HomeMy WebLinkAboutResolutions - 2015.12.09 - 22110MISCELLANEOUS RESOLUTION #15306 December 9,2015
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2015/2016
COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) AGREEMENT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Michigan Department of Health and Human Services(MDHHS) has awarded the Oakland
County Health Division funding via the Comprehensive Planning, Budgeting, and Contracting Agreement for
the period October 1, 2015 through September 30, 2016; and
WHEREAS the 2014/2015 Comprehensive Planning, Budgeting, and Contracting Agreement award included a
total funding amount of $10,188,437 in grant revenue and expenditures; and
WHEREAS the 2015/2016 Comprehensive Planning, Budgeting, and Contracting Agreement award reflects
grant funding in the amount of $10,234,461, an increase of $46,024 (0.045%) 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 MDHHS; amendments will be recommended to the FY 2016 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
2015/2016 Comprehensive Planning, Budgeting, and Contracting (CPBC) agreement for funding in the
amount of $10,234,461 for the period of October 1,2015 through September 30, 2016.
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 Health and Human Services, and that
the failure of the Michigan Department of Health and Human Services 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 with Fleming absent.
FISCAL NOTE (MISC. #15306) December 9, 2015
BY: Finance Committee, Thomas Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION —2015/2016
COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) AGREEMENT
ACCEPTANCE
To The Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The Michigan Department of Health and Human Services (MDHHS) has awarded Oakland
County Health Division funding in the amount of $10,234,461 for the period October 1,2015,
through September 30, 2016.
2. The initial FY 2016 award reflects an increase in the amount of $46,024 from the initial Fiscal
Year 2014/2015 award amount of $10,188,437 (Please note that the Adopted Budget does not
reflect the latest FY 2016 award).
3. The current FY 2016 General Fund Revenue Budget (Fund 10100) is $4,349,877. The FY 2016
award amount for the General Fund Revenue is $4,531,247.
4. The current FY 2016 Grant Fund Revenue Budget is $5,976,308, which includes all fees and
collections along with a Transfer In from Non Departmental Operations. The FY 2016 award
amount for the Grant Fund Revenue is $5,983,709, which includes all fees and collections along
with a Transfer In from Non Departmental Operations.
5. Details of the total General Fund Revenue are as follows:
Michigan Dept. of Health & Human Svcs. $2,251,290
Food Protection 859,213
MDEQ Drinking Water 514,301
MDEQ On-Site Sewage 372,426
Hearing 225,684
Vision 225,683
Sexually Transmitted Disease 82,650
Total General Fund $4,531,247
6. Details of the total Grant Fund Revenue are as follows:
Adolescent Screening
EVD Phase II
Immunization Action Plan
Fetal Infant Mortality
Gonococcal Isolate
WIC
WIC Breastfeeding Peer Council
TB Control
Aids Prevention
HIV Surveillance
Vaccine Replacement/Handling
Maternal and Infant Support
CSHCS Outreach and Advocacy
Infant Safe Sleep
Bioterrorism Coordinator
BT Lab Program
Cities Readiness Initiative
EPI Planner Workplace
Nurse Family Partnership
Total Grants
Total Program
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote.
$ 73,000
95,760
531,835
5,400
10,000
2,476,239
143,397
48,678
498,900
35,000
113,241
321,457
285,000
22,500
226,917
30,000
159,225
5,625
621,040
$5,703,214
$10,234,461
7. The General and Grant Fund Revenue Budgets are amended per the attached Schedule A, to
reflect the FY 2016 award.
8. Schedule A also includes budget amendments totaling $280,495 to recognize generated program
fees and collections for CSHCS Outreach and Advocacy - $236,855 and Immunization Action
Plan - $35,000 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 #15306 December 9, 2015
Moved by Dwyer supported by Zack the resolutions (with fiscal notes attached) on the amended Consent
Agenda be adopted (with accompanying reports being accepted).
AYES: Dwyer, Fleming, Gershenson, Gingell, Gosselin, Hoffman, Jackson, Kochenderfer, KowaII,
Long, McGillivray, Middleton, Quarles, Scott, Spisz, Taub, Weipert, Woodward, Zack, Bowman,
Crawford. (21)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent
Agenda were adopted (with accompanying reports being accepted).
NEREEIY APPROVE 711111S P.F8oLorc.)K
CHIEF DEPUTY
ACTING PURSUANT TO MCL
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 December 9, 2015,
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 9th day of December 2015.
Lisa Brown, Oakland County
GRANT REVIEW SIGN OFF — Health Division
GRANT NAME: FY 2016 Comprehensive Planning, Budgeting, and Contracting Agreement
FUNDING AGENCY: Michigan Department of Health and Human Services
DEPARTMENT CONTACT PERSON: Rachel Shymkiw / 452-2151
STATUS: Grant Acceptance
DATE: October 12, 2015
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 (10/6/2015)
Department of Human Resources:
HR Approved (No Committee) — Lori Taylor (10/6/2015)
Risk Management and Safety:
Approved by Risk Management. — Robert Erlenbeek (10/7/2015)
Corporation Counsel:
I have reviewed the above referenced grant and see no legal issues with it, approved. — Bradley G. Benn
(10/912015)
From:
To:
Cc:
Subject:
Date:
Van Pelt, Laurie Ni
West. Catherine A
5econtine. Julie L; Taylor, Lori; Davis. Patricia G.; 5hyrnkiw. Rachel M; Forzlev Kathleen C; McLernon. Kathteen
11; Pisacreta, Antonio a
Re: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive Planning, Budgeting,
and Contracting (CPBC) - Grant Agreement
Tuesday, October 06, 2015 4:02:39 PM
Approved
Sent from my iPhone
On Oct 6, 2015, at 3:04 PM, West, Catherine A <westca cgoakgov.com > wrote:
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor — Julie
Secontine — Pat Davis
RE: GRANT CONTRACT REVIEW RESPONSE —Health and Human
Services/Health Division
2015/2016 Comprehensive Planning, Budgeting, and Contracting (CPBC)
Agreement
Michigan Department of Health and Human Services
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: October 15, 2015
GRANT INFORMATION
Date: October 6, 2015
Operating Department: Health and Human Services/Health Division
Department Contact: Rachel Shymkiw
Contact Phone: 2-2151
Document Identification Number:
REVIEW STATUS: Acceptance - Resolution Required
Original source of funding: Federal and State
Will you issue a sub award or contract: yes
Funding Period: 10/1/15 through 9/30/16
New Facility / Additional Office Space Needs: N/A
IT Resources (New Computer Hardware / Software Needs or Purchases):
N/A
Funding Continuation/New: Continuation
Application Total Project Amount: $10,234,461.00
From: Tavloc,Lori
To: West, Catherine A; Secontine. Julie L; Van Pelt. Laurie II; Davis. Patricia G
Cc: Shvmkiw Rachel 14; Forzley. Kathleen C; McLernon. Kathleen M; Fisacreta Antonio S
Subject: RE: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive Planning, Budgeting,
and Contracting (CPBC) - Grant Agreement
Date: Tuesday, October 06, 2015 5:03:14 PM
HR Approved (No Committee)
From: West, Catherine A
Sent: Tuesday, October 06, 2015 3:05 PM
To: Secontine, Julie L; Van Pelt, Laurie M; Taylor, Lori; Davis, Patricia G
Cc: Shymkiw, Rachel M; Forzley, Kathleen C; McLernon, Kathleen M; Pisacreta, Antonio S
Subject: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive
Planning, Budgeting, and Contracting (CPBC) - Grant Agreement
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor — Julie Secontine — Pat
Davis
RE: GRANT CONTRACT REVIEW RESPONSE —Health and Human Services/Health
Division
2015/2016 Comprehensive Planning, Budgeting, and Contracting (CPBC) Agreement
Michigan Department of Health and Human Services
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: October 15, 2015
GRANT INFORMATION
Date: October 6, 2015
Operating Department: Health and Human Services/Health Division
Department Contact: Rachel Shymiciw
Contact Phone: 2-2151
Document Identification Number:
REVIEW STATUS: Acceptance - Resolution Required
Original source of funding: Federal and State
Will you issue a sub award or contract: yes
Funding Period: 10/1/15 through 9130/16
New Facility / Additional Office Space Needs: N/A
IT Resources (New Computer Hardware / Software Needs or Purchases): N/A
Funding Continuation/New: Continuation
Application Total Project Amount: $10,234,461.00
Prior Year Total Funding: $10,188,437.00 (original award amount prior to amendments)
New Grant Funded Positions Request: 0
Changes to Current Positions: N/A
From: frienbeck. Robert C
To: West. Catherine A; Secontine. Julie L; VanPelt. Laurie M; Taylor, Loh; Davis. Patricia G
Cc: 5hymkiw Rachel M; Forzley, Kathleen C; McLernon Kathleen M; Pisacreta Antonio S
Subject: RE: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive Planning, Budgeting,
and Contracting (CPBC) - Grant Agreement
Date: Wednesday, October 07, 2015 9:28:19 AM
Approved by Risk Management. R.E. 10-07-15.
From: Easterling, Theresa
Sent: Tuesday, October 06, 2015 3:38 PM
To: West, Catherine A; Secontine, Julie L; Van Pelt, Laurie M; Taylor, Lori; Davis, Patricia G
Cc: Shymkiw, Rachel M; Forzley, Kathleen C; McLernon, Kathleen M; Pisacreta, Antonio S
Subject: RE: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive
Planning, Budgeting, and Contracting (CPBC) - Grant Agreement
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,
RM15-0373, regarding this matter.
Thank you.
From: West, Catherine A
Sent: Tuesday, October 06, 2015 3:05 PM
To: Secontine, Julie L; Van Pelt, Laurie M; Taylor, Lori; Davis, Patricia G
Cc: Shymkiw, Rachel M; Forzley, Kathleen C; McLernon, Kathleen M; Pisacreta, Antonio S
Subject: GRANT REVIEW: Health and Human Services/Health Division - FY 2016 Comprehensive
Planning, Budgeting, and Contracting (CPBC) - Grant Agreement
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor — Julie Secontine — Pat
Davis
RE: GRANT CONTRACT REVIEW RESPONSE —Health and Human Services/Health
Division
2015/2016 Comprehensive Planning, Budgeting, and Contracting (CPBC) Agreement
Michigan Department of Health and Human Services
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: October 15, 2015
GRANT INFORMATION
Date: October 6, 2015
Operating Department: Health and Human Services/Health Division
Department Contact: Rachel Shymkiw
From:
To:
Cc:
Subject:
Date:
fienn. Bradley G
West. Catherine A
5hvmk1w. Rachel M
2015-1051 HEALTH FY 2016 Comprehensive Planning, Budgeting, and Contracting (CPBC) - Grant Agreement
Friday, October 09, 2015 2:35:05 PM
I have reviewed the above referenced grant and see no legal issues with it, approved.
Thanks,
Bradley G. Benn
Assistant Corporation Counsel
Department of Corporation Counsel
1200 N. Telegraph Road Bldg 14 East
Courthouse West Wing Extension, 3rd Floor
Pontiac, MI 48341-0419
Phone: (248) 858-0558
Fax: (248) 858-1003
Email: bennb(aoakgov.com
PRIVILEGED AND CONFIDENTIAL — ATTORNEY CLIENT COMMUNICATION
This e-mail is intended only for those persons to whom it is specifically addressed. It is confidential 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 ar
e
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.
Contract #: 20161702-00
Agreement Between
Michigan Department of Health and Human
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. 34 East
Pontiac MI 48341 0432
Federal I.D.#: 38-6004876, DUNS #: 136200362
hereinafter referred to as the "Grantee"
for
The Delivery of Public Health Services under
the Comprehensive Agreement
Part I
1. Purpose
This agreement is entered into for the purpose of setting forth a joint and cooperative
Grantee/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 Grantee 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, 2015 and continue through September
30, 2016. 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
Grantee 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 $10,234,461.00.
Datei 11/0612015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 1 of 167
Health Division, Comprehensive Agreement - 2016
B. Equipment Purchases and Title
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 Grantee 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 limited 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 Cl, 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 Grantee 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 II -
General Provisions, which are part of this agreement through reference:
1. Attachment 1- Annual Budget
2. Attachment III - Program Specific Assurances and Requirements
3. Attachment IV - Funding/Reimbursement Matrix
B. The attachments are added into this Agreement as follows:
1. Original Agreement (Part I and Part II) - Attachment I, Ill, IV
Date: 11 /06/201 5 Contract # 20161702-CO, Oakland County Department of Health and Human Services/ Page: 2 of 167
Health Ofvision, Comprehensive Agreement - 2010
5. Statement of Work
The Grantee 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 II and Attachment I -
Annual Budget and Attachment IV - 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 Grantee 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: May Alkhafaji Brenda Roys
Title: Departmental Analyst Departmental Analyst
Telephone No.: 517-241-0176 517-373-1207
E-Mail Address alkhafajim@michigan.gov 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 Grantee, 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 Grantee prior to the signing of this agreement.
D. The Grantee is required by PA 533 of 2004 to receive payments by electronic
funds transfer.
Date: 11/06/2015
Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 3 of 167
Health Division, Comprehensive Agreement - 2016
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 Grantee.
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 Health and Human Services
Kim Stephen
Kim Stephen, Director
Bureau of Purchasing
11/06/2015
Date
Date: 1110612016 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 4 of 167
Health Division, Comprehensive Agreement - 2016
Part ll
General Provisions
Responsibilities - Grantee
The Grantee in accordance with the general purposes and objectives of this agreement
will:
A. Publication Rights
1. Where the Grantee exclusively develops books, films, or other such
copyrightable materials through activities supported by this agreement,
the Grantee may copyright those materials. The materials that the
Grantee copyrights cannot include service recipient information or
personal identification data. Grantee 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 Grantee 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 Grantee 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 granted in this agreement to the Grantee.
If the Grantee 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
Grantee has to the federal government.
3. The Grantee shall give recognition to the Department in any and all
publications papers and presentations arising from the program and
service contract herein; the Department will do likewise.
4. The Grantee must notify the Department's Grants and Purchasing
Division 30 days before applying to register a copyright with the U.S.
Copyright Office. The Grantee must submit an annual report for all
copyrighted materials developed by the Grantee 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 Financial Status Report
Instructions. Any underrecoveries of otherwise available fees resulting from
failure to bill for eligible services will be excluded from reimbursable
expenditures.
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Health Division, Comprehensive Agreement - 2016
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 and 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 "Title 2 Code of Federal
Regulations (CFR) Part 200, Subpart F Audit 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 Grantee'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 Grantee 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.
Date: 11/06/2015 Contract It 20161702-00, Oakland County Department of Health and Human Services/
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Health Division, Comprehensive Agreement -2016
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 Grantee'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 Grantee 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 Grantee'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
Grantee 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 Grantee 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 MDHHS-
AuditReports@michigan.gov . The required materials must be
assembled as one document in a POE 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. SubrecipientlContractor Monitoring
The Grantee must ensure that each of its subrecipients comply with the
Single Audit Act requirements. The Grantee must issue management
decisions on audit findings of their subrecipients as required by Title 2 Code of
Federal Regulations (CFR) Section 200.501(h), as applicable.
The Grantee 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
Date: 11/0612015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 7 o1167
Health Division, Comprehensive Agreement -2016
with laws, regulations, and the provisions of contracts, and that performance
goals are achieved. The subrecipient monitoring plan should include a risk-
based assessment to 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 Grantee must establish requirements to ensure compliance by for-profit
subrecipients as required by Title 2 CFR Section 200.501(h), as applicable
The Grantee must ensure that transactions with contractors comply with
laws, regulations and provisions of contracts or grant agreements in
compliance with Title 2 CFR Section 200.501(h), as applicable
I. Notification of Modifications
Provide timely notification to the Department, in writing, of any action by the
Grantee, 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 Grantee must ensure 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 Grantee's business
operations for processing date/time data. All information systems, electronic or
hard copy that contain State or Federal data must be protected from
unauthorized access.
K. Human Subjects
The Grantee will comply with Protection of Human Subjects Act, 45 CFR, Part
46. The Grantee agrees that prior to the initiation of the research, the Grantee
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 Grantee's IRB Chairperson or Executive Officer(s).
L. Terms
To abide by the terms of this agreement including all attachments.
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M. Minimum Program Requirements
To comply with Minimum Program Requirements established 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 Grantee/Department negotiated amendment(s). Failure to
submit a complete Annual Budget and Plan by the due date through MI 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
P. Accreditation
1. All Grantees 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. Grantees 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." Grantees designated as "Not Accredited" may have their
Department allocations reduced for costs incurred in the assurance of
service delivery.
Grantees 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 Grantee 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" Grantees:
a. Grantees designated as "Not Accredited", will receive a Consent
Agreement Package from the Department. Grantees and their
local governing entities shall be given 75 days to review the
package, meet with the Department, and sign/return the Consent
Agreement.
b. Fulfillment of the terms and conditions of the Consent Agreement
will not affect accreditation status, but impacts the Grantees'
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ability to fulfill its contractual obligations under the
Comprehensive Planning, Budgeting and Contracting
Agreement. Grantees designated as "Not Accredited", will retain
this designation until the subsequent accreditation cycle.
c. Grantee 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 Grantee 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 Grantee 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 Grantee 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
In accordance with the Medicaid Bulletin, MSA 05-29, the Grantee agrees to
target their Medicaid outreach effort toward Department established priorities.
For FY 15/16, 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 Grantee
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
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COMPREHENSIVE FSR is due into the Department. The Local Health
Department Medicaid Outreach report are to be sent through MI E-Grants as
an attachment report to the Financial Status Report.
R. Mandatory Disclosures
The Grantee must disclose, in a timely manner, in writing to the Department all
violations of Federal and State criminal law involving fraud, bribery, or gratuity
violations potentially affecting the agreement.
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
Grantee.
B. Report Forms
Provide any report forms and reporting formats required by the Department at
the effective date of this agreement, and provide to the Grantee any new report
forms and reporting formats proposed for issuance thereafter at least ninety
(90) days prior to their required usage in order to afford the Grantee an
opportunity to review and offer comment.
C. Terms
Abide by the terms of this agreement including all attachments.
D. Notification of Modifications
To notify the Grantee in writing of modifications to Federal or State laws, rules
and regulations affecting this agreement.
E. Identification of Laws
To identify for the Grantee relevant laws, rules, regulations, policies,
procedures, guidelines and State and Federal manuals, and provide the
Grantee with copies of these documents to the extent they are not otherwise
available to the Grantee.
F. Modification of Funding
To notify the Grantee 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 Grantee and the Department.
G. Monitor Compliance
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.
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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 Grantee 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" Grantees. 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 Grantee 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 Grantee.
III. Assurances
The following assurances are hereby given to the Department:
A. Compliance with Applicable Laws
The Grantee will comply with applicable federal and state laws, guidelines, rules
and regulations in carrying out the terms of this agreement. The Grantee 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.
B. Anti-Lobbying Act
The Grantee 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 of the FY 1997 Omnibus Consolidated Appropriations
Act (Public Law 104-208). Further, the Grantee shall require that the language
of this assurance be included in the award documents of all subawards at all
tiers (including subcontracts, subgrants, and contracts under grants, loans and
cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
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C. Non-Discrimination
1. The Grantee 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 Grantee 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 Grantee 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
disabilities;
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 (PI. 92-255),
as amended, relating to nondiscrimination on the basis of drug
abuse;
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)
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under which application for Federal assistance is being made;
and,
the requirements of any other nondiscrimination statute(s) which
may apply to the application.
3. Additionally, assurance is given to the Department that proactive 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 Grantee 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 Grantee will comply with
Federal Regulation, 2 CFR part 180 and certifies to the best of its knowledge
and belief that the Grantee's local health department or an official of the
Grantee's local health department and the Grantee's subcontractors:
1. Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any federal department or Grantee;
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.
E. Federal Requirement: Pro-Children Act
1. Assurance is hereby given to the Department that the Grantee 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
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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 Grantee also assures that this language will be included in
any subawards which contain provisions for children's services.
2. The Grantee 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 Grantee. If activities or services are
delivered in facilities or areas that are not under the control of the
Grantee (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 Grantee 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, 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. National Defense Authoriation Act Employee Whistleblower Protections
The Grantee will comply with the National Defense Authorization Act "Pilot
Program for Enhancement of Grantee Employee VVhistleblower Protections".
1. This agreement and employees working on this agreement will be
subject to the whistleblower rights and remedies in the pilot program on
Grantee employee whistleblower protections established at 41 U.S.C.
4712 by section 828 of the National Defense Authorization Act for Fiscal
Year 2012 and FAR 3.908.
2. The Grantee shall inform its employees in writing, in the predominant
language of the workforce, of employee whistleblower rights and
protections under 41 U.S.C. 4712, as described in section 3.908 of the
Federal Acquisition Regulation.
3. The Grantee shall insert the substance of this clause, including this
paragraph (3), in all subcontracts over the simplified acquisition
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threshold.
H. Home Health Services
If the Grantee provides Home Health Services (as defined in Medicare Part B),
the following requirements apply:
1. The Grantee 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 Grantee's service area.
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 Grantee'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 Grantee 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).
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 Grantee 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 Grantee in this agreement.
3. That the subcontract does not affect the Grantee's accountability to the
Department for the subcontracted activity.
4. That any billing or request for reimbursement for subcontract costs is
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supported by a valid subcontract and adequate source documentation on
costs and services.
5. That the Grantee 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:
a. Allow the Grantee 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 Grantee, including the manner by
which termination will be effected and the basis for settlement.
7. That all 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 USC
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 Grantee 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.
J. Procurement
Assure that all purchase transactions, whether negotiated or advertised, shall
be conducted openly and competitively in accordance with the principles and
requirements of Title 2 Code of Federal Regulations, Part 200, as amended, as
applicable and that records sufficient to document the significant history of all
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purchases are maintained for a minimum of three years after the end of the
agreement period.
K. Health Insurance Portability and Accountability Act
To the extent that this act is pertinent to the services that the Grantee provides
to the Department under this agreement, the Grantee assures that it is in
compliance with the Health Insurance Portability and Accountability Act (HIPAA)
requirements including the following:
1. The Grantee must not share any protected health data and information
provided by the Department that falls within HIPAA requirements except
as permitted or required by applicable law; or to a subcontractor as
appropriate under this agreement.
2. The Grantee will ensure that any subcontractor will have the same
obligations as the Grantee 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 Grantee must only use the protected health data and information for
the purposes of this agreement.
4. The Grantee 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 Grantee's employees.
5. The Grantee must have a policy and procedure to immediately report to
the Department any suspected or confirmed unauthorized use or
disclosure of protected health data and information that falls under the
HIPAA requirements of which the Grantee becomes aware. The Grantee
will work with the Department to mitigate the breach, and will provide
assurances to the Department of corrective actions to prevent further
unauthorized uses or disclosures.
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. Agreement Termination.
7. In accordance with HIPAA requirements, the Grantee is liable for any
claim, loss or damage relating to unauthorized use or disclosure of
protected health data and information by the Grantee received from the
Department or any other source.
8. The Grantee will enter into a business associate agreement should the
Department determine such an agreement is required under HIPAA.
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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
Grantee can view their monthly prepayment within the MI E-Grants system.
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 Grantee
adjustment requests per Department approval.
C. Prepayment Adjustments
If the sum of the prepayments do not equal at least 90% of the Grantee's
expenditures for a quarter of the contract period, the Grantee 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.
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 electronically not later than thirty
(30) days after the close of the fiscal quarters through MI E-Grants. Reports
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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 Grantee 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 Grantee's monthly
prepayment.
E. Reimbursement Method
The Grantee will be reimbursed in accordance with the reimbursement methods
for applicable program elements described as follows:
1. Performance Reimbursement - A reimbursement method by which
Grantees 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 Grantee 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 Grantee's 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
Grantees 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
Grantee are reimbursed a specific amount for each output actually
delivered and reported.
4. Essential Local Public Health Services (ELPHS) - A reimbursement
method by which Grantees are reimbursed a share of reasonable and
allowable costs incurred for required services, as noted in the current
Appropriations Act.
F. Reimbursement Mechanism
All Grantees must sign up through the on-line vendor registration process to
receive all State of Michigan payments as Electronic Funds Transfers
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(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 Grantee 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
An Obligation Report is based on annual guidelines and due date using the
format provided by the Department through MI E-Grants. The Grantee must
provide, by program, an estimate of total expenditures for the entire agreement
period (October 1 through September 30). This report must represent the
Grantee'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 Grantee 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 Grantee
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 Grantee 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.
Final Total Grantee FSR
Project
Final FSR Due Date
Public Health Emergency Preparedness 11/15/2016
WIC 11/30/2016
All Remaining Projects 12/15/2016
The final total Grantee PSR 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 MI E-
Grants, the Department will determine by program, if funds are owed to the
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Grantee or if the Grantee owes funds to the Department. If funds are owed to
the Grantee, payment will be processed. However, if the Grantee
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 Grantee, the Department will
make every effort to process full reimbursement to the Grantee 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
Grantee to send in a payment. Instead the Department will make the necessary
entries to offset other payments and as a result the Grantee will receive a net
monthly prepayment. When this does occur, clarifying documentation will be
provided to the Grantee by the Department's Accounting Division.
J. Penalties for Reporting Noncompliance
For failure to submit the final total Grantee FSR report by December 15,
through MI E-Grants after the agreement period end date, the Grantee 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 Grantees (local health
departments). Reductions will be one-time only and will not carryforward to the
next fiscal year as an ongoing reduction to a Grantee's ELPHS allocation.
Penalties will be assessed based upon the submitted date in MI 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 Grantee's
ELPHS allocation.
K. Indirect Costs and Cost Allocations/Distribution Plans
The Grantee is allowed to use approved federal indirect rate, 10% de minimis
indirect rate and/or cost allocation/distribution plans in their budget calculations.
1. Costs must be consistently charged as indirect, direct or cost allocated,
but may not be double charged or inconsistently charged.
2. If the Grantee does not have an existing approved federal indirect rate,
they may use a 10% de minirnis rate in accordance with Title 2 Code of
Federal Regulations (CFR) Part 200 to recover their indirect costs.
3. Grantees using the cost allocation/distribution method must develop
certified plan in accordance with the requirements described in Title 2
CFR, Part 200 which includes detailed budget narratives and is retained
by the Grantee and subject to Department review.
4. There must be a documented, well-defined rationale and audit trail for
any cost distribution or allocation based upon Title 2 CFR, Part 200 Cost
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Principles and subject to Department review.
V. Agreement Termination
The Department may cancel this agreement without further liability or penalty to the
Department for any of the following reasons:
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 Grantee's local health
department, or an official of the Grantee's local health department, is convicted
of any activity referenced in Part II, Section 11I.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 Grantee shall provide the Department with all financial, performance
and other reports required as a condition of this agreement. The Department will make
payments to the Grantee for allowable reimbursable costs not covered by previous
payments or other state or federal programs. The Grantee shall immediately refund to
the Department any funds not authorized for use and any payments or funds advanced
to the Grantee 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 Grantee and the Department. When submitting a proposed
agreement/budget amendment, the Grantee 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 Grantee's or Department's control, which reduce or otherwise
interfere with the Grantee'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.
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C. Amendments to this agreement shall be made as follows:
1. Any change proposed by the Grantee 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 Grantee 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 Grantee 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 Grantee 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 11Al E-Grants to assure the amendment can be executed prior to
the end of the agreement period.
IX. Liability
A. All liability 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 Grantee in the performance of this agreement shall be the
responsibility of the Grantee, 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 Grantee, any subcontractor, anyone directly or indirectly
employed by the Grantee, provided that nothing herein shall be construed as a
waiver of any governmental immunity that has been provided to the Grantee or
its employees by statute or court decisions.
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 Grantee, if the liability, loss, or damage is caused by, or
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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 Grantee and the Department in fulfillment of
their responsibilities under this agreement, such liability, loss, or damage shall
be borne by the Grantee 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 Grantee, the State,
its agencies (the Department) or their employees, respectively, as provided by
statute or court decisions.
X. Conflict of Interest
The Grantee and the Department are subject to the provisions of 1968 PA 317, as
amended, MCL 15.321 et seq, and 1973 PA 196, as amended, MCL 15.341 et seq.
and Title 2 Code of Federal Regulations, Section 200.318 (c)(1) and (2).
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.
XII. Confidentiality
Both the Department and the Grantee 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 permitted or required by applicable state or
federal law or regulation. Such information may be disclosed in summary, statistical, or
other form, which does not directly or indirectly identify particular individuals.
XIII. 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 Grantee, 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.
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 Instructions for the Annual Budget, Attachment III, Program
Specific Assurances and Requirements, and as outlined in Attachment IV,
Funding/Reimbursement Matrix.
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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 Grantee 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, MDARD 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 Grantee. Any redistributions will be effected
through the established amendment process.
AA Attachments
Al Attachment I - Instructions for the Annual Budget
Attachment I- Instructions for the Annual Budget
Attachment II - FY 15116 Agreement Addendum A
Oakland County FY Agreement Addendum A
A2 Attachment III - Program Specific Assurances and Requirements
Attachment III - Program Specific Assurances and Requirements
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Contract # 20161702-00 Date: 11/06/2015 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Comprehensive Agreement - 2016 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor! Subrecepient (f) Adolescent STD Screening Reg. Alloc. F 73,000 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Body Art Fixed Fee Cal c. Amt. 250.00/Numb Fixed Unit Rate (2) N/A N/A N/A N/A N/A Contractor ers Childrens Special Hlth Care Calc. Amt. 150.00Nario Fixed Unit Rate (1), N/A N/A N/A N/A N/A Contractor Services (CSHCS) Care us (7) Coordination Childrens Special Hlth Care Reg. Moe. 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 Enabling Services Women - MCH Local MCH F 150,028 Local MCH (3), (6) N/A N/A N/A N/A N/A Subrecepient 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 859,213 ELPHS (3), (4) N/A N/A N/A N/A N/A Contractor General Communicable Disease ELPHS S 660,161 ELPHS (3), (6) N/A N/A N/A N/A N/A Contractor ELPHS MDHHS Other Gonococcal Isolate Surveillance Reg. Alloc. F 10,000 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Project Hearing ELPHS ELP HS S 225,684 ELPHS (3), (6) N/A N/A N/A N/A N/A Subrecepient Hearing HIV ELPHS ELPHS S 305,899 ELPHS (3), (4) N/A N/A N/A N/A N/A Contractor MDHHS Other HIV Prevention Reg. Alloc. F 369,186 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Reg. Alloc. S 129,714 HIV Surveillance Support Reg. Alloc. F 7,000 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Reg. Alloc. F 17,500 Reg. Alloc. F 10,500 Immunization Action Plan (IAP) Reg. Alloc. F 531,835 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/ Page: 27 of 167 Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11/06/2015 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Comprehensive Agreement - 2016 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (t) Immunization ELPHS ELPHS S 884,466 ELPHS (3), (6) N/A N/A N/A N/A N/A Contractor MDHHS Other Immunization Fixed Fees Cab. Amt. 300.00/Numb Fixed Unit Rate (2), N/A N/A N/A N/A N/A Contractor ers (7) Immunization Vaccine Quality Reg. Moe. S 113,241 Staffing (6) N/A N/A N/A N/A N/A Contractor Assurance 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. Alioc. F 30,000 Staffing (6) N/A N/A N/A N/A N/A Subrecepient MDEQ On-site Wastewater Treatment ELPHS On- site Waster S 372,426 ELPHS (3), (6) N/A N/A N/A NJA N/A Contractor MDEQ Private and Type III Water ELPHS S 514,301 ELPHS (3), (6) N/A N/A N/A N/A N/A Contractor Supply Private and Ty Nurse Family Partnership -MCH Local MCH F 129,505 Local MCH (3), (6) N/A N/A N/A N/A N/A Subrecepient Nurse Family Partnership Reg. Alloc. F 31,052 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Services Reg. Alloc. S 589,988 Public Health Emergency Preparedness (PHEP) 10/1/15 - Reg. Alloc. F 232,542 Staffing (6), (14), (18) N/A N/A N/A N/A N/A Subrecepient 6/30/16 Public Health Emergency Preparedness (PHEP) CRI Reg. Alloc. F 159,225 Staffing (6), (14), (18) N/A N/A N/A N/A N/A Subrecepient 10/1/15- 6/30/16 Public Health Emergency Reg. Alloc. F 95,760 Staffing (6) N/A N/A N/A N/A N/A Subrecepient Preparedness (PHEP) Ebola Virus Disease (EVD) Phase II Public Hlth Functions & Infratruct - Local MCH F 41,924 Staffing (6) N/A N/A N/A N/A N/A Subrecepient MCH Sexually Transmitted Disease Reg. Alloc. F 82,650 Staffing (6) N/A N/A N/A N/A N/A Subrecepient (STD) Control Date: 11/0612015 Contract #20161702-00, Oakland County Department of Health and Human Services/ Page: 28 of 167 Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Comprehensive Agreement - 2016 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDFIFIS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (0 Sexually Transmitted Disease ELPHS S 400,764 ELPHS(3), (6) N/A N/A N/A N/A N/A Contractor (STD-ELPHS) MDHHS Other SIDS Calc. Amt. 85.00/Numbe rs Fixed Unit Rate (2), (11) N/A N/A N/A N/A N/A Contractor TB Control Reg. Alloc. F 48,678 Staffing (6) N/A N/A N/A N/A N/A Contractor Vision ELPHS ELPHS S 225,683 ELPHS (3), (6) N/A N/A N/A N/A N/A Subrecepient Vision WIC Breasffeeding Reg. AlIoc. F 143,397 Staffing (6) N/A N/A N/A N/A N/A Subrecepient WIC Resident Services Reg. Alloc. F 2,476,239 Performance (8) # Average N/A 15450 97 14986 Subrecepient Monthly Participation TOTAL MDHHS FUNDING 10,234,461 *SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Attachment IV Notes Attachment IV Notes Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 29 of 167 Heath Division, Comprehensive Agreement- 2015
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Administration
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
rs-i, Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 4,714,607.00 4,714,607.00
2 Fringe Benefits 3,155,209.00 3,155,209.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 142,384.00 142,384.00
5 Supplies and Materials 383,337.00 383,337.00
6 Travel 59,038.00 59,038.00
7 Communication 53,853.00 53,853.00
8 County-City Central Services 0.00 0.00
9 Space Costs 687,269.00 687,269.00
10 All Others (ADP, Con. Employees, Misc.) 1,115,698.00 1,115,698.00
Total Program Expenses 10,311,395.00 10,311,395.00
TOTAL DIRECT EXPENSES 10,311,395.00 10,311,395.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 650,973.00 650,973.00
2 Other Costs Distributions -8,592,038.00 -8,592,038.00
Total Indirect Costs -7,941,065.00 -7,941,065.00
TOTAL INDIRECT EXPENSES -7,941,065.00 -7,941,065.00
TOTAL EXPENDITURES 2,370,330.00 2,370,330.00
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Contract /f 20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash Inkind Total
I Source of Funds
Fees and Collections - 1st and 2nd
Party
0.00 557,400.00 0.00 557,400.00
Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00
Federal or State (Non MDCH) 0,00 OM 0.00 0.00
Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00
Federally Provided Vaccines OM 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHSComprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0,00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type HI Water
Supply
0.00 0.00 0.00 0,00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0,00 1,812,930.00 0.00 1,812,930.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate 0.00 0.00 0.00 0.00
Total Source of Funds 0.00 2,370,330.00 0,00 2,370,330.00
Totals 0.00 2,370,330.00 0.00 2,370,330.00
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Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
,
Line Item Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 4,714,607.00
2 Fringe Benefits 3,155,209.00
3 Cap. Exp. for Equip & Fac.
4 Contractual 142,384.00
5 Supplies and Materials 383,337.00
6 Travel 59,038.00
7 Communication 53,853.00
8 County-City Central Services
9 Space Costs 687,269.00
10 All Others (ADP, Con. Employees, Misc.) 1,115,698.00
Total Program Expenses 10,311,395.00
TOTAL DIRECT EXPENSES 10,311,395.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 650,973.00
2 Other Costs Distributions
Other Cost Distributions-Other Inf Disea -1,159,714.00
Other Cost Distributions-Misc Distributi -1,206,930.00
Other Cost Distributions-SIDS fee -2,000.00
Health Adm Distribution -6,223,394.00
Total for Other Costs Distributions -8,592,038.00
Total Indirect Costs -7,941,065.00
TOTAL INDIRECT EXPENSES -7,941,065.00
TOTAL EXPENDITURES 2,370,330.00
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Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Environmental
Administration
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To :9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
P'. Original r. Amendment
AMENDMENT # o
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 3,796,726.00 3,796,726.00
2 Fringe Benefits 2,465,158.00 2,465,158.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 54,012,00 54,012.00
6 Travel 235,947.00 235,947.00
7 Communication 92,808.00 92,808.00
8 County-City Central Services 0.00 0.00
9 Space Costs 91,520.00 91,520.00
10 All Others (ADP, Con. Employees, Misc.) 291,686.00 291,686.00
Total Program Expenses 7,027,857.00 7,027,857.00
TOTAL DIRECT EXPENSES 7,027,857.00 7,027,857.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 510,847.00 510,847.00
2 Other Costs Distributions -1,787,413.00 -1,787,413.00
Total Indirect Costs -1,276,566.00 -1,276,566.00
TOTAL INDIRECT EXPENSES -1,276,566.00 -1,276,566.00
TOTAL EXPENDITURES 5,751,291.00 5,751,291.00
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Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category I Amount Cash Inkind Total
1 Source of Funds
Fees and Collections - 1st and 2nd
Party
0.00 669,450.00 0.00 669,450,00
Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00
Federal or State (Non MDCH) 0.00 1,946,956.00 0.00 1,946,956.00
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHSHearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0,00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 3,134,885.00 0.00 3,134,885.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate 0.00 0.00 0.00 0.00
Total Source of Funds 0.00 5,751,291.00 0.00 5,751,291.00
Totals 0.00 5,751,291.00 0.00 5,751,291.00
Date: 11/06/2015 Contract #20131702-00, Oakland County Department c/ Health and Human Services/ Page: 34 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 3,796,726.00
2 Fringe Benefits 2,465,158.00
3 Cap. Exp. for Equip & Fac. 0.00
4 Contractual 0.00
5 Supplies and Materials 54,012.00
Travel 235,947.00
7 Communication 92,808.00
8 County-City Central Services
9 Space Costs 91,524.00
10 All Others (ADP, Con, Employees, Misc.) 291,686.00
Total Program Expenses 7,027,857.00
TOTAL DIRECT EXPENSES 7,027,857.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 510,847.00
Other Costs Distributions
EH Adm Distribtions -4,544,002.00
Other Cost Distributions-Body Art Fees -15,000.00
Other Cost Distributions-Health Educatio 38,897.00
Health Adm Distribution 2,732,692.00
Total for Other Costs Distributions -1,787,413.00
Total Indirect Costs -1,276,566.00
TOTAL INDIRECT EXPENSES -1,276,566.00
TOTAL EXPENDITURES 5,751,291.00
Date; 11/06/2015 Contract #20101702-00, Oakland County Department of Health and Human Services/ Page: 35 of 167
Health Division, Comprehensive Agreement -2010
Contract # 20161702-00 Date: 1110612015
Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -2016 / Adolescent STD
Screening
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
2"; Original IT Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category I Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 36,167.00 36,167.00
2 Fringe Benefits 20,360.00 20,360.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 4,773.00 4,773.00
6 Travel 575.00 575.00
7 Communication 336.00 336.00
8 County-City Central Services 0.00 0.00
Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 5,780.00 5,780.00
Total Program Expenses 67,991.00 67,991.00
TOTAL DIRECT EXPENSES 67,991.00 67,991.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 5,009.00 5,009.00
2 Other Costs Distributions 8,798.00 8,798.00
Total Indirect Costs 13,807.00 13,807.00
TOTAL INDIRECT EXPENSES 13,807.00 13,807.00
TOTAL EXPENDITURES 81,798.00 81,798.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 36 of 167
Health Division, Comprehensive Agreement- 2016
Contract 20161702-00 Date: 11/06/2015
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 73,000.00 0.00 0.00 73,000.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private ) Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 8,798.00 0.00 8,798.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 73,000.00 8,798.00 0.00 81,798.00
Date: 11/0612015 Conirant #23161702-00, Oakland County Department of Health and Human services/ Page: 37 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item I Qty[ Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse 180.0000 25.879 0.000 FTE 4,658.00
Assistant 210.0000 18.840 0.000 FTE 3,956.00
Technician 400.0000 30.515 0.000 FTE 12,206.00
Coordinator 150.0000 33.493 0.000 FTE 5,024.00
Public Health Nurse
Notes : PHN III
325.0000 31.763 0.000 FTE 10,323.00
Total for Salary & Wages 36,167.00
2 Fringe Benefits
All Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 56.295 36167.000 20,360.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 392.00
Medical Supplies 0.0000 0.000 0.000 1,000.00
Printing 0.0000 0.000 0.000 250.00
Educational Supplies 0.0000 0.000 0.000 3,131.00
Total for Supplies and Materials 4,773.00
6 Travel
Mileage
Notes : 1,000 miles @ .575
0.0000 0.000 0.000 575.00
7 Communication
Telephone 0.0000_ 0.000 0.000 336.00
8 County-City Central Services
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 36 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
Line Item Qtyl_ Rate] Units[UOM Total
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 180.00
Information Technology 0.0000 0.000 0.000 2,800.00
Advertising 0.0000 0.000 0.000 2,800.00
Total for All Others (ADP, Con. Employee 5,780.00
Total Program Expenses 67,991.00
TOTAL DIRECT EXPENSES 67,991.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan 0.0000 13.850 36167.000 5,009.00
2 Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 6,553.00
Nursing Adm Distribution 0.0000 0.000 0.000 2,245.00
Total for Other Costs Distributions 8,798.00
Total Indirect Costs 13,807.00
TOTAL INDIRECT EXPENSES 13,807.00
TOTAL EXPENDITURES 81,798.00
Date: 11/0612015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 39 of 167
Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -2016 / Public Health
Emergency Preparedness (PHEP) 10/1/15 - 6/30/16
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
WI Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
I Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 119,809.00 119,809.00
2 Fringe Benefits 89,857.00 89,857.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 5,768.00 5,768.00
6 Travel 1,639.00 1,639.00
7 Communication 2,982.00 2,982.00
8 County-City Central Services 0.00 0.00
9 Space Costs 5,073.00 5,073.00
10 All Others (ADP, Con. Employees, Misc.) 13,524.00 13,524.00
Total Program Expenses 236,652.00 238,652.00
TOTAL DIRECT EXPENSES 238,652.00 238,652.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 16,582.00 16,582.00
2 Other Costs Distributions 22,910.00 22,910.00
Total Indirect Costs 39,492.00 39,492.00
TOTAL INDIRECT EXPENSES 39,492.00 39,492.00
TOTAL EXPENDITURES 278,144.00 278,144.00
Date: 11/06/2015 Contract # 20101702-00, Oakland County Department of Health and Human ServIces/ Page: 40 of 167
Health Divislort, Comprehensive Agreement - 2010
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash Inkind Total
1 Source of Funds
Fees and Collections - lot 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-ELP HS 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
MDHHS Non Comprehensive 0.00 0.00 0,00 0.00
MDHHS Comprehensive 232,542.00 0.00 0.00 232,542.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0,00
ELPHS - Private! Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 22,910.00 0.00 22,910.00
Inkind Match 0.00 0.00 22,692.00 22,692.00
MDFIFIS Fixed Unit Rate
Totals 232,542.00 22,910.00 22,692.00 278,144.00
Date: 11/06/2015 Contract 4 20161702-00, Oaktand County Department of Health and Human Services/ Page: 41 of 167
Health Division, Comprehensive Agreement - 2016
Contract tt 20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
'Line Item Qtyl Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Coordinator
Notes : Health Program
Coordinator
1560.0000 27.232 0.000 FTE 42,482.00
Office Manager
Notes : Office Assistant II
780.0000 17.015 0.000 FTE 13,272.00
Health Educator
Notes : Public Health Educator II
780.0000 21.737 0.000 FTE 16,955.00
Assistant
Notes : Technical Assistant
780.0000 18.702 0.000 FTE 14,588.00
Specialist
Notes : Public Health Emer Prep
Specialist
780.0000 26.275 0.000 FTE 20,495.00
Manager
Notes : MATCH FUNDS - K
FORZLEY HEALTH MANAGER
225.0000 53.409 0.000 FTE 12,017.00
Total for Salary & Wages 119,809.00
2 Fringe Benefits
All Composite Rate
Notes : MATCH $9013
FICA
Unemp Ins
Retirement
Hospital Ins
Life Ins
Vision Ins
Short/Long Term Disability
Dental Ins
Work Comp
0.0000 75.000 119809.000 89,857.00
3 Cap. Exp. for Equip & Pao.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 1,600.00
Disaster Supplies 0.0000 0.000 0.000 2,810.00
Printing 0.0000 0.000 0.000 1,358.00
Total for Supplies and Materials 5,768.00
6 'Travel
Date: 11/06/2015 Contract it 20161702-00, Oakland County Depariment al Health and Human Services/
Page: 42 of 167
Health Division, Comprehensive Agreement - 2016
Coat act #20161702-00 Date: 11106/2015
Line Item Qty Rate Units UOM Total
Mileage
Notes : 2850 miles @ .575
0.0000 0.000 0.000 1,639.00
7 Communication
Telephone Communications 0.0000 0.0001 0.000 2,982.00
8 County-City Central Services
9 Space Costs
Building Space Rental I 0.00001 0.000 0.000 5,073.00
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 585.00
Copier 0.0000 0.000 0.000 3,917.00
IT Operations 0.0000 0.000 0.000 6,300.00
Software support 0.0000 0.000 0.000 2,622.00
Publications, Books, Periodicals 0.0000 0.000 0.000 100.00
Total for All Others (ADP, Con. Employee 13,524.00
Total Program Expenses 238,652.00
TOTAL DIRECT EXPENSES 238,652.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Other Approval
Notes : MATCH $1662
0.0000 13.840 119809.000 16,582.00
2 Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 22,910.00
Total Indirect Costs 39,492.00
TOTAL INDIRECT EXPENSES 39,492.00
TOTAL EXPENDITURES 278,144.00
Date: 11/0612015 Contract #20151702-00, Oakland County Department of Health and Human Services/ Page: 43 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Body Art Fixed Fee
DATE PREPARED
1116/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/3012016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
ro" Original r, Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
6 Supplies and Materials 0.00 0.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
B County-City Central Services 0,00 0.00
9 Space Costs 0.00 0,00
10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Other Costs Distributions 15,000.00 15,000,00
Total Indirect Costs 15,000,00 15,000.00
TOTAL INDIRECT EXPENSES 15,000.00 15,000.00
TOTAL EXPENDITURES 15,000.00 15,000.00
Date: 1110612015 Contract #20161102-00, Oakland County Department of Health and Human Services/
Page: 44 of 167
Health Division Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind Total
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
MDHHS Non Comprehensive 0.00 0,00 0.00 0.00
MDHHS Comprehensive 0,00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 OM 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type III Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
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
MDHHS 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
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/ Page: 45 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM 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
Cost Distributions for Fees-from
Environ
0.0000 0.000 0.000 15,000.00
Total Indirect Costs 15,000.00
TOTAL INDIRECT EXPENSES 15,000.00
TOTAL EXPENDITURES 15,000.00
Date: 11)0612015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 46 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -2016 / Childrens Special Hlth
Care Services (CSHCS) Care Coordination
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
RiT Original n Amendment
AMENDMENT 0
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount I Total
DIRECT EXPENSES
Program Expenses
'1 Salary & Wages 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00
INDIRECT EXPENSES
Indirect Costs
'1 Indirect Costs 0.00 0.00
2 Other Costs Distributions 236,855.00 236,855.00
Total Indirect Costs 236,855.00 236,855.00
TOTAL INDIRECT EXPENSES 236,855.00 236,855.00
TOTAL EXPENDITURES 236,855.00 236,855.00
Date: 1110612015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 47 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind 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-ELP HS 0.00 0.00 0.00 0.00
Other Non-ELPHS 0.00 0.00 0.00 0.00
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0,00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
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
MDHHS Fixed Unit Rate
CSHCS Care Coordination 236,855.00 0.00 0.00 236,855.00
Totals 236,855.00 0.00 0.00 236,855.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 48 of 167
Health Division, Comprehensive Agreement - 2016
Contract 4 20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
'Line Item Qty[ Rate! Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
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 0
0.0000 0.000 0.000 236,855.00
Total Indirect Costs 236,855.00
TOTAL INDIRECT EXPENSES 236,855.00
TOTAL EXPENDITURES 236,855.00
Date: 11106/2015 Contract #20101702-00, Oakland County Department of Health and Human Services/
Page: 49 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -2016 / CSHCS Medicaid
Outreach
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
rci; Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
Travel 0.00 0.00
7 Communication 0.00 0.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Other Costs Distributions 329,827.00 329,827.00
Total Indirect Costs 329,827.00 329,827.00
TOTAL INDIRECT EXPENSES 329,827.00 329,827.00
TOTAL EXPENDITURES 329,827.00 329,827.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 50 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-03 Date: 11)06)2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind 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 103,846.00 0.00 0.00 103,846.00
Required Match - Local 0.00 103,846.00 0.00 103,846.00
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 122,135.00 0.00 122,135.00
Inkind Match 0.00 0.00 0.00 0.00
IVIDHHS Fixed Unit Rate
Totals 103,846.00 225,981.00 0.00 329,827.00
Date: 11106/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 51 of 167
Heath Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
ILine Item Qty Rate Units UOM 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 0.00001 0.000 0.000 329,827.00
Total Indirect Costs 329,827.00
TOTAL INDIRECT EXPENSES 329,827.00
TOTAL EXPENDITURES 329,827.00
Date: 1110612015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 52 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Public Health
Emergency Preparedness (PHEP) CRI 10/1/15 - 6/30/16
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From :10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
17 Original n Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 73,742.00 73,742.00
Fringe Benefits 55,306.00 55,306.00
3 Cap, Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 4,575.00 4,575.00
6 Travel 7,650.00 7,650,00
7 Communication 1,296.00 1,296.00
8 County-City Central Services 0.00 0.00
9 Space Costs 4,110.00 4,110.00
10 All Others (ADP, Con. Employees, Misc.) 18,263.00 18,263.00
Total Program Expenses 164,942.00 164,942.00
TOTAL DIRECT EXPENSES 164,942.00 164,942.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 10,206.00 10,206.00
2 Other Costs Distributions 15,722.00 15,722.00
Total Indirect Costs 25,928.00 25,928.00
TOTAL INDIRECT EXPENSES 25,928.00 25,928.00
TOTAL EXPENDITURES 190,870.00 190,870.00
Date: 11/06,120:15 Contract t 20161702-O0, Oakland County Department of Health and Human Services/
Page: 53 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount L Cash I Inkind Total
I 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 159,225.00 0.00 0.00 159,225.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0,00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 15,722.00 0.00 15,722.00
lnkind Match 0.00 0.00 15,923.00 15,923.00
MDHFIS Fixed Unit Rate
Totals 159,225.00 15,722.00 15,923.00 190,870.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 54 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item I Qty Rate' Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Specialist
Notes : PH Emer Prep Specialist
780.0000 25.275 0.000 FTE 20,495.00
Office Manager
Notes : Office Assistant 2
780.0000 17.015 0.000 FTE 13,272.00
Health Educator
Notes : PH Educator 1
780.0000 21.737 0.000 FTE 16,955.00
Assistant
Notes : Tech Assistant
780.0000 18.702 0.000 FTE 14,588.00
Administrator
Notes : Administration - MATCH
FUNDS
189.0000 44.615 0.000 FTE 8,432.00
Total for Salary & Wages 73,742.00
2 Fringe Benefits
All Composite Rate
Notes : MATCH $6324
FICA
Unemp Ins
Retirement
Hospital Insurance
Life Insurance
Vision Ins.
Short/Long Term Disability
Dental Insurance
Work Comp
0.0000 74.999 73742.000 55,306.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
Supplies and Materials
Printing 0.0000 0.000 0.000 2,413.00
Disaster Supplies 0.0000 0.000 0.000 2,162.00
Total for Supplies and Materials 4,575.00
6 Travel
Mileage
Notes : 1000 miles @ 575
0.0000 0.000 0.000 575.00
Conferences 0.0000 0.000 _ D.000 7,475.00
Total for Travel 7,650.00
7 Communication
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 55 of 167
Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11/06/2015
Line item Qty Rate Units UOIVI Total
Telephone Communications 0.0000 0,000 0.000 1,296.00
13 County-City Central Services
9 Space Costs
Space/Rental Costs 0.0000 0,000 0.000 4,110.00
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 450.00
IT Operations 0.0000 0.000 0.000 9,408.00
Software support - Barcode Inc 0.0000 0.000 0.000 5,405.00
Equipment Repair 0.0000 0.000 0.000 3,000.00
Total for All Others (ADP, Con. Employee 18,263,00
Total Program Expenses 164,942.00
TOTAL DIRECT EXPENSES 164,942.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Other Approval 0.0000 13.840 73742.000 10,206.00
Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 15,722.00
Total indirect Costs 25,928.00
TOTAL INDIRECT EXPENSES 25,928.00
TOTAL EXPENDITURES 190,870.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 56 of 167
Health Division, Comprehensive Agreement -2016
Contract # 20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Childrens Special 1-11th
Care Services (CSHCS) Outreach & Advocacy
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
17 Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category I Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 284,801.00 284,801.00
2 Fringe Benefits 114,852.00 114,852.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 7,471.00 7,471.00
6 Travel 830.00 830.00
7 Communication 12,500.00 12,500.00
8 County-City Central Services 0.00 0.00
9 Space Costs 19,691.00 19,691.00
10 All Others (ADP, Con. Employees, Misc.) 42,265.00 42,265.00
Total Program Expenses 482,410.00 482,410.00
TOTAL DIRECT EXPENSES 482,410.00 482,410.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 39,445.00 39,445.00
2 Other Costs Distributions -236,855.00 -236,855.00
Total Indirect Costs -197,410.00 -197,410.00
TOTAL INDIRECT EXPENSES -197,410.00 -197,410.00
TOTAL EXPENDITURES 285,000.00 285,000.00
Date: 11/0612015 Contract 20161702-00, Oakland County Department of Health and Human Services/ Page: 57 of 167
Health Division, Comprehensive Agreement - 2016
Contract # 20161702-00 Date: 1110612015
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-ELP HS 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 285,000.00 0.00 0.00 285,000.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
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
lnkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 285,000.00 0.00 ] 0.00 285,000.00
Date: 11/0612015 Contract # 20161702-00, Oakland County Department of Health and Human Services! Page: 58 of 167
Health Division, Comprehensive Agreement - 2018
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
1Line Item I Qty l Rate Units
,
UOM Total
DIRECT EXPENSES
Program Expenses
I Salary & Wages
Supervisor 1.0000 71113.000 0.000 FTE 71,113.00
Public Health Nurse 0.4808 55746.000 0.000 FTE 26,803.00
Public Health Nurse 0.4808 50175.000 0.000 FTE 24,124.00
Assistant 0.2404 30796.000 0.000 FIE 7,403.00
Outreach Worker 0.4808 41263.000 0.000 FTE 19,839.00
Assistant 1.0000 30796.000 0.000 FTE 30,796.00
Assistant 1.0000 39188.000 0.000 FTE 39,188.00
Assistant 0.4808 30796.000 0.000 FTE 14,807.00
Assistant 0.1683 30796.000 0.000 FIE 5,183.00
Clerk 0.4808 24031.000 0.000 FTE 11,554.00
Public Health Nurse 0.2885 55746.000 0.000 FIE 16,083.00
Public Health Nurse 0.3005 55746.000 0.000 FTE 16,752.00
OVERTIME 0.0337 34300.000 0.000 FTE 1,156.00
Total for Salary & Wages 284,801.00
2 Fringe Benefits
All Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 40.327 284801.000 114,852.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 2,471.00
Postage 0.0000 0.000 0.000 3,000.00
Printing 0.0000 0.000 0.000 2,000.00
Date: 11/06/2015 Contract #20101702-00, Oakland County Department of Health and Human Services/
Page: 59 of 167
Health Division, Comprehensive Agreement - 2010
Contract #20161702-00 Date: 11/06/2015
'Line item I Qtyl Rate UnitslUOM Total
Total for Supplies and Materials 7,471.00
6 Travel
Mileage
Notes : 400 miles @.575
0.0000 0.000 0.000 230.00
Conferences 0,0000 0.000 0.000 300.00
client transportation 0.0000 0.000 0.000 300.00
Total for Travel 830.00
Communication
Telephone 0.0000 0.000 0.000 12,500.00
8 County-City Central Services
9 Space Costs
Building Space Rental 0.0000 0.000 0.000 19,691.00
10 All Others (ADP, Con. Employees, Misc.)
Convenience Copier 0.0000 0.000 0.000 2,500.00
Insurance 0.0000 0.000 0.000 765.00
IT Operations 0.0000 0.000 0.000 39,000.00
Total for All Others (ADP, Con. Employee 42,265.00
Total Program Expenses 482,410.00
TOTAL DIRECT EXPENSES 482,410.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan 0.0000 13.850 284801.000 39,445.00
2 Other Costs Distributions
Other Cost Distributions-CSHCS
Care Coor
0.0000 0.000 0.000 -236,855.00
Health Adm Distribution 0.0000 0.000 0.000 46,121.00
Other Cost Distributions-Nursing
Staff
0.0000 0.000 0.000 268,161.00
Nursing Adm Distribution 0.0000 0.000 0.000 15,545.00
Other Cost Distributions-CSHCS
- Medical
0.0000 0.000 0.000 -329,827.00
Total for Other Costs Distributions -236,855.00
Total Indirect Costs -197,410.00
TOTAL INDIRECT EXPENSES -197,410,00
TOTAL EXPENDITURES 285,000.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 60 of 167
Health Div'sion, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11106/2015
1 Program Budget Summary
PROGRAM) PROJECT
Comprehensive Agreement - 2016 / Enabling Services
Women - MCH
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From: 10/1/2015 To :9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
17 Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 77,590.00 77,590.00
2 Fringe Benefits 48,088.00 48,088.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
6 Travel 5,700.00 5,700.00
7 Communication 2,304.00 2,304.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 At Others (ADP, Con. Employees, Misc.) 5,600.00 5,600.00
Total Program Expenses 139,282.00 139,282.00
TOTAL DIRECT EXPENSES 139,282.00 139,282.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 10,746.00 10,746.00
Other Costs Distributions 16,996.00 16,996.00
Total Indirect Costs 27,742.00 27,742.00
TOTAL INDIRECT EXPENSES 27,742.00 27,742.00
TOTAL EXPENDITURES 167,024.00 167,024.00
Date: 11106/2015 Contract # 20161792-00, Oakland County Department of Health and Human Services/
Page: 61 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 1110612015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind 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 1100 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 150,028.00 0.00 0.00 150,028.00
Local Funds - Other 0.00 16,996.00 0.00 16,996.00
lnkind Match 0.00 0,00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 150,028.00 16,996,00 , 0.00 167,024.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 62 of 167
Health Division, Comprehensive Agreement - 2016
Contract if 20161702-00 Date: 1110612015
3 Program Budget - Cost Detail
Line Item Qtyl Ratel Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Nutritionist/Dietician 1.0000 57736.000 0.000 FTE 57,736.00
Nutritionist/Dietician 0.3606 55061.000 0.000 FTE 19,854.00
Total for Salary & Wages 77,590.00
2 Fringe Benefits
Composite Rate
Notes : FICA, UNEMPLY INS,
RETIREMENT, HOSPITAL INS,
LIFE INS, VISION, DENTAL,
WORK COMP, SHORT/LONG-
TERM DISABILITY
0.0000 61.977 77590.000 48,088.00
Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
Mileage
Notes : 9913 miles @ .575
0.0000 0.000 0.000 5,700.00
7 Communication
Telephone 0.0000 0.000 _ 0.000 2,304.00
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
IT operations 0.0000 0.000 0.000 5,600.00
Total Program Expenses 139,282.00
TOTAL DIRECT EXPENSES 139,282.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan I 0.0000 13.850 77590.000 10,746.00
Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 12,800.00
Nursing Adm Distribution 0.0000 0.000 0.000 4,196.00
Total for Other Costs Distributions 16,996.00
Total Indirect Costs 27,742.00
Date: 11/0642015 Contract if 20161702-00, Oakland County Department of Health and Human Services/
Page: 63 of 167
Health Division, Comprehensive Agreement - 2016
Contract # 20161702-00 Date: 11/06/2015
'Line Item QtY I Rate' Units UOM Total
TOTAL INDIRECT EXPENSES 27,742.00
TOTAL EXPENDITURES 167,024.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 64 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 1110612015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -20161 Fetal Infant Mortality
Review (FIMR) Case Abstraction
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
pz Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
Amount I
Total
4,510.00 4,510.00
243.00 243.00
0,00 0.00
0.00 0.00
0.00 0,00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
10 All Others (ADP, Con. Employees, Misc.)
22.00 22.00
Total Program Expenses 4,775.00 4,775.00
TOTAL DIRECT EXPENSES
4,775.00 4,775,00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 625.00 625.00
2 Other Costs Distributions 651.00 651.00
Total Indirect Costs 1,276.00 1,276.00
TOTAL INDIRECT EXPENSES 1,276.00 1,276.00
TOTAL EXPENDITURES
6,051.00 6,051.00
Date: 11/06/2015 Contract #20161702-00, OWand County Department of Health and Human Services/
Page: 65 of 167
Health Division, Comprehensive Agreement 2018
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash Inkind Total
i 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 5,400.00 0.00 0.00 5,400.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private ) Type ill Water
Supply
0,00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0,00 0.00
MCH Funding 0,00 0.00 0.00 0.00
Local Funds - Other 0.00 651.00 0.00 651.00
lnkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 5,400.00 651.00 0.00 6,051.00
Date: 1110612016 Contract #20161702-00, Oakland County Department of Health and Human Serviced Page: 66 of 167
Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 1110612015
3 Program Budget - Cost Detail
1Line Item Qty Rate UnitslUOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse 142.0000 31.763 0.000 FTE 4,510.00
2 Fringe Benefits
All Composite Rate
Notes : Social Security (FICA)
Unemp Ins
Retirement
Hospital Ins
Life Ins
Vision Ins
Dental Ins
Work Comp
0.0000 5.390 4510.000 243.00
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 0.0000 0.000 0.000 22.00
Total Program Expenses 4,775.00
TOTAL DIRECT EXPENSES 4,775.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan 0.0000 13.850 4510.000 625,00
2 Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 485.00
Nursing Adm Distribution 0.0000 0.000 0.000 166.00
Total for Other Costs Distributions 651.00
Total Indirect Costs 1,276.00
TOTAL INDIRECT EXPENSES 1,276.00
TOTAL EXPENDITURES 6,051.00
Date: 11106/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 67 of 167
Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11/06/2016
1 Program Budget Summary
PROGRAM! PROJECT
Comprehensive Agreement - 2016 / Food ELPHS
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
F : la' Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 0,00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Other Costs Distributions 2,744,116.00 2,744,116.00
Total Indirect Costs 2,744,116.00 2,744,116.00
TOTAL INDIRECT EXPENSES 2,744,116.00 2,744,116.00
TOTAL EXPENDITURES 2,744,116.00 2,744,116.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 68 01167
Health Division, Comprehensive Agreement - 2018
Contract #20161102-00 Date: 11/0612015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash Inkind Total
"I Source of Funds
Fees and Collections - 1st and 2nd
Party
0.00 1,205,250.00 0.00 1,205,250.00
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 859,213.00 0.00 0.00 859,213.00
ELPHS - Private / Type ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 679,653.00 0.00 679,653.00
lnkind Match 0.00 0.00 0.00 0.00
MDFINS Fixed Unit Rate
Totals 859,213,00 1,884,903.00 0.00 2,744,116.00
Date: 11106/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 69 of 167
Health Division, Comprehensive Agreement 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
'Line Item I Qty Rate' Units I UOM 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
Environmental 1-11th Adm
Distribution
0.0000 0.000 0.000 2,744,116.00
Total Indirect Costs 2,744,116.00
TOTAL INDIRECT EXPENSES 2,744,116.00
TOTAL EXPENDITURES 2,744,116.00
Date: 11106/2016 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 70 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / General Communicable
Disease ELPHS
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To : 9/3012016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
WI Original n Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 0,00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
Other Costs Distributions 3,696,330.00 3,696,330.00
Total Indirect Costs 3,696,330.00 3,696,330.00
TOTAL INDIRECT EXPENSES 3,696,330.00 3,696,330.00
TOTAL EXPENDITURES 3,696,330.00 3,696,330.00
Date: 11/0612015 Contract #20161702-00, Oakiand County Department of Health and Human Services/
Page: 71 of 167
Health Division, Comprehensive Agreement -2016
Contract # 20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind 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-ELP HS 0.00 0.00 0.00 0.00
Local Non-ELPHS 0.00 0.00 0.00 0.00
Local Non-ELP HS 0,00 0.00 0.00 0.00
Other Non-ELPHS 0.00 0.00 0.00 0.00
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDI-IHS Other 660,161.00 0.00 0.00 660,161.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 3,036,169.00 0.00 3,036,169.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 660,161.00 3,036,169.00 0.00 3,696,330.00
Date: 11/0612015 Contract rit 20161702-00, Oakland County Department of Health and Human Services/
Page: 72 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item 1 Qty Rate! Units UOM 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 FTE Medical
Director's salary and fringes
100% of CD Staff Unit time
includes,Epidemiologists, PHN's,
PHN Supervisor, Office
Assistants
0.0000 0.000 0.000 1,159,714.00
Other Cost Distributions-Misc
Cost disti
Notes : 1% of total Health
Division Clinic Expenses (based
on a workload management
program that tracks Clinic
Nursing time)
0.0000 0.000 0.000 78,358.00
Health Adm Distribution
Notes : 4.25 % of Central
Support Unit Staff expenses
0.3 % of Lab Support staff
expenses
0.13 % of Health Division
Administration Expenses
0.0000 0.000 0.000 158,301.00
Other Cost Distributions-Field
Nursing D
0.0000 0.000 0.000 2,262,744.00
Date: 1110612015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 73 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11106/2015
Line item Qty Rate Units UOM Total
Nursing Adm Distribution 0.0000 0.000 0.000 37,213.00
Total for Other Costs Distributions 3,696,330.00
Total Indirect Costs 3,696,330.00
TOTAL INDIRECT EXPENSES 3,696,330.00
TOTAL EXPENDITURES 3,696,330.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 74 of 167
Health Division, Comprehensive Agreement - 2016
Contract # 20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Gonococcal Isolate
Surveillance Project
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
p7. Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fn. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 10,000.00 10,000.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.) 0.00 0.00
Total Program Expenses 10,004.00 10,000.00
TOTAL DIRECT EXPENSES 10,000.00 10,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Other Costs Distributions 1,206.00 1,206.00
Total Indirect Costs 1,206.00 1,206.00
TOTAL INDIRECT EXPENSES 1,206.00 1,206.04
TOTAL EXPENDITURES 11,206.00 11,206.00
Date: 11/06/2015 Contract it 20101702-00, Oakland County Department of Health and Human Services/
Page: 75 of 167
Health Division, Comprehensive Agreement - 2010
Contract #20161702-00 Date: 11106/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount . Cash Inkind Total
"I 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 10,000.00 0.00 0.00 10,000.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0,00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 1,206.00 0.00 1,206.00
lnkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 10,000.00 1,206.00 0.00 11,206.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 76 of 167
Health Division, Comprehensive Agreement 2016
Contract #20161702-00 Date: 1110612015
3 Program Budget - Cost Detail
-1Line Item QtYI Rate' Units UOM I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
Contractual
5 Supplies and Materials
Laboratory Supplies 0.0000 0.000 0.000 10,01)0.00
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Total Program Expenses 10,000.00
TOTAL DIRECT EXPENSES 10,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 898.00
Nursing Adm Distribution 0.0000 0.000 0.000 308.00
Total for Other Costs Distributions 1,206.00
Total Indirect Costs 1,206.00
TOTAL INDIRECT EXPENSES 1,206.00
TOTAL EXPENDITURES 11,206.00
Date: 11106/2015 Contract #20161702-00, Oakland County Department of Health and Human Services/ Page: 77 of 167
Health Division, Comprehensive Agreement 2016
Contract # 20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016 / Hearing ELPHS
DATE PREPARED
1116/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
17 Original n Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category Amount Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 236,231.00 236,231.00
2 Fringe Benefits 56,522.00 56,522.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 SupplIes and Materials 3,706.00 3,706.00
Travel 6,127.00 6,127.00
7 Communication 670.00 670.00
8 County-City Central Services 0.00 0.00
9 Space Costs 12,610.00 12,610.00
10 All Others (ADP, Con. Employees, Misc.) 4,340.00 4,340.00
Total Program Expenses 320,206.00 320,206.00
TOTAL DIRECT EXPENSES 320,206.00 320,206.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 32,718.00 32,718.00
2 Other Costs Distributions 94,816.00 94,816.00
Total Indirect Costs 127,534.00 127,534.00
TOTAL INDIRECT EXPENSES 127,534.00 127,534.00
TOTAL EXPENDITURES 447,740.00 447,740.00
Date: 11/06/2016 Contract #20161702-00, Oakland County Department of Health and Human Services/ Page: 78 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-03 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash lnkind 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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0.00
ELPHS - MDHHS Hearing 225,684.00 0.00 0.00 225,684.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private! Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0,00 0,00
Local Funds - Other 0.00 222,056.00 0.00 222,056.00
lnkind Match 0.00 0.00 0.00 0.00
N1131-1HS Fixed Unit Rate
Totals 225,684.00 . 222,056.00 0.00 447,740.00
Date: 11/0612015 Contract #20161702-00 Oakland County Department of Health and Human Services/
Page: 79 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
Line Item QtYI Ratel UnitslUOM I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Supervisor 2080.0000 22.966 0.000 FTE 47,769.00
Technician 1000.0000 19.838 0.000 FTE 19,838.00
Technician 2000.0000 15.681 0.000 FTE 31,363.00
Technician 1000.0000 18.911 0.000 FTE 18,911.00
Technician 1000.0000 15.234 0.000 FTE 15,234.00
Technician 1000.0000 19.827 0.000 FTE 19,827.00
Technician 1000.0000 16.152 0.000 FTE 16,152.00
Technician 1000.0000 16.152 0.000 FTE 16,152.00
Technician 1000.0000 16.152 0.000 FTE 16,152.00
Coordinator 1040.0000 33.493 0.000 FTE 34,833.00
Total for Salary & Wages 236,231.00
2 Fringe Benefits
All Composite Rate
Notes : FICA
UNEMPLOYMENT INS
RETIREMENT
HOSPITAL INS
LIFE INS
VISION INS
HEARING INS
DENTAL INS
WORK COMP
SHORT/LONG TERM
DISABILITY
0.0000 23.927 236231.000 56,522.00
Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office/Medical Supplies, Printing 0.0000 0.000 0.000 3,706.00
Travel
Travel-terms not specified 0.0000 0.000 0.000 6,127.00
7 Communication
Telephone 0.0000 0.000 0.000 670.00
8 County-City Central Services
9 Space Costs
Bldg Space Costs 0.0000 0.000 0.000 12,610.00
Date: 11 0612015 Contract # 20161702-00, Oakland Conn y Department of Health and Human Services/
Page: 80 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/0612015
Line Item QtY I Rate' UnitslUOIVI Total
10 All Others (ADP, Con. Employees, Misc.)
Copier, Equip Maint, Exp Equip,
Tr
0.0000 0.000 0.000 4,340.00
Total Program Expenses 320,206.00
TOTAL DIRECT EXPENSES 320,206.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan 0.0000 13.850 236231.000 32,718.00
2 Other Costs Distributions
Other Cost Distributions-Misc. 0.0000 0.000 0.000 59,059.00
Health Adm Distribution 0.0000 0.000 0.000 35,757.00
Total for Other Costs Distributions 94,816.00
Total Indirect Costs 127,534.00
TOTAL INDIRECT EXPENSES 127,534.00
TOTAL EXPENDITURES 447,740.00
Date: 1110512015 Contract #20161702-00, Oakland County Department of Health and Human Services/
Page: 81 of 167
Health Division, Comprehensive Agreement - 2016
Contract # 20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement.. 2016 / HIV ELPHS
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
rv7, Original r Amendment
AMENDMENT #
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category
DIRECT EXPENSES
Program Expenses
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
TOTAL INDIRECT EXPENSES
TOTAL EXPENDITURES
Amount Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 0.00
888,987.00 888,987.00
888,987.00 888,987.00
888,987.00 888,987.00
888,987.00 888,987.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department ot Health and Human Services/
Page. 82 of 167
Health Division, Comprehenstve Agreement- 2016
Contract # 20161702-00 Date: 11/06/2015
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 0.00 0.00 0.00 0,00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0,00 0.00 0.00
ELPHS - MDHHS Other 305,899.00 0.00 0.00 305,899.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0,00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 583,088.00 0.00 583,088.00
lnkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 305,899.00 583,088.00 0.00 888,987.00
Date: 11/0612015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 83 of 167
Health Division, Comprehensive Agreement -2016
Contract #20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
'Line Item I QtYI Rate Units UOM 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
Nursing Adm Distribution 0.0000 0.000 0.000 15,344.00
Other Cost Distributions-Misc 0.0000 0.000 0.000 873,643.00
Total for Other Costs Distributions 888,987.00
Total Indirect Costs 888,987.00
TOTAL INDIRECT EXPENSES 888,987.00
TOTAL EXPENDITURES 888,987.00
Date: 11/06/2015 Contract # 20161702-00, OaMand County Department of Health and Human Serviced Page: 84 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement - 2016/ HIV Prevention
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
Fi Original r Amendment
AMENDMENT if
0
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category I Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 287,248.00 287,248.00
Fringe Benefits 128,456.00 128,456.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
Contractual 0.00 0.00
5 Supplies and Materials 4,325.00 4,325.00
6 Travel 8,653.00 8,653.00
7 Communication 4,200.00 4,200.00
8 County-City Central Services 0.00 0.00
9 Space Costs 5,432.00 5,432.00
10 All Others (ADP, Con. Employees, Misc.) 20,802.00 20,802.00
Total Program Expenses 459,116.00 459,116.00
TOTAL DIRECT EXPENSES 459,116.00 459,116.00
INDIRECT EXPENSES
Indirect Costs
Indirect Costs 39,784.00 39,784.00
2 Other Costs Distributions 44,782.00 44,782.00
Total Indirect Costs 84,566.00 84,566.00
TOTAL INDIRECT EXPENSES 84,566.00 84,566.00
TOTAL EXPENDITURES 543,682.00 543,682.00
Date: 11/06/2015 Contract # 20161702-00, Oakland County Department of Health and Human Services/ Page: 85 01167
Health Division, ComprehensIve Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
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
MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 498,900.00 0.00 0.00 498,900.00
ELPHS - MDHHS Hearing 0.00 0.00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 44,782.00 0.00 44,782.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 498,900.00 44,782.00 0.00 543,682.00
Date: 1110612016 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 86 of 167
Health Division, Comprehensive Agreement - 2016
Contract # 20161702-00 Date: 11/06/2015
3 Program Budget - Cost Detail
ILine Item I Qty Rate! Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse 1000.0000 25.349 0.000 FTE 25,349.00
Coordinator 1930.0000 33.493 0.000 FTE 64,641.00
Assistant
Notes : Office Assistant
1870.0000 18.840 0.000 FTE 35,232.00
Public Health Nurse 1000.0000 26.801 0.000 FIE 26,801.00
Public Health Nurse
Notes :
2080.0000 31.763 0.000 FTE 66,066.00
Overtime 15.0000 25.061 0.000 FIE 376.00
Public Health Nurse 1000.0000 27.353 0.000 FTE 27,353.00
Public Health Nurse
Notes : PHN II
1000.0000 25.349 0.000 FTE 25,349.00
Public Health Nurse 600.0000 26.801 0.000 FTE 16,081.00
Total for Salary & Wages 287,248.00
2 Fringe Benefits
All Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 44.720 287248.000 128,456.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 1,000.00
Medical Supplies 0.0000 0.000 0.000 1,625.00
Postage 0.0000 0.000 0.000 300.00
Lab Supplies 0.0000 0.000 0.000 800.00
Printing 0.0000 0.000 0.000 600.00
Total for Supplies and Materials 4,325.00
Date: 11/0612016 Contract # 20161702-00, Oakland County Department of Health and Human Services/
Page: 87 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
Line Item Qty[ Rate! UnitslUOM Total
6 Travel
Mileage
Notes :10,970 miles @ .575
0.0000 0.000 0.000 6,308.00
Client Transportation 0.0000 0.000 0.000 345.00
Conferences 0.0000 ._ 0.000 0.000 2,000.00
Total for Travel 8,653.00
7 Communication
Telephone 0.0000 0.000 0.000 4,200.00
8 County-City Central Services
9 Space Costs
Building Space Rental 0.0000 0.000 0.000 5,432.00
10 All Others (ADP, Con. Employees, Misc.)
IT Operations
Notes : it operations
0.0000 0.000 0.000 15,000.00
Convenience Copier
Notes : copier
0.0000 0.000 0.000 685.00
Interpretation
Notes : printing
0.0000 0.000 0.000 600.00
Insurance 0.0000 0.000 0.000 1,385.00
Advertising
Notes : interpretation
0.0000 0.000 0.000 2,132.00
Lab Fees 0.0000 0.000 0.000 1,000.00
Total for All Others (ADP, Con. Employee 20,802.00
Total Program Expenses 459,116.00
TOTAL DIRECT EXPENSES 459,116.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
Cost Allocation Plan 0.0000 13.850 287248.000 39,784.00
2 Other Costs Distributions
Health Adm Distribution 0.0000 0.000 0.000 44,782.00
Total Indirect Costs 84,566.00
TOTAL INDIRECT EXPENSES 84,568.00
TOTAL EXPENDITURES 543,682.00
Date: 11/06/2015 Contract # 20161702-00, Oakland county Department of Health and Human Services/
Page: 88 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
1 Program Budget Summary
PROGRAM / PROJECT
Comprehensive Agreement -2016 / HIV Surveillance
Support
DATE PREPARED
11/6/2015
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2015 To: 9/30/2016
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
p Original r, Amendment
AMENDMENT # o
CITY
Pontiac
STATE
MI
ZIP CODE
48341-0432
FEDERAL ID NUMBER
38-6004876
Category I Amount I Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 3,082.00 3,082.00
Fringe Benefits 177.00 177.00
3 Cap. Exp. for Equip & Fac. 0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
6 Travel 0.00 0.00
7 Communication 6,731.00 6,731.00
8 County-City Central Services 0.00 0.00
9 Space Costs 23,923.00 23,923.00
10 All Others (ADP, Con. Employees, Misc.) 660.00 660.00
Total Program Expenses 34,573.00 34,573.00
TOTAL DIRECT EXPENSES 34,573.00 34,573.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 427.00 427.00
2 Other Costs Distributions 4,218.00 4,218.00
Total Indirect Costs 4,645.00 4,645.00
TOTAL INDIRECT EXPENSES 4,645.00 4,645.00
TOTAL EXPENDITURES 39,218.00 39,218.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department ot Health and Human Services/
Page: 89 of 167
Health Division, Comprehensive Agreement - 2016
Contract #20161702-00 Date: 11/06/2015
2 Program Budget - Source of Funds
SOURCE OF FUNDS
Category Amount Cash Inkind Total
i 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
MDI-IIS Non Comprehensive 0.00 0.00 0.00 0.00
MDHHS Comprehensive 35,000.00 0.00 0.00 35,000.00
ELPHS - MDHHS Hearing 0.00 0,00 0.00 0.00
ELPHS - MDHHS Vision 0.00 0.00 0.00 0.00
ELPHS - MDHHS Other 0.00 0.00 0.00 0.00
ELPHS - Food 0.00 0.00 0.00 0.00
ELPHS - Private / Type Ill Water
Supply
0.00 0.00 0.00 0.00
ELPHS - On-Site Wastewater
Treatment
0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 4,218.00 0.00 4,218,00
Inkincl Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 35,000.00 4,218.00 0.00 39,248.00
Date: 11/06/2015 Contract #20161702-00, Oakland County Department of Health and Human Service&
Page: 90 of 167
Health Division, Comprehensive Agreement - 2016