FASD Interagency Strategic Plan, 2012-2014 to prevent prenatal alcohol exposure among women of reproductive age and to refer affected children, birth to 18 years of age, and their families to an FASD Diagnostic Center for evaluation and intervention for the purpose of improving care and services for women, infants and families. Contractor Requirements 1. FASD project coordinator (or designee) must participate/attend semi-annual FASD Grantees Conference Calls provided by the department during FY 2014. 2. Implement the FASD Interagency Strategic Plan, 2012-2014 activities as approved by the department. 3. Produce quarterly and year-end reports using the Uniform Data collection Tool (UDCT) form provided by the department that provides documentation of the types, numbers and demographic data including racial data of contacts for screening, motivational interviews and/or referrals from the grantee's FASD community based program. The UDCT from is available at www.michiqan.aov/fas FASD UDCT quarterly reports are to be submitted via EGRAMS attached to the FSR. The 4th quarter report, due 10/15/14, will serve as the year-end report. Department Requirements 1. Convene FASD Grantees semi-annual conference calls during FY 2014 to discuss progress toward community project goals outlined in the cooperative agreement and provide technical assistance questions/answers as outlined in the cooperative agreement. 2. Describe and provide resources and updates for the evidence-based interventions required by this contract. 3. Provide technical assistance for each requirement of this contract. 4. Provide reporting formats for data collection and deliverables. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 19 of 87 Reporting Requirements 1. Deliverables are due QUARTERLY and a YEAR-END REPORT will summarize the results of the contract year. The Contractor shall submit the following reports within 15 days after the end of each quarter on the following dates: Quarter End Date Report Due Date 1st Qtr (12/31/13) 01/15/142nd Qtr (03/31/14) 04/15/143rd Qtr (06/30/14) 07/15/144th Qtr (09/30/14)10/15/14 2. The Contractor will collect data using the Uniform Data Collection Tool (UDCT) project evaluation/data tracking forms to monitor the FASD community program effectiveness. The Uniform Data Collection Tool (UDCT) is available at www.michiqan.qov/fas 3. The Contractor shall submit the following information electronically to MDCH FASD Program : via EGrams attached to FSR A. The Contractor must provide documentation that FASD services are tracked for ail individuals referred through the FASD community project program and shall submit a UDCT Data Tracking Form to be sent at the end of each quarter. Submit quarterly & year-end reports via EGrams attached to FSR Program Contact Information: Debra Kimball, FASD State Program Coordinator Division of Family and Community Health Michigan Department of Community Health Kimballdl @michigan,gov P.O. Box 30195 Lansing, Ml 48909 Phone (517)335-8379 Fax (517)335-8822 FETAL AND INFANT MORTALITY REVIEW (FIMR) CASE ABSTRACTIONS SPECIAL REQUIREMENTS(ALLEGAN COUNTY HEALTH DEPARTMENT, BENZIE-LEELANAU DISTRICT HEALTH DEPARTMENT, BERRIEN COUNTY HEALTH DEPARTMENT, CALHOUN COUNTY HEALTH DEPARTMENT, CITY OF DETROIT HEALTH AND WELLNESS, GENESEE COUNTY HEALTH DEPARTMENT, JACKSON COUNTY HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTHDEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT, MUSKEGON COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY HEALTH DEPARTMENT, SAGINAW COUNTY HEALTHDEPARTMENT) Contractor Requirements Objective: To assist local communities to learn from individual cases of fetal and infant death what are factors contributing to poor pregnancy outcome in their community, for the purpose of improving care and sen/ices for women, infants and families. Key Activities: Qualified individuals will perform medical record case abstraction for Fetal Infant Mortality Review to include the following: 1. Review of medical records involved in fetal and infant death to include but not limited to hospital records, pre-natal records, pediatric records, emergency and medical examiner's record. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 20 of 87 2. Interact with other agencies and service providers involved in infant's death (Ml Department of Human Services, Child Protective Services, (oca! health department, law enforcement). 3. Develop case summaries from the above abstracted information as well as the Home Interview, using Michigan FIMR Network tools and guidelines 4. Attend the review team meetings to facilitate the presentation of the cases. 5. Entry of cases into access data base and submission of cases to MPHi for MFIMR data base Department Requirements Each completed case abstraction will be compensated at $270.00 per case. Department will provide ongoing technical assistance to local FIMR teams for medical record case abstraction, developing case summaries, maintaining a functioning Case Review Team, and facilitate moving recommendations to community action. Department provides the statewide FIMR database, administered through MPHI. Reporting Requirements Quarterly progress reports following the template supplied by the FIMR State support program. Quarterly reports are due 1/15, 4/15, 7/15, and 9/15, and are submitted to State coordinator. End of FY final report on cases completed and team findings are submitted to State coordinator. HIV SCREENING IN DENTAL CLINIC SPECIAL REQUIREMENTS(DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION) Purpose: The purpose of this agreement is to support HIV screening for clients receiving dental care services. Program development, implementation and evaluation will be delivered according to the methods, time line, work plan, budget and staffing plan approved by HIV/AIDS Prevention and Intervention Services(HAPIS). Contractor Requirements: 1. Adhere to ail federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. 2. Adhere to all federal and HIV/AIDS Prevention and Intervention Services (HAPIS) issued guidance and policy for services provided. 3. Develop, in consultation with HAPIS, and implement an annual work plan that describes the objectives, activities and measures for work to be performed under this contract. It will include the planned achievement of quality or performance indicators and anticipated numbers of clients and services provided for each funded service, if outreach services are provided, it will describe how the purpose goes beyond HIV prevention education to include testing and early entry into care. The work plan will be submitted in EGrAMS. 4. Develop and implement a Quality Management plan. The quality management plan will be submitted to the Grants and Contracts Administrator. 5. Participate in monitoring site visits including review of fiscal and programmatic compliance with HAPIS policies and contract requirements. 6. Ensure that records are available for review by MDCH auditors, staff and federal government agencies, if applicable, to monitor performance. Maintain and provide access to primary source documentation. MDCH/G&PD FY 13/148/1/13 ATTACHMENT IN Page 21 of 87 7. Contractors may enter into subcontracts or vendor agreements to fulfill the service delivery expectations of this agreement. A. All subcontracts issued under this funding agreement are subject to the same requirements as outlined in this agreement and subject to prior approval by HAPIS. B. The Contractor will monitor subcontractors annually to assess compliance with the subcontract; take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract; report the results of all contract monitoring activities to HAPIS. C. Provide one copy of all fully signed subcontracts, memorandums of understanding (MOUs) or letters of agreement related to the services in this agreement to HAPIS by October 15, 2013 or within 30 days of execution. 8. Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or Client Level Data program; c) use of virus protection software to guard against computer viruses; and d) provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDCH policies concerning Sharing and Secured Electronic Data. 9. The following language must be included in all Client Consent and Release of Information forms used for services in this agreement. "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same data network." 10. Client and service level data is the property of HAPIS. In the event that services are no longer delivered under this agreement, electronic data files held outside of the central CAREWare and/or HES database must be returned to HAPIS within 30 days of the loss of services. 11. Provide immediate notification to HAPIS, in writing, in the event of any of the following: A. Any formal grievance initiated by a sen/ice recipient and subsequent resolution of that grievance. B. Any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. C. Staff vacancies that negatively impact the delivery of services to clients. 12. Assess client or participant satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. Establish and maintain a mechanism to obtain input about needed services from infected and affected persons. Use results from these assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. 13. Adhere to Culturally and Linguistically Appropriate Service (CLAS) Standards. Standards and Practices must address sexual minorities. 14. Submit all educational materials (e.g., brochures, posters, pamphlets and videos) used in conjunction with program activities to the HAPIS Program Review Panel for review and approval prior to their use, regardless of the source of funding used to purchase these materials. 15. Submit preliminary agendas to HAPIS for review and approval, for conferences, trainings, workshops and similar activities supported wholly or in part under this agreement. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 22 of 87 16. Submit program manuals, intervention curricula, training curricula, service protocol and procedures, and similar documents to HAPIS for review and approval prior to publication and use if development and implementation is supported wholly or in part under this agreement or if such documents are to be used in conjunction with activities supported under this agreement. 17. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) The dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 18. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 19 Assist HAPIS in appropriate needs assessment activities. 20. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 21. Financial Status Reports (FSR) must be submitted quarterly in EGrAMS, no later than 30 days after the end of the period. Contractor Specific Requirements: 1. Routinely recommend to all clients receiving dental care services HIV testing. 2. Develop, implement and maintain protocol and procedures necessary to implement services responsive to the intent of the funding made available through this agreement. Protocol and procedures must be reviewed periodically and approved by HAPIS. 3. Comply with guidelines and standards issued by the MDCH and: a. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised, are to be submitted to HAPIS. Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDCH (October 2008, or subsequent revisions). b. Enroll and participate in the Model Performance Evaluation Program (MPEP), CDC's externa! proficiency testing program. c. Submit a photocopy of the local health department's current CLIA certificate to HAPIS. d. Report anomalous test results to the HAPIS pursuant to established protocol. e. Submit quality control, daily patient logs and test inventory on a monthly basis. f. Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course (if applicable), test device training, and proficiency testing. g. Ensure that site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training. h. Develop, implement and monitor protocol and procedures to ensure that patients receive MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 23 of 87 confirmatory test results. 4. The contractor and its subcontractors are required to use the HRSA-supported software HES to enter client and service data into the centrally managed database on a secure server. Data must include all clients who receive any Part B eligible service (regardless of the source of funding for the services) and all Part B eligible services delivered to HIV-infected or affected clients. The collection of all required data variables and the clean-up of any missing data or service activities should be completed in HES no later than the 15th day after the end of each calendar quarter. 5. A Semi-annual and Annual Progress Report will be required. Submit program Progress Reports in accordance with the following dates: Period Covered Due to HAPIS October 1,2013-March 31, 2014 April 21,2014 April 1 — September 30, 2014 October 20, 2014 The report, to be submitted in EGrAMS, will include: A. The status of current performance indicators. B. Other performance measures negotiated between the Contractor and HAPIS An additional narrative report will be submitted as an attachment to EGrAMS and will include: A. A summary of successes and challenges during the period. B. Plans to address over- or under-spending and program performance issues, if any. C. Brief update on Quality Management plan. D. Summary of customer satisfaction and changes made as a result (Annual Report only). HAPIS Requirements 1. The Department will provide rapid HIV test devices and external controls in sufficient quantity to ensure that HIV testing is provided as a standard of care to clients seeking STD prevention and treatment services (formerly known as the "Expanded HIV Testing in High Prevalence Health Care Settings to Address Racial/Ethnic Disparities in Access to Testing Services") and to facilitate staff training and proficiency testing. 2. Provide training and technical assistance in support of implementation of HIV testing as a standard of care and use of rapid HIV tests. 3. HAPIS will provide training on HES, CLAS, EGrAMS and other issues related to Prevention services. 4. HAPIS will conduct a site visit, including both fiscal and programmatic review, at least annually. HAPIS will provide 30 days written notice of the site visit, including an agenda and the assessment tool. 5. HAPIS will review Semi-annual and Annual reports. Questions or clarifications, if any, will be requested within 30 calendar days of submission date. HIV/STD PARTNER SERVICES PROGRAM SPECIAL REQUIREMENTS(CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT) Contractor Requirements 1. Adhere to all federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 24 of 87 2. Adhere to all federal and HIV/AIDS Prevention and Intervention Services (HAPIS) issued guidance and policy for services provided. 3. Develop, in consultation with HAPIS, and implement an annual work plan that describes the objectives, activities and measures for work to be performed under this contract. It will include the planned achievement of quality or performance indicators and anticipated numbers of clients and services provided for each funded service. If outreach services are provided, it will describe how the purpose goes beyond HIV prevention education to include testing and early entry into care. The work plan will be submitted in EGrAMS. 4. Develop and implement a Quality Management plan. The quality management plan will be submitted to the Grants and Contracts Administrator. 5. Participate in monitoring site visits including review of fiscal and programmatic compliance with HAPIS policies and contract requirements. 6. Ensure that records are available for review by MDCH auditors, staff and federal government agencies, if applicable, to monitor performance. Maintain and provide access to primary source documentation. 7. Contractors may enter into subcontracts or vendor agreements to fulfill the service delivery expectations of this agreement. A. All subcontracts issued under this funding agreement are subject to the same requirements as outlined in this agreement and subject to prior approval by HAPIS. B. The Contractor will monitor subcontractors annually to assess compliance with the subcontract; take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract; report the results of all contract monitoring activities to HAPIS. C. Provide one copy of all fully signed subcontracts, memorandums of understanding (MOUs) or letters of agreement related to the services in this agreement to HAPIS by October 15, 2013 or within 30 days of execution. 8. Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or Client Level Data program; c) use of virus protection software to guard against computer viruses; and d) provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDCH policies concerning Sharing and Secured Electronic Data. 9. The following language must be included in all Client Consent and Release of Information forms used for services in this agreement. "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same data network." 10. Client and service level data is the property of HAPIS. In the event that services are no longer delivered under this agreement, electronic data files held outside of the central CAREWare and/or HES database must be returned to HAPIS within 30 days of the loss of services. 11. Provide immediate notification to HAPIS, in writing, in the event of any of the following: A. Any formal grievance initiated by a service recipient and subsequent resolution of that grievance. B. Any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 25 of 87 action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. C. Staff vacancies that negatively impact the delivery of services to clients. 12. Assess client or participant satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. Establish and maintain a mechanism to obtain input about needed services from infected and affected persons. Use results from these assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. 13. Adhere to Culturally and Linguistically Appropriate Service (CLAS) Standards. Standards and Practices must address sexual minorities. 14. Submit all educational materials (e.g., brochures, posters, pamphlets and videos) used in conjunction with program activities to the HAPIS Program Review Panel for review and approval prior to their use, regardless of the source of funding used to purchase these materials. 15. Submit preliminary agendas to HAPIS for review and approval, for conferences, trainings, workshops and similar activities supported wholly or in part under this agreement. 16. Submit program manuals, intervention curricula, training curricula, service protocol and procedures, and similar documents to HAPIS for review and approval prior to publication and use if development arid implementation is supported wholly or in part under this agreement or if such documents are to be used in conjunction with activities supported under this agreement. 17. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) The dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 18. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 19 Assist HAPIS in appropriate needs assessment activities. 20. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, underthe terms of this agreement, for clients residing in the State of Michigan. 21. Financial Status Reports (FSR) must be submitted quarterly in EGrAMS, no later than 30 days after the end of the period. Contractor Specific Requirements 1. Pursuant to a protocol established by MDCH, provide positive test notification, HIV and syphilis partner counseling and referral services, victim notification and recalcitrant investigation for the following local health departments: Barry-Eaton District Health Department, Bay County Health Department, Benzie-Leelanau District Health Department, Central Michigan District Health Department, Chippewa County Health Department, Dickinson-Iron District Health Department, District Health Department # 2, District Health Department # 4, District Health Department #10, Grand Traverse County Health Department, Huron County Health Department, Ionia County Health Department, Lapeer County Health Department, Ottawa County Health Department, Livingston County Health Department, Luce-Mackinac-Alger-Schoolcraft District Health Department, MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 26 of 87 Marquette County Health Department, Mid-Michigan District Health Department, Midland County Health Department, Northwest Michigan Community Health Agency, Public Health, Delta and Menominee Counties, Sanilac County Health Department, Shiawassee County Health Department, St Clair County Health Department, Tuscola County Health Department, and Western Upper Peninsula District Health Department. 2. Provide these services fifty-two weeks a year. 3. Conduct program activities pursuant to applicable federal and state laws, rules and policies and in accordance with the Recommendations for Conducting Partner Services in the Prevention of HIV/STDs, MDCH (2011). 4. Establish, maintain and document (e.g., via MOD orMOA) linkages with community resources that are necessary and appropriate to addressing the needs of clients and that are essential to the success and effectiveness of services supported under this agreement. 5. The contractor and its subcontractors are required to use the HRSA-supported software HES to enter client and service data into the centrally managed database on a secure server. Data must include all clients who receive any Part B eligible service (regardless of the source of funding for the services) and all Part B eligible services delivered to HIV-infected or affected clients. The collection of ail required data variables and the clean-up of any missing data or service activities should be completed in HES no later than the 15tb day after the end of each calendar quarter. 6. A Semi-annual and Annual Progress Report will be required. Submit program Progress Reports in accordance with the following dates: Period Covered Due to HAPIS October 1,2013-March 31, 2014 April 21,2014 April 1 - September 30, 2014 October 20, 2014 The report, to be submitted in EGrAMS, will include: C. The status of current performance indicators. D. Other performance measures negotiated between the Contractor and HAPIS An additional narrative report will be submitted as an attachment to eGrams and will include: A. A summary of successes and challenges during the period. B. Plans to address over-or under-spending and program performance issues, if any. C. Brief update on Quality Management plan. D. Summary of customer satisfaction and changes made as a result (Annual Report only). HAPIS Requirements 1. HAPIS will provide technical assistance, as requested, on the development and implementation of the Quality Management Plan. 2. HAPIS will provide training on HES, CLAS, EGrAMS and other issues related to Prevention services. 3. HAPIS will conduct a site visit, including both fiscal and programmatic review, at least annually. HAPIS will provide 30 days written notice of the site visit, including an agenda and the assessment tool. 4. HAPIS will review Semi-annual and Annual reports. Questions or clarifications, if any, will be requested within 30 calendar days of submission date. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 27 of 87 HIV PREVENTION PROGRAM SPECIAL REQUIREMENTS Purpose: Local health departments will provide HIV counseling, testing and referral and partner services within their jurisdiction, pursuant to applicable federal and state laws; and policies and program standards issued by the Department. Contractor Requirements - Categorical 1. Adhere to all federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. 2. Adhere to all federal and HIV/AIDS Prevention and Intervention Services (HAPiS) issued guidance and policy for services provided. 3. Develop, in consultation with HAPIS, and implement an annual work plan that describes the objectives, activities and measures for work to be performed under this contract. It will include the planned achievement of quality or performance indicators and anticipated numbers of clients and services provided for each funded service, if outreach services are provided, it will describe how the purpose goes beyond HIV prevention education to include testing and early entry into care. The work plan will be submitted in EGrAMS. 4. Develop and implement a Quality Management plan. The quality management plan will be submitted to the Grants and Contracts Administrator. 5. Participate in monitoring site visits including review of fiscal and programmatic compliance with HAPIS policies and contract requirements. 6. Ensure that records are available for review by MDCH auditors, staff and federal government agencies, if applicable, to monitor performance. Maintain and provide access to primary source documentation. 7. Contractors may enter into subcontracts or vendor agreements to fulfill the service delivery expectations of this agreement. A. Ail subcontracts issued under this funding agreement are subject to the same requirements as outlined in this agreement and subject to prior approval by HAPIS. B. The Contractor will monitor subcontractors annually to assess compliance with the subcontract; take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract; report the results of all contract monitoring activities to HAPIS. C. Provide one copy of all fully signed subcontracts, memorandums of understanding (MOUs) or letters of agreement related to the services in this agreement to HAPIS by October 15, 2013 or within 30 days of execution. 8. Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or Client Level Data program; c) use of virus protection software to guard against computer viruses; and d) provide annua! training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDCH policies concerning Sharing and Secured Electronic Data. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 28 of 87 9. The following language must be included in all Client Consent and Release of Information forms used for services in this agreement. "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same data network." 10. Client and service level data is the property of HAPIS. In the event that services are no longer delivered underthis agreement, electronic data files held outside of the central CAREWare and/or HES database must be returned to HAPIS within 30 days of the loss of services. 11. Provide immediate notification to HAPIS, in writing, in the event of any of the following: A. Any formal grievance initiated by a service recipient and subsequent resolution of that grievance. B. Any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. C. Staff vacancies that negatively impact the delivery of services to clients. 12. Assess client or participant satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. Establish and maintain a mechanism to obtain input about needed services from infected and affected persons. Use results from these assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. 13. Adhere to Culturally and Linguistically Appropriate Service (CLAS) Standards. Standards and Practices must address sexual minorities. 14. Submit all educational materials (e.g., brochures, posters, pamphlets and videos) used in conjunction with program activities to the HAPIS Program Review Panel for review and approval prior to their use, regardless of the source of funding used to purchase these materials. 15. Submit preliminary agendas to HAPIS for review and approval, for conferences, trainings, workshops and similar activities supported wholly or in part underthis agreement. 16. Submit program manuals, intervention curricula, training curricula, service protocol and procedures, and similar documents to HAPIS for review and approval prior to publication and use if development and implementation is supported wholly or in part under this agreement or if such documents are to be used in conjunction with activities supported under this agreement. 17. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) The dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 18. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 19 Assist HAPIS in appropriate needs assessment activities. 20. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, underthe terms of this agreement, MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 29 of 87 for clients residing in the State of Michigan. 21. Financial Status Reports (FSR) must be submitted quarterly in EGrAMS, no later than 30 days after the end of the period. Contract Specific Requirements - Categorical 1. If conducting HIV testing using rapid HIV testing, comply with guidelines and standards issued by the MDCH and: i. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised, are to be submitted to HAPIS, Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDCH (October 2008, or subsequent revisions). j. Enroll and participate in the Model Performance Evaluation Program (MPEP), CDC's external proficiency testing program. k. Submit a photocopy of the local health department's current CLiA certificate to Division or Health, Wellness and Disease Control. I. Report anomalous test results to the Division of Health, Wellness and Disease Control, pursuant to established protocol. m. Submit quality control, daily patient logs and test inventory on a monthly basis. n. Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course (if applicable), test device training, and proficiency testing. o. Ensure that site supervisors have completed, successfully, appropriate laboratory quality assurance training, biood borne pathogens training and rapid test device training. p. Develop, implement and monitor protocol and procedures to ensure that patients receive confirmatory test results. 2. The contractor and its subcontractors are required to use the HRSA-supported software HES to enter client and service data into the centrally managed database on a secure server. Data must include all clients who receive any Part B eligible service (regardless of the source of funding for the services) and all Part B eligible services delivered to HIV-infected or affected clients. The collection of all required data variables and the clean-up of any missing data or service activities should be completed in HES no later than the 15th day after the end of each calendar quarter. 3. A Semi-annual and Annual Progress Report will be required. Submit program Progress Reports in accordance with the following dates: The report, to be submitted in EGrAMS, will include: E. The status of current performance indicators. F. Other performance measures negotiated between the Contractor and HAPIS An additional narrative report will be submitted as an attachment to EGrAMS and will include: E. A summary of successes and challenges during the period. F. Plans to address over-or under-spending and program performance issues, if any. G. Brief update on Quality Management plan. H. Summary of customer satisfaction and changes made as a result (Annual Report Period Covered October 1, 2013 - March 31, 2014 April 1 - September 30, 2014 Due to HAPIS April 21,2014 October 20, 2014 only). MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 30 of 87 HAPIS Requirements - Categorical 1. HAPIS will provide rapid HIV test devices and external controls in sufficient quantity to ensure that HIV testing is provided as a standard of care to clients seeking STD prevention and treatment services (formerly known as the "Expanded HIV Testing in High Prevalence Health Care Settings to Address Racial/Ethnic Disparities in Access to Testing Services") and to facilitate staff training and proficiency testing. For FY 13/14, the quantity of rapid HIV test devices provided by the Department shall not exceed: Local Health Agency Maximum Number of Rapid HIV Test Devices Berrien County Health Department 1,140 Calhoun County Health Department 2,235 Detroit Department of Health and Wellness Promotion 9,020 Genesee County Health Department 3,300 Ingham County Health Department 2,440 Jackson County Health Department 300 Kalamazoo County Health and Community Services 3,340 Kent County Health Department 3,420 Muskegon County Health Department 2,200 Oakland County Health Division 14,420 Saginaw County Health Department 1,620 Washtenaw County Health Department 1,700 Wayne County Health Department 2,200 Van Buren-Cass District Health Department 920 Additional quantities of rapid HIV test devices and controls may be made available to iocai health agencies provided that the agency can demonstrate that test devices will be used in a manner consistent with the general purposes of this agreement and in accordance with approved program methodologies and predicated upon availability of resources. 2. Provide training and technical assistance in support of implementation of HIV testing as a standard of care and use of rapid HIV tests. 3. HAPIS will provide technical assistance, as requested, on the development and implementation of the Quality Management Plan. 4. HAPIS will provide training on HES, CLAS, EGrAMS and other issues related to Prevention Services. 5. HAPIS will conduct a site visit, including both fiscal and programmatic review, at least annually. HAPIS will provide 30 days written notice of the site visit, including an agenda and the assessment tool. 6. HAPIS will review Semi-annual and Annual reports. Questions or clarifications, if any, will be requested within 30 calendar days of submission date. Contractor Requirements - Non-Categorical MDCH/G&PD FY 13/148/1/13 ATTACHMENT Mi Page 31 of 87 Local health departments that do not receive categorical AIDS/HIV prevention funds and that elect to conduct HIV testing may request reimbursement for performing HIV tests. For local health departments that do not receive categorical AIDS/HIV prevention funds and who elect to conduct HIV testing. 1. Provide HIV Counseling, testing and referral services, pursuant to statute, and MDCH-issued accreditation standards. 2. Submit client-level service data to the HAPIS via the HES. The time line and procedures for submitting these data are to conform to guidelines issued HAPIS. 3. Reimbursement requests must be submitted quarterly on the FSR. Requests for reimbursement will be verified based on data submitted to the Department via HES. Local health departments will not receive reimbursement for tests not entered into the HES. Department Requirements - Non-Categorical Reimburse local health departments at a rate of $11.00 per test, not to exceed $2,000 for FY 13/14.HIV PREVENTION HIV RAPID TESTING SPECIAL REQUIREMENTS(DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION - STD CLINIC) OCTOBER 1, 2013-SEPTEMBER 30, 2014 Purpose: The purpose of this agreement is to facilitate HIV testing as standard of care in the STD clinic by providing support for dedicated staff to conduct point-of-care rapid HIV testing in the STD Clinic statlab. Contractor Requirements 1. Adhere to all federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. 2. Adhere to all federal and HIV/AIDS Prevention and Intervention Services (HAPIS) issued guidance and policy for services provided. 3. Develop, in consultation with HAPIS, and implement an annual work plan that describes the objectives, activities and measures for work to be performed under this contract. It will include the planned achievement of quality or performance indicators and anticipated numbers of clients and services provided for each funded service. If outreach services are provided, it will describe how the purpose goes beyond HIV prevention education to include testing and early entry into care. The work plan will be submitted In EGrAMS. 4. Develop and implement a Quality Management plan. The quality management plan will be submitted to the Grants and Contracts Administrator. 5. Participate in monitoring site visits including review of fiscal and programmatic compliance with HAPIS policies and contract requirements. 6. Ensure that records are available for review by MDCH auditors, staff and federal government agencies, if applicable, to monitor performance. Maintain and provide access to primary source documentation. 7. Contractors may enter into subcontracts or vendor agreements to fulfill the service delivery expectations of this agreement. A. All subcontracts issued under this funding agreement are subject to the same requirements as outlined in this agreement and subject to prior approval by HAPIS. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 32 of 87 B. The Contractor will monitor subcontractors annually to assess compliance with the subcontract; take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract; report the results of all contract monitoring activities to MARIS. C. Provide one copy of all fully signed subcontracts, memorandums of understanding (MOUs) or letters of agreement related to the services in this agreement to MARIS by October 15, 2013 or within 30 days of execution. 8. Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or Client Level Data program; c) use of virus protection software to guard against computer viruses; and d) provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDCH policies concerning Sharing and Secured Electronic Data. 9. The following language must be included in all Client Consent and Release of Information forms used for services in this agreement. "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same data network." 10. Client and service level data is the property of MARIS. In the event that services are no longer delivered underthis agreement, electronic data files held outside of the central CAREWare and/or HES database must be returned to MARIS within 30 days of the loss of services. 11. Provide immediate notification to MARIS, in writing, in the event of any of the following: A. Any formal grievance initiated by a service recipient and subsequent resolution of that grievance. B. Any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. C. Staff vacancies that negatively impact the delivery of services to clients. 12. Assess client or participant satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. Establish and maintain a mechanism to obtain input about needed services from infected and affected persons. Use results from these assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. 13. Adhere to Culturally and Linguistically Appropriate Service (CLAS) Standards. Standards and Practices must address sexual minorities. 14. Submit all educational materials (e.g., brochures, posters, pamphlets and videos) used in conjunction with program activities to the MARIS Program Review Panel for review and approval prior to their use, regardless of the source of funding used to purchase these materials. 15. Submit preliminary agendas to MARIS for review and approval, for conferences, trainings, workshops and similar activities supported wholly or in part under this agreement. 16. Submit program manuals, intervention curricula, training curricula, service protocol and procedures, and similar documents to MARIS for review and approval prior to publication and use if development and implementation is supported wholly or in part under this agreement or if such documents are to be used in conjunction with activities supported underthis agreement. Page 33 of 87MDCH/G&PD FY 13/14 ATTACHMENT ill8/1/13 17. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) The dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 18. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 19 Assist HAPIS in appropriate needs assessment activities. 20. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, underthe terms of this agreement, for clients residing in the State of Michigan. 21. Financial Status Reports (FSR) must be submitted quarterly in EGrAMS, no later than 30 days after the end of the period. Contractor Specific Requirements 6. Provide dedicated staff for the STD clinic stat lab to ensure and support routine HIV testing for clients receiving services for the prevention and/or treatment of sexually transmitted diseases. 7. Comply with guidelines and standards issued by the MDCH and: q. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised, are to be submitted to HAPIS. Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDCH (October 2008, or subsequent revisions). r. Enroll and participate in the Model Performance Evaluation Program (MPEP), CDC's external proficiency testing program. s. Submit a photocopy of the local health department's current CLIA certificate to HAPIS. t. Report anomalous test results to the HAPIS pursuant to established protocol. u. Submit quality control, daily patient logs and test inventory on a monthly basis. v. Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course (if applicable), test device training, and proficiency testing. w. Ensure that site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training. x. Develop, implement and monitor protocol and procedures to ensure that patients receive confirmatory test results. 2. The contractor and its subcontractors are required to use the HRSA-supported software HES to enter client and service data into the centrally managed database on a secure server. Data must include all clients who receive any Part B eligible service (regardless of the source of funding for the services) and all Part B eligible services delivered to HIV-infected or affected clients. The collection of all required data variables and the clean-up of any missing data or service activities should be completed in HES no later than the 15th day after the end of each calendar quarter. 3. A Semi-annual and Annual Progress Report will be required. Submit program Progress Reports in MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 34 of 87 accordance with the following dates: Period Covered Due to HAP1S April 21,2014 October 20, 2014 October 1, 2013 - March 31, 2014 April 1 - September 30, 2014 The report, to be submitted in EGrAMS, will include: G. The status of current performance indicators. H. Other performance measures negotiated between the Contractor and HAPIS An additional narrative report will be submitted as an attachment to EGrAMS and will include: A. A summary of successes and challenges during the period. B. Plans to address over- or under-spending and program performance issues, if any. C. Brief update on Quality Management plan. D. Summary of customer satisfaction and changes made as a result (Annual 1. Provide training and technical assistance in the use of rapid HIVtests. 2. HAPIS will provide technical assistance, as requested, on the development and implementation of the Quality Management Plan. 3. HAPIS will provide training on HES, CLAS, EGrAMS and other issues related to Prevention services. 4. HAPIS will conduct a site visit, including both fiscal and programmatic review, at least annually. HAPIS will provide 30 days written notice of the site visit, including an agenda and the assessment tool. 5. HAPIS will review Semi-annual and Annual reports. Questions or clarifications, if any, will be requested within 30 calendar days of submission date. Contractor Specific Requirements 1. Adhere to all federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. 2. Adhere to all federal and HIV/AIDS Prevention and Intervention Services (HAPIS) issued guidance and policy for services provided. 3. Develop, in consultation with HAPIS, and implement an annual work plan that describes the objectives, activities and measures for work to be performed under this contract. It will include the planned achievement of quality or performance indicators and anticipated numbers of clients and services provided for each funded service. If outreach services are provided, it will describe how the purpose goes beyond HIV prevention education to include testing and early entry into care. The work plan will be submitted in EGrAMS. Report only). HAPIS Requirements HIV RYAN WHITE PART B- SPECIAL REQUIREMENTS(CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, MARQUETTE COUNTY HEALTH DEPARTMENT) MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 35 of 87 4. Develop and implement a Quality Management plan. The quality management plan will be submitted to the Grants and Contracts Administrator. 5. Participate in monitoring site visits including review of fiscal and programmatic compliance with HAPIS policies and contract requirements. 6. Ensure that records are available for review by MDCH auditors, staff and federal government agencies, if applicable, to monitor performance. Maintain and provide access to primary source documentation. 7. Contractors may enter into subcontracts or vendor agreements to fulfill the service delivery expectations of this agreement. A. All subcontracts issued under this funding agreement are subject to the same requirements as outlined in this agreement and subject to prior approval by HAPIS. B. The Contractor will monitor subcontractors annually to assess compliance with the subcontract; take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract; report the results of all contract monitoring activities to HAPIS. C. Provide one copy of all fully signed subcontracts, memorandums of understanding (MOUs) or letters of agreement related to the services in this agreement to HAPIS by October 15, 2013 or within 30 days of execution. 8. Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or Client Level Data program; c) use of virus protection software to guard against computer viruses; and d) provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDCH policies concerning Sharing and Secured Electronic Data. 9. The following language must be included in all Client Consent and Release of Information forms used for services in this agreement. "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same data network." 10. Client and service level data is the property of HAPIS. In the event that services are no longer delivered under this agreement, electronic data files held outside of the central CAREWare and/or HES database must be returned to HAPIS within 30 days of the loss of services. 11. Provide immediate notification to HAPIS, in writing, in the event of any of the following: A. Any formal grievance initiated by a service recipient and subsequent resolution of that grievance. B. Any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. C. Staff vacancies that negatively impact the delivery of services to clients. 12. Assess client or participant satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. Establish and maintain a mechanism to obtain input about needed services from infected and affected persons. Use results from these assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 36 of 87 13. Adhere to Culturally and Linguistically Appropriate Service (CLAS) Standards. Standards and Practices must address sexual minorities. 14. Submit all educational materials (e.g., brochures, posters, pamphlets and videos) used in conjunction with program activities to the HAPIS Program Review Panel for review and approval prior to their use, regardless of the source of funding used to purchase these materials. 15. Submit preliminary agendas to HAPIS for review and approval, for conferences, trainings, workshops and similar activities supported wholly or in part under this agreement. 16. Submit program manuals, intervention curricula, training curricula, service protocol and procedures, and similar documents to HAPIS for review and approval prior to publication and use if development and implementation is supported wholly or in part under this agreement or if such documents are to be used in conjunction with activities supported under this agreement. 17. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) The dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 18. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 19 Assist HAPIS in appropriate needs assessment activities. 20. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, underthe terms of this agreement, for clients residing in the State of Michigan. 21. Financial Status Reports (FSR) must be submitted quarterly in EGrAMS, no later than 30 days after the end of the period. Contractor Specific Requirements 1. Adhere to all Ryan White HIV/AIDS Treatment Extension Act Part B (Part B), and HAPIS policies, standards and guidelines, as identified in the current Comprehensive "Applicable Laws, Rules, Regulations, Policies, Procedures and Manuals," or as issued by HAPiS during the current contract year. 2. Administrative costs, including direct and indirect costs, cannot exceed 10% of the allocation. On request, provide documentation of compliance with this requirement, as defined in the "HAPIS Administrative versus Service/Program Cost Budget Guidance" issued by HAPIS. 3. Submit to the Grants and Contract Administrator a signed assurance/certification form (provided by HAPIS) that lists and defines unallowable expenses no later than 15 days after this agreement is fully executed. 4. The contractor and its subcontractors are required to use the HRSA-supported software CAREWare to enter client and service data into the centrally managed database on a secure server. Data must include all clients who receive any Part B eligible service (regardless of the source of funding for the services) and all Part B eligible services delivered to HIV-infected or affected clients. The collection of all required data variables and the clean-up of any missing data or service activities should be completed in CAREWare no later than the 15th day after the end of each calendar quarter. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 37 of 87 5. A Semi-annual and Annual Progress Report will be required. Submit program Progress Reports in accordance with the following dates: Period Covered Due to HAPIS October 1,2013-March 31, 2014 April 21,2014 April 1 - September 30, 2014 October 20, 2014 The report, to be submitted in EGrAMS, will include: I. The status of current quality indicators; data must be reconciled with CAREWare reports.J. Other performance measures negotiated between the Contractor and HAPIS. An additional narrative report will be submitted as an attachment to EGrAMS and will include: I. A summary of successes and challenges during the period. J. Plans to address over- or under-spending and program performance issues, if any. K. Brief update on Quality Management plan. L. Summary of customer satisfaction and changes made as a result (Annual Report only). HAPIS Requirements 5. HAPIS will provide technical assistance, as requested, on the development and implementation of the Quality Management Plan. 6. HAPIS will provide training on CAREWare, CLAS, EGrAMS and other issues related to Part B services. 7. HAPIS will conduct a site visit, including both fiscal and programmatic review, at least annually. HAPIS will provide 30 days written notice of the site visit, including an agenda and the assessment tool. 8. HAPIS will review Semi-annual and Annual reports. Questions or clarifications, if any, will be requested within 30 calendar days of submission date. HOPWA SPECIAL REQUIREMENTS (Housing Opportunities for Persons Living with HIV/AIDS)(MARQUETTE COUNTY HEALTH DEPARTMENT) Special Note: The annual FY HOPWA Formula Operating Instructions have yet to be issued. If or when they are issued, it may be necessary to amend these Program Specific Assurances and Agreements 1. Budget and Agreement Requirements HOPWA PROGRAM OVERVIEW The Housing Opportunities for Persons with AIDS (HOPWA) program provides housing assistance and related supportive services for low-income persons living with HIV/AIDS and their families. The HOPWA program helps eligible clients improve their health by providing stable housing as a basis for increased participation in the coordinated delivery of supportive services. These services may involve support with their daily living activities; case management; substance abuse treatment and counseling; and other sen/ices, to help beneficiaries maintain appropriate housing and access other needed support. HOPWA clients very often use a range of health and supportive services funded by HHS through the Ryan White Care Act and other public or private support, which will improve their ability to participate in health care and access other supportive services. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 38 of 87 A. HOPWA Eligibility An eligible person means a person with acquired immunodeficiency syndrome or related diseases who is below 80% median income. A family member regardless of income is eligible to receive housing information services. Any person living in proximity to a community residence is eligible to participate in that residence's community outreach and educational activities regarding AIDS or related diseases. Within the population eligible for this program, nondiscrimination and equal opportunity regulations must be followed, including fair housing and affirmative outreach. A project sponsor and all contractors and subcontractors must adopt procedures to ensure that ail persons who qualify for the assistance, regardless of their race, color, religion, sex, age, national origin, familial status, or handicap, know of the availability of the HOPWA program, including facilities and services accessible to persons with a handicap, and maintain evidence of implementation of the procedures. HIV Status Determination HIV status must be documented for each client, subject to confidentiality procedures. Acceptable forms of documentation include the following: • Documentation from a health professional qualified to make such a determination. • Documentation from an HIV test conducted by a physician, community health center, or HIV counseling center. Income Determination Household Income must be determined and verified prior to housing assistance being provided and annually thereafter. Income determination includes all members of the household. Nondiscrimination and equal opportunity Within the population eligible for this program, the nondiscrimination and equal opportunity requirements apply including Fair Housing and Affirmative Outreach. Affirmative outreach requires that a project sponsor must adopt procedures to ensure that all persons who qualify for the assistance, regardless of their race, color, religion, sex, age, national origin, familial status, or handicap, know of the availability of the HOPWA program, including facilities and services accessible to persons with a handicap, and maintain evidence of implementation of the procedures. B. Allowable Use of Funds Funds may be used to assist all forms of housing designed to prevent homelessness. This includes emergency housing, shared housing arrangements, apartments, single room occupancy (SRO) dwellings, and community residences, it includes assistance to remain in current homes, whether owned or rented, and assistance in relocating to another home if needed, in the DCH Michigan State HOPWA program, housing options have been limited by excluding the construction, purchase or renovation of a structure by HOPWA Sponsors or to establish a Facility-based housing option. The following activities may be carried out with HOPWA funds: 1. HOUSING SUBSIDY ASSISTANCE Tenant Based Rental Assistance (TBRA^: Subsidy for use on the open rental market. Tenant holds lease to unit rented at or under Fair Market rent (FMR)), is documented to be Rent Reasonable, and meets Housing Quality Standards (HQS)) or HOPWA Habitability Standards. Calculation of utility allowances as needed. Short-Term Rent. Mortgage and Utility (STRMU) MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 39 of 87 payments: Subsidy to prevent homelessness of mortgagers or renters in their current place of residence. Persons cannot be homeless and the subsidy is limited to 21-weeks in any 52-week period. Permanent Housing Placement: Expenditures that help establish a household in a housing unit. May include application fees, related credit check fees, reasonable security deposits (limited to amount equal to two months rent), and one-time utility connection fees. Provide counseling in understanding a residential lease and its obligations, and mediation of disputes. 2. SUPPORT SERVICES. A. Housing Case management: The goal is to establish stable permanent housing and prevent homelessness. It is expected that many of the services needed by the client will be provided by other staff or assistance agencies via referral from the Housing Case Manager. Housing Case management may include directly or through other agencies: client advocacy: assistance with access to local, State, and Federal government benefits(SSI/SSDI application using the SOAR model); assistance completing the housing application and assessment form; assistance with developing a budget; assuring that all required forms and documents are completed fully and in a timely manner; Fair housing counseling for eligible persons who may encounter discrimination on the basis of race, color, religion, sex, age, national origin, familial status, or handicap. B. Other Support Services: Assistance obtaining other support services needed. HOPWA funded Support Services are limited to categories in the CAPER: Adult Day Care & personal assistance; Alcohol and Drug abuse services outreach, Child Care and other child services; Education; life skills management; education; Legal services; Transportation; Mental Health services; Meals and nutritional services; Health/medical/intensive care services if approved bv DCH/HUD (conform with 24CFR 574.310) and health services may only be provided to individuals with acquired immunodeficiency syndrome or related diseases and not to family members of these individuals. HOPWA cannot fund services already available through other agencies or funding sources. 3. HOUSING INFORMATION SERVICES Housing Information Services: Information and referral services to assist eligible persons and their families with locating, acquiring, financing and maintaining housing. Activities may include housing counseling, housing advocacy, housing search assistance, etc. 4. GRANT ADMINISTRATION AND OTHER ACTIVITIES Resource Identification: Activities to establish, develop, and coordinate housing assistance resources. This can include attending Continuum of Care meetings, meeting with landlord associations, etc. Does not include any client contact activities Administration: General management, oversight, coordination, evaluation, and reporting on eligible activities. Such costs do not include costs directly related to carrying out eligible activities, since those costs are eligible as part of the activity delivery costs of such activities. C. DCH will determine the total budget for HOPWA. Sponsors, in consultation with the HOPWA Specialist will determine the estimated funding amounts for each activity (See Operating Year Budget and Plan below). Deviations in funded amounts of activity categories are allowed as long as the total contract amount is not exceeded and the DCH HOPWA Specialist is notified. Deviations over 5% of the Activity budget must be approved by the DCH HOPWA Specialist. Expenditures for Administration cannot exceed 7% of the total budget as it is fixed at 7% by law. A formal amendment is required to request an increase in the total contractual amount. 2. Contractor Requirements A. The HOPWA OPERATING YEAR PLAN and OPERATING YEAR BUDGET. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 40 of 87 The HOPWA Operating Year is July 1st through June 30th. This coincides with the Reporting Yearfor HOPWA. The annual report, the Consolidated Annual Performance and Evaluation Report (CAPER), must report on the funds expended, household demographics and answers to narrative questions concerning the households assisted during this Operating / Reporting Year. DCH is reimbursed by HUD according to the Operating Year and Budget. HUD notifies the HOPWA Consolidated Plan Lead Agency Michigan State Housing Development Authority (MSHDA for the Michigan HOPWA program of the total HOPWA grant amount available. This notification usually occurs between February and the end of March (although at times it has been later). DCH administrative staff will review the grant funds available and the DCH HOPWA Specialist will notify each sponsor of the planned amount of funding for the HOPWA Operating year for each sponsor. The HOPWA Specialist will send each Sponsor instructions for completing the Operating Year Narrative Plan and Operating Year Budget, in consultation with and assistance from the HOPWA Specialist, the Sponsor will determine the estimated Operating year budget amounts for each allowed HOPWA Activity and complete the narrative Operating Year Plan covering July 1, 2013through June 30, 2014. This Operating year Budget and Plan is to be submitted to DCH by with the Fiscal Year contract. NOTE: The 1st quarter of the HOPWA Operating year (7-1 to 9-30) will be the amount of funds remaining from the previous fiscal year contract with DCH. The amount for the balance of the Operating Year Budget (10-1-13 to 6-30-14) will generally be calculated as 3 quarters of the new Fiscal Year (10-1-13 to 9-30-14) budget. . This plan, along with an annual report (the CAPER), data from ongoing HMIS (or other) data collection systems and the agency FSR Supplemental Forms, will provide MDCH with information to satisfy most federal reporting requirements, carry out monitoring activities, and assure that departmental goals for this program can be met. See Operational Plan Details below. The Operating Year Plan and Budget are to be returned to DCH with the new Fiscal Year contract - generally in August. An electronic copy of the Operating Year Budget in Excel format must be submitted electronically to: lversonb@michigan.gov B. Fiscal Year Contract and Budget The DCH/State of Michigan Fiscal Year runs from October 1,2013 through September 30, 2014. The Fiscal Year contract from DCH is sent to Health Department Sponsors via EGrAMS in early July. The contract in EGrAMS needs to be completed and returned to DCH within 2 weeks of receipt of that EGrAMS contract. Billing for HOPWA reimbursement will involve completing a DCH FSR form and attaching the HOPWA FSR Supplemental form (Attached). The FSR for HOPWA will not be reimbursed without the FSR Supplemental form. . The pages of the FSR-Supplemental form must be attached in E- Grants in an Excel format. C. CONTRACTOR SERVICE REQUIREMENTS Project Sponsors must assure access to HOPWA assistance in their assigned service area. Qualified households from outside the Sponsor's assigned service area but seeking assistance from your service area are to be assisted. (See attached 'Service Areas' page). The Contractor must assure that all persons living with HIV/AIDS (PLWH/A) and seeking housing assistance must be provided Housing Information Services. To the extent that HOPWA funds are available, persons seeking housing assistance are to be provided: 1. DIRECT HOUSING ASSISTANCE Tenant Based Rental Assistance fTBRA\ Short- MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 41 of 87 Term Rent. Mortgage and Utility (STRMIA and Permanent Housing Placement services. See descriptions above 2. SUPPORT SERVICES: Housing Case management and Other Support Services. See descriptions above. 3. Mm ifiiNfi INFORMATION SERVICES: Housing Information Services and. See descriptions above Contractors are also responsible for: 4. GRANT ADMINISTRATION AND OTHER ACTIVITIES: Resource Identification. See description above D. Reporting and Data Collection Submission of the FSR and the FSR Supplemental Forms for reimbursement per the billing instructions, the collection of data used for the annual HOPWA report, the CAPER, and collection of data required by standards regarding eligibility, HIV status, and documentation of provision of required/needed services. In orderto submit the Michigan CAPER report, HOPWASponsors are required to obtain a DUNS (Data Universal Numbering System) number and )t—obtain an account with the System for Award Management CSAMi-https://www.sam.aov/portal/public/SAM/. The SAM Service Desk is at URL: http://www.FSD.gov. If you had an active record in CCR, you have an active record in SAM. You do not need to do anything in SAM at this time, unless a change in your business circumstances requires updates to your Entity record(s) in order for you to be paid or to receive an award or you need to renew your Entity(s) prior to its expiration. SAM will send notifications to the registered user via email 60, 30, and 15 days prior to expiration of the Entity. To update or renew your Entity records(s) in SAM you will need to create a SAM User Account and link it to your migrated Entity records. You do not need a user account to search for registered entities in SAM by typing the DUNS number or business name into the search box. References: Section 872 of the National Defense Authorization Act, the American Recovery and Reinvestment Act (ARRA) and the Federal Funding Accountability and Transparency Act (FFATA). 1. Sponsors must fully implement HUD's Measurement of Performance Outcomes Reporting Reouirements. Data collected must include all data required for the HOPWA Consolidated Annual Performance and Evaluation Report (CAPER) Exp 10-31-2014. Currently the plan is that the demographic will be coilected in the HMIS System and use of HMIS must continue until another DCH approved data collection system is approved . Data not collected in HMIS must be collected and reported by the Sponsor to the HOPWA Specialist.. Data must be internally consistent and complete per Data Quality checks and consistent with data obtained via FSRs, FSR Supplemental forms and any monitoring of records. Data not obtainable from HMIS (Financial data) must be provided directly from Sponsor records to the DCH HOPWA Specialist. Data and answers to Narrative questions will be combined and summarized by the HOPWA Specialist for the Michigan CAPER. Separate CAPER reports for each Sponsor will be created by the Integrated Disbursment and Information System (IDIS), therefore all narrative questions applicable to the Sponsor must be complete. 2. Staff are required to attend offered HMIS training to increase skills and use of HMIS or another approved data collection system that DCH is using. Staff assigned to MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 42 of 87 complete data entry into HMIS and/or run HMIS reports are to attend the HOPWA HMIS Webinars. 3. The project sponsor agrees, to Staff assigned to complete data entry into HMIS and/or run HMIS reports are to attend the HOPWA HMIS Webinars of the HOPWA Financial Management Online Training (http://www.hudhre.info/index.cfm?do=viewHopwaFinanciaITrainina.'). or to demonstrate financial management capacity by the use of other credentials related to Federal requirements at 24 C.F.R. 85.20, as specified in a HUD- approved plan. If the HOPWA Financial Management trained staff leaves the Sponsor's employment, another staff must complete the HOPWA Financial Management training within 90 days. 4. Sponsors and staff will work cooperatively with DCH and provide staff time to develop HUD required Policies and Procedures to be used by all sponsors and to develop and/or revise required HOPWA forms. The current mandatory forms in use include but which may be modified during the operating year include: • Conflict of Interest Assurances - included with the contract. Must be signed and returned each year. • Housing Application & Assessment • Client File Documentation-STRMU assistance • Client Budget Worksheet - — . • DCH HOPWA Habitability Standards inspection form (TBRA) with Lead based paint Acknowledgement form when required • Zero income Affidavit • Client File Contents Checklist - TBRA • Ciient File Contents Checklist - STRMU Additional forms and documents that must be used and filed in the client record include those that are needed to verify: o HiV Status o Status of Disability o Releases of Information completed o Household Income and HOPWA financial eligibility (Pay stubs, Benefit letters or copies of checks, copy of checking and savings account statements, Median Income documents; etc.) o Home ownership or lease responsibility o Expenditures claimed. For Example: lease/house payment; taxes; payments for home/apartment/vehicle/life insurance; vehicle debt & payments; credit card debt & payments; phone, cable, TV expenses; utilities that are not part of the lease; other personal debts owed & the payments; etc. o Estimates of Other expenditures. For example: food, out of pocket medical expenses; gas & vehicle repairs; bus or other transportation costs; etc. Household supplies; cigarette & entertainment expenses; etc. o Calculation and determination of Household Median Income with published current HUD/MSHDA Median Incomes for the county of residence, o Calculation of adjusted income o Shared Housing Rent Calculation o Income and Rent Calculation including current Utility Allowance calculation with Utility Allowance documents for the county of residence, o Domestic Partnership Declaration o Client Housing Plan that includes: Need(s) identified - the reason(s) this MDCH/G&PD FY 13/148/1/13 ATTACHMENT ||:Page 43 of 87 household needs HOPWA housing assistance at this time, what precipitated the current situation; eligibility status; current type of housing, make-up of Household; analysis of income, expenditures; a monthly budget; specific goals with measureable short term tasks to meet the goal(s); responsibility for completing tasks. Must be regular updates on the Plan (can be a call to check on status of the completion of a task, questions about any household changes, etc. The Plan should address immediate needs first then move on to longer term goals of increasing income, benefits, skills, job training, education, etc. Also address ways to decrease expenses and/or reduce barriers to housing stability. All households should be required to apply for all other supported housing options, o Current Fair Market rent (FMR) form for county of residence o Verification of Rent Reasonableness o Receipt of Grievance policy form and a Client Termination of Services policy that includes the involvement of DCH as needed. A copy must be kept in the client record.Current Documents and Forms are subject to review and modification with DCH approval. HOPWA Client forms and documents must be coliected/filed so that they are easily assessable (table of contents, location of document in file - use of tabs) legible and signed and dated as needed, and renewed annually as specified in policies and procedures. Documents may be kept electronically with DCH approval. Must have a plan to meet concerns for security, confidentiality, ease of use for monitoring, and data back-up as needed. Sponsors must have a backup of HMIS client access codes. 5. All forms, policies and procedures are subject to review by the HUD Field Office. Contractor Requirements - Standards 1. All Project sponsors using grant funds to provide housing must adhere to the following standards: A. Ensure that qualified available, mainstream service providers in the area make available appropriate supportive services to the individuals assisted with housing assistance through HOPWA. If services are denied or unavailable, notify the Grantee in writing specifying denials or unavailability of the support services. Monthly summary reports are adequate. If available, qualified Sponsor staff may provide these needed support services as a last resort. B. For any individual with acquired immunodeficiency syndrome or a related disease who requires more intensive care than can be provided in housing assisted under HOPWA, the project sponsor shall provide assistance in locating a care provider who can appropriately care for the individual and for referring the individual to the care provider. C. Ensure that grant funds will not be used to make payments for health services for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to that item or service: under any State compensation program; under an insurance policy; under any Federal or State health benefits program; or by an entity that provides health services. D. Operate the program in accordance with the provision of 24 CFR 574 and other applicable HUD regulations. Prior to dispensing HOPWA direct housing assistance and at least annually thereafter, document the eligibility of each person receiving HOPWA benefits: To include documentation of HIV status of the eligible individual and verification of income of all members of the household (household income to be less than 80% of area Median MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 44 of 87 income). E. Keep records and reports which are consistent with the information required by the current Consolidated Annual Performance and Evaluation Report (CAPER) as requested by MDCH through the operating year Annual reports for HOPWA. implement the Uniform Reporting System which includes data regarding HOPWA eligible persons and information needed for the CAPER. Submit needed financial data for the CAPER and have HMIS data fully available in HMIS for the operating year July 1, 2013 through June 30, 2014. F. Participate with MDCH in facilitating and conducting site visits. Comply with on-site and/or remote monitoring of their program. Monitoring may include but not limited to reviews of: Housing Applications and Assessment forms; documentation of eligibility-documentation of household income, number of persons in the household, HIV status; housing habitability inspection reports; tracking of TBRA & STRMU expenditures and the 21 week limit for STRMU; current conflict of interest statement; use of DCH specified mandatory forms; documentation relating to the annual report data; tracking of program income (tenant co- pay for TBRA; returned security deposits); adequate documentation of expenditures, etc. G. Provide services in accordance with an approved housing plan and comply with reporting requirements as specified by law, HUD and/or MDCH. H. Retain documentation of the rental subsidy payment calculations, Habitability inspections, and for repayment of security deposits and other HOPWA records for a period of 4 years. Disposal of confidential records must assure confidentiality. Keep a record of their destruction. I. The Department of Housing and Urban Development has insisted that all employee costs that are to be billed to the HOPWA grant be documented through the use of a time sheet. All time/costs billed to the HOPWA grant must be documented and readily available to HUD and MDCH staff. This includes calculations of salaries, fringe benefits, and in-direct costs as allowed. Rather than specify a particular format, MDCH requires only that the tracking document conform to general accounting principles in the applicable OMB circulars, in acknowledgment of sponsor accounting system variations. J. Oversee process and performance of subcontractors for the provision of HIV related HOPWA services. Ensure a contractual requirement to adhere to ail applicable state and federal laws and regulations for all subcontractors. K. Conduct an ongoing assessment of the housing assistance and supportive services required by participants as identified in Individual Housing and Service Plans, including an annual assessment of their housing situation, a reevaluation of the appropriateness of rental subsidies or other support, and a report on annual results of program activities under the HOPWA client outcome goals for achieving stable housing, reducing risks of homelessness and improving access to healthcare and other support. Specifically complete and report the results of the Housing component of the Acuity Scale. Prepare a summary report annually and keep original assessments on file. L. Assist the Grantee in completing elements of the Consolidated Plan per 24 CFR part 91. The HOPWA Consolidated Plan should incorporate the following elements: 1. Consult with other public and private agencies that provide assisted housing, health services, and social services for persons with HiV/AIDS and their families; 2. Consider any comments or views expressed on HIV/AIDS housing and service needs by citizens under their citizen participation plan; 3. Estimate the number and type of family members in need of housing assistance for persons with HIV/AIDS and their families under the housing and homeless needs assessment (including needs in their HOPWA service area, i.e. the size and MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 45 of 87 characteristics of the population with HIV/AIDS in the entire eligible metropolitan statistical area (EMSA) for a city grantee, or, for a state grantee, the areas of the state that are outside of any EMSA); in addition to homeless needs, the plan's assessment of "other special needs" should include the number of persons with HIV/AIDS; 4. Individuals and theirfamilies who are not homeless but require supportive housing; 5. In providing a housing market analysis, including the supply, demand, condition and cost of housing and the housing stock available to serve persons with HIV/AIDS and theirfamilies; 6. Address other special needs with components relative to persons with HIV/AIDS and theirfamilies who are not homeless but require supportive housing that: a. Indicate general priorities for allocating HOPWA program funds geographically within the eligible metropolitan statistical area and among priority needs; b. Describe the basis for assigning the priority given to each category of priority needs; c. Identify any obstacles to meeting underserved needs; d. Summarize the priorities and specific objectives, describing how funds made available will be used to address identified needs; and e. For each specific objective, identify proposed accomplishments the jurisdiction hopes to achieve in quantitative terms over a specific time period (e.g. over two-five years), or in other measurable terms as identified and defined by the jurisdiction. 7. Provide outcome, measures for activities in the action plan consistent with the HOPWA reporting format; 8. Provide specific one-year goals for the number of households to be provided housing through the use of HOPWA activities for STRMU assistance payments to prevent homelessness, as well as TBRA assistance and units provided in housing facilities that are developed and/or operated with HOPWA funds; 9. Identify the method of selecting project sponsors, including providing full access of HOPWA funds to grassroots, faith-based, and other community organizations; and 10. In annual reporting compare proposed to actual outcomes for measures in their plan; explain, if applicable, why progress was not made toward meeting goals and objectives. M. Obtaining Certification of Consistency with the Consolidated Plans in your service area is not required for existing DCH HOPWA programs. They are only required when a new Sponsor is awarded a HOPWA contract. They would also be required for establishing a community residence or housing facility which DCH HOPWA does not do. That said, contact with the agencies or units of local government that complete Consolidated Plans is encouraged. These are the grantees that would establish low income housing and for them to be aware of the need of low income HIV positive persons could be beneficial to people needing affordable housing. N. Defaults and Remedies. A default shall occur when the Sponsor materially fails to comply with program requirements. A default may consist of using Grant Funds other than as authorized by this Agreement, noncompliance with statutory, regulatory, or other MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 46 of 87 requirements applicable to this HOPWA award, any other material breach of this Agreement, or any material misrepresentation, which, if known to the Grantee, would have resulted in the Grant Funds not being provided. If the Sponsor fails to comply with any term of this award, including the prompt submission of data for reporting, keeping HM1S data up- to-date, fully completing needed documents and forms, serving only qualified individuals and families, or other Sponsor requirements, the Grantee may: 1. Temporarily withhold further payments pending corrective action by the Project Sponsor; 2. Disallow all or part of the cost of an activity or action not in compliance; 3. Wholly or partly suspend or terminate the current award for the Sponsor's program; 4. Withhold further awards for the HOPWA program; 5. Reduce or recapture Grant Funds; 6. Require the Sponsor to reimburse program accounts with non-Federal funds for the amount of ineligible costs; or 7. Take other appropriate action, including, but not limited to, any remedial action legally available, such as affirmative litigation seeking declaratory judgment, specific performance, damages, temporary or permanent injunctions and any other available remedies. Nothing in this paragraph shall limit any remedies otherwise available to the Grantee in the case of a default by the Sponsor. No delay or omissions by the Grantee in exercising any right or remedy available to it under this Agreement shall impair any such right or remedy or constitute a waiver or acquiescence in any Sponsor default. The Grant may be terminated for convenience when both parties agree that the continuation of the award would not produce beneficial results. Email a copy of all HOPWA required documents to: lversonb@michiaan.qov With approval, mail a copy to: Division of Community Living Michigan Department of Community Health Lewis Cass Building, 5th Floor North, 320 S. Walnut Lansing, Michigan 48913 Attention: HOPWA Program Grantee Requirements A. Assure that contractors and subcontractors have developed and make available to service recipients both grievance and appeals processes (Termination of Services Policy). B. Determine/document the unit cost per service for each funded service. Retain data supporting the per-unit cost and how it was determined. C. Assure the confidentiality of the name of any individual assisted and any other information regarding individuals receiving assistance per HIPAA standards that apply. The grantee shall agree, and shall ensure that each project sponsor agrees, to ensure the confidentiality of the name of any individual assisted under this part and any other information regarding individuals receiving assistance D. Assure that no fee, except tenant portion of rent, shall be charged to an eligible person for housing or services. E. Assure that contractors and subcontractors have the capacity to effectively carry out the activity and that they agree to maintain and make available to HUD for inspection financial records sufficient to ensure proper accounting and disbursing of amounts received. F. Ensure that issue statements, press releases, RFP, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal funds, clearly state MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 47 of 87 1)the percentage or total cost of the program or project which will be funded with Federal funds; 2) the amount of Federal funds for the project or program; and 3) percentage and dollar amount of the total costs of the project or program that will be financed by non¬ governmental resources. Releases by the Sponsor need to include copies sent to DCH of statements and press releases issued by the Contractor. Retain copies of same on file for two (2) years. H. Ensure all services are available in the entire agency catchment's area. If persons from outside a catchment's area are assisted, communicate with the Sponsor for that catchment's area to verify that assistance is not duplicated and that STRMU funds do not exceed the 21 week limit. i Ensure that all activities funded under the program will meet urgent needs that are not being met by available public and private sources. J. Provide ongoing monitoring and on-site monitoring as required of all HOPWA Sponsors. Provide technical assistance where required or seek it through the HUD Field Office. Provide Policy and procedures governing HOPWA Operations and supply all Sponsors with needed forms and HOPWA related information provided by HOPWA/HUD offices. Contractors Reporting Special Requirements Sponsors must fully implement HUD's Measurement of Performance Outcomes reporting requirements. See the HOPWA Consolidated Annual Performance and Evaluation Report (CAPER) HUD-40110-D (Expires 10/31/2014). Obtain at http://www.hudhre.info/index.cfm?do=viewResource&ResourcelD=383- As such demographic data should be collected from HMIS as possible. — Some demographic data, mostfinancial data and all narrative responses will need to be reported separately to DCH from Sponsor records. 1. Copies of all HOPWA required documentation, a copy of the FSRand FSR Supplemental HOPWA forms and the CAPER Financial Data must be emailed to Brian Iverson at Sversonb@michiqan.gov. Materials that cannot be emailed, should be sent to: HOPWA Program Division of Community Living Michigan Department of Community Health Lewis Cass Building, 5th Floor North 320 S. Walnut Lansing, Ml 48913 2. Reimbursement: Financial Status Reports (FSRs) shall be prepared and submitted to MDCH via the eGrAMS system. The FSR Supplemental (FSR-S) pages must be included as an attachment Follow the instructions provided for use of this automated system including completing a Fiscal Year (10-1-2013 to 9-30-2014) Budget. A copy should be with the documents in eGrAMS. Reimbursement for Administration is limited to the 7% of your contract as allowed by law (3% for agencies providing fiduciary services only). Total expenditures for other Activity categories can vary from the ones proposed in your budget by 5% with notification of the HOPWA Specialist, but total expenditures cannot exceed the total amount of the contract. Contact the HOPWA Program manager prior to changes exceeding 5% of the Activity amount. An Excel formatted copy of the FSR Supplemental (FSR-S) form has been emailed to all Sponsors. Additional copies can be obtained from Housing Services staff, iversonb@michiqan.qov. 3. Sponsor will participate in the training for and the continued implementation of the Homeless Management Information System (HMIS). It is expected that all persons who are recipients of HOPWA services will be entered into the HMIS system during the current contract year. At the end of the operating year (June 30, 2012 & again June 30, 2013) it is expected that service data extracted from the HMIS system will be consistent with the data submitted in the FSR & FSR MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 48 of 87 Supplemental forms and internally consistent. Continue to work with DCH staff to develop a means to collect data on qualified people that cannot obtain housing assistance - Unmet Need. This would include people, who are turned away for any reason including a decision that sufficient funds are not available, or the person's financial needs are too great to be assisted at this time, or there are persons with a higher priority. Or other reasons that you may be aware of. OPERATING YEAR NARRATIVE PLAN AND OPERATING YEAR BUDGET - COMPONENTS Attached is a copy of alternative Operating Year Budget forms. The HOPWA Specialist will email you the amount of your budget by May 30th, 2013. An Excel formatted version will be emailed to sponsors or you can contact the HOPWA Specialist for a copy. It is recommended that you enter a minimum amount in every activity, even if it is just $50. That $50 can always be transferred to another Activity at the end of the year. However, if you do not have any funds entered into an Activity at the beginning of the year, you cannot bill from that activity without completing an amendment which is a lengthy process. The HOPWA Specialist will contact each Sponsor to review this budgeting process. This operating year budget will serve as the basis for reporting financial information for the CAPER. As mentioned in Contractor Requirements 2A, the completed Operating Year Budget will be used to complete the Fiscal Year Budget quickly but with forethought. The Operating Year Plan is a narrative summary of the past Operating Year (July 1,2012 through June 30, 2013) and a narrative of your plans for the upcoming Operating Year (July 1, 2013 through June 2014). The summary of the past year will be questions that need to be answered on the upcoming CAPER. Page references below are to the corrected 2011 CAPER. Send a Word document to the attention of the HOPWA Specialist that contains the following information plus the plan budget: Begin by reviewing the 2011 CAPER (sent to you electronically) to make sure the data for your agency is correct for Item 2 Project Sponsor Information. Pages 3-12. Send corrections if needed. (A).Grantee and Community Overview. Provide information about your organization, area of service and an overview of the type of housing provided. See the 2011 CAPER. Please add a description of where clients assisted were/are located (city/county). Note that this section is to be 1-3 pages and DCH has to combine/summarize 7 sponsor's information for the Michigan Caper, however individual sponsor CAPWERs will also be completed so provide all relevant information. • (B). Annual Performance under the action Plan. Questions 1 & 2 it will be difficult to answer the numeric questions until the 2012 CAPER is compiled in July or August. However you can provide information from question 2 to describe other steps you want to take with your program. • fB). Annual Performance under the action Plan. Question 3 Coordination needs to be addressed by your agency as to coordination with other mainstream housing and supportive services resources - be sure to name them. • (B). Annual Performance under the action Plan. Question 4 Technical Assistance. Provide your input as to training that would benefit your agency and the clients assisted. Please specify by subject: training on utility allowances, developing a Housing Plan, identifying housing plan tasks, etc. Or you can broaden your scope to a training session between various community agencies so that you can work more cooperatively. • (C) Barriers and Trends overview Questions 1 through 3. When describing (1) Barriers, note those barriers that clients face and those barriers that your agency faces (lack of funds, hard to keep staff, cost of implementing a new accounting system, lack of agency cooperation, whatever is hampering you and ultimately impacting service to your clients. What is particularly difficult in your area? High rent in Kalamazoo due to the college? Has SOAR training been MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 49 of 87 helpful? Check applicable boxes. For (2) Trends I think we need some mention of people living longer, being older and having health problems, needing longer term assistance, harder to find jobs, etc. Trends can be local, state or national. Are fewer people qualifying as.dlsabled? Has bus service been cut? Inability to get mental health diagnosis (use numbers of people) For (3) Evaluations, please include a summary of the housing evaluation that is to be done yearly (See Contractor Requirements - Standards (K) above), plus any satisfaction surveys or maybe a review of the Acuity scale scores from July 1,2012 until Mayor June 1, 2013. It does not have to be a HOPWA initiated evaluation. Provide references where possible. The Plan Narrative and Plan Budget should be emailed to iversonb@michiqan.qov when the Fiscal Year contract and budgets are completed.. References See: 24 CFR574; 24 CRF 5.611; 24 CFR 5.601; 24 CFR 5.609; 24 CFR 21; 24 CFR 35; 24 CFR 87; 24 CFR 100; 24 CFR 107; and 24 CFR 82.306(d); CPD Notices 01-01; 02-09; 03-09; 04- 10; 06-06; 06-07; 07-06; 07-07; 08-05; and 94-05; FAQSTRMU updated 8/3/06; OMB Circulars A- 110, A-122 and A-133; CPD Monitoring Handbook Chapter 10; HOPWA Grantee Oversight Resource Guide; CAPER form HUD-40110-D, HOPWA Financial Management online training guide. IMMUNIZATION ACTION PLAN SPECIAL REQUIREMENTS Contractor Requirements 1. Service Delivery: Offer immunization services to the public. A. Collaborate with public and private sector organizations to promote childhood, adolescent and adult immunization activities in the county including but not limited to recall activities. B. Educate providers about vaccines covered by Medicare and Medicaid. C. Provide and implement strategies for addressing the immunization rates of special populations (i.e., college students, educators, health care workers, detention centers, homeless, tribal and migrant and child care employees). D. Develop mechanisms to improve jurisdictional and LHD immunization rates for children, adolescents and adults. E. Ensure clinic hours are convenient and accessible to the community, operating both walk-in and scheduled appointment hours. F. Coordinate immunization services, including WIC, Family Planning, and STD, developing plans or memorandums of understanding. G. Collaboratively work with regional MCIR staff to ensure providers are using MCIR appropriately. H. Develop strategies to identify and target local pocket of need areas. 2. Adhere to federal and state appropriation laws pertaining to use of programmatic funds. See Immunization Allowable Expenditures in Attachment I for appropriate use of Federal Funds. 3. Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993, section 1928 Part IV — Immunizations and the most current CDC Vaccines for Children Operations Manual, Michigan Resource Book for VFC Providers, and documents that are updated throughout the year pertaining to the Vaccines For Children (VFC) Program. 4. Ensure that federally procured vaccine is administered to eligible children only and is properly MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 50 of 87 documented per VFC guidelines. A. The VFC Program provides VFC vaccine to only eligible children who meet the following criteria: are Medicaid eligible, have no health insurance, are American Indian or Alaskan Native, are served at a Federally Qualified Health Center (FQHC), a Rural Health Center (RHC) or a public health clinic affiliated with a FQHC and are also under-insured. B. Ensure state-supplied vaccines provided in the jurisdiction are administered only to eligible clients as determined by the state. This program allows for the immunization of select populations who are underinsured and not served at a FQHC, RHC, or a public health immunization clinic affiliated with a FQHC as defined by current state program requirements. C. Ensure that ail providers receiving vaccine from the state screen children for VFC eligibility. D. Fraud or abuse of federally procured vaccine should be monitored and reported. 5. Adhere to all Federal and Michigan Laws pertaining to immunization administration and reporting including reporting to the MCIR, VAERS and schools and daycare reporting 6. Coordinate the submission of immunization data from schools and child care centers in your jurisdiction and follow-up with programs providing incomplete or inaccurate data. Assure compliance levels are adequate to protect the public. 7. Monitor any provider receiving federally procured vaccine including but not limited to VFC site visit 8. Ensure on-site attendance of at least 1 LHD immunization program staff to two (2) Immunization Action Plan (IAP) meetings each year. 9. Submit original FSR's to MDCH on a quarterly basis. 10. IAP Reports are submitted electronically in accordance with due dates set by the Department. 11. IAP Plan will be submitted electronically using a template provided by the Department, in accordance with due dates set by the Department2014. 12. By February 15 of each year provide one copy of the provider enrollment form which includes a profile for each provider who receives vaccine from the state. These documents must be postmarked or filed electronically no later than February 15. 13. Implements Perinatal Hepatitis B program activities to prevent the spread of Hepatitis B Virus (HBV) from mother to newborn. A. Verify pregnancy status on all hepatitis B surface antigen (HBsAg) positive pregnant women of childbearing years (10-60 years of age.) B. Ensure HBsAg positive pregnant women are reported to the Perinatal Hepatitis B case manager and according to the Public Health Code. C. Coordinate Perinatal Hepatitis B case management activities between local health department, provider, and Perinatal Hepatitis B Case Manager to: 1. Ensure that all infants, born to women who are HBsAg positive receive hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of life, a complete hepatitis B vaccine series with post vaccination serology testing and program support services,. 2. Ensure that all susceptible household and sexual contacts associated with HBsAg positive women receive appropriate testing, vaccination, and support services. D. Ensure birthing hospitals are able to offer hepatitis B vaccine to all newborns prior to hospital discharge by enrolling them in the Universal Hepatitis B Vaccination Program for MDCH/G&PD FY 13/148/1/13 ATTACHMENT lit Page 51 of 87 Newborns. 14. Surveiliance of vaccine preventable disease (VPD) activities: A. Ensure that all reportable diseases are reported to MDCH in the time specified in the public health code and appropriate case investigation is completed. B. Conduct active surveillance when indicated (i.e. during an outbreak) and contact hospitals, laboratories, and/or other providers on a regular basis. C. Utilize VAERS to report all adverse vaccine reactions. Department Requirements 1. The department will develop templates for submission of IAP reports and the annual IAP plan, and provide feedback to the local health departments. 2. Provide technical assistance in establishing and operating immunization action plans. 3. Provide technical assistance in MCIR activities through regional coordinators. 4. Provide supportive services and resource identification when needed. 5. Provide financial support for LHD and Community / Migrant Health Centers for immunization in pocket of need (PON) areas. 6. Each LHD will have an annual VFG site visit by the Department.— 7. Develop pre-formatted tools including training for new initiatives and IAP reports / plan. IMMUNIZATION ASSESSMENT FEEDBACK INCENTIVE EXCHANGE (AFIX) FOLLOW-UP SITE VISIT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement per AFIX follow-up visit is $100 for an on-site personal visit to the provider office or $50 for a follow-up phone call (with information mailed afterward) to the provider office. Contractor Requirements 1. The rate of reimbursement is $100 per AFIX follow-up that is conducted on-site at the provider office or $50 for a phone call to the provider office with an informational packet mailed to the provider office. All LHD staff involved with any AFIX site visit must complete the MDCH AFIX training module, presented by the MDCH AFIX Coordinator, prior to conducting any AFIX visits. Annual training review will be provided to each LHD at the IAP meetings and individual consult will be provided to the LHD by the MDCH Immunization Field Representative. LHD staff must generate the AFIX reports from the MCIR no earlier than 10 days prior to the date of the AFIX foilow-up. An AFIX Follow-up report form must be completed and received, at MDCH/lmmunization Program within 30 days of the AFIX foilow-up. AFIX follow ups are in addition to the combined VFC/AFIX site visits and must comply with current MDCH procedures to be eligible for the reimbursement. AFIX follow-up visits should be prioritized and conducted for providers that have more than 100 children 19-35 months oid and have a coverage level less than 70% of the current MDCH recommended vaccine series, and should be conducted no soonerthan 5 months and no later than 7 months after a VFC/AFiX site visit. . AFIX follow-up visits can be conducted at any VFC provider office that will benefit from the visit, however AFIX follow-up visits can only be conducted at VFC provider offices that received a VFC/AFIX site visit in the current contract year. 2. Data from the Department's Immunization Program regarding the number of AFIX follow-ups will be used to reconcile the reimbursement. The AFIX follow-up report form must be received by the Department's Immunization Program within 30 days of the follow-up to qualify for reimbursement. For additional detail on the program requirements, refer to the guidance provided by the MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 52 of 87 Department's Immunization Program in correspondence to immunization Action Plan (IAP), Immunization Coordinators, or through health officers. . All reimbursement requests should be submitted on the quarterly Financial Status Report (FSR). The submission should include, as an attachment, detail of all visits during the quarter using the spreadsheet information provided by the Department. Department Requirements 1. The Department will provide payment quarterly based on the fixed unit rate reimbursement mechanism upon completion and timely submission of the required documents mentioned above. 2. The Department will develop pre-formatted tools. The Department will provide support to the Contractors. 3. The Department will provide AFIX training module upon request by the LHD and will also provide guidance at IAP meetings and through the MDCH Immunization field representatives. IMMUNIZATION - FIELD SERVICE REPRESENTATIVES SPECIAL REQUIREMENTS (DISTRICT HEALTH DEPARTMENT #10,KALAMAZOO COUNTY HEALTH & COMMUNITY SERVICES, LIVINGSTON COUNTY HEALTH DEPARTMENT, MARQUETTE COUNTY HEALTH DEPARTMENT, MONROE COUNTY HEALTH DEPARTMENT,ST. CLAIR COUNTY HEALTH DEPARTMENT) Contractor Requirements (District #10. Marquette and St. Clair Counties 1. Employ and oversee a full-time Immunization Field Representative for the Immunization Program who shall be acceptable to the Department and who shall be supported by this agreement, understanding that their full time is to be devoted for regional immunization related activities. 2. Provide the Immunization Field Representative with permanent office space and supplies, including, but not limited to: a telephone, general office supplies, a computer with high speed internet capabilities, a printer, a cellular telephone and a use of vehicle or reimbursement mechanism for transportation unless otherwise arranged. 3. Ensure the Immunization Field Representative will be available to all local health departments in the assigned regions to provide Immunization Program activities equitable and at the direction of the Department. Refer to field representative responsibilities as defined by the Department and distributed to the contractor. 4. Provide for reimbursement for reasonable telephone charges incurred in the conduct of business by the Immunization Field Representative unless otherwise arranged. 5. Provide reasonable reimbursement for any travel and subsistence expenses incurred by the Immunization Field Representative necessary to the conduct of the Immunization Program. Travel could include the annual National Immunization Conference or other professional immunization related conferences, attendance at the MDCH immunization staff meetings and trainings, and accreditation visits made in other areas of the state. Contractor Requirements - Kalamazoo. Livingston and Monroe Counties 1. Provide adequate office space, telephone connections, and high-speed internet access. Also provide access to fax and photocopiers. 2. Provide feedback to Division Director as needed, on employee work related conduct. Field Representative Roles and Responsibilities District #10. Marquette, and St. Clair Counties MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 53 of 87 This position serves as a liaison, resource person and as a regional expert for local health jurisdictions regarding all MDCH immunization programs and initiatives. 1. PROGRAM SUPPORT: A. Assist with the regional MCIR activities and act as a regional resource on MCIR processes and assessment protocols. B. Assist with the local implementation and monitoring of all state programs at the regional level- including lAP implementation, VFC, AFIX, Accreditation, Perinatal Hepatitis B, School / Childcare reporting, special projects and the INE program. C. Participate in planning for regional conferences, IAP Coordinator meetings, apd other MDCH programs and initiatives as needed. D. Assist state, regional and local epidemiologists and communicable disease staff as needed with VPD surveillance and outbreak control. 2. PROGRAM QUALITY ASSURANCE: A. Assist in the orientation of new IAP Coordinators. B. Work with local health departments to assess and increase immunization levels for all age groups, especially identifying and targeting pockets of need. C. Identify evidence-based strategies that support improved coverage levels in the region, including use of recall, coordination of LHD services, and provider and LHD staff education. D. Consult with the local health department on the immunization component of the accreditation process, including preparation for reviews and conducting a walk through or mock accreditation review. E. Consult with local coalitions and private stakeholders to promote immunizations and ensure consistent messages are relayed to the public. F. Consult with local health departments on the school and day care assessment process. G. Encourage or provide educational updates and interventions on all immunization issues with staff at local health departments, healthcare providers, school and chiidcare staff and other stakeholders. 3. PROGRAM COMPLIANCE: A. Monitor compliance with policies/legislation at national/state and local levels such as: 1. VFC program requirements and vaccine distribution 2. VAERS program 3. Public Health Code 4. Administrative Rules a. School and childcare legislation and reporting requirements b. MCIR legislation and rules c. Communicable Disease Rules 4. PROGRAM OVERSIGHT and PROGRAM REVIEW: A. Perform oversight of the following programs with assigned local health departments. B. Accreditation-Conduct reviews, and monitor corrective actions. C. VFC including orientation to annual VFC site visit process, monitoring of VFC vaccine losses, submission of mandatory reports, annual LHD VFC site visits and support of the MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 54 of 87 transition to centralized vaccine distribution. D. AFIX-including assuring local feedback with providers, and follow up on recommendations. E. Perinatal Hepatitis B-regional birth dose levels and universal vaccine program. F. Review and summarize LHD IAP Annual Plans and Biannual IAP Reports. G. Monitor LHD compliance with Comprehensive agreements and special requirements relating to the Immunization program. H. Subrecipient monitoring of funds. Department Requirements 1. As financially feasible, provide necessary adjunct clerical services to the immunization Field Representatives for the duplicating/printing of materials and the packaging and distribution of these materials. 2. Provide program direction, responsibilities and definition of immunization Field Service Representative responsibilities. 3. Support or solicit the Immunization Field Service Representative input into policy-making decisions. IMMUNIZATION MICHIGAN CARE IMPROVEMENT REGISTRY (MCIR) REGIONAL SPECIAL REQUIREMENTS(DISTRICT HEALTH DEPARTMENT #10,GENESEE COUNTY HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTH & COMMUNITY SERVICES, MID-MICHIGAN DISTRICT HEALTH DEPARTMENTMUSKEGON COUNTY HEALTH DEPARTMENT PUBLIC HEALTH, DELTA AND MENOMINEE COUNTIES) Contractor Requirements - Muskegon County Only 1. Support the statewide scanner, fax server, and any other related systems that contain childhood immunization records. Collaborate with the scan form software support company, Teleform, on an as needed basis. 2. Provide data quality and data entry support staff for scan center services. 3. Provide monthly reports to regions and the Department on doses entered per user. Contractor Requirements - All Other Departments The Contractor shall ensure the performance of the following activities on behalf of the Department to support the MCIR: 1. Promote and train providers and Health Care Organizations (HCOs) on all features of the MCIR Web application. 2. Support regional MCIR users by operating the regional help desk in accordance with Department approved procedures. 3. Monitor and develop strategies to increase private provider and HCO enrollment and participation in the MCIR which includes development of strategies to encourage all providers to fully participate with the MCIR, (such as sites of excellence awards). 4. Process all user/usage agreements, according to the Department's approved procedures, to create user accounts. 5. Implement and update marketing plans in support of increased provider and parent acceptance MDCH/G&PD FY 13/148/1/13 ATTACHMENT ill Page 55 of 87 and use of the MC1R. 6. Keep regional users updated on MCIR status and system changes. 7. Conduct ad hoc reporting and querying on behalf of MCIR users. 8. Work with local health departments to establish a mechanism and internal process to assure persons who have died within their county are appropriately flagged in the MCIR. 9. Maintain a listing of HCO private and public immunization providers. This listing should be as comprehensive as possible and should include all providers in the region. 10. Conduct regular de-duplication activities to assure that duplicate records are removed from the MCIR as quickly as possible. 11. Process user petitions to change MCIR data according to Department approved procedures. 12. Monitor ongoing immunization data submission for all local health departments and private providers. 13. Conduct training functions as needed to assure that local health department staff can train and educate providers on how to access and submit data into MCIR. 14. Maintain a policy/procedure manual, approved by the Department. 15. Process and file all "opt out" forms according to the Department approved procedures. 16. Attend regular MCIR regional contractor/coordinator meetings. 17. Perform quality assurance checks on the MCIR data for the region as prescribed by the Department. A. Assist local health departments and private providers with methodologies to "clean up" their data. B. Provide assistance to the Department on User Acceptance Testing (UAT) enhancements. C. Attend all UAT training sessions as required by the Department. 18. The Contractor shall provide to the MCIR Regional Coordinator: a) permanent office space; b) general office supplies; c) a land based telephone; d) a computer with high speed internet capabilities; e) a printer; f) a cellular telephone; and g) use of a vehicle or in the alternative reimbursement mechanism for transportation unless otherwise arranged. 19. When sufficient funding is available, provide to the MCIR Regional Coordinator reimbursement for travel to attend the National Immunization conference. This includes travel related expenses concerning airfare, lodging, baggage processing, taxi services, etc. 20. Consult with the Department on any personnel or performance issues that could affect the above mentioned contract requirements. 21. Facilitate the Department's attendance in the interview process for hiring of a MCIR Regional Coordinator / MCiR staff. This process includes consultation with the Department regarding selection of interview candidates as well as participation in the hiring determination. Contractor Performance/Progress Report Requirements 1. Ensure the quarterly submission of status reports on work plan progress. Reports are due within 30 days of the end of each quarter. (January 31, April 30, July 31, October 31). 2. Final quarterly report shall be an annual report. The annual report will be distributed to the Department and shall include: A. Summary of provider enrollment (breakdown by role); B. The amount of data submitted to the region during the fiscal year; C. Summary of staff resources; MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 56 of 87 D. Sites of excellence award recipients. 3. Any other information as specified in the special requirements shall be developed and submitted by the Contractor as required by the Department. Reports and information should be submitted to: Robert C. Miller, JD, MSA Michigan Department of Community Health Immunization Division P.O. Box 30195 Lansing, Mi 48909 Phone: (517) 335-8159 The Contractor shall permit the Department or its designee to visit and to evaluate on an as- needed basis. Department Requirements 1. Provide support and technical assistance to Regional staff. 2. Provide initial training and support to a MCIR Regional Coordinator 3. The Department shall evaluate submitted reports as described above for their completeness and adequacy. IMMUNIZATION - NURSE EDUCATION REIMBURSEMENT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $200 per eligible educational session for all modules except Vaccines Across the Lifespan, which is to be reimbursed at $250 per eligible educational session to the Contractor, upon completion and submission of INE Provider Contact and Report Forms. Reimbursement will be based on a first come-first served basis and also based on most current INE Program Guidelines. . All requests for reimbursement should be submitted on the quarterly Financial Status Report (FSR) and should include all sessions conducted during that quarter. The submission should include, as an attachment to the FSR, detail of the sessions during that quarter using the spreadsheet information provided by the Department. Contractor Reguirements 1. Ensure that all Immunization Nurse Educators are trained as required by the Department. 2. Ensure that the INE Provider Contact and Report Form is complete and submitted to the Department/Immunization Program within 5 days after the presentation. Department Requirements 1. The Department will provide payment based upon the fixed unit rate reimbursement mechanism upon completion and submission of the INE Provider Contact and Report Forms for eligible sessions. Payment wili be based on submission of the quarterly FSR that should include all sessions conducted during that quarter with detail of the sessions documented on the spreadsheet that is provided by the Department. 2. The Department will provide two (2) sessions per calendar year for Contractor Immunization Nurse Educators. MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 57 of 87 IMMUNIZATION - VACCINE QUALITY ASSURANCE PROGRAM SPECIAL REQUIREMENTS Contractor Requirements 1. Follow-up on vaccine losses and reimbursement for compromised vaccines for immunization providers within the jurisdiction. 2. Monitor and approve all temperature logs, doses administered reports, and ending inventory reports received from participating VFC providers within the jurisdiction. 3. Monitor and approve vaccine orders for participating VFC providers within the jurisdiction 4. Act as the Primary Point of Contact (PPOC) for VFC providers within the jurisdiction. 5. Provide education and intervention on inappropriate use of publicly purchased vaccine. 6. Follow-up on VFC site visit corrective action issues. 7. Assist VFC providers within the jurisdiction on issues related to balancing vaccine inventories. 8. Assist with the redistribution of short dated vaccine for providers within the jurisdiction. 9. Assist with the equitable allocation of vaccines to providers in the jurisdiction during a vaccine shortage. Department Requirements 1. Monitor and approve all temperature logs, doses administered reports and ending inventory reports received from Local Health Departments. 2. Monitor and approve vaccine orders for Local Health Departments. 3. Consult with Local Health Departments on vaccine losses and assist as needed. 4. Act as the PPOC to Local Health Departments. 5. Assist Local Health Departments on education and intervention on the inappropriate use of publicly purchased vaccine. 6. Assist Local Health Departments on issues related to MCIR functionality and operation. 7. Assist Local Health Departments with the redistribution of short dated vaccine. IMMUNIZATION VFC/AFIX SITE VISIT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $150 for a VFC Enrollment or VFC only visit, or $300 for a combined VFC/AFIX or birthing hospital visit. 1. The rate of reimbursement is $150 for a VFC Enrollment or a VFC Only visit, $300 for a combined VFC/AFIX or birthing hospital visit. An enrollment visit is required for all new VFC enrolled provider sites. All LHD staff involved with any AFIX site visits must complete the MDCH AFIX training module, presented by the MDCH AFIX Coordinator, prior to conducting any AFIX visits. Annual VFC/AFIX visit guidance and review will be provided to each LHD at the lAP Meetings and consult will be conducted by the MDCH Immunization Field Representative for each LHD. 2. Jurisdictions are expected to visit at least 50 percent of their sites every year. The goal is to ensure that all enrolled and active VFC providers receive a VFC site visit at least every other year. This means that one half are visited one year and the other half are visited the following year. Detroit Department of Health and Wellness Promotion Immunization Program is required to complete visits annually to 100% of the VFC providers in accordance with the SEMHA Quality Assurance Specialist (QAS) contractual obligations. Combined VFC/AFIX site visits will be conducted using registry based AFIX reports and AFIX tools developed by the Department. MDCH/G&PD FY 13/148/1/13 ATTACHMENT ill Page 58 of 87 3. Combined VFC/AFiX site visits shall be conducted in practices that have any children 19-35 months of age in the MCIR, using the AFIX reports. The site visit questionnaire is answered using the AFIX Reports generated from MCIR, no earlier than 10 days prior to the date of the site visit and using information from previous years VFC/AFIX site visit questionnaires. LHD staff must generate the AFIX reports and review along with the previous years' site visit questionnaire and then complete the AFIX portion of the questionnaire prior to arrival at the site visit. The data contained in the AFIX reports and the previous years' questionnaire assist LHD staff to identify changes in coverage level percentages, possible barriers around missed opportunities for vaccination, invalid doses and patients overdue for immunizations. Two recommendations for the provider to focus on immunization behaviors must be identified and included in the questionnaire, including specific information that facilitates feedback and exchange of information with the provider office to further develop strategies and efforts for reducing barriers to vaccination, improving coverage levels and protecting their patients from VPD. LHD staff must submit the completed site visit questionnaire to MDCH within 30 days of the site visit. Ail reimbursement requests should be submitted on the quarterly Comprehensive Financial Status Report (FSR). The submission should include, as an attachment, detail all of the visits during the quarter using the spreadsheet information provided by the Department. 4. The format of the site visit will be based on the complete site visit questionnaire distributed at the most recent Fall IAP meeting and the site visit guidance documents (VFC and AFIX) provided by the department and the CDC. Completed site visit documents shall be sent to the MDCH/Immunization Program within 30 days of the site visit. 5. Data from the Department's/immunization Program regarding the number of site visits will be used to reconcile the request for reimbursement. For additional detail on the program requirements, refer to the Resource Book for Vaccine for Children Providers and the AFIX site visit guidance documents, as weli as other guidance provided by the MDCH/Immunization Program in correspondence to Immunization Action Plan (IAP), Immunization Coordinators, or through health officers. Department Requirements 1. The Department will provide payment quarterly based upon the fixed unit rate reimbursement mechanism upon completion and submission of the questionnaires. 2. The Department will develop pre-formatted tools. 3. The Department will provide support to the Contractors. 4. The Department will provide training at IAP meetings and through field representatives. INFANT SAFE SLEEP - SPECIAL REQUIREMENTS (BERRIEN COUNTY HEALTH DEPARTMENT, CALHOUN COUNTY HEALTH DEPARTMENT, GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, KENT COUNTY HEALTH DEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY HEALTH DEPARTMENT, SAGINAW COUNTY HEALTH DEPARTMENT, WASHTENAW COUNTY HEALTH DEPARTMENT,CITY OF DETROIT HEALTH AND WELLNESS, KALAMAZOOCOUNTY HEALTH DEPARTMENT, WAYNE COUNTY HEALTH DEPARTMENT) Objective: Provide one-time funding to select local health departments (LHD) to support promotion and awareness of infant safe sleep best practices in their communities. Funding must be expended by September 30, 2014. Contractor Requirements 1. LHD personnel will provide educational activities, conduct community outreach efforts and/or expand community awareness of infant safe sleep. These efforts must adhere to the MDCH/G&PD FY 13/148/1/13 ATTACHMENT lil Page 59 of 87 guidelines for infant safe sleep safety and S1DS risk reduction issued by the American Academy of Pediatrics in 2011. Activities are to be culturally relevant to at-risk, high-risk families in the community and reflect diversity in terms of race, ethnicity, language, and socioeconomic status. 2. LHD will convene and facilitate a local advisory team that focuses on infant safe sleep, a public/private partnership that coordinates local efforts to promote infant safe sleep and reduce infant deaths related to unsafe sleep environments. If a similar community based group or team addressing infant safe sleep already exists, it is not necessary to create a new one. 3. Funds are not to be used for purchase of giveaways such as cribs, pack-and-plays, sleep sacks, etc. However, these items may be purchased if used as demonstration tools for educational purposes. Department Requirements 1. Provide technical assistance for infant safe sleep through Infant Safe Sleep Coordinator. Reporting Requirements 1. LHD will submit a final report on all activities by October 30, 2014 via email to Patti Kelly, MDCH Infant Safe Sleep Program Coordinator, at kellyp2@michigan.gov. INFORMED CONSENT SPECIAL REQUIREMENTS Contractor Requirements The following requirements apply to all local health departments, whether the health department operates a Family Planning Clinic or not: 1. When a woman states that she is seeking an abortion and is requesting services for that purpose the Contractor will provide: A pregnancy test with a determination of the probable gestational stage of a confirmed pregnancy. Note: The contractor must destroy the individual "informed consent" files containing identifying information (Name, Address, etc.) after 30 days. 2. When a woman seeks a pregnancy test and does not explicitly state that she is doing so for the purpose of obtaining an abortion, she should be directed to a family planning clinic or to her primary care provider for a pregnancy test. Services to comply with PA 345 of 2000 should not be provided to a woman in a Title X funded family planning clinic. Department Requirements The Department will provide funding, at the fixed rate of $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services noted in item 1 above. The number of services, rate per service and total amount due must be noted as a funding source, under the element where the staff providing the services are funded, on the Comprehensive FSR through Ml E-Grants. LABORATORY SERVICES SPECIAL REQUIREMENTS(KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES, MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 60 of 87 KENT COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY HEALTH DIVISION,SAGINAW COUNTY HEALTH DEPARTMENT) Contractor Requirements 1. Contractor Specific Requirements - All Contractors A. Meet established standards of performance and objectives in the following areas: 1. Bioterrorism: a. Make one FTE available to participate in training and exercises associated with Bioterrorism (BT). b. Train additional staff to perform Laboratory Response Network (LRN) Sentinel and Reference level laboratory procedures. c. Secure and maintain Select Agent Registration. d. Maintain competency and proficiency for testing procedures described in the LRN protocols including result entry into LRN Results Messenger. e. Participate in the MDCH sponsored proficiency testing (PT) program consisting of two PT shipments per year and with CDC provided LRN PT. Continued funding is based on successful participation with a minimum passing grade of 80%. f. Temporarily assign one FTE to MDCH or another LRN Reference level laboratory as surge capacity for emergency situations if needed. g. Develop a plan to provide laboratory services 24 hours a day, 7 days a week for a BT event. h. Provide secure facilities to store reagents, quality control organisms and patient isolates. i. Provide 24/7 contact information. j. Initiate BT testing within 4 hours of sample receipt in contractor lab. 2. Maintain Clinical Laboratory Improvement Amendments (CLIA) of 1988 certification for high complexity testing. 3. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. 4. Renew yearly a Memorandum of Understanding (MOU) with MDCH BOL for Laboratory Response Network (LRN) testing. B. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. C. Provide the Bureau of Epidemiology, and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH all specimen submission data and reporting data will be entered and reported using Bureau of Laboratories (BOL) Laboratory Information Management Systems (LIMS) software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in LIMS training activities. D. Provide information on specimen submission to local health jurisdictions to assure that specimens are submitted to LRN regional laboratory, or nearest appropriate LRN MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 61 of 87 laboratory as determined by the Department. Department Requirements 1. Department Requirements (for AH Contractors): A. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. B. The Department will provide access to LIMS, support for LIMS hardware and software, user training for LIMS utilized for testing performed under contract, advanced training for LIMS liaisons for test master and Contractor specific data. The Department will maintain the sole contract with LIMS vendor. Backups and maintenance of all moduie(s)/customization(s) will be performed by MDCH staff, C. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to ongoing program activities. D. Assist in technical training of testing personnel and computer software utilization. E. Supply Contractor with a copy of the contracts associated with this program. F. Renew yearly a Memorandum of Understanding (MOU) with MDCH BOL for Laboratory Response Network (LRN) testing. G. The Department will provide funding for one FTE and provide training at MDCH for up to two individuals in Laboratory Response Network (LRN) Sentinel and Reference level laboratory procedures. The Department will provide access to LRN protocols on a secure website and funding for supplies used to train for or to handle a potential BT event. The Department will provide proficiency testing materials on a semi-annual basis and funding, as available, for equipment necessary to perform designated LRN Reference level lab protocols. 2. Department Requirements (for Kalamazoo County Health & Community Services, Kent County Health Department and Saginaw County Department of Public Health Only) A. Michigan Department of Community Health (MDCH): 1. Designate and assign personnel who meet the qualifications required as a high complexity laboratory director in CLIA 1988. 2. Laboratory Directors will: a. Sign the appropriate CMS paperwork for CLIA certification for their region as needed. b. Perform annual site visit of the Agency high complexity laboratory and assist in CLIA surveys. c. Be available for consultation to the Agency laboratory by telephone, email, and other communication methods. d. Provide technical consultation for laboratory guidelines, testing procedures, quality control methods or quality assurance in accordance with CLIA requirements. e. Review Quality Assurance program with attention to effective quality control activity and corrective action. f. Review and sign training records and competency evaluations. g. Review and sign external proficiency testing results in a timely manner. MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 62 of 87 h. Review and sign procedure manual(s) annually, and any new procedure prior to its implementation. Contractor Specific Requirements 1. Saginaw County Department of Public Health A. Perform pre-paid tests for Gonorrhea and Chlamydia by nucleic acid amplification. A list of assigned submitters will be provided by MDCH. The Saginaw County Department of Public Health will meet established standards of performance and objectives in the following areas: 1. Perform testing using the Gen Probe APTIMA Tigris system. 2. Maintain CLIA certification. 3. Subscribe to and successfully participate in proficiency testing for CT/GC. 4. Enter all specimens and report results in StarLIMS. Data entry should include all fields associated with race, ethnicity, date of collection, gender, specimen type, provider type, reason for test and all other fields required for regulatory compliance. 5. Initiate testing on the day the specimen is received by the laboratory and no later than one calendar day after the specimen is received. 6. Perform testing Monday - Friday, except for the following holidays: New Year's Eve, New Year's Day, Martin Luther King Day, Presidents day, Good Friday, Memorial Day, July 4th, Labor Day, Veteran's Day, Thanksgiving Day, day after Thanksgiving, Christmas Eve, and Christmas Day. 7. Participate in quarterly Michigan Infertility Prevention Program Alliance (MIPP) meetings held in Lansing. 8. Provide a quarterly report that include test volumes, turn around times, and a summary of any quality assurance issues encountered and action taken to resolve them. Average turn around times shall not exceed 4 days, including weekends. 9. Work with MDCH staff to resolve data integrity issues that are found when quarterly IPP reports are prepared for the Centers for Disease Control and Prevention (CDC). 10. Maintain an adequate inventory of reagents and disposables to insure no interruptions in testing. 11. Attempt to establish reimbursement agreements with relevant Medicaid Managed Care Provider Networks to secure third party reimbursement for non- voucher tests submitted for eligible Medicaid patients. 12. The laboratory will test appropriately collected specimens from Medicaid Provider Networks even in the absence of a reimbursement agreement with that provider. The STD, Family Planning, or Adolescent Health Programs will reimburse the testing laboratory the comprehensive agreement cost per voucher test for rejected charges as funding permits. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 63 of 87 13. Follow a quality system plan equivalent to the Department's plan including but not limited to quality control intervals, occurrence management, personnel assessment (education, training, and competency). 14. Package and ship collections kits for all voucher and non-voucher tests for all submitters assigned to their laboratory. 15. Develop a continuity of operations with MDCH to assure uninterrupted testing. 16. Test 15,000 CT/GC voucher tests and 2,930 CT only voucher tests. The department will reimburse the Saginaw County Department of Public Health $12.72 for each voucher GC/CT test reported in StarLIMS and $11.33 for each voucher CT only test reported in StarLIMS. A test is considered a voucher test if it is received on a voucher requisition showing a valid control number. LABORATORY SERVICES ELC SPECIAL REQUIREMENTS (KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES DEPARTMENT) Contractor Specific Requirements — Kalamazoo County Department of Public Health 1. Provide laboratory support to investigate all suspect Norovirus outbreaks that occur in Kalamazoo County. 2. Act as a surge capacity laboratory for MDCH to perform Norovirus testing when MDCH has reached maximum testing capacity or if MDCH laboratory resources are required for another purpose. Activation of the Kalamazoo County laboratory for this purpose will be made by the BOL Infectious Diseases Division Director. 3. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. 4. Provide the Bureau of Epidemiology, and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH all specimen submission data and reporting data will be entered and reported using Bureau of Laboratories (BOL) Laboratory Information Management Systems (LIMS) software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in LIMS training activities. 5. Meet established standards of performance and objectives in the following areas: A. Participate in an MDCH sponsored proficiency testing program consisting of two proficiency events per year. Continued funding is based on successful participation with a minimum passing grade of 80%. B. Provide Laboratory support for examination of up to 100 stool specimens associated with suspect Norovirus disease outbreaks. Specimens are to be processed within 2 business days of receipt. C. Utilize standardized testing procedures, standards of quality assurance and quality control approved by the Department laboratory director. Assist the Department in Quality Assurance Assessment semi-annually or as determined by the Department. D. Establish and maintain a personnel training and competency assessment program. Maintain documentation of training of all testing personnel. E. Maintain Clinical Laboratory Improvement Amendments (CLIA) of 1988 certification for high MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 64 of 87 complexity testing. LOCAL HEALTH DEPARTMENT SNAP-ED SPECIAL REQUIREMENTS(BERRIEN COUNTY HEALTH DEPARTMENT, DICKINSON-IRON DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT #10, , MARQUETTE COUNTY HEALTHDEPARTMENT, OAKLAND COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION, OTTAWA COUNTY HEALTH DEPARTMENT, , WASHTENAW COUNTY HEALTH DEPARTMENT, WESTERN UPPER PENINSULA DISTRICT HEALTH DEPARTMENT) The Local Health Department will: implement the Local Health Department SNAP-Ed Project in local communities in its jurisdiction, delivering programming with a primary focus on nutrition education according to the approved Supplemental Nutrition Assistance Plan-Education (SNAP-Ed) plan of work between October 1, 2013 through September 30, 2014; assure that efforts are made to target Supplemental Nutrition Assistance Program (SNAP) participants and eligible populations, especially adults and families; use appropriate allowable educational strategies and implementation methods to reach potentially SNAP eligible individuals/families; collect and report data regarding participation in SNAP-Ed and characteristics of those served. Contractor Requirements 1. The contractor's program plan will be on file with the department. 2. Participate in an evaluation process for the project in collaboration with MDCH staff. 3. Assist MDCH staff and its partners with Local Health Department SNAP-Ed regional trainings. 4. Attend required meetings and trainings as identified by MDCH. 5. The contractor shall collaborate with their program consultant to schedule site visits. 6. Implement programming with a primary focus on nutrition education according to the approved SNAP-Ed plan; assuring that efforts have been made to target SNAP-Ed participants; using appropriate educational strategies and implementation methods that are in compliance with Federal and State SNAP-Ed policies and procedures; collect and report data regarding participation in SNAP-Ed, and characteristics of those served and outcomes of educational programming. 7. Ensure cash or in-kind donations from other non-federal sources to SNAP-Ed have not been claimed or used as match or reimbursement under any other Federal program. 8. Upload a total of four progress reports into egrams using the reporting formats as required and made available by the Cardiovascular Section of the MDCH. a) Submit two quarterly progress reports in the same document as the Local Health Department SNAP-Ed Work Plan. Reporting Period Report Due Dates October 1, 2013 - January 31, 2014 February 15, 2014 February 1 - May 31,2014 June 15, 2014 b) Submit two Michigan Nutrition Network bi-annual progress reports and all requested deliverable materials, using the reporting format as required and made available by MDCH. Reporting Period Report Due Dates October 1, 2013 - March 30, 2014 April 15, 2014 April 1 - September 30, 2014 October 15, 2014 MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 65 of 87 9. Each Health Department has a 35% required match amount. Local Health Departments match spending must be allowable under SNAP-Ed guidelines and be accurately reported each month on the monthly Financial Status Reports (FSR). Supporting documentation for allowable monthly match spending must be kept on file at the Local Health Department and made available for review on request or during site visits. 10. Health Departments will be paid monthly based on actual expenditures reported on their monthly Financial Status Reports (FSR), which are due by the 15th of every month, using the reporting format as required by MDCH through MI E-Grants. 11. Documentation of local costs, payments, procedures, inventory, and itemized receipts for non- personnel expenses, in addition to original timesheets and personnel activity reports for billed hours must be maintained by the local agency and will be available for the MDCH, the Michigan Nutrition Network, the Michigan Department of Human Services and/or the USDA to review and audit. 12. All materials developed or printed with SNAP-Ed funds MUST include the appropriate USDA nondiscrimination statement, credit to SNAP-ED, the Michigan Nutrition Network orthe MDCH as a funding source, and a brief message about how the SNAP can help provide a healthy diet and how to apply for benefits. - Materials that cannot be e-mailed should be mailed/faxed to: Michigan Department of Community Health 109 W. Michigan Ave., Qth Floor Lansing, Ml 48913 ATTN: Katherine Nault Fax: 517-335-9056 13. Messages of nutrition education must be consistent with the Dietary Guidelines for Americans and stress the importance of variety, balance, and moderation, and do not disparage any specific food, beverage, or commodity. 14. Failure to comply with contract requirements may result in consequences including but not limited to denial of reimbursement for activities that were not performed, documented or were unallowable denial of future funding, and/or others as appropriate. LOCAL MATERNAL AND CHILD HEALTH WICH)PROGRAM SPECIAL REQUIREMENTS General Performance Requirements 1. LOCAL MATERNAL AND CHILD HEALTH Local MCH funds are intended to be flexible and available to local health departments to address locally identified needs related to the health of women and children in their jurisdictions. It is expected that each local health department will use a defined needs assessment process to determine and identify its MCH needs. In addition, local health departments are asked to examine, (to the extent data is available) their status on each of 28 MCH National and State Performance Measures. Eighteen of these indicators have been established by the MCH Bureau (MCHB) of the federal Department of Health and Human Services (DHHS) as mandated reporting requirements for all states. An additional ten measures have been selected as State measures by MDCH for annual monitoring and reporting to MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 66 of 87 DHHS in accordance with Title V MCH Block Grant requirements. It is important that local jurisdictions review these performance measures and identify any efforts to address these measures using their Local MCH allocation. It is left to local health departments to determine how Local MCH funds are to be used to address MCH needs. Contractor Requirements Submit a Local Maternal and Child Health Community Plan for use of the funds allocated for Local MCH Programs and report on the previous year's activity. The department will develop the format for the plan and the previous year's activity report. The plan due date is September 3, 2013 The previous year's activity report will be due at the time of the final FSR submission on December 16, 2013. Local MCH funds are to be budgeted as a funding source under any appropriate program element(s) (i.e., CSHCS, Child Health, Family Planning, Immunization, Maternal Infant Health Program, or Other Local MCH (locally defined program as described in the Local MCH Community Plan). This funding source cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of the expenditures and evidence is provided that the expenditures satisfy all funding requirements. Local MCH funds may not be used to supplant available/billable program income such as Medicaid or Plan First! fees or additional funding under the Medicaid Cost-Based Reimbursement process. Local effort for program elements supported by Local MCH funds must not be reduced in instances in which added Medicaid has been generated through enhanced collection of Medicaid fees and/or funding under the Medicaid Cost-Based Reimbursement process. LOCAL TOBACCO REDUCTION SPECIAL REQUIREMENTS (BARRY EATON DISTRICT HEALTH DEPARTMENT, BRANCH/HILLDSDALE/ST. JOSEPH HEALTH AGENCY, CHIPPEWA COUNTY HEALTH DEPARTMENT, DICKINSON-IRON DISTRICT HEALTH DEPARTMENT, GENESEE COUNTY HEALTH DEPARTMENT, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, INGHAM COUNTY HEALTH DEPARTMENT, JACKSON COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH DEPARTMENT DELTA & MENOMINEE COUNTIES, WASHTENAW COUNTY HEALTH, WESTERN UPPER PENINSULA HEALTH DEPARTMENT) Budget and Agreement Requirements No funds may be expended for lobbying as defined in Act No. 472 of the Public Acts of 1978, being sections 4.411 to 4.431 of the Michigan Compiled Laws. Agency Reguirements Complete requirements and update information in attached reports: 1sttri-annual report- 10/1/13- 1/31/14 - due February 15, 2014, 2nd tri-annual report - 2/1/14- 5/31/14- due June 12, 2014; 3rd tri- annual report- 6/1/14 - 9/30/14 - due Nov. 2, 2014. MICHIGAN ABSTINENCE PROGRAM (MAP) - SPECIAL REQUIREMENTS (DISTRICT HEALTH DEPARTMENT #2, DISTRICT HEALTH DEPARTMENT #4, JACKSON COUNTY HEALTH DEPARTMENT, TUSCOLA COUNTY HEALTH DEPARTMENT) Contractor Reguirement 1. Provide fourteen (14) or more hours of structured intervention to youth ages 10-15 (up to 21 for special education populations), spread across at least a four week period. Activities that are solely recreational or social shall not be included. 2. Develop and/or maintain a coalition/advisory council representative of the diversity of the community (including teens and parents/guardians) who are instrumental in all phases of the MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 67 of 87 program planning, implementation and evaiuation. The coalition/advisory council must meet at least quarterly throughout the funding period. 3. if programming will be provided by a subcontractor, a Letter of Understanding (LOU) detailing the responsibilities to which both parties agree must be completed. 4. Secure local matching funds (either cash or in-kind resources) totaling 50 percent or more of the amount requested. 5. A minimum of 90% of the proposed users must be served to access the total amount of allocated funds. 6. In addition to those mentioned here, the contractor must adhere to all of the Michigan Abstinence Program's Minimum Program Requirements (MPRs). Department Requirements 1. Provide administrative professional and technical consultation to the program. 2. Provide a minimum of one MAP-sponsored coordinator meetings/trainings per year. Reporting Requirements 1. The contractor shall submit program narrative reports on the following dates: Type of Report and Timeframe Due Date Quarterly Report (October 1, 2013 - December 31, 2013) January 30, 2014 Quarterly Report (January 1, 2014 - March 31, 2014) April 30, 2014 Quarterly Report (April 1, 2014 - June 30, 2014) July 30, 2014 Year-End Report (October 1, 2013 — September 30, 2014) November 30, 2014 2. Any such information as specified in the contract requirements and MAP Report Fact Sheet shall be developed and submitted by the Contractor as required by the Contract Manager. 3. Reports and information shall be submitted to the Contract Manager at: Robyn Corey Teen Pregnancy Prevention Consultant Michigan Department of Community Health P.O. Box 30195109 W. Michigan Ave., 4th Floor Lansing, MI 48909 4. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. 5. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the projects as determined by the Contract Manager. 6. MICHIGAN CARE IMPROVEMENT REGISTRY SPECIAL REQUIREMENTS Contractor Requirements 1. Michigan Care Improvement Registry (MCIR) responsibilities: A. Ensure that all immunizations administered to persons born after December 31,1993 by the contractor, or by any provider with the jurisdiction are reported to the MCIR. B. Ensure that all immunization providers within the Contractor's jurisdiction are registered through the MCIR and that all of their activities are coordinated with the regional contractor of the Department and operated within their guidelines. MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 68 of 87 MICHIGAN COLORECTAL CANCER EARLY DETECTION PROGRAM SPECIAL REQUIREMENTS (BARRY-EATON DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT #10, DISTRICT HEALTH DEPARTMENT #4, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, HURON COUNTY HEALTH DEPARTMENT, AND MUSKEGON COUNTY HEALTH DEPARTMENT) Contractor Requirements The Michigan Colorectal Cancer Early Detection Program (MCRCEDP) provides colorectal screening services to program eligible men and women: • Aged 50-64 years • Average risk for colorectal cancer - screened by Fecal Occult Blood Test (FOBT) • Increased risk for colorectal cancer - screened by colonoscopy • Low income (up to 250% of the Federal poverty level) • Who have inadequate or no health insurance For specific MCRCEDP requirements please refer to the most current MCRCEDP manual available at http://www.michiqancancer.ora/Colorectal/. MICHIGAN HEALTH AND WELLNESS 4X4 PLAN SPECIAL REQUIREMENTS(BERRIEN COUNTY HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT #10, OAKLAND COUNTY HEALTH DEPARTMENT) Contractor Requirements 1. Develop, submit and implement an approved work plan and budget which will be maintained on file The quarterly progress reports shall be submitted through MDCH E-Grants on the following dates: at MDCH. 2. Develop and implement an evaluation process, as appropriate and approved by MDCH staff. 3. Maintain an active coalition, to support the funded project, interventions and activities. 4. Submit quarterly progress reports, using the reporting format as required and made available by MDCH. Period Covered Report Due Dates October 1, 2013 - December 31, 2013 January 1, 2014- March 31, 2014 April 1, 2014-June 30,2014 July 1, 2014-September30, 2014 January 15, 2014 April 15, 2014 July 15, 2014 October 15, 2014 5. Attend required meetings. 6. The Contractor shall collaborate with the program consultant to schedule and participate in site visits. 7. Provide interventions and strategies to support physical activity, health eating and community wide public awareness campaign. Page 69 of 87MDCH/G&PD FY 13/148/1/13 ATTACHMENT Hi 8. Health Departments will be reimbursed monthly based on actual expenditures reported on monthly Financial Status Reports (FSR), which are due by the 15th of every month, using the reporting format as required by MDCH through Ml E-Grants. 9. Performance will be measured based on the progress towards meeting work plan objectives. Activities in your work plan, the expenditures, reports, site visits, success stories and evaluation outcomes will also be used to assess progress and level of impact. 10. Each Health Department will have a 25% required match. 11. Failure to comply with these requirements may result in punitive consequences including but not limited to reimbursement of activities that were not performed, denial of future funding and/or other consequences as appropriate. NURSE FAMILY PARTNERSHIP (NFP1 SERVICES SPECIAL REQUIREMENTS (BERRIEN COUNTY HEALTH DEPARTMENT, GENESEE COUNTY HEALTH DEPARTMENT,INGHAM COUNTY HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES DEPARTMENT, KENT COUNTY HEALTH DEPARTMENT,OAKLAND COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION, AND SAGINAW COUNTY HEALTH DEPARTMENT) Contractor Requirements for All State Funded Projects Maintain Fidelity to the Model: 1. Adhere to the Nurse Family Partnership (NFP) National Service Office program standards and operate the program with fidelity to the requirements of MDCH and the National Service Office Application Review Team approved Implementation Plan and Annual Plan. Projects must incorporate MDCH and NSO NFP requirements as required for fidelity. Staffing: 2. NFP home visiting nursing staff will reflect the community served. If unable to obtain and maintain a staff that reflects the population served, the agency must document their good faith, due diligent effort to comply with this requirement. Submit a staff roster for the fiscal year and within 30 days of a change. Target Population: 3. Michigan is using NFP as a specialized home visiting service strategy for low income, first time mothers whose population group contributes to the community's excess infant deaths. This specialized service strategy is a focused way use limited resources, directing it to the most at risk populations. 4. The Provider shall develop an Outreach Plan for NFP that is consistent with the risk-based analysis identified in the Annual Kitagawa analysis county profile for excess infant death rates provided by MDCH. 5. The provider shall demonstrate that enrollment reflects the use of the outreach plan and shall submit quarterly reports on outreach activities and caseload population status. 6. The provider shall refer clients not eligible for NFP to the Maternal Infant Health Program(s) in their community or another home visiting program designed for at risk pregnant women in their county. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 70 of 87 Program Monitoring. Assessment. Support and Technical Assistance (TA): 7. Fully participate with National Service Office Site Developer and MDCH Nurse Consultant program monitoring, assessment, support and technical assistance services. Professional Development and Training: 8. All NFP program staff will participate in professional development and training activities, as required by NFP. They will also be required to participate in home visiting learning communities and/or other learning opportunities offered by the state. Engage and Coordinate with Community Stakeholders: 9. Assure that there is a broad-based community advisory committee that is providing oversight for NFP. This will occur collaboratively with other early childhood committees or advisory bodies, or the Local Leadership Group established to work with the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program as listed below. Coordinate with Appropriate Entities/Programs: 10. Build upon and maintain diverse community and target population collaboration and support. 11. Participate in a local home visiting committee (or if none, at the Great Start Collaborative) that seeks to effectively align home visiting efforts across the community, and represent NFP in Continuous Quality Improvement efforts that assess the impact of the overall home visiting effort in the community. Data Collection: 12. Comply with all NFP and MDCH data collection requirements. 13. Authorize the Michigan Department of Community Health (MDCH) and the Michigan Public Health Institute (MPHI) to receive information from the national NFP clinical information system (CIS) known as Efforts to Outcomes (ETO). 14. Work with the MIECHV Evaluation contractor to develop a plan to collect and report additional data beyond that required for NFP. Continuous Quality Improvement (CQh: 15. Participate in all NFP quality initiatives including: research, evaluation and continuous quality improvement. 16. Participate in all State and local Home Visiting CQI (established by the Local Leadership Group) activities as required by MDCH. Nurse-Family Partnership Medicaid Outreach Reguirements For Berrien. Kalamazoo. Kent, Oakland and Calhoun Counties only: 17. Nurse Family Partnership Medicaid Outreach Requirements are in the Annual Budget Instructions document. Follow Nurse-Family Partnership Medicaid Outreach Requirements in the FY13 Attachment I "Instructions for the Annual Budget." The percentage match is 50% based on the percentage of project clientele that are Medicaid enrolled beneficiaries. Match funding is only available for NFP clients who are Medicaid enrolled beneficiaries. Reporting Reguirements 18. The contractor shall adhere to the NFP, Inc., National Office program reporting requirements. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 71 of 87 19. The Provider shall submit all required reports in accordance with the MDCH reporting requirements. a. Staff Roster: within 30 days of the beginning of each fiscal year and within 30 days of a staffing change. b. NFP Community Outreach Plan: within 30 days of the beginning of each fiscal year. c. Quarterly Reports (on outreach activities and caseload population status): within 30 days of the end of each quarter. d. Medicaid Outreach Report: within 30 days of the end of each quarter. 20. Reports and information shall be submitted to: Rosemary Foumier Division of Family and Community Health Michigan Department of Community Health P.O. Box 30195 Lansing, Michigan 48909 orThe Division of Family Community Health mail box at DFCH@michiqan.qov (put "Nurse Family Partnership Reports FY 14 in the subject line). PRACTICES TO REDUCE INFANT MORTALITY THROUGH EQUITY (PRIME) LOCAL LEARNING COLLABORATIVE SPECIAL REQUIREMENTS (INGHAM COUNTY HEALTH DEPARTMENT) Project Overview: Practices to Reduce Infant Mortality through Equity (PRIME). This project received 3 years of funding from W. K. Kellogg Foundation. The project began in May 2010. The project has three goals: 1) Develop a replicable workforce training and practice model that incorporates social justice and the elimination of racism in both organizational policy and practice. The model is to be used as a strategy for eliminating disparities in health outcomes, related to infant mortality in Michigan; 2) Use a state/local partnership network to codify effective efforts that undo racism and improve infant health in Michigan. Share local lessons learned statewide and disseminate experience of Michigan communities that inform this work and improve effective engagement of stakeholders in policy making decisions; and 3) Identity a sustainable quality assurance process that recognizes social determinants of health in policies, program models and practices, allocation formulas and/or program accreditation review. This should include public documentation of health status data and stories of African Americans and American Indians in Michigan. The PRIME Local Learning Collaborative formed in March 2011 to accomplish the work outlined in Goal 2. The agency will be responsible for participating in the following: 1. Assist the PRIME Steering Team assemble, codify and share activities and experiences from and around the state that inform the work in PRIME 2. Assist in developing an Dissemination Plan to share the LLC's work in health equity, health disparities and undoing racism throughout the state 3. Gather and submit data on the agencies' work in health equity, health disparities and undoing racism 4. Participate in PRIME Local Learning Collaborative meetings Funds may be used to pay for: 1. Project staff salaries and associated payroll taxes and fringe benefits 2. Program administration (e.g. accounting, payroll) 3. Travel associated with PRIME meetings & activities 4. Communications (e.g. telephone, fax, postage, internet access) 5. Printing and copying MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 72 of 87 6.Consultant/professional fees (evaluation consultant) 2013 - 2014 PUBLIC HEALTH EMERGENCY PREPAREDNESS fPHEP) SPECIAL REQUIREMENTS (INCLUDING CRI FUNDING FOR, CITY OF DETROIT HEALTH AND WELLNESS, WAYNE, OAKLAND, LIVINGSTON, LAPEER, MACOMB AND ST. CLAIR COUNTY HEALTH DEPARTMENTS) OCTOBER 1, 2013-JUNE 30, 2014 Contractor Requirements The Public Health Emergency Preparedness section of Attachment III is effective from October 1. 2013 through June 30. 2014. Funds are provided by MDCH for nine months based on the Department's fiscal year. As a sub-recipient of funding provided through the Centers for Disease Control and Prevention (CDC) National Bioterrorism Hospital Preparedness Progrma (HPP) and Public Health Emergency Preparedness (PHEP) Cooperative Agreement, each local health department (LHD) shall conduct activities to buiid preparedness and response capacity and capability. These activities shall be conducted in accordance with the HPP/PHEP Cooperative Agreement guidance for 2013-2014 plus any and all related guidance from the CDC and Michigan Department of Community Health (MDCH) that is issued for the purpose of clarifying or interpreting overall program requirements. All LHD activities shall be consistent with all. approved BP2 work plan(s) and budget(s) on file with the MDCH through Ml E-Grams. In addition to these broad requirements, the LHD will comply with the following: 1. Required one (1) full time equivalent (FTE) emergency preparedness coordinator, as a point of contact. In addition to the LHD health officer, the emergency preparedness coordinator shall participate in collaborative capacity building activities of the HHP/PHEP Cooperative Agreement, all required reporting and exercise requirements and in regional Healthcare Coalition (HCC)initiatives. 2. There are a number of special initiatives, projects, and/or supplementals that are facilitated under this cooperative agreement. For example, the Cities Readiness Initiative (CRI) and performance and evaluation initiatives. Each LHD that is designated to participate in any "special" initiative, project, or supplemental is required to comply with all CDC and MDCH-OPHP guidance, and ail accompanying work plan and budgeting requirements implemented for the purpose of sub- recipient monitoring and accountability. Some or ail "special" initiatives, projects, orsupplementais may require separate recordkeeping of expenditures. If so, this separate accounting will be identified in separate project budgets in Ml E-Grams. These special projects may also require additional reporting and exercise activities. 3. LHDs are required to submit a 3-month (7/1/2013 to 9/30/2013) and 9-month (10-1-2013 to 6/30/2014) budget for both Base PHEP and Cities Readiness Initiative (CRI) funding, including the 10 percent MATCH for those periods (see #13 below for detail regarding Match). Submitted to OPHP PHEP@michiqan.Qov by May 8, 2013. 4. Submit all budget amendments to the Office of Public Health Preparedness (OPHP) for review prior to submitting them in E-Grams. Budget amendments that contain line items deviating more than 15 percent from the original budgeted line item must be approved by OPHP prior to implementation (15 percent deviation rule) via email to Jolene Miller at miileri39@michiaan.aov. Note: This change reflects the removal of the $10,000 maximum deviation. 5. Final Financial Status for funding period ending 6/30/14 reports MUST be submitted in E-Grams for this funding source no later than August 15, 2014. MDCH/G&PD FY 13/148/1/13 ATTACHMENT 111 Page 73 of 87 6. Supplantation: The replacement of non-federal funds with federal funds to support the same activities. The Public Health Service Act, Title I, Section 319(c) specifically states, "SUPPLEMENT NOT SUPPLANT. - Funds appropriated under this section shall be used to supplement and not supplant other federal, state, and local public funds provided for activities under this section." This law strictly and expressly prohibits using cooperative agreement funds to supplant any current state or local expenditures. 7. Unallowable Costs: A. Funds (PHEP) may not be used for relabeling activities.. B. Recipients may not use funds for fund raising activities or lobbying. C. Recipients may not use funds for research. D. Recipients may not use funds for construction or major renovations. E. Recipient may not use funds for clinical care. F. Recipients may not use funds to purchase vehicles to be used as means of transportation for carrying people or goods, e.g., passenger cars or trucks, electrical or gas - driven motorized carts. G. Recipients may not use funds to purchase pharmaceutical caches. H. Recipients may not use funds for reimbursement of pre-award costs. I. Recipients may supplement but not supplant existing state or federal funds for activities described in the budget. J. Payment or reimbursement of backfilling costs for staff is not allowed. K. None of the funds awarded to these programs may be used to pay the salary of an individual at a rate in excess of Executive Level II or $179,700 per year. 8. Exercise and Performance Measure Requirements: A. High Priority Performance Goal (HPPG): To ensure a timely and effective response to an incident, public health agencies must demonstrate their capability to immediately (with no advance notice) assemble pre-identified public health staff, with senior incident management roles, within 60 minutes of notification. The target date for reaching the 60 minute benchmark is November 1, 2013. B. All performance measures must be completed and the required data submitted to MDCH - OPHP by the due dates established in the LHD Work Plan for FY 2013-2014. C. Demonstrate capability to receive stage, store, distribute, track, and dispense medical countermeasures (MCM) during a public health emergency. 1. Attain a score of 89 percent or higher on the Division of Strategic National Stockpile (DSNS) Local Technical Assessment Review (TAR) tool. 2. Conduct a mass prophylaxis drill utilizing three of the eight RAND points of dispensing templates. This activity is MANDATORY for all seven CRI funded LHDs and OPTIONAL (but recommended) for the remaining LHDs. 3. The CRI Metropolitan Statistical Area (MSA) must conduct one full functional exercise in BP2 (or real event) testing key components or CAP from June 2013 exercise of their massdispensing/prophylaxis plan (This is related to the Medical Countermeasure Distribution and Dispensing (MCMDD) guidance required by CDC). 4. All SNS assets must be tracked by using CDC's Inventory Management and Tracking System (IMATS) at the LHD Distribution Node. MDCH/G&PD FY 13/148/1/13 ATTACHMENT II! Page 74 of 87 5. All pharmaceuticals and vaccines received from the SNS must be tracked down to the dispensing/administration level by using the Michigan Care Improvement Registry (MCIR). 9. Under the alignment of the HPP and PHEP cooperative agreements, LHD's must partner with the Regional Healthcare Coalition (HCC) and support HCC initiatives to ensure that healthcare organizations receive resources to meet medical surge demands. Working well together during a crisis, is facilitated by working together on a regular basis. To this end, Emergency Preparedness Coordinators, supported by CDC PHEP, are required to participate in, and support Regional Healthcare Coalition initiatives. In addition, the EPC or designee is required to attend 100 percent of Regional Healthcare Coalition planning or advisory board meetings; this will be confirmed through attendance registration. Each LHD aligned with multiple regions need only align with one region to meet this requirement. 10. Maintain National Incident Management System (NIMS) compliance as detailed in the LHD work plan and submit annually to MDCH - OPHP. 11. Each sub-recipient agency must retain program-related documentation for activities and expenditures consistent with Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations, to the standards that will pass the scrutiny of audit. 12. PHEP awardees shall, not less often thari once every two years, audit their expenditures from amounts received under these awards. Such audits shall be conducted by an entity independent of the agency administering a program funded, in accordance with the Comptroller General's standards for auditing governmental organizations, programs, activities, and functions and using generally accepted auditing standards. Awardees may choose to include PHEP as a major program in their required A - 133 audit process to fulfill the PAH PA - required biennial audit However, if awardees choose not to include PHEP expenditures as a part of their required A-133 audit process, a separate audit must be performed to fulfill the PAPHA - required biennial audit (Base and CRI). 13. Comply with required 10 percent MATCH for July 1, 2013 through September 30, 2013 and October 1, 2013 through June 30, 2014. LHDs are required to submit a letter (on agency letterhead) stating the source, calculation and narrative description of how the match was achieved. This was due with the narrative budget submission to MDCH - OPHP. 14. The Pandemic and All Hazards Preparedness Reauthorization Act (PAHPA) of 2013 requires the withholding of amounts from entities that fail to achieve PHEP benchmarks. The following PHEP benchmarks have been identified by CDC for FY 2013-2014: A. Demonstrated adherence to all PHEP application and reporting deadlines. Failure to submit required PHEP program data and reports by the stated deadlines will constitute a benchmark failure. B. Demonstrated capability to receive, stage, store, distribute, and dispense material during a public health emergency. 1. DSNS local TAR conducted within each planning/local jurisdiction within each CRI during Budget Period 1 2013-2014 2. A minimum of three different drills (not the same drill performed three times) conducted within each planning/local jurisdiction within each CRI metropolitan statistical area (MSA) during Budget Period 1 2013-2014. 3. Compliance with established medical countermeasure distribution and dispensing standards, target measures, and metrics as described in CDC's MCMDD Composite Guide. See LHD Work Plan for more information on submission of these requirements. MDCH/G&PP FY 13/148/1/13 ATTACHMENT III Page 75 of 87 15. LHDs that fail substantially to meet benchmarks for the immediately preceding fiscal year or who fail to submit pandemic influenza plans may have funds withheld from their awards. An awardee that fails to correct such noncompliance shall be subject to withholding in the following amounts per PAPHA: A. For the fiscal year immediately following a fiscal year in which an LHD has failed substantially to meet performance measures/benchmarks or submit a satisfactory pandemic influenza plan, an amount equal to 10 percent of funding the LHD was eligible to receive. B. For the fiscal year immediately following two consecutive fiscal years in which an LHD experienced such a failure, an amount equal to 15 percent of funding the LHD was eligible to receive, taking into account the withholding of funds for the immediately preceding fiscal year. C. For the fiscal year immediately following three consecutive fiscal years in which an LHD experienced such a failure, an amount equal to 20 percent of funding the LHD was eligible to receive, taking into account the withholding of funds for the immediately preceding fiscal year. D. For the fiscal year immediately following four consecutive fiscal years in which an LHD experienced such a failure, an_amount equal to 25 percent of funding the LHD was eligible to receive for such a fiscal year, taking into account the withholding of funds for the immediately preceding fiscal year. SEXUAL VIOLENCE PREVENTION SPECIAL REQUIREMENTS(KENT COUNTY HEALTH DEPARTMENT) Contractor Requirements Forward subcontracts, as applicable by January 2014. Strengthen individual knowledge in 80% of youth served. (Ongoing). Promote community education in Kent County (Ongoing). Educate Kent County Providers (Ongoing). Foster coalitions and networks in Kent County (Ongoing). Work with local businesses to change organizational practices (Ongoing). Provide information to assist local/state policy makers (Ongoing). 1. 2. 3. 4. 5. 6. 7. Reporting Requirements 1. The Contractor shall submit the following reports on the following dates: Deliverable Period Covered Due Date Project Report 1 10/01/13 - 02/29/14 04/14/14 Final Project Report 10/01/13-09/30/14 10/17/14 Evaluation Report 10/01/13-09/30/14 10/17/14 2. Any such other information as specified in the Contractor Requirements section shall be developed and submitted by the Contractor as required by the Contract Manager. 3. Reports and information shall be submitted to the Contract Manager at: Page 76 of 87 MDCH/G&PD FY 13/14 ATTACHMENT 1118/1/13 qrzwaczi@michiaan.qov. SEXUALLY TRANSMITTED DISEASE fSTD) CONTROL SPECIAL REQUIREMENTS(BERRIEN COUNTY HEALTH DEPARTMENT, CALHOUN COUNTY HEALTH DEPARTMENT, CITY OF DETROIT HEALTH AND WELLNESS, GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, JACKSON COUNTY HEALTH DEPARTMENT, KALAMAZOO COUNTY HUMAN SERVICES DEPARTMENT, KENT COUNTY HEALTH DEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT, MUSKEGON COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY HEALTH DEPARTMENT, SAGINAW COUNTY HEALTH DEPARTMENT, ST. CLAIR COUNTYHEALTH DEPARTMENT, WASHTENAW COUNTY HEALTH DEPARTMENT, WAYNECOUNTY HEALTH DEPARTMENT) OCTOBER 1, 2013 - December 31, 2013 1. For medical providers that identify 5% or more of the County's gonorrhea, chlamydia, and/or syphilis morbidity, the local STD program will visit them at least annually to review provider screening, reporting, treatment, and partner management methods. 2. Quarterly Reports: Contractor shall submit the Quarterly Clinic Activity and Medication Inventory Reports within 10 calendar days after the end of each quarter. 3. Participate in technical assistance/capacity development, quality assurance and program evaluation activities as directed by DHWDC/STD. 4. Implement program standards and practices to ensure the delivery of culturally, linguistically, and developmentally appropriate services. Standards and practices must address sexual minorities 5. Inform DHWDC/STD at least 2 weeks prior to changes in clinic operation (hours, scope of service, etc.) 6. Adhere to budgets and staffing plans submitted to and approved by DHWDC. Deviations outside of allowance must be approved by DHWDC. 7. For gonorrhea and chlamydia cases in the Michigan Disease Surveillance System, 50% shall be completed within 30 days and 60% within 60 days from the date of specimen collection. SUDDEN UNEXPLAINED INFANT DEATH fSUID) AND OTHER INFANT DEATH - SPECIAL REQUIREMENTS Contractor Requirements 1. LHD personnel will maintain current expertise in infant death research, bereavement and counseling techniques through educational in-service and/or personal professional development. 2. The LHD will update current curriculum and materials for maternal and child health programs to incorporate Sudden Unexplained Infant Death (SUID) and other infant death risk reduction information and interconception care education and/or counseling. Interconception care, per the joint program brief issued by the CDC and HRSA in 2008, is comprised of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and management, emphasizing those factors which must be acted on before conception or early in pregnancy to have maximal impact. Thus, it is more than a single visit and less than all well-woman care. It includes care before a first pregnancy or between pregnancies. 3. The LHD will facilitate bereavement support services to families and other caretakers of infants experiencing a SUID infant death. . In communities with an active Fetal Infant Mortality Review (FIMR) team, the LHD will facilitate bereavement support services to families and other caretakers experiencing any type of infant and perinatal death. MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 77 of 87 4. The LHD will encourage all infant deaths to be reviewed in the local Child Death Review team process or Fetal-Infant Mortality Review process (if available) to improve the consistency of death scene investigation, autopsy, death certificate documentation and accurate SUID diagnosis. Department Requirements 1. Provide payment of $125 for each family support visit. A maximum of 6 visits is reimbursable per infant death. 2. Provide training for certification of family support providers. 3. Provide technical assistance for bereavement support through Tomorrow's Child (Michigan SIDS). SEAL! MICHIGAN DENTAL SEALANT PROGRAM SPECIAL REQUIREMENTS(INGHAM COUNTY HEALTH DEPARTMENT AND OTTAWA COUNTY HEALTH DEPARTMENT) Contractor Requirements 1. Administer screening, fluoride and dental sealant applications to all eligible children with a signed consent form in MDCH Oral Health Program designated schools, to meet goals of the priority population. 2. Provide oral health promotion of dental sealants through literature and/or presentations to parents/guardians of children that are culturally and linguistically sensitive. 3. Provide instruction on oral health and sealant placement to children targeted for the SEAL! Michigan program prior to sealant placement. 4. Measure quality control of the sealant program through SEALS data software and provide hard copy forms to MDCH upon request: 5. Ensure all staff has received training in the SEAL! Michigan Program via on-line training provided by MDCH, which includes SEALS training. Note: even if training has been completed by grantees in previous years, attendance for the 2013-2014 grant cycles is required. 6. Adhere to CDC, OHSA and MIOSHA Standards and the State of Michigan Administrative Rules. 7. Ensure sealant material is approved by ADA, is non-expired, and applied according to manufacturer's specifications. 8. Demonstrate activity in establishing a dental home or referral network for children referred for dental treatment. Grantees must document that personal contact via phone or letter is made to the parent/guardian of child with urgent dental care needs. (Urgent means care needed within 24 hours). Grantee must have a mechanism to track the children receiving emergency dental restorative emergency services within 20 miles of the sealant site and provide the tracking information to MDCH upon request. 9. Provide details on how the program is working toward sustainability beyond the grant. Grantees must provide documentation on how sustainability is taking place, for example: Medicaid, 3rd party billing protocols or in-kind contributions. 10. Grantees must utilize experienced and competent staff to accomplish program goals. 11. Grantees must track separately the amount of schools they serve, how many children received dental sealants, and how many dental sealants have been placed separately from SEALS and be able to provide this information upon request. 12. Retention checks must be performed on 20% of children serviced and achieve 90% or better retention rates on occlusal surfaces and 65% retention rates on buccal pits. If retention is found to be less than 90% (meaning more than 10% of dental sealants are falling out) then 40% of students MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 78 of 87 must be checked for sealant retention. Any dental sealants which have fallen out upon the retention check must be replaced immediately free of charge and then rechecked for retention. 13. Grantees shall be compliant with sub-recipient grantee meetings quarterly. A minimum of two on- site visits will be required yearly, remaining two will take place via conference call. 14. To be considered for the non-competitive continuation grant the following must be completed: A. Meet and/or exceed all grant requirements and priorities B. Complete the non-competitive grant application in its entirety (see RFP) C. Have the application postmarked or received by the MDCH by December 1, 2013 for the second year. Reporting Requirements The Contractor shall submit the following reports within 15 days as stated on the following dates: Quarter End Date Report Due Date1s,Qtr (12/31/13) 01/15/142nd Qtr (03/31/14) 04/15/14 3rd Qtr (06/30/14) 07/15/144th Qtr (09/30/14) 10/15/14 1: Collect data through SEALS software so as to monitor the program effectiveness, final reporting due within two (2) weeks of the end of the year fourth quarter grant period. 2. The Contractor shall submit the following information electronically in an encrypted manner to MDCH Oral Health Program or through the State of Michigan File Transfer system. A. Complete Sealant Efficiency Assessment for Locals and States (SEALS) software to include: (Exported Child Level, Exported Event Level and entire software). This should be updated weekly and sent at the end of grant year in the fourth quarter and/or upon request by MDCH. B. Electronic copy of Program Level. This should be sent at the end of the 4th quarter and prepared for each quarterly site visit. C. Demonstration of retention check of sealants of 90% or greater on occlusal surfaces and 65% on lingual and buccal pits. 1. A sampling of 20% of the teeth sealed by new employees must be checked for retention within 3-6 weeks following sealant placement. All retention checks shall be entered into SEALS within each grant year. 3. A work plan should be submitted at the end of every quarter. The work plan should include an update on all of the contractor requirements. 4. Provide documentation that emergency dental restorative services are tracked for children referred through the SEAL! Michigan dental sealant program within a 20 mile radius of the sealant program. 5. The Contractor shall submit an Evaluation Form to be sent at the end 4th quarter. This will be provided to grantees by September 1, 2014, by Oral Health Coordinator. Send reports to: Jill Moore, Dental Sealant Coordinator Contact Information: Oral Health Program - SEAL! Michigan P.O. Box 30195 Division of Family and Community Lansing, Ml 48909 Health Phone (517)373-4943 Michigan Department of Community Fax (517)335-8697Health MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 79 of 87 MooreJ14@michiaan.aov TB CONTROL 340B PROGRAM SPECIAL REQUIREMENTS(BAY COUNTY HEALTH DEPARTMENT, BERRIEN COUNTY HEALTH DEPARTMENT, BENZIE- LEELANAU DISTRICT HEALTH DEPARTMENT, CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DICKINSON-IRONDISTRICT HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES DEPARTMENT, LIVINGSTON COUNTY DEPARTMENT OF PUBLIC HEALTH, LUCE- MACKINAC-ALGER-SCHOOLCRAFT DISTRICT HEALTH DEPARTMENT, MID-MICHIGAN DISTRICT HEALTH DEPARTMENT, MIDLAND COUNTY HEALTH DEPARTMENT, MONROECOUNTY HEALTH DEPARTMENT, PUBLIC HEALTH DELTA & MENOMINEE COUNTIES, SAGINAW COUNTY HEALTH DEPARTMENT, ST. CLAIR COUNTY HEALTH DEPARTMENT,WESTERN UPPER PENINSULA HEALTH DEPARTMENT) For those local health departments certified to participate in the 340B program to obtain reduced pricing for anti-tuberculosis medications, minimal funds are provided to offset expenses for administrative activities. Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds to purchase anti-tuberculosis medications or to pay for inpatient services. TUBERCULOSIS CONTROL AND ELIMINATION SPECIAL REQUIREMENTS(GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, KENT COUNTY HEALTH DEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY DEPARTMENT OF HEALTH AND HUMANSERVICES/HEALTH DIVISION, OTTAWA COUNTY HEALTH DEPARTMENT, WASHTENAWCOUNTY HEALTH DEPARTMENT, AND WAYNE COUNTY HEALTH DEPARTMENT) General RequirementsEach local health department as a sub-recipient of the CDC Tuberculosis Elimination Cooperative Agreement shall conduct activities for the purposes of tuberculosis control and elimination. Funds may be used support personnel, purchase equipment and supplies, and provide services directly related to core TB control front-line activities, with a priority emphasis on DOT (Directly Observed Therapy), case management, completion of treatment and contact investigations. Funds may also be used to support incentive or enabler offerings to enhance patient adherence to treatment. Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds to purchase anti-tuberculosis medications or to pay for inpatient services. Examples of appropriate incentive/enabler offerings include retail coupons, public transit tickets, food, non-alcoholic beverages, or other goods/services that may be desirable or critical to a particular patient. For more information and suggested uses of incentive/enabler options, refer to CDC's Self-Study Module #9, Enhancing Adherence to Tuberculosis Treatment at http://www.cdc.qov/tb/education/ssmoduies/module9/ss9readina3.htm. Contract Specific Requirements 1. Utilize DOT as the standard of care to achieve at minimum 80% of TB cases enrolled in DOT (Jan 1-Dec 31). 2. Document in MDSS all changes to treatment regimen using the Report of Verified Case of Tuberculosis (RVCT) comments field (pg. 12), and completion of therapy using RVCT FolIow-Up2 (pg-7)-3. Maintain evidence of monthly DOT logs on site (to be made available if needed). Monthly submission of DOT logs is no longer required. 4. Achieve at least 94% completion of treatment within 12 months for eligible TB cases. The determination of treatment completion is based on the total number of doses taken, not solely on the duration of therapy. Consult the most current ATS document Treatment of Tuberculosis for guidance in the number of doses needed and the length of treatment required following any interruptions in therapy. MDCH/G&PD FY 13/148/1/13 ATTACHMENT ill Page 80 of 87 5. Maintain appropriate documentation on site (to be made available if needed). Document the appropriate use of expenditures for incentive and enabfers for clients to best meet their needs to complete DOT and appropriate therapy. 6. Ensure >90% completion of RVTC pages 1 - 6 in MDSS within one month of diagnosis. 7. Unallowable Costs per federal guidelines: a. Funds can not be used for procurement of anti-tuberculosis medications b. Funds can not be used for research c. Funds can not be used for inpatient services 8. Ensure that confidential public health data, is maintained and transmitted to MDCH, in compliance with applicable standards defined in the "CDC Data Security and Confidentiality Guidelines for HIV, Virai Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Programs" http://www.cdc.qov/nchhstp/proqramintearation/docs/PCSIDataSecuntvGuidelines.pdf Reporting Requirements: DOT Logs are maintained on site and available if needed. All other data must be entered into MDSS as stipulated in contract specific requirements. TAKING PRIDE IN PREVENTION fTPIP) SPECIAL REQUIREMENTS (CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT, JACKSON COUNTY HEALTH DEPARTMENT) Contractor Requirements 1. Implement, with fidelity, the approved evidence-based intervention to youth ages 12-19. Activities that are solely recreational or social shall not be included. 2. Develop and/or maintain a coalition/advisory council representative of the diversity of the community (including teens and parents/adults/caregivers) who are instrumental in all phases of the program planning, implementation and evaluation. The coalition/advisory council must meet at least quarterly throughout the funding period. 3. If programming will be provided by a subcontractor, a Letter of Understanding (LOU) detailing the responsibilities to which both parties agree must be completed. 4. Secure local matching funds (either cash or in-kind resources) totaling 35 percent or more of the amount requested. 5. A minimum of 90% of the proposed users must be served to access the total amount of allocated funds. 6. In addition to those mentioned here, the contractor must adhere to its approved program work plan and all of the Teen Pregnancy Prevention Initiative's Minimum Program Requirements (MPRs). Department Requirements 1. Provide administrative professional and technical consultation to the program. 2. Provide two two-day TPIP-sponsored Institutes per year. Reporting Requirements 1. The contractor shall submit progress reports on the following dates: Type of Report and Timeframe Due Date Quarterly Report (October 1, 2013 - December 31, 2013) January 30, 2014 Quarterly Report (January 1, 2014 - March 31, 2014) April 30, 2014 Quarterly Report (April 1, 2014-June 30, 2014) July 30, 2014 Year-End Report (October 1, 2013- September 30, 2014) November 30, 2014 MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 81 of 87 2. Any such information as specified in the contract requirements and TRIP Report Fact Sheet shall be developed and submitted by the Contractor as required by the Contract Manager. 3. Reports and information shall be submitted to the Contract Manager at: Kara Anderson Teen Pregnancy Prevention Coordinator Michigan Department of Community Health P.O. Box 30195 109 W. Michigan Ave., 4th Floor Lansing, Ml 48909 4. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. 5. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the projects as determined by the Contract Manager. TEEN PREGNANCY PREVENTION INITIATIVE rTPPH SPECIAL REQUIREMENTS (DISTRICT HEALTH DEPARTMENT #10) Contractor Requirements 1. Provide approved evidence-based, comprehensive teen pregnancy prevention intervention to youth ages 10-19. Activities that are solely recreational or social shall not be included. 2. Develop and/or maintain a coalition/advisory council representative of the diversity of the community (including teens and parents/adults/caregivers) who are instrumental in all phases of the program planning, implementation and evaluation. The coalition/advisory council must meet at least quarterly throughout the funding period. 3 .If programming will be provided by a subcontractor, a Letter of Understanding (LOU) detailing the responsibilities to which both parties agree must be completed. 4. Secure local matching funds (either cash or in-kind resources) totaling 35 percent or more of the amount requested. 5. A minimum of 90% of the proposed users must be served to access the total amount of allocated funds. 6. In addition to those mentioned here, the contractor must adhere to its approved program work plan and all of the Teen Pregnancy Prevention Initiative's Minimum Program Requirements (MPRs). Department Requirements 1. Provide administrative professional and technical consultation to the program. 2. Provide two two-day TPPI-sponsored coordinator meetings/trainings (institutes) per year. Reporting Requirements 1. The contractor shall submit progress reports on the following dates: Type of Report and Timeframe Due Date Quarterly Report (October 1, 2013 - December 31, 2013) January 30, 2014 Quarterly Report (January 1, 2014 - March 31, 2014) April 30, 2014 Quarterly Report (April 1, 2014 — June 30, 2014) July 30, 2014 Year-End Report (October 1, 2013 - September 30, 2014) November 30, 2014 2. Any such information as specified in the contract requirements and TPPI Report Fact Sheet shall be developed and submitted by the Contractor as required by the Contract Manager. Page 82 of 87 MDCH/G&PD FY 13/14 ATTACHMENT ill8/1/13 3. Reports and information shall be submitted to the Contract Manager at: Kara Anderson Teen Pregnancy Prevention Coordinator Michigan Department of Community Health P.O. Box 30195 109 W, Michigan Ave., 4th Floor Lansing, Ml 48909 4. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. 5. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the projects as determined by the Contract Manager. WiC SPECIAL REQUIREMENTS Contractor Requirements 1. Provide for security of Project FRESH coupons and WIC EBT cards stored in the local contractor prior to issuance. The Contractor must notify the WIC Division in writing of any lost, stolen, inappropriately issued or otherwise unaccounted for Project FRESH coupons or EBT cards, immediately upon recognition of such condition. 2. Comply with the requirements of the WIC program as prescribed in the Code of Federal Regulations (7 CFR, Part 246) including the following special provisions: If a local Contractor operates a WIC Program within a hospital or has a cooperative agreement with one or more hospitals, the hospital is required to advise the potentially eligible individuals that receive inpatient or outpatient prenatal, maternity, or postpartum services or accompany a child under age 5 years who receives well-child services, of the availability of WIC benefits [246.6(F)(1)]. 3. Maintain an inventory of all equipment purchased with WIC program funds and maintain such inventory at each WIC clinic location. 4. Assure each Contractor employee authorized for or requesting access to the automated WIC system complete and sign a security agreement. 5. The Agency in accordance with the general purposes and objectives of this agreement, will comply with the federal regulations requiring that any individual that embezzles, willfully misapplies, steals or obtains by fraud, any funds, assets or property provided, whether received directly or indirectly from the USDA, that are of a value of $100 or more, shall be subject to a fine of not more than $25,000. 6. The Agency is responsible for installation and maintenance of WIC hardware according to guidance provided by the MDCH WIC Program. Special Reporting Requirements Local agencies shall (when requested) annually report expenditures related to nutrition education and breastfeeding promotion and support, on a supplemental form, if needed and required, to be provided by the Department and attached to the final Financial Status Report (FSR) which is due on November 30 after the end of the fiscal year through Ml E-Grants. The supplemental form will focus on expenditures related to Travel, Equipment, Subcontract and Other Expense categories and will not include expenditures related to salaries, wages and fringe benefits. Additionally, only expenditures supported bv regular WIC funds should be reflected on this supplemental form. Local agencies shall report nutrition education and breastfeeding promotion and support expenditures by completing the WIC Nutrition Education and Breastfeeding Time Study as required by MDCH. Page 83 of 87MDCH/G&PD FY 13/14 ATTACHMENT ill8/1/13 Breastfeeding Peer Counseling Program expenditures are not to be included. The 1/6^ nutrition education requirement and breastfeeding target must still be met with regular WIC/NSA funds. Expenditures incurred that are related to general nutrition education and forthe promotion and support of breastfeeding are to be summarized as: 1. Nutrition Education 2. Breastfeeding Allowable Nutrition Education (NE) Expenses are: 1. Costs for procuring equipment for NE (as approved by the State WIC Program). 2. Interpreter or translator services to facilitate NE. 3. Evaluation or monitoring of NE. 4. NE material costs. 5. Costs of training nutrition educators, including costs related conducting training sessions and purchasing & producing training materials. 6. Costs for clinic space devoted to NE activities. 7. Travel and related expenses incurred by WIC staff to conduct any NE activity. 8. Costs of reimbursable agreements with other organizations, public or private, to provide NE to WIC participants. Allowable Breastfeeding (BR Promotion & Support Expenses are: 1. Peer counseling if supported with funds allocated through the WIC funding formula. (Report as time study data.) 2. Cost of procuring BF educational materials. 3. Interpreter or translator services to facilitate BF promotion and support. 4. Costs of training BF promotion & support educators, including costs related to conducting training sessions and purchasing and producing training materials. 5. Costs of clinic space devoted to BF promotion & support educational and training activities, including space set aside for BF WIC infants. 6. BF aids which directly support the initiation and continuation of BF, as purchased with WIC funds allocated through the funding formula. 7. Costs of documenting, monitoring and/or evaluating BF promotion and support staff, activities, methods and materials. This includes the cost of collecting, analyzing and evaluating data concerning WIC participant's opinions on the effectiveness of the BF promotion and support they received. (Report as time study data.) 8. Travel and related expenses incurred by WIC staff to conduct any BF promotion and support activity. 9. Costs of reimbursable agreements with other organizations, public or private, to undertake training and direct service delivery to WIC participants concerning BF promotion and support. The examples above are not all inclusive. In-kind support can also be included, if other non-WIC resources are used for those costs. Please note that costs for data processing, communications, postage, freight, rent and utilities necessary to conduct NE and BF activities must be prorated to the applicable functional category (NE/ BF promotion and support). The Agency is required to complete the NE and BF staff time study survey as instructed by the MDCH WIC Program. Page 84 of 87 MDCH/G&PD FY 13/14 ATTACHMENT III 8/1/13 Special Requirements for the WIC Breastfeeding Peer Counseling Program Funds allocated for the Breastfeeding Peer Counseling Program are exempt from the WIC Nutrition Education and Breastfeeding Time Study. The agency may only charge certain allowed expenses to the Peer Counselor Grant. Expenses for Breastfeeding education and supplies must be charged to the normal WIC budget; not the Peer Counselor Grant. See "Allowable Expenses" below. Financiai Reporting A Financial Status Report (FSR) must be submitted to the MDCH Accounting Office on a quarterly basis. To meet USDA grant reporting deadlines, the local agency shall submit program expenditures to the State WIC Division using DCH-0386 Attachment B.2 Program Budget - Cost Detail Schedule Attachment B.2. Send to the attention of the State WIC Breastfeeding Coordinator. Reports are due by the 15th day of January, March, July and October. Allowable Expenses The primary purpose of these funds is to provide breastfeeding support services through peer counselingto WIC participants. Expenses may include: • Supervisor and/or mentor staff time • Materials that educate/advertise to WIC clients about the Peer Counseling Program • Educational resources for Peer • Voicemail, cell phones or phone-line expenses • Equipment or office furniture • Indirect costs The Agency, however, must not charge a disproportionate amount of funds for these above noted items when compared to funds spent on direct service delivery by the Peer Counselor. Other Reporting The Agency shall maintain monthly records for each individual Peer Counselor. Specific supplemental reporting forms will be provided by the State WIC Office. Reports are due to the State WIC Office by the 15th day of January, March, July and October. Training and Education Designated local agency staff are required: • To attend Supervisory training. • To attend a minimum of two program updates. • To train the peer counselors per standards set forth by USDA and the State WIC Division. Designated Peer Counselors are required to attend specific training that includes, but is not limited to: • Breastfeeding Basics Training • State WIC Peer Counselor Meetings • Annual WIC Conference Staff Training and Education MDCH/G&PD FY 13/148/1/13 ATTACHMENT III Page 85 of 87 Designated local agency staff are required: • To attend Supervisory training. • To include designated State Lactation Consultants (LC) as part of the peer counselor recruitment and applicant interview team. • To attend a minimum of two program updates. • To train the peer counselors per standards set forth by USDA and the State WIC Division. Peer Counselors are required to attend specific training that includes, but is not limited to Breastfeeding Basics Training, State WIC Peer Counselor meetings and Annual WIC Conference. Other Local Aaencv Obligations The following requirements apply to the local agency receiving a special allocation for the Breastfeeding Peer Counseling Program. USDA and MDCH/WIC require the local agency to comply with the following nine components: 1. Hire staff that meet the definition of Peer Counselor. 2. Designate a Breastfeeding Peer Counselor Manager at the local level. 3. Establish job parameters and a description for the peer counselor that is consistent with State -WIC policy. 4. Establish compensation and reimbursement rates for peer counselors. 5. Train appropriate WIC local peer counseling management and clinic staff. 6. Establish standardized breastfeeding peer counseling program procedures at the local level as part of the Agency's WIC Nutrition Services Plan. 7. Supervise and monitor the peer counselor(s). Establish community partnerships to enhance the effectiveness of the WIC peer counseling program. 8. To include designated State Lactation Consultants (LC) as part of the peer counselor recruitment and applicant interview team. 9. Provide: • timely access to breastfeeding coordinators/lactation experts for assistance outside the peer counselor scope of practice; • regular, systematic contact with the supervisor; • participation in clinic staff meetings and breastfeeding in-services as part of the WIC team; • opportunities to meet regularly with other peer counselors. 10. Provide training and continuing education of the peer counselor(s). 11. Provide access to Peer Counselor outside of normal business hours via a cell phone or direct line with voicemail that can be accessed after hours. WELL-INTEGRATED SCREENING AND EVALUATION FOR WOMEN ACROSS THE NATION fWISEWOMAN) PROJECT SPECIAL REQUIREMENTS (BARRY EATON DISTRICT HEALTH DEPARTMENT, CITY OF DETROIT HEALTH AND WELLNESS, DISTRICT HEALTH DEPARTMENT #10, DISTRICT HEALTH DEPARTMENT #2, GENESEE COUNTY HEALTH DEPARTMENT, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, HURON COUNTY HEALTH DEPARTMENT, LENAWEE COUNTY HEALTH DEPARTMENT, PUBLIC HEALTHDEPARTMENT DELTA & MENOMINEE COUNTIES) MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 86 of 87 Contractor Requirements WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) is a program designed to screen women for chronic disease risk factors, counsel them about lifestyle changes to reduce risk factors, and refer them for medical treatment of hypertension, hyperlipidemia, and/or diabetes meliitus. This program will be based within Michigan's Breast and Cen/ical Cancer Control Program. For specific WISEWOMAN Program requirements, refer to the most current WISEWOMAN Program Policies and Procedures Manual. Contractor Requirements - Barry Eaton District Health Department, Public Health, Delta & Menominee Counties, District Health Department #10, Health Department of Northwest Michigan Through the WISEWOMAN Systems and Environmental Change project, agencies are required to conduct one low cost systems or environmental change intervention that will benefit WISEWOMAN participants and the communities where they live. The WISEWOMAN Systems and Environmental Change Funding will not be subject to the caseload performance requirement. Therefore, these funds will not be included in the settlement that may be required if screening levels do not meet caseload performance requirements. Reporting requirements: Progress Report (November 1, 2013 - December 31, 2013 Due: February 1, 2014 Progress Report (November 1, 2013-July 31, 2014 Due: August 30, 2014 Final Progress Report (November 1, 2013 - September 30, 2014 Due: October 25, 2014 Reports shall be submitted to the Contract Manager at: Paulette M. Valliere, Ph.D. Manager, Breast and Cervical Cancer Control Unit Cancer Prevention & Control Section P.O. Box 30195 Lansing, MI 48909 Phone: (517) 335-8049 E-mail: vajlierep@michiqan.aov MDCH/G&PD FY 13/148/1/13 ATTACHMENT II!Page 87 of 87 FOOTNOTES: FY 13 14 (a) Refer to Plan and Budget Framework for element definitions.(b) Refer to master comprehensive agreement and program and budget instructions package for further explanation of applicability of these reimbursement methods. (c) Negotiated starting from the average of the past two complete years'actual number where available.(d) Calculated by multiplying the "Total Performance Expectation" column by the ratio of the elements total State funding (DCH 0410, Line 24) to "Total Expenditures DCH 0410, Line 17). Prior to calculation, adjustments will be made for unallowable cost, equipment funded by local funds and MDCH reimbursement not performance based (I.E., fixed unit rate, staffing).(e) Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. (f) Refer to master comprehensive agreement and budget instructions package for further explanation regarding these designations. (1) CSHCS Care Coordination 1. Case Management i A. Maximum of six (6) services per year ! B. Reimbursement - $201.58 per service provided face-to-face in the home setting.2. CARE COORDINATIONA. LEVEL I PLAN OF CARE1. Annual Plan of Care in the home or home-like setting that requires the Care Coordinator to travel to a non-LHD site $150 2. Annual Plan of Care over the telephone $100B. LEVEL II CARE COORDINATION 1. Level II Care Coordination is reimbursed at $30.00 per unit 2. A maximum of 10 units per beneficiary per eligibility year will be reimbursed. (2) Reimbursement Chart for Fixed Rates AIDS/HIV Prevention Non- $11.00 per blood draw for non-categorical health departments. Limited annually to $2,000. Categorical Biomonitoring of Toxic $40.00 per participant, with minimum payment of $800 per clinic session Substances in MichiganUrban Fisheaters I Body Art $250/appl. annual license prior to 7/1; $125/appl. annual license after 7/1; $112.50/appl. temporary license; $250/appl. renewal prior to 12/1; $375/appl. renewal after 12/1; $25/duplicate license FDA Tobacco Retailer $325.20 per inspection. i(A&L) Inspections-Oakland only Immunization Assessment $100 per personal visit or $50 for a phone call (with information mailed afterward) to the provider office, not to exceed the Feedback Incentive maximum set for each individual contractor. Exchange (AFIX) Follow-up Immunization Nurse $200 per session except Vaccines Across the Lifespan, which is to be reimbursed at $250 per session, upon completion and submission of Education Provider Contracts and Report Forms. Reimbursement can only be made for one in-service module session per physician clinic site per year. Immunization VFC (only) $150 per site visit, not to exceed the maximum set for each individual Contractor.Provider Site Visits Immunization VFC/AFIX $300 per site visit, not to exceed the maximum set for each individual Contractor. Original Notes FY 13 148/14/2013 Combined Provider SiteVisits Informed Consent $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services. Laboratory Services & STD See contract language for gonorrhea and chlamydia testing reimbursement performance requirementsAIDS SIDS $125 for each family support visit. A maximum of six (6) visits per infant death is reimbursable (3) Allocation to be reflected in individual programs during budgeting process. (4) Funding Source (not a single element). Hearing and Vision are single elements.(5) Subject to Statewide Maintenance of Effort requirement for Title X. (6) State funding is first source (after fees and other earmarked sources). (7) Fixed unit rate subject to actual costs. (8) The performance reimbursement target will be the base target caseload established by MDCH. (9) Subject to a match requirement (hard or in-kind) of $1 for each $3 of MDCH agreement funding for Coordination.(10) Fixed rate limited to contract amount. (11) Up to six (6) visits per family. (12) Non-categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum of $2,000 annually. (13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Quarterly FPAR data will be used to determinetotal Title X users and Plan First! Enrollees. (14) Public Health Emergency Preparedness (PHEP) funding must be expended by June 30, 2014 and is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a nine month budget and a quarterly Financial Status Report (FSR)column for this program element. (15) Public Health Emergency Preparedness (PHEP) funding for Julyl, 2014-September 30, 2014 is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a three-month budget and a quarterly Financial Status Report(FSR) column for this program element. (16) Project meets the Research and Development criteria as defined by OMB Circular A-133, Audits of States, Local Governments and Non-Profit Organizations. (17) American Recovery and Reinvestment Act (ARRA) provision applies. See attached appendix for provision. (18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements. NOTE: Some footnotes may not apply to this agency. Original Notes FY 13 148/14/2013 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals GeneralAdministration (Law) Annual StateAppropriation Bills* (Law) Public HealthCode PA 368 of 1978 (as amended)* (Law) Single Audit Act -Amended*1996 (Law) Federal MCH Block Grants-P.L. 97-35 of 1981 (as amended)'1' (Law) Subcontract Requirements, CivilRights Laws/SpecialAssurances as specified in the agreements* (Law) Local UniformBudgeting Act P.A. 621 of 1978 (as amended)* (Law) Local UniformAccounting Act P.A. 71of 1919 (as amended)* (Law) Section 1352 of P.L. 101-121 (re:Lobbying)(3> (Law) Management andBudget Act* (Law) OBRA 89 P.L. 101 -239 (amendment toTitle V)* (Law) 1968 P.A. 317 and1973 P.A. 196 as amended regardingconflict of interest* (Law) P.L. 103-227 Part C Environmental Tobacco Smoke* (Law) PA 533 of 2004 (Rules) 325.13053 - 2CFR Part 225 (OMB Circular A-87) (Revised) Cost Principles for State, Local and Indian Tribal Governments - Federal OMB Circular A-102 (Revised) Implemented through "Common Rules- Grants Management* - PHS Grants Management Handbook* - 45 CFR Part 96 Block Grant Regulations (1) - 45 CFR Part 74 Administration of Grants(3) or; 45 CFR Part 92, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments, as applicable* - Federal OMB Circular A-133 Audits of States, Local Governments and Non-Profit Organizations* - Federal OMB Circular A-133 Compliance Supplement - 2 CFR Part 180 Guidelines to Agencies onGovernmentwide Debarment and Suspension * - 45 CFR Part 93 Lobbying* - 45 CFR Parte, Inventions and Patents* - 42 CFR Parts 432 and 433 (Title XIX Funded Programs) - 45 CFR, Part 46, Protection of Human Subjects - Catalog of Federal Domestic Assistance (CFDA)* FORSUBGRANTEES: - 2 C.F.R. Part 220 (OMB Circular A-21) Cost Principles for Educational Institutions* ¦ 2 CFR Part 215 (OMB Circular A-110) UniformAdministrative Requirements for Grants and Other Agreements with Institutions of Higher Education, Hospitals and Other Non-profit Organizations* - 2 C.F.R. Part 230 (OMB Circular A-122) CostPrinciples for Non-profit Organizations* - Federal OMB Circular A-133 Audit Requirements for States, Locai Governments and Non-ProfitOrganizations* - Federal OMB Circular A-133 Compliance Supplement - Americans With Disabilities Act of 1990* Waiver Policy BCS-2007* MDCH Funding Allocation Policy* Minimum Program Requirements - Department Policy8000* Capita! Outlay PriorApproval Policy - BCS-014* - Waiver Procedure BCS-2007.1< - Capital Outlay Prior Approval Procedure BCS-014.1* (State) Local FMIS Manual* (State) Treasury LHDAccounting Procedures Manual* (State) MDCH ReportingRequirements Notebook (H-284)* (State) Minimum ProgramRequirements (Fed) PHS Grants PolicyStatement* (Fed) PHS GrantsAdministration Manual* (Fed) HHS GrantsAdministration Manual* (State) Annual Budget, FSR& Indirect Instructions* MDCH/G&PD FY 13/14 Page 1 of 10 Program/Element FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures Breast & Cervical Cancer State/Federal Manuals - (Law) P.L 101-354 of1990 Title XV of Preventive Health Services Act (42 U.S.C.201) - (Law) Public Health Code PA 368 of 1978, Part 95- (Law) P.L. 105- 340-Women=s Health Research and Prevention Amendments of 1998. Campground Inspection Care for Individuals with serious communicabledisease orinfection Child Health Childhood Lead PoisoningPrevention Program - (Law) Public HealthCode PA 368 of 1978 as amended - (Rule) 325.1551 et, seq, (Law) Public HealthCode PA 368 of 1978 Part 53 (Rule) 325.177 - Dept. of HHS, CDC: Annua! Announcements, Early Detection & Control of Breast & Cervical Cancer; Program Guidance, Instruction and Information - Breast & Cervical Cancer Amendment of 1993 - 0) ¦ (1) - (Law) Public Health Code PA 368 of 1978Part 24 and 51 -PA 55of2004 - (Law) Lead AbatementAct -(1) - (1) CDC Screening Young Children for Lead Poisoning,1977 - CDC Managing Elevated Blood Lead Levels AmongYoung Children, 2002 MDCH EBLL Protocol, 2005, orany subsequent revision MDCH Case ManagementProtocol for Children, revised2007- Provider Guidelines,MDCH CLPPP, September 2007, or any subsequent revision. MDCH CLPPP Statewide LeadTesting/Lead Screening Plan,August 2007. Lead Safe Home Program Regional Field Consultant Policy and Procedures Field Guide CDC: "Preventing Lead Poisoning in YoungChildren", 2005 CDC: "Screening YoungChildren for Lead Poisoning"1997 CDC: "Managing Elevated BLLs Among YoungChildren", 2002 MDCH/G&PD FY 13/14 Page 2 of 10 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures Children's Special Health Care Services(CSHCS) - (Law) Public HealthCode PA 368 of 1978 Part 58 - (Law) Title V of the Social Security Act of 1935 42 U.S.C. 701 to706 Emergency Management-Community Health Annex - (Law) EmergencyManagement Act 310 of1978 MCL 30.410 i Family Planning - 0) - (Law) PA 303 (1965);PA 226(1997); PublicHealth Code P.A. 368 of1978; PA 360 (2002) - (Law) The Family Planning PopulationResearch Act (Title X ofthe Public Health Service Act - (Law) P.L 91-572,1970 - 0) - Catalog of Federal Domestic Assistance (93.217) - 42 CFR Part 59, Grants for Family PlanningServices - (State) Title X Family Planning Standards & Review Manual (2006) - (Fed) Federal ProgramGuidelines for Project Grants for Family PlanningServices (2001) - (Fed) Family PlanningAnnual Report (Eff.2007) - (Fed) Family Planning Annual Report,Effective2007, Standards and Guidelines FamilyPlanning Services for IndigentWomen - (Law) Public HealthCode P.A. 368 of1978-MCL 333.9131 - (Rules) 325-151 et, seq, Food Protection - (Law) Food Law of 2000Act 92 of 2000 MCL289,3105 - (Rules) 285.553.1 et. seq. HealthEducation - (Law) Public HealthCode PA 368 of 1978MCL 33.2433 Hearing - (Law) P.A. 368 SectionsR325.3271-3276. - School Aid Act - State of Michigan HearingScreening Technician Manual MDCH/G&PD FY 13/14 Page 3 of 10 FY 13/1 COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals HIV/AIDS Care (Law) Michigan LawMCL 333.5151 and MCL 333.1299 (Law) -Ryan WhiteHIV/AIDS TreatmentModernization Act of2006 - DSS Policy Guidelines: - No. 1: EligibleIndividuals and Services for Individuals Not Infected with HIV - No. 2: Allowable Uses of Funds for Discretely Defined Categories of Services, including Supplement - No 8: Staff Training - No. 4: DSS Policy onContracting with ForProfit Entities HAB Policy Notices: - No. 08-01: Use of RyanWhite HIV/AIDS Program funds forHousing Referral Services and Short- term or Emergency Housing Needs. ¦ No. 07-02: Use of RyanWhite HIV/AiDS Program Funds for HIVDiagnostics and Laboratory Tests ¦ No.07-01: Use of RyanWhite HIV/AIDS Program Funds for American Indians andAlaska Natives andIndian Health Service Programs - No. 07-04 TransitionalSocial Support and Primary Care Services for Incarcerated Persons. - No. 07-06- Use ofRyan White HIV/AIDSProgram Funds forOutreach Services - No. 07-07 Use of RyanWhite HIV/AiDS Program Funds for Veterans. Principles and Standards ofServices for HIV/AIDS Case Management in Michigan. CARF-MDCH Procedures forcompleting the ClientAuthorization for Counselor Assisted Referral form (CARF), January, 2006, or any subsequent revisions. HAPIS Administrative Versus Service/Program Cost Budget Guidance. - (Federal) Ryan White CAREAct Title II Manual MDCH/G&PD FY 13/14 Page 4 of 10 Program/Element FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals HIV Prevention Services - (Law) PA 488 of 1988,as amended by Act 200of 1994, and Act 420 of1994 (MCL 333.5133) - (Law) P.A. 489 of 1988(MCL333.5144a) ¦ (Law) P.A. 86 of 1992(MCL 333.5131) - (Law) Public HealthCode P.A. 368 of 1978(as amended) Quality Assurance Standards forHIV Prevention Interventions,May 2003 or subsequent revisions. • MDCH, Important HealthInformation, DCH 0675(previously HP-143). Michigan HIV Event System CTR and PCRS modules. Recommended Guidance for Conducting Partner Counseling and Referral Services (PCRS) Application for categoricallyFunded Local Public HealthDepartments, MDCH, October2006 Local Health Department PCRS Patient Field Investigation Form DCH-1275 or subsequent revisions. Addendum to PCRS Guidance; Useful HIV and STD Investigation Techniques, January 2007 Information Based TestingGuidance, MDCH 2004. Policy for Provision of HIV Test results Via Telephone. MDCH, October 2002. Michigan HIV Laws; WhatPhysicians and Other Health Care Providers Need to know. MDCH, January 2006. Confidential Request for Assistance with Partner Counseling and Referral ServicesForm (DCH-1221), or subsequent revisions. • MDCH Strategies to Improve Client Return Rates for Receiving HIV Test Results., May 2007, or subsequent revisions. Michigan HIV Event SystemCTR and Data definitionsand data collection templates. HIV Prevention Referral Guidelines and ToolboxMDCH, July 2007 MDCH/HAPIS HIV Prevention Counseling Quality Assurance Toolbox, February, 2007 MDCH Rapid HiV TestingQuality Assurance Manual,2008 or subsequent revisions. MDCH/G&PD FY 13/14 Page 5 of 10 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals MDCH-Protocol for HIV Counseling and Testing using Oral Mucosal Transudate Technology, MDCH 2002. CARF-MDCH Procedures for Completing the ClientAuthorization for CounselorAssisted Referral Form (CARF),August 2003, or any subsequent revisions. Michigan Local Public Health Accreditation Standards: Section Xli 2008, or subsequent revisions. Protocol for Low Morbidity Health - Department Response to Request for Assistance withDisease Management, MDCHJune 2006, or any subsequent revisions. Recalcitrant Behaviors AmongHIV/AIDS Diagnosed Populations: Guidance for Local Pubic Health Department Response to HealthThreat to Other Situations, 2005 or any subsequent revisions. CDC Integrated STD/HiV Partner Services Guidelines, June 2008 MDCH Targeted partnerCounseling and Referral Servicesfor HIV-infected Women, June 2008 or subsequent revisions HOPWA - MCL 112 of 1968, Fair Housing; 42 USCSection 800, Fair Housing -42 USC 12901 TheAIDS HousingOpportunity Act - 24 CFR Part 574 - 24 CFR part 5; income verification and subsidycalculation - The Lead-Based Paint Poisoning Prevention Act {42U.S.C. 4821-4846), the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851-4856), and implementing regulations at part 35,subparts A, B, H, J, K, M, and R of this part apply to activities under this program. - 24 CFR 82.306(d) receiving benefits when housedwith a family member - The policies, guidelines, and requirements of 24 CFRpart 85 (codified pursuant to OMB Circular No. A- 102) and 2 CFR Part 225 (OMB Circular No. A-87) apply with respect to the acceptance and use offunds under the program by States and units of general local government, including public agencies, and 2 CFR 215 (OMB Circular A-110) and 2 CFR Part 230 (OMB Circular A-122) apply with respect to the acceptance and use of funds under the program - Adhere to HUD documentation & program requirements - Annual Fiscal Year HOPWA FormulaOperating Instructions and attachments. Issued yearly. • MDCH INSTRUCTIONS FORPREPARATION OF BUDGETFORMS (DCH-0385, DCH-0386)in Attachment III Completion of MDCH FSR Formand FSR-Supplemental (FSR-S)form, with FSR MDCH instructions for the use of HMIS and completion of CAPER data entry. HUD Community Development Program (CPD) GranteeMonitoring Handbook; Chapters: 1 Introduction, 2 Management of Monitoring Activities, and 10 HousingOpportunities for Persons With AIDS (HOPWA). Be familiar with Chapter 20 Consolidated Plan. HUD Office of HIV/AIDSHousing HOPWA Grantee Oversight Resource Guide HOPWA Online Financial Management Training.Minimum of one current staff that has passed the training. MDCH/G&PD FY 13/14 Page 6 of 10 FY 13/14COMPREHENS1VE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals by private non-profit entities. - 24 CFR part 91 the Consolidated Plan must incorporate listed HIV/AIDS housing strategy orHOPWA elements & Submit a CAPER annually - Section 504 of the Rehabilitation Act of 1973 ("Section 504"), and Title II of the Americans with Disabilities Act of 1990 ("ADA"). - Notice CPD-06-06 Issued; May 15, 2006 Subject;Standards for Fiscal Year 2006 HOPWA Permanent Supportive Housing Renewal Grant Applications - Notice CPD-06-07 Issued August 3, 2006 Subject; Standards for HOPWA Short-term Rent, Mortgage,and Utility (STRMU) Payments and Connections toPermanent Housing - Frequently asked questions on HOPWA STRMU - NOTICE: CPD 04-10 Issued; September 29, 2004 SUBJECT: Guidelines for Ensuring Equal Treatment of Faith-based Organizations participating in the HOME, CDBG, HOPE 3, HOPWA. EmergencyShelter Grants, Shelter Plus Care, SupportiveHousing, and Youth-build Programs - CAPER-Measuring Performance Outcomes OMBNumber 2506-0133 Exp Date 10/31/2014 form HUD-040110-D - HUD Notice of Outcome Performance MeasurementSystem for CPD Formula Grant Programs [Docket No. FR-4970-N-02] - Fed Reg/Vol. 71, No. 45/Wednesday, March 8,2006/Notices HOPWA- Guidance to State Agencies Regarding the Use of Funds Received Under the American Recovery andReinvestment Act (ARRA) - Meet terms of the Federal Funding Accountability and Transparency Act of 2006 (FFATA) see www.whitehouse.aov/omb/oDen Staff that complet? TenantBased Rental Assistanceiabitability Inspections or ,-|QS Inspection must completehe online Lead-based PaihtVisual Assessment Training immunization - d)- (Law) P.L 99-660, revised by P.L 103-183, The Preventive HealthLaw of 1993, section1928, Part IV andsection 13631- (Law) P.L. 99-660, TheNational Childhood Vaccine Injury Act of1986- (Law) P.A. 540 of 1996- (Law) Public HealthCode PA 368 of 1978.as amended- (Law) P.A. 273 of 1996 - (1)- WIC policy memorandum ,#2001 - Vaccines for ChildrenOperations Manual - Immunization ProgramOperations Manual (1POM) - Vaccine PreventableDisease Reporting Manual - VFC Resource Book for Providers MDCH/G&PD FY 13/14 Page 7 of 10 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures AIDS Section Public/Private Sewer - (Law) Public Health Code PA 368 of 1978, as amended* - (Rules) R299.4101 et. seq. Public/Private Water Supply - (Law) Public Health Code PA 368 of 1978, as amended - (Rules) 325.2291 et, seq,- (Rules) 323.19691 et, seq,- (Rules) 325.11391 et, PublicSwimming Poo!Inspections - (Law) Public HealthCode PA 368 of 1978 - (Rules) 325.2111 et. SexualViolencePrevention (Law) Violence Against Women Act of 2005,TITLE 42. CHAPTER RA SUBCHAPTER II . Part J. S 280b-1c SMILE! MichiganDental Sealant - SEALS Data Collection Software, SEAL American, SMILE! Michigan DentalSealant User's Guide STD Control - (Rules) MDCH, Communicable &Related Diseases, byAuthority of Sec. 5111 ofPublic Health Code 368PA of 1978 (as amended), - (Rules) 325.1777 - CDC Integrated STD/HIV partner Services Guidelines, June 2008 - (Fed) Centers for DiseaseControl and Prevention Program Operations and Treatment Guidelines(Advisory Only) SIDS - (Law) Act 350 PA of1974 (MCL 52.205a) - (State) Sudden Infant Death Professional Services Manual- (State) SIDS Task Force Manual TB Controi-DOT - Public Health Code 5203& 5205 - (State) Core Curriculum MDCH/G&PD FY 13/14 Page 9 of 10 FY 13/14COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES AND MANUALS Program/Element Laws/Administrative Rules Federal Regulations/Circulars Policies Procedures State/Federal Manuals Vaccine Quality Assurance - 0)- (Law) Public Health Code PA 368 of 1978,Part 92- (Law) Section 317 of thePublic Health Service Act (42U.S.C. 247b) as amended - (1) - 42 CFR, Part 51b, Sub Parts A & B: Project Grantsfor Preventive Health Services; General Provisions; Grants for Communicable Disease Control - Federal Register, Vol. 58, No. 63, April 5, 1993 Vision - (Law) P.A. 368, SectionsR 325.13091-13096 - School Aid Act - State of Michigan VisionScreening TechnicianManual WIC - (Law) Federal Public Law 95-627 (Reauthorized through P.L. 101-147 Pursuantto the Child NutritionAct) - (Law) Section 17 of the Child Nutrition Act of 1966, as amended- (Law) Following Public Laws: 95-627,96-499, 97-35, 99-500, 99-591, 100-237, 101-147, 102- 518, 107-249 (Reauthorized through P.L. 109-85 and P.L.108-265) - 7 CFR, Part 246 and Part 3015 and 3016 - USDA Policy Memos - (MDCH/WIC LaboratoryProcedure Manual (DCH0476)- (State) WIC/MDCH - (State) WIC Policy andProcedure Manuaf (DCH-0296)- (State) Vendor Unit Policy and Procedures Manual- (Fed) Food and NutritionService (FNS) Instructions800-1 through 821-1 and113-2 - (Fed) WIC Administrative Cost Handbook/Advance Planning Handbook- (Fed) Financial ManagementHandbook (FNS-154) WISEWOMAN - (Law) P.L. 101-354 of1990 Title XV of Preventive Health Services Act (42 U.S.C.201)- (Law) Public HealthCode PA 368 of 1978,Part 95 - (Law) P.L. 105-340- Women's Health Research and Prevention Amendmentsof 1998. - Dept. of HHS, CDC: Annual Announcements, Early Detection & Control of Breast & Cervical Cancer;Program Guidance, Instruction and Information- Breast & Cervical Cancer Amendment of 1993 Footnotes: * Applies to multiple programs/elements, specific sections of the Law are noted for some programs/elements.' Initially noted under General Administration, but applies to other programs noted.^ initially noted under MIHAS, but applies to other programs noted.Initially noted under Genera! Administration, but applies to all federally funded programs/elements."Laws/Administrative Rules" column: (Law) signifies a Law, (Rule) signifies Administrative Rule. "State/Federal Manuals" column: (State) signifies a State Manual, (Fed) signifies a Federal Manual. MDCH/G&PD FY 13/14 Page 10 of 10 FISCAL NOTE (MISC. #13270) October 17, 2013 BY" FINANCE COMMITTEE, TOM MIDDLETON, CHAIRPERSONIN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2013/2014 COMPREHENSIVE PLANNING, BUDGETING, AND CONTRACTING (CPBC) AGREEMENT ACCEPTANCE TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule Xll-C of this Board, the Finance Committee has reviewed the above referenced resolution and finds:1. The Michigan Department of Community Health (MDCH) has awarded Oakland County Health Division funding in the amount of $9,681,849 for the period October 1, 2013, through September 30, 2014. 2. The initial FY 2014 award reflects an increase in the amount of $478,901 from the initial Fiscal Year 2012/2013 award amount of $9,202,948 (Please note that the Adopted Budget does not reflect the latest FY 2014 award).3. The current FY 2014 General Fund Revenue Budget (Fund 10100) is $4,133,189. The FY 2014 award amount for the General Fund Revenue is $4,287,890. 4. The current FY 2014 Grant Fund Revenue Budget is $5,956,685, which includes all fees and collections along with a Transfer In from Non Departmental Operations. The FY 2014 award amount for the Grant Fund Revenue is $5,716,175, which includes all fees and collections along with a Transfer In from Non Departmental Operations.5. The Grant Fund Revenue Budget is expected to balance with the award amount through anticipated additional State funding awards.6. If funding from the anticipated future awards fail to be realized, the Health Division will address this matter by way of submitting a separate resolution to amend the Budget through a reduction in expenditures. 7. Details of the total General Fund Revenue award are as follows: Michigan Dept. of Community Health $2,152,829 Food Protection 827,691 MDEQ Drinking Water 495,433 MDEQ On-Site Sewage 358,763 Hearing 219,078 Vision 213,433 Sexually Transmitted Disease 20,663 Total General Fund $4,287,890 8. Details of the total Grant Fund Revenue award are as follows: Adolescent Screening $ 18,250 Snap-Ed 50,073 Health & Wellness (4x4) 25,000 Immunization Action Plan 478,833 Fetal Infant Mortality 5,400 WIC 2,525,939 WIC Breastfeeding Peer Council 64,133 TB Control 60,024 Aids Prevention 497,900 Vaccine Replacement/Handling 105,464 Maternal and Infant Support 321,457 CSHCS Outreach and Advocacy 285,000 Infant Safe Sleep 22,500 Bioterrorism Coordinator 204,470 BT Lab Program 82,605 Cities Readiness Initiative 154,411 EPl Planner Workplace 7,500 Nurse Family Partnership 485.000 Total Grants $5.393.959 Total Program $9.681.849 9. The General and Grant Fund Revenue Budgets are amended per the attached Schedule A, to reflect the FY 2014 award. FINANCE COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Crawford absent. 10. Schedule A also includes budget amendments totaling $322,216 to recognize generated program fees and collections for CSHCS Outreach and Advocacy - $273,576 and Immunization Action Plan - $40,000 as well as Transfers In from Non Departmental Operations of $8,640 from a lease agreement with Walled Lake Consolidated School District for office space as approved per M.R. #11257. Resolution #13270 October 17, 2013 Moved by Hoffman supported by Quarles the resolutions (with fiscal notes attached) on the Consent Agenda be adopted (with accompanying reports being accepted). AYES: Dwyer, Gershenson, Gingell, Gosselin, Hatchett, Hoffman, Jackson, Long, Matis, McGillivray, Middleton, Quarles, Runestad, Scott, Spisz, Taub, Weipert, Woodward, Zack, Bosnic, Crawford. (21) NAYS: None. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the Consent Agenda were adopted (with accompanying reports being accepted). STATE OF MICHIGAN)COUNTY OF OAKLAND) I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on October 17, 2013, with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this 17th day of October 2013. i HEREBY APPROVE THIS RESOLUTION CHIEF DEPUTY COUNTY EXECUTIVE ACTING PURSUANT TO MCL 45.559A (7) Lisa Brown, Oakland County