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HomeMy WebLinkAboutResolutions - 2001.11.08 - 26575MISCELLANEOUS RESOLUTION #01280 October 25, 2001 BY: General Government Committee, William R. Patterson, Chairperson IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTP DIVISION - 2001/2002 COMPREHENSIVE, PLANNING, BUDGETING AND CONTRACTING CIRBC) ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Michigan Department of Community Health (MDCH) has awarded the Oakland County Health Division funding in the amount of $7,987,371, which is a 0.94 56. ($75,356) decrease from the Fiscal Year 2000/2001 amended allocation of $8,062,727; and WHEREAS the following changes have been made by MDCH from the previous fiscal year's amended amounts: • Funding for Women, Infants, and Children has been decreased by $80,389. • Child Well Being funding has been eliminated from this year's agreement, a decrease of $20,000. • Funding for the Hepatitis C program has also been eliminated, a decrease of $50,000. • Maternal and Infant Health Advocacy Services has been increased $49,621. • Funding for Aids/HIV Prevention has been increased by $10,773. • Funding for Family Planning General Services has been increased by $12,456. • Funding for the Lead Hazard Remediation Program has been increased $5,000. Other programs have generally remained the same with a slight increase or decrease in total funding; and WHEREAS the budget detail for the various programs is a matter of negotiation between the Health Division and MDCH; amendments will be recommended to the FY 2002 Budget when details are finalized; and WHEREAS this agreement is for the period of October 1, 2001 through September 30, 2002; and WHEREAS the CPBC Agreement has been submitted through the County Executive Review Process, including Corporation Counsel and is recommended for approval. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby accepts the 2001/2002 Comprehensive Planning, Budgeting, and Contracting (CPBC) agreement for funding in the amount of $8,037,371 for the period of October 1, 2001 through September 30, 2002. 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 (15t), which is consistent with the agreement as originally approved. BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its Chairperson to execute this Agreement subject to the following additional condition: That the County's approval for entering into this Agreement is specifically conditioned and premised upon the acceptance, approval and execution of the Agreement containing Addendum A, by the Michigan Department of Community Health, and that the failure of the Michigan Department of Community Health to execute the Agreement as specified shall, without any further act of the Oakland County Board of Commissioners, automatically negate and void the County's approval and/or acceptance of this agreement as provided for in this resolution. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. GENERAL GOVERNMENTOMMITTEE i5 t GENERAL GOVERNMENT COMMITTEE: Motion carried unanimously on a roll call vote. epilayr-art*T2/..aa.ore TrtleiSubiect: Contact Person: 2C01102 cpsc A greement Torn Flck:er Department: Human Services Telephone #: 41.52-2.15 I PERSONNEL DEPT: Approved El Disapproved [7 Modify * f Date: Ej Disapproved El Modify * Date: ••nn••n• r • • F t.04. £0'8 1U101 L /17( obt//HUC, 411" CC:MT:q.ACTir;AC.G2,r,M P.E.ZUEST Date: T .7/26/01 inec:21 72er/ices. fiisk Mot, C:77.. Psracr:rel 7cm FtIckier, Heetrh Division STATUS: (Check appropriate hosl Initial El Revision # El Extension Ill Final L J Other • 'if "other" is checked, please explain: I I Is 13oard Resolution required? No Fx.1 Yes — Resolution # Date: RISK MANAGEMENT AND SAFETY: M Approved 747/0 n Modify Date: Disapproved M!!+11AgPAkNIANP BUDGET: .;4 Approved CORPORATION COUNSEL: (7)<1 Approved j Disapproved * r Modify' Date: CONTRACTIPROGFIAM SYNOPSIS: The CPBC Agreement provides funding for severalHealth Division progams. Signed agreement is due to MDCH by September 15, 2001. 4 When "Disapproved" is noted or 'Modify" is requested, attach explanation. Risk Management 111 Safety - Reeked 2/98 Unary% FileakWard *97\SandreWheriecdnCONTRACf-PItoGeAtvi Rb.N1R.W EQIIEStilee. 1 DEPARTMENT OF HUMAN SERVICES HEALTH DIVISION FY 2001/2002 COMPREHENSIVE PLANNING, BUDGETING, AND CONTRACTING AGREEMENT (CPBC) ACCEPTANCE • The Oakland County Health Division (OCHD) is accepting funding through the CPBC Agreement from the Michigan Department of Community Health (MDCH) in the total amount of $7,987,371. The Agreement is for the period October 1, 2001 through September 30, 2002. • The Agreement provides for categorical grant funding and partial reimbursement for services provided in accordance with the Public Health Code (PA. 368 of 1978, as amended). Changes included in the FY 2001/02 Agreement include: • The initial level of funding for Women, Infants, and Children is $80,389 lower than the final amended allocation from the prior fiscal year. • Child Well Being funding has been eliminated from this year's agreement, a decrease of $20,000. • Funding for the Hepatitis C program has been eliminated, a decrease of $50,000. • Maternal and Infant Health Advocacy Services funding has been increased $49,621. • Funding for Aids/HIV Prevention has been increased by $10,773. • Funding for Family Planning General Services has been increased by $12,456. • Funding for the Lead Hazard Remediation Program has been increased $5,000. No positions are to be created with the acceptance of this Agreement. Contract # P.O. # Agreement Between Michigan Department of Community Health hereinafter referred to as the "Department" and Oakland County Health Division (OCHD) (the local health department mandated by MCL 333.2413) 1200 N. Telegraph Road. Dept. 432 Pontiac. Michigan 48341-0432 • Federal I.D.#. 38-6004876 • hereinafter referred to as the "Contractor" for The Delivery of Public Health Services under • the Comprehensive Planning, Budgeting and Contract (CPBC) Agreement Part I 1. Purpose: This agreement is entered into for the purpose of setting forth a joint and cooperative Contractor/Department relationship and basis for facilitating the delivery of public health services to the citizens of Michigan under their jurisdiction, as described in the attached Output Measures and Annual Budget, established Minimum Program Requirements, and all other applicable Federal, State and Local laws and regulations pertaining to the Contractor and the Department. Public health services to be delivered under this agreement include Local Public Health Operations (LPHO) and Categorical Programs as specified in the attachments to this agreement. 2. Period of Agreement: This Agreement shall commence on October 1 2001 and continue through September 30, 2002. This agreement is full force and, effect for the period specified. The Department has the option to assume no responsibility for costs incurred by the contractor prior to the signing of this agreement. MDCH/CMS 7/01 Page 1 of 20 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 shall be $8,037,371. 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 Contractor upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department's proportionate interest in such equipment supports such retention or transfer of title. C. Budget Transfers and Adjustments 1. Transfers between categories within any program element budget supported in whole or in part by state/federal categorical sources of funding shall be limited to increases in an expenditure budget category by $5,000 or fifteen percent (15%) whichever is greater. This transfer authority does not authorize establishment of new budget categories, 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 the above provisions, 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 above provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the • Department shall be recovered proportionately from each local Contractor that, during the course of the agreement period, chose to reduce or transfer local funds from the Family Planning program. MDCH/CMS 7101 Page 2 of 20 4. Agreement Attachments: A. The following documents are attachments to this Agreement Part 1 and Part II - General Provisions, which are hereby made part of this agreement through reference: 1. Attachment 1 - Annual Budget 2. Attachment 11 - Output Measures 3. Attachment III - Program Specific Assurances and Requirements 4. Attachment IV - Funding/Reimbursement Matrix The attachments are added into this Agreement as follows: 1. Original Agreement (Part I and Part II) - Attachment III, IV 2. First Amendment - Attachment I, II and IV (Revised) 5. Statement of Work : The Contractor agrees to undertake, perform and complete the services described in Attachment III - Program Specific Assurances and Requirements and the other applicable attachments to this agreement which are hereby made a 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 hereby made a part of this agreement through reference. 7. Performance/Progress Report Requirements : The progress reporting methods, as applicable, shall be followed as described in Attachments 11 - Output Measures and IV- Funding/Reimbursement Matrix, which are hereby made a part of this agreement through reference. 8. General Provisions : The Contractor agrees to comply with the General Provisions outlined in Part II, which are hereby made part of this agreement through reference. 9. Administration of Agreement : The person acting for the Department in administering this Agreement (hereinafter referred to as the Contract Consultant) will be : • Richard McCubbin (Contract Consultant) 10. Special Conditions: A. This agreement is valid upon approval by the State Administrative Board as appropriate and approval and execution by the Department. MDCI-I/CMS 7/01 Page 3 of 20 B. The Department and Contractor, under the terms of this agreement shall, subject to availability of funding and other applicable conditions, provide resources and continuous services throughout the period of this agreement as shown in Attachment I - Annual Budget and in Attachment II - Output Measures. 11. Special Certification : The individual or officer signing this agreement certifies by his or her signature that he or she is authorized to sign this agreement on behalf of the responsible governing board, official or Contractor. 12. Signature Section : For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Date Peter L. Trezise, Chief Operating Officer For the LOCAL GOVERNING ENTITY/CONTRACTOR Name and Title Signature Date Part II MDCH/CMS 7/01 Page 4 of 20 Part 11 General Provisions Responsibilities - Contractor The Contractor in accordance with the general purposes and objectives of this agreement will: A. Publication Rights Where activities supported by this agreement produce books, films, or other such copyrightable materials issued by the Contractor, the Contractor may copyright such but shall acknowledge that the Department reserves a royalty- free, non-exclusive and irrevocable license to reproduce, publish and use such materials and to authorize others to reproduce and use such materials. This cannot include service recipient information or personal identification data. Any copyrighted materials or modifications bearing acknowledgment or the Department's name must be approved by the Department prior to reproduction and use of such materials. The Contractor shall give recognition to the Department in any and all publication papers and presentations arising from the program and service contract herein; the Department will do likewise. B. Fees Make reasonable efforts to collect l' and 3rd party fees, where applicable, and report these as outlined by the Department's fiscal procedures. Any underrecoveries of otherwise available fees resulting from failure to bill for eligible services will be excluded from reimbursable expenditures. C. Program Operation Provide the necessary administrative, professional, and technical staff for operation of the program. D. Reporting Utilize all report forms and reporting formats required by the Department at the effective date of this agreement, and provide the Department with timely review and commentary on any new report forms and reporting formats proposed for issuance thereafter. E. Record Maintenance/Retention - Maintain adequate program and fiscal records and files including source documentation to support program activities and all expenditures made under the terms of this agreement, as required. Assure that all terms of the agreement will be appropriately adhered to; and, that records and detailed documentation for the project or program identified in this agreement will be maintained for a period of not less than three (3) years from the date of termination, the date of submission of the final expenditure report or until litigation or audit findings have been resolved. F. Authorized Access Permit upon reasonable notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to the extent authorized by applicable state or federal law, rule or regulation, to records, files, and documentation related to this agreement. G. Single Audit To comply with requirements of the Single Audit Act Amendments of 1996, 31 USC 7501 et seq, and Office of Management and Budget (OMB) Circular A-133, "Audits of States, Local Governments, and Non-Profit Organizations", and provide to the Department copies of any audits of the Contractor on any program elements covered by this agreement. The audit reporting package and management letter are required to be filed with the Department even if there are no findings reported in the audit pertaining to Department programs. The Contractor must also assure that each of its subcontractors comply with the above audit requirements (i.e., Subcontractors expending $300,000 or more in federal awards during the subcontractor's fiscal year are required to have audits performed in accordance with Circular A-133, that should be provided to the Contractor). Due Date: The audit reporting package is due nine months after the end of the Contractor's fiscal year. Where to Send: A copy of the audit reporting package should be forwarded to: Michigan Department of Community Health Rate Development, Revenue Reimbursement and Payment Settlement Bureau P.O. Box 30479 Lansing, Michigan 48909-7979 H. Notification of Modifications Provide timely notification to the Department, in writing, of any action by the Contractor, its governing board or any other funding source which would require or result in significant modification in the provision of services or funding or compliance with operational procedures. Year 2000 Compatibility The Contractor must ensure year 2000 compatibility for any software purchases related to this agreement. This shall include, but is not limited to: data structures (databases, data files, etc.) that provide 4-digit date century; stored data that contain date century recognition, including but not limited to, data stored in databases and hardware device internal system dates; calculations and program logic (e.g., sort algorithms, calendar generation, event recognition, and all processing actions that use or produce date values) that accommodates same century and multi-century formulas and date values; interfaces that supply data to and receive data from other systems or organizations that prevent non-compliant dates and data from I entering any State system; user interfaces (i.e., screens, reports, etc.) that accurately show 4-digit years; and assurance that the year 2000 shall be correctly treated as a leap year within all calculation and calendar logic. The Department actively worked to ensure that computer applications used by the contractor were Year 2000 compliant or operable by December 31, 1999. The applications include those that support the programs of Immunization; Medicaid; Women, Infants, and Children; Public Health Services; Maternal Health Services; Services to the Aging, and Substance Abuse Services. The Department followed the requirements of Executive Directive 1998-8 issued to the Executive Branch departments and agencies in order to address the Y2K issues. J. Human Subjects The Contractor agrees to submit 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 Human Subjects Committee for approval prior to the initiation of the research. K. Terms To abide by the terms of this agreement including all attachments. L. Minimum Program Requirements To comply with Minimum Program Requirements promulgated in accordance with Section 2472.3 of 1978 PA 368 as amended, MCL 333.2472.3, MSA 14.15 (2472.3), for each applicable program element funded under this agreement. M. Annual Budget and Plan Submission To submit an Annual Budget and Plan (Output Measures) request to the Department, in accordance with instructions established bythe Department, to serve as the basis for completion of specific details for Attachments I, II, and IV of this agreement via Contractor/Department negotiated amendment(s). Failure to submit a complete Annual Budget and Plan by the due date will result in the deferral of Department payments until these documents are submitted. N. Maintenance of Effort All agencies shall comply with maintenance of effort requirements for LPHO as defined in current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part 0. Accreditation All agencies 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. Agencies designated as "not accredited" may have their Department allocations reduced for costs incurred in the assurance of service delivery. mnrwr.mn Pace 7 of 20 II. Responsibilities - Department The Department in accordance with the general purposes and objectives of this agreement will: A. Payment Provide payment in accordance with the terms and conditions of this agreement based upon appropriate reports, records, and documentation maintained by the Contractor. B. Report Forms Provide any report forms and reporting formats required by the Department at the effective date of this agreement, and to provide the Contractor with any new report forms and reporting formats proposed for issuance thereafter at least ninety (90) days prior to required usage to afford the Contractor an opportunity for review and commentary. C. Terms Abide by the terms of this agreement including all attachments. D. Notification of Modifications To notify the Contractor in writing of modifications to Federal or State laws, rules and regulations affecting this agreement. E. Identification of Laws To identify for the Contractor relevant laws, rules, regulations, policies, procedures, guidelines and State and Federal manuals, and provide the Contractor with copies of these documents to the extent they are not otherwise available to the Contractor. F. Modification of Funding • To notify the Contractor in writing within thirty (30) calendar days of becoming aware of the need for any modifications in agreement funding commitments made necessary by action of the Federal Government, the Governor, the Legislature or the Department of Management and Budget on behalf of the Governor or the Legislature. Implementation of the modifications will be determined jointly by the Contractor and the Department. G. Monitor Compliance To monitor compliance with all applicable provisions contained in federal grant awards and their attendant rules, regulations and requirements pertaining to program elements covered by this agreement. H. Reimbursement To reimburse local agencies for costs based upon timely, accurately completed Financial Status Reports in accordance with Section IV. Technical Assistance To make technical assistance available to the Contractor forthe implementation of this agreement. J. Health Insurance Portability and Accountability Act The Department assures that it will be in compliance with the Health Insurance Portability and Accountability Act. Ill. Assurances The following assurances are hereby given to the Department: A. Compliance with Applicable Laws The Contractor will comply with applicable federal and state laws, guidelines ., rules and regulations in carrying out the terms of this agreement. The Contractor will also comply with all applicable general administrative requirements such as OMB Circulars covering cost principles, grant/agreement principles, and audits in carrying out the terms of this agreement. B. Anti-Lobbying Act The Contractor will comply with the Anti-Lobbying Ad, 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 Appropriations Act (Public Law 104-208). Further, the Contractor shall require that the language of this assurance be included in the award documents of all subawards at all tiers (including subcontracts, subg rants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. • C. Non-Discrimination 1. The Contractor agrees not to discriminate against any employee or applicant for employment or service delivery and access, with respect to their hire, tenure, terms, conditions or privileges of employment, programs and services provided or any matter directly or indirectly • related to employment, because of race, color, religion, national origin, ancestry, age, sex, height, weight, marital status, physical or mental disability unrelated to the individual's ability to perform the duties of the particular job or position. The Contractor further agrees that every subcontract entered into for the performance of any contract or purchase order resulting here from 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. Additionally, assurance is given to the Department that efforts will be made to identify and encourage the participation of minority owned, women owned, and handicapper owned businesses in contract solicitations. The Contractor shall incorporate language in all contracts awarded: (1) prohibiting discrimination against minority owned, women owned, and handicapper owned businesses in subcontracting; and (2) making discrimination a material breach of contract. mncHrnms D. Debarment and Suspension Assurance is hereby given to the Department that the Contractor will comply with federal regulation 45 CFR Part 76 and certifies to the best of its knowledge and belief that the Contractor's local health department or an official of the Contractor's local health department and the contractor's subcontractors: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or Contractor; 2. Have not within a 3 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 b, and; 4. Have not within a 3 year period preceding this agreement had one or -more public transactions (federal, state or local) terminated for cause or default. E. Federal Reauirement: Pro-Children Act 1. Assurance is hereby given to the Department that the Contractor will comply with Public Law 103-227, also known as the Pro-Children Act of 1994,20 USC 6081 et seq, which requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted by and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by federal programs either directly or through state or local governments, by federal grant, contract, loan or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where Women, Infants, and Children (WIC) coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. The Contractor also assures that this language will be included in any subawards which contain provisions for children's services. MDCH/CMS Page 10ot 20 2. The Contractor also assures, in addition to compliance with Public Law 103-227, any service or activity funded in whole or in part through this agreement will be delivered in a smoke-free facility or environment. Smoking shall not be permitted anywhere in the facility, or those parts of the facility under the control of the Contractor. If activities or services are delivered in facilities or areas that are not under the control of the Contractor (e.g., a mall, restaurant or private work site), the activities or services shall be smoke-free. F. Hatch Political Activity Act and Intergovernmental Personnel Act The Contractor will comply with the Hatch Political Activity Act 5,USC 1501- 1508 and the Intergovernmental Personnel Act of 1970, as amended by Title VI of the Civil Service Reform Act, Public Law 95-454, Section 42 USC 4728. Federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs. G. Home Health Services If the Contractor provides Home Health Services (as defined in Medicare Part B), the following requirements apply: 1. The Contractor shall not use State LPHO or categorical grant funds provided under this agreement to unfairly compete for home health services available from private providers of the same type of services in the Contractor's service area. 2. For purposes of this agreement, the term "unfair competition" shall be defined as offering of home health services at fees substantially less than those generally charged by private providers of the same type of services in the Contractor's area, except as allowed under Medicare customary charge regulations involving sliding fee scale discounts for low-income clients based upon their ability to pay. ' 3. If the Department finds that the Contractor is not in compliance with its assurance not to use state LPHO and categorical grant funds to unfairly compete, the Department shall follow the procedure required for failure by local health departments to adequately provide required services set forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15 (2497) and (2498). H. Subcontracts Assure for any subcontracted service, activity or product: • 1. That a written subcontract is executed by all affected parties prior to the initiation of any new subcontract activity. Exceptions to this policy may be granted by the Department upon written request. 2. That any executed subcontract shall require the subcontractor to comply with all applicable terms and conditions of this agreement. In the event of a conflict between this agreement and the provisions of the subcontract, the provisions of this agreement shall prevail. A conflict between this agreement and a subcontract, however, shall not be deemed to exist where the subcontract: a. Contains additional non-conflicting provisions not set forth in this agreement; or b. Restates provisions of this agreement to afford the Contractor the same or substantially the same rights and privileges as the Department; or c. Requires the subcontractor to perform duties and/or services in less time than that afforded the Contractor in this agreement. 3. That the subcontract does not affect the Contractor's accountability to the Department for the subcontracted activity. 4. That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5. That the Contractor will submit a copy of the executed subcontract if requested by the Department. 6. That subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $10,000 shall contain provisions or conditions that will: a. Allow the Contractor or Department to seek administrative, contractual or legal remedies in instances in which the contractor violates or breaches contract terms, and provide for such remedial action as may be appropriate. • b. Provide for termination by the Contractor, including the manner by which termination will be effected and the basis for settlement. 7. That 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 subg rants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Contractor shall include a provision: a. For compliance with the Copeland "Anti-Kickback" Act (18 USC 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b. For compliance with the Davis-Bacon Act (40 USC 276a to a-7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). MDCH/CMS Page 12 of 20 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. Procurement Assure that all purchase transactions, whether negotiated or advertised, shall be conducted openly and competitively in accordance with the principles and requirements of OMB Circular A-102 (as revised), implemented through applicable portions of the associated "Common Rule" as promulgated by responsible federal Contractor(s), or OMB CircularA-110 as applicable and that records sufficient to document the significant history of all purchases are maintained for a minimum of three years after the end of the agreement period. J. Health Insurance Portability and Accountability Act To the extent that this Act is pertinent to the services that the Contractor provides to the Department, the Contractor assures that it is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) Requirements. IV. Payment and Reporting Procedures A. Operating Advance Under the new pre-payment reimbursement method, no additional operating advances will be issued. B. Comprehensive Planning and Budgeting Contract (CPBC) Prepayments The Department will make monthly prepayments equal to 1/12th of the agreement amount for each non-fee-for-service program contained in Attachment IV of this agreement. One single payment covering all non-fee-for- service programs will be made within the first week of each month. The Department will send to the Contractor a worksheet itemizing the individual program amounts included in the monthly prepayment within five working days of processing the monthly prepayment. Prepayments for the months of October thru January will be based upon the initial agreement amounts in Attachment IV. Subsequent monthly prepayments may be adjusted based upon agreement amendments and/or Contractor adjustment requests per Department approval. C. Prepayment Adjustments: If the sum of the prepayments do not equal at least 90% of the Contractor's expenditures for a quarter of the contract period, the Contractor may submit documentation for an adjustment to the monthly prepayment amount via the following process: 1. Submit a written request for the adjustment to the Department's Accounting Division, Expenditure Operations Section. MOCH/CMS Pane 13 of 20 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) DCH-0411 must be submitted for all programs listed on Attachment IV. All FSR's must be prepared in accordance with the Department's FSR instructions and submitted not later than thirty (30) days after the close of the first three fiscal quarters. The reports are due 1130/XX, 4130/XX, and 71301XX. All FSR's must be submitted to: Michigan Department of Community Health, Budget and Finance Administration, Accounting Division, Expenditure Operations Section, P.O. Box 30720, Lansing, Michigan 48909- 8220. FSR's must report total actual program expenditures regardless of the source of funds. The Department will reimburse the Contractor for expenditures in accordance with the terms and conditions .of this agreement Failure to comply with the reporting due dates will result in the deferral of the Contractor's monthly prepayment. E. Reimbursement Method The Contractor will be reimbursed in accordance with the reimbursement mechanisms for applicable program elements described as follows: I. Performance Reimbursement - A reimbursement mechanism by which local health departments are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of State funds. Any local funds used to support program elements operated under such provisions of this agreement may be transferred by the Contractor within, among, to or from the affected elements without Department approval, subject to applicable provisions of Sections 3.B. and 3.C.3 of Part I and Section XIV of Part II. If local health department performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the State maximum MDCH/CMS Dan. 14 rif 9n allocation will be reduced equivalent to actual performance in relation to the minimum performance. 2. Staffing Grant Reimbursement A reimbursement mechanism by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total State allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department Department funding under this reimbursement mechanism is allocable as a source before any local funding requirement unless a specific local match condition exists. 3. Fixed Unit Rate Reimbursement - A reimbursement mechanism by which local health departments are reimbursed a specific amount for each output actually delivered and reported. 4. LPHO -A reimbursement mechanism by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required services, as noted in the current Appropriations Act. F. Unobligated Funds Any unobligated balance of funds held by the Contractor at the end of the agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. G. Fiscal Year-End Reporting A Preliminary Close Out Report is due within the first week of October using the format provided by the Department in August and will include the actual report due date. The Contractor must provide, by program, an estimate of total expenditures for the entire agreement period (October 1 through September 30). This report must represent the Contractor's best estimate of total program expenditures for the agreement period. The information on the report will be used to record the Department's year-end accounts payables and receivables by program for this Agreement. The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Contractor in the monthly prepayments and quarterly fee-for-service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of contract amendments, the Contractor may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of a program at fiscal year-end. MDCHICAAS 7/111 Page 15 of 20 Within 120 days after the agreement fiscal year-end, the Contractor must liquidate any unpaid year-end commitments and obligations. Any obligation remaining unliquidated after 120 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. H. Final Total Contractor FSR and Output Measure Reoort: The final total contractor FSR and Output Measures reoort tH-977) is due January 31, after the agreement period end date. Upon receipt of the final FSR and output measures report including final actual service outputs, the Department will determine by program, if funds are owed to the Contractor or if the Contractor owes funds to the Department. If funds are owed to the Contractor, payment will be processed. However, if the Contractor underestimated their year-end obligations in the preliminary close out report as compared to the final FSR and the total reimbursement requested does not exceed the agreement amount that is due to the Contractor, the Department will make every effort to process full reimbursement to the Contractor per the Final FSR. Final payment may be delayed pending final disposition of the Department's year-end obligations. If funds are owed to the Department, it will generally not be necessary for Contractor to send in a payment. Instead the Department will make the necessary entries to offset other payments and as a result the Contractor will receive a net monthly prepayment. When this does occur, clarifying documentation will be provided to Contractor by the Department's Accounting Division. I. Penalties for Reporting Noncompliance For failure to submit the final total Contractor FSR and Output Measures report by January 31, after the agreement period end date, the Contractor will be penalized with a one-time reduction in their. current LPHO allocation for noncompliance with the fiscal year-end reporting deadlines. Any penalty funds will be reallocated to other CPBC contractors (local health departments). Reductions will be one-time only and will not carryforward to the next fiscal year as an ongoing reduction to a Contractor's LPHO allocation. Penalties will be assessed based upon the postmark date of the mailing envelope: LPHO Penalties for Noncompliance with Reporting Requirements: a. 1% - 1 day to 30 days late; b. 2% - 31 days to 60 days late; • c. 3% - over 60 days late with a maximum of 3% reduction in the Contractor's LPHO allocation MDCH/CMS Patin ift ni 7(1 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 Contractor's local health department, or an official of the Contractor's local health department, is convicted of any activity referenced in Part II, Section 111.0, of this agreement • during the term of this agreement or any extension thereof. - VI. Final Reporting upon Termination Should this agreement be terminated by either party, within thirty (30) days after the termination, the Contractor shall provide the Department with all financial performance, and other reports required as a condition of the agreement. The Department will make • payments to the Contractor for allowable reimbursable costs not covered by previous payments, other state or federal programs. The Contractor shall immediately refund to the Department funds not authorized for use and any payments advanced to the Contractor in excess of allowable reimbursable expenditures. Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. VII. Severability If any provision of this agreement or any provision of any document attached to or incorporated by reference is waived or held to be invalid, such waiver or invalidity shall not affect other provisions of this agreement. VIII. Amendments Any changes to this agreement will be valid only if made in writing and accepted by all parties to this agreement. • A. This agreement, including attachments, may be amended by mutual written consent of the Contractor and the Department. When submitting a proposed agreement/budget amendment, the Contractor must also revise or amend its related Output Measures (H-977) whenever the amendment results in a significant change of program scope, and as specifically required by the Department, and submit copies of the revised sheets and a summary description of the changes. B. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Contractor's or Department's control, which reduce or otherwise interfere with the Contractor's or Department's ability to provide or maintain specified services or operational procedures, immediate written notification must be provided to the other party and an amendment to this agreement negotiated. MDCH/CMS Page 17 of 20 C. Amendments to this agreement shall be made as follows: 1. Any change proposed by the Contractor which would affect the State funding of any element funded in whole or in part by funds provided by the Department, subject to Part I, Section 3.C, of the agreement, must be submitted in writing to the Department immediately upon determining the need for such change. The proposed change may be implemented upon receipt of written notification from the Department. Within thirty (30) days after receipt of the proposed change, the Department shall advise the Contractor in writing of its determination. Subsequently the Department will initiate any necessary formal amendment to the agreement for execution by all parties to the agreement. Any changes proposed by the Department must be agreed to in writing by the Contractor and upon such written agreement, the Department shall initiate any necessary formal amendment as above. • 2. Other amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Contractor at any time prior to July 15th. The Department will provide a written response within thirty (30) calendar days. All amendments must be submitted to the Department by July 15th 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 Contractor in the performance of this agreement shall be the responsibility of the Contractor, and not the responsibility of the Department, if the liability, loss, or damage is caused by, or arises out of, the actions or failure to act on the part of the Contractor, any-subsentractor, anyone directly or indirectly employed by the Contractor, provided that nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Contractor or its employees by statute or court decisions. B. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as the provision of policy and procedural direction, to be carried out by the Department in the performance of this agreement shall be the responsibility of the Department, and not the responsibility of the Contractor, if the liability, loss, or damage is caused by, or arises out of, the action or failure to act on the part of any Department employee or agent, provided that nothing herein shall be construed as a waiver of any governmental immunity by the State, its agencies (the Department) or employees as provided by statute or court decisions. MDCH/CMS 7101 Page 18 of 20 C. In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Contractor and the Department in fulfillment of their responsibilities under this agreement, such liability, loss, or damage shall be borne by the Contractor and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein shall be construed as a waiver of any governmental immunity by the Contractor, the State, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. X. Conflict of Interest The Contractor and the Department are subject to the provisions of 1968 PA 317, as amended, MCL 15.321 et seq, MSA 4.1700(51) et seq, and 1973 PA 196, as amended, MCL 15.341 et seq, MSA 4.1700(71) et seq. XL State of Michigan Agreement This is a State of Michigan Agreement and is governed by the laws of Michigan. Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. XII. Confidentiality Both the Department and the Contractor shall assure that medical services to and information contained in medical records of persons served under this agreement, or • other such recorded information required to be held confidential by federal or state law, rule or regulation, in connection with the provision of services or other activity under this agreement shall be privileged communication, shall be held confidential, and shall not be divulged without the written consent of either the patient or a person responsible for the patient, except as may be otherwise required by applicable law or regulation. Such information may be disclosed in summary, statistical, or other form which does not directly or indirectly identify particular individuals. 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 Contractor, upon presentation of written justification by the requesting party. Such waiver may be temporary or for the life of the agreement and may affect any or all program elements covered by this agreement. XIV. Fundina A. State funding for this agreement shall be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds shall be as stated in the approved Annual Budget - Attachment I, the Program Specific Assurances and Requirements - Attachment III, and as outlined in the Funding/Reimbursement Matrix - Attachment IV. aanrutraae P2111.1 114 rlf 20 B. The funding provided through the Department for this agreement shall not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Contractor must advise the Department in writing by May 1 if the amount of Department funding may not be used in its entirety or appears to be insufficient for any program element. LPHO transfer requests between MDCH, MDA and MDEQ must also be requested in writing by May 1. All LPHO required services must be maintained throughout the entire period of the agreement. C. The Department may periodically redistribute funds between agencies during the agreement period in order to ensure that funds are expended to meet the • varying needs for services. Such redistributions will be based upon projections obtained in consultation with the Contractor. Any redistributions will be effected through the established amendment process. Part II MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 01/02 AGREEMENT ADDENDUM A 1. This addendum adds the following section to Part I and Renumbers existing 11 Special Certification to 12 and existing 12 Signature Section to 13: Part I 11. Agreement Exceptions and Limitations Notwithstanding any other term or condition in this Agreement including, but not limited to, any provisions related to any services as described in the Annual Action Plan, any • Contractor (Oakland County) services provided pursuant to this Agreement, or any limitations upon any Department funding obligations herein, the Parties specifically intend and agree that the Contractor may discontinue, without any penalty or liability whatsoever, any Contractor services or performance obligations under this Agreement when and if it • becomes apparent that State or Department funds for any such services will be no longer available. Notwithstanding any other term or condition in this Agreement, the Parties specifically understand and agree that no provision in this Agreement shall operate as a waiver, bar or limitation of any kind, on any legal claim or right the Contractor may have at any time under any Michigan constitutional provision or other legal basis (e.g., any Headlee Amendment limitations) to challenge any State or Department program funding obligations; and, the parties further agree that no term or condition in this Agreement is intended and no such provision shall be argued to state or imply that the Contractor voluntarily assumed or undertook to provide any services as described in the Annual Action Plan, and thereby, waived any rights the Contractor may have had under any legal theory, in law or equity, without regard to whether or not the Contractor continued to perform any services herein after any State or Department funding ends. 2. This addendum modifies the following sections of Part H, General Provisions: I. Responsibilities-Contractor - I. Year 2000 Compatibility. This section will be deleted in its entirety and replaced with the following language: The Michigan Department of Community Health and the County of Oakland will work together to determine and avoid potential Year 2000 computer systems problems. Ill. Assurances A. Compliance with Applicable Laws. This first sentence of this paragraph will be stricken in its entirety and replace with the following language: The Contractor will comply with applicable Federal and State laws, and lawfully enacted administrative rules or regulations, in carrying out the terms of this agreement. VIII. Liability. Paragraph A. will be deleted in its entirety and replaced with the following language: A. Except as otherwise provided for in this Contract, all liability, loss, or damage as a result of claims, demands, costs; or judgments arising out of activities to be carried out pursuant to the obligations of the Contractor under this Contract shall be the responsibility of the Contractor and not the responsibility of the Department, if the liability, loss, or damage is caused by, or arises out to the actions or failure to act on the part of the Contractor, its employees, officers or agents. Nothing therein shall be construed as a waiver of any governmental immunity for the Contractor, its agencies, employees, or Oakland County, as provided by statute or modified by court decisions. 3. This addendum modifies the following sections of Attachment Ill, Program Specific Assurances and Requirements: Attachment Ill. 1. CSHCS Outreach and Advocacy Requirements Contractor Requirements 4. General Performance Requirements The requirements that the County of Oakland enter into contracts with CSHCS Special Health Plans will be modified by the following language: The Director of the MDCH, CSHCS program has agreed to accept a Letter of Collaboration between Oakland County and each of the CSHCS Special Health Plans in lieu of a signed contractual agreement as currently required by Attachment 2. Care Coordination Services The obligation of Oakland County to continue providing care coordination services if CPBC funds for those services become depleted will be removed and the following language will apply: If funding for direct reimbursement to local health departments for care coordination services is depleted, in lieu of Oakland County obtaining the reimbursement from the CSHCS Special Health Plans, MDCH will make direct payments to Oakland County. 4. Special Certification: The individual or officer signing this agreement certifies by his or her signature that he or she is authorized to sign this agreement on behalf of the responsible governing board, official or Contractor. 5. Signature SeCtion: For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Peter L. Trezise, Chief Operating Officer Date For the CONTRACTOR Name and Title Signature Date ATTACHMENT HI MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 01/02 CPBC AGREEMENT PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Contractor and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. Utilization of a Minimum RepOrting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, minimum reporting requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on-site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Many program specific assurances and other requirements are defined within the above referenced documents including Minimum Program Requirements established for the following program elements as of October 1, 2001: B. a. Adolescent Health-Alternative Models b. Adolescent Health-Teen Health Centers c. AIDS/HIV Prevention d. Breast and Cervical Cancer Control e. Cardiovascular Disease Prevention f. Childhood Lead g. Childhood Immunization Registry h. Family Planning i. Food Service Sanitation j. General Communicable Disease Control k. Hearing I. Immunization - (Local Public Health Operations & Categorical) MDCH/CMS 7/01 m. LHD/CSHCS Services n. Maternal and Child Outreach, Enrollment And Coordination o. Maternal and Infant Health Advocacy Services (MINAS) p. Maternal and Infant Support q. Oral Health r. Primary Dental Care s. Sexually Transmitted Disease t. Vaccine Handling U. Vision V. VVIC Page 1 of 42 For FY 01/02, special requirements are applicable for the remaining program elements and funding sources listed in the attached pages and checked below: - AIDS/HIV Consortia • AIDS/HOPWA (Housing Opportunities for Persons Living with HIV/AIDS) - AIDS/HIV Prevention Community Planning (Specific by Agency for Funded Agencies) • - AIDS/HIV Prevention - CSHCS • - Childhood Immunization Registry • - Childhood Lead ▪ - Community Health Assessment and Improvement - Diabetes Program - Diabetes Outreach Network - Family Planning/BCCCP Joint Demonstration Project • - Family Planning-Long-Term Contraceptive Distribution • - Family Planning-Pregnancy Prevention - Family Planning-Model Project Special Requirements - Hepatitis B . • - Hepatitis C - Immunization-Field Service Representatives • - Immunization VFC and MI-VFC • - Immunization - Nurse Training Reimbursement - Indian Health • - Informed Consent - Laboratory Services - Lead Hazard Remediation Program • Local MCH ▪ - Local Public Health Operations (LPHO) - Local Tobacco Reduction - Michigan Childhood Immunization Registry (MCIR) • - Minority Health • - Outreach for Medicaid and MI-Child - Primary Care Dental Special Project • -SIDS • - TB Control (DOT) • -WIC Services - WIC Increased Participation - VVISEWOMAN FORMAT (PROGRAM/ELEMENT) SPECIAL REQUIREMENTS I. Budget and Agreement Requirements - Lists those special funding and agreement requirements applicable to the program/element as a whole. II. Contractor Requirements - Lists those special requirements applicable to all agencies administering the program element. III. Department Requirements - Lists those special requirements applicable to the Department. IV. Contractor Specific Requirements - Lists those unique requirements applicable only to the single Contractor covered by this agreement. ronr.Hinms PanA 7 nf 42 AIDS/HIV CONSORTIA SPECIAL REQUIREMENTS Contractor Specific Requirements 1. Adhere to all Ryan White CARE Act Title II and MDCH/DHAS-HAP1S Continuum of Care Policies and Guidelines, as identified in the CPBC "Applicable Laws, Rules, Regulations, Policies, Procedures and Manuals, listing issued for the current contract year. 2. Adhere to all Federal and Michigan Laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination and confidentiality. 3. Assure Ryan White Title 11 and Michigan Health Initiative (MHI) resources are used as payor of last resort. 4. For contractors that are consortia fiduciaries or direct service providers, collaborate with MDCH/DHAS- HAPIS to annually monitor compliance with contractual and programmatic requirements as appropriate. 5. Monitor annually, subcontracted agencies to assess compliance with the subcontract. Take primary responsibility to monitor follow-up and remediate in cases where the subcontracted entity is not in compliance with the contract. Report the results of all contract monitoring activities to MDCH/DHAS- HAPIS. 6. Participate in oversight of all remediation efforts for agencies found in non-compliance with established MDCH/DHAS-HAPIS program and practice standards, policy directives and program guidance. 7. The following requirements must be included in all subcontracts with service providers. Contractors that are direct service providers must also comply with the following: A. Adhere to all policy directives, program guidance and practice and program standards as established by MDCH/DHAS-HAPIS. B. Adhere to all Federal and Michigan HIV laws regarding treatment, non-discrimination, disability accommodations, and confidentiality. C. Adhere to the following additional requirements: • Establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client-level data will minimally include: a) regular back-up of client records with back-up files stored in a secure location; b) use of passwords to prevent unauthorized access to the computer or URS program; c) use of virus protection software to guard against computer viruses; and d) storage of desktop computers and laptop computers in a secure location, preferably a locked room or cabinet. D. Provide immediate notification to the Department, in writing, of any formal grievance procedures initiated by a service recipient and subsequent resolution of that grievance. E. Provide immediate notification to the Department, in writing, of any event occurring, or notice received by the contractor or subcontractor, that reasonably suggests that the contractor or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or contractor or subcontractor employees. F. Assure that clients who are employees are granted the same level of care and access to care as non-employees. G. Establish client-level outcome objectives for each service funded with Ryan White Title II and MHI resources and conduct outcome evaluation based on those objectives. MDCH/CMS 7/01 Page 3 of 42 H. Assess client satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. I. Utilize results of client satisfaction assessments and other evaluation activities to inform program development and implement program level changes. - J. Submit detailed expenditure reports (e.g. FSRs) to fiduciary at a minimum of every 3 months. K. Demonstrate, as directed by the fiduciary, appropriate expenditure of funds consistent with the contract, HRSA regulations and MDCH/DHAS-HAPIS regulations and guidelines. L. Attend all mandatory training sponsored by MDCH/DHAS-HAPIS. M. Demonstrate that the agency provides opportunity and fiscally supports on-going staff development and training. N. Submit progress reports to the fiduciary as requested and in accordance with the program portion of the MHIfTitle II progress reports and the MHI/Title ll application. 0. Collect and report client-level Uniform Reporting System (URS) data, documenting services delivered and describing the clients who received the services. Submit URS data quarterly, by the 15th of the month following the end of the quarter. Submit the Annual Administrative Report for the period of January 1 through December 31 by January 15 th of each year. 8. Collaborate with the Regional Care Consortium to establish a comprehensive plan, using the guidelines described in the Ryan White Care Act Title II Manual, Section VI, Chapter 6, "Comprehensive Planning." 9. Assure that HIV secondary prevention practices are integrated into the delivery of HIV/AIDS care services. 10. Utilize sound accounting methods to distribute and monitor expenditures of funds for HIV Care services, ensuring allocation of funds are in accordance with the Ryan White Title ll and MHI application as submitted. 11. Submit separate budgets and financial status reports by funding sources. 12. Submit original FSR's to MDCH-Budget and Finance Administration, as detailed in Part II General Provisions, and submit one copy to MDCH/DHAS-HAPIS. 13. Submit Table IV, "Allocation by Service Category" to MDCH/DHAS-HAPIS as requested to meet HRSA deadlines. 14. In coordination with the regional HIV/AIDS care consortium, develop an agreement identifying roles and • responsibilities of the fiduciary, care consortium and providers, and delineate which entity is responsible for each task. 15. Maintain secure records of the following at the fiduciary site: A. Provider contracts. B. Documentation of all quality assurance activities conducted by the fiduciary at the provider sites. C. Copies of all quality assurance reports prepared by MDCH/DHAS-HAPIS. D. All financial accounting records. E. All expenditure reports submitted to MDCH by the fiduciary. F. Copies of all fiscal audits of the fiduciary conducted either internally or externally. 16. Submit program Progress Reports in accordance with the following dates and reporting format: Period Covered Due to MDCH/DHAS-HAPIS • October 1, 2001- March 31, 2002 April 15, 2002 April 1, 2002 - September 30, 2002 October 15, 2002 MDCH/CMS 7/01 Page 4 of 42 MDCH/DHAS-HAPIS reserves the right to require quarterly reporting from contractors not in -compliance with Progress Report requirements. Progress Report Format Submit a brief (3-5 page) progress report that includes all of the following components in the order listed: A. Planning 1. Highlight the region's accomplishments during this report period as they relate specifically to the four components of comprehensive planning: a. Where are you now? (Needs assessment/resource inventory) b. Where are you going? (Continuum of Care Statement and prioritization). c. How are you going to get there? (Establishing goals and objectives related to achieving desired service system outcomes) d. How will you monitor your progress? (Evaluation activities to determine success in achieving desired service system outcomes) 2. Attach relevant reports or findings of any of the consortium planning activities described above. Attach any policies or procedures developed during this report period. B. Fiscal Accountability and Contract Monitoring 1. Attach a revised Table IV for the fiscal year, if applicable (the original was submitted with the region's care application). 2. Report on expenditures to date, according to the eligible service categories identified in Table IV. 3. Identify any cost saving efforts. 4. Summarize any contract monitoring, quality assurance and oversight activities conducted during the report period. Attach relevant findings. 5. Provide updates on any remediation activities and/or corrective action plans initiated in this report period. 6. List and attach copies of any new subcontracts and/or formal vendor agreements executed this report period. C. Program 1. Provide the following information for each funded service provider agency name, address, telephone and fax number, name and title of contact person. 2. Identify any program level changes, including changes in staff, services, catchment area, etc. 3. Describe 2-5 program highlights for each funded service provider. (Attaching provider reports does not meet this requirement.) 4. Identify any new services provided during the report period, and/or new access points to existing services. 5. Identify any concerns related to program activities that were not identified in the Fiscal Accountability/Contract Monitoring section above. MDCH/CMS 7/01 Page 5 of 42 17. Ensure that all funded providers track clients and services through the client-level Uniform Reporting System (URS) and that the URS data is submitted quarterly, according to the following schedule: Quarter Covered October 1 - December 31, 2001 January 1 - March 31, 2002 April 1 - June 30, 2002 July. 1 - September 30, 2002 Due to MDCH/DHAS-HAPIS January 15, 2002 April 15, 2002 July 15, 2002 October 151 2002 Ensure that the Annual Administrative Report (MR) for the period of January 1 through December 31 is submitted by January 15 of each year. 18. Provide one copy of all fully-signed subcontracts to MDCH/DHAS-HAPIS with annual care application, but no later than January 15. 19. Submit a consolidated list of all Ryan White Title II and MHI funded subcontracts as an attachment to the care application, and subcontracts within 10 days. Include the following information: Corporate name, address, telephone, fax numbers and project director of each organization. Amount awarded to each organization. Type of service and the amount budgeted for each service to be provided. Beginning and end dates of each contract and subcontract. Amount and source of other federal, state and local funds for the same service. Minority provider status. 20. By April 15, provide to MDCH/DHAS-HAPIS a programmatic, categorical budget and narrative justification (by funding source) for each contract and subcontract. This must be a regional budget. Use these budget categories: Personnel, Fringe Benefits, Travel, Supplies, Equipment, Contractual, Other and Indirect. Base the budgets on the following funding cycles: Ryan White Title 11 (4/01/-3/31) and MHI (10/01-9/30). Budgets should be prepared on forms provided by MDCH/DHAS-HAPIS. In the case of unit cost reimbursement contracts, the narrative justification should describe how the unit cost was established, and the rationale for the number of clients proposed, unless the Medicaid rate is being applied. 21. Certify, in a format provided by MDCH/DHAS-HAPIS, that administrative expenditures have not exceeded the 10% cap authorized by HRSA for "first-line entities* receiving Ryan White CARE Act Title ll funds. If requested, document compliance with HRSAs "Issue Paper: Administrative Costs." 22. Ensure that an annual regional application is completed and submitted to MDCH/DHAS-HAPIS by the deadline and in accordance with the requested format. Submit a revised plan, and budget for prior approval if the Contractor or consortium establishes a new program not described in the regional application. AIDS/HOPWA SPECIAL REQUIREMENTS (Housing Opportunities for Persons Living with HIV/AIDS) 1. Budaet and Agreement Requirements A. HOPWA Eligibility An eligible person means a person with acquired immunodeficiency syndrome or related diseases who is below 80% median income. A family member regardless of income is eligible to receive housing information services. Any person living in proximity to a community residence is eligible to participate in that residence's community outreach and educational activities regarding AIDS or related diseases. MDCH/CMS 7/01 A. B. C. D. E. F. Pace 6 of 42 • Within the population eligible for this program, nondiscrimination and equal opportunity regulations must be followed, including fair housing and affirmative outreach. A project sponsor and all contractors and subcontractors must adopt procedures to ensure that all persons who qualify for the assistance, regardless of their race, color, religion, sex, age, national origin, familial status, or handicap, know of the availability of the HOPWA program, including facilities and services accessible to persons with a handicap, and maintain evidence of implementation of the procedures. B. Allowable Use of Funds Funds may be used to assist all forms of housing designed to prevent homelessness. This includes emergency housing, shared housing arrangements, apartments, single room occupancy (SRO) dwellings, and community residences. It includes assistance to remain in current homes, whether owned or rented, and assistance in relocating to another home, whether owned or rented. The following activities may be carried out with HOPWA funds: 1. Housing information services including, but not limited to, counseling, information, and referral services to assist an eligible person to locate, acquire, finance and maintain housing. This may also include fair housing counseling for eligible persons who may encounter discrimination on the basis of race, color, religion, sex, age, national origin, familial status, or handicap. 2. Resource identification to establish, coordinate and develop housing assistance resources for eligible persons, including conducting preliminary research and making expenditures necessary to determine the feasibility of specific housing-related initiatives. 3. Permanent housing placement. 4. Acquisition, rehabilitation, conversion, lease, and repair of facilities to provide housing and services ( repairs require prior authorization from Housing and Urban Development (HUD)). 5. New construction [for single room occupancy (SRO) dwellings and community residences only]. 6. Project- or tenant-based rental assistance, including assistance for shared liousing arrangements. 7. Short-term rent, mortgage, and utility payments to prevent the homelessness of the tenant or mortgagor of a dwelling. 8. Operating costs for housing including maintenance, security, operation, insurance, utilities, furnishings, equipment, supplies, and other incidental costs. 9. Technical assistance in establishing and operating a community residence, including planning and other pre-development or preconstruction expenses and including, but not limited to, costs relating to community outreach and educational activities regarding AIDS or related diseases for persons residing in proximity to the community residence. 10. Supportive services including, but not limited to, health, mental health, assessment, drug and alcohol abuse treatment and counseling, day care, personal assistance, nutritional services, intensive care when required, and assistance in gaining access to local, State, and Federal government benefits and services, except that health services may only be provided to individuals with acquired immunodeficiency syndrome or related diseases and not to family members of these individuals. 11. Administrative expenses (general management, staff training, oversight, coordination, evaluation, and reporting on eligible activities). Such costs do not include costs directly related to carrying out eligible activities, since those costs are eligible as part of the activity delivery costs of such activities. Each project sponsor receiving amounts from grants made under this program may use not more than 7% of the amounts received for administrative costs. Fiduciaries who are not project sponsors may not use more than 3% for administrative costs. MDCH/CMS 7/01 This information was taken from the HOP WA regulations (24 CFR 574). Please check the regulations for further information. . C. HOPWA Certificate Program The Michigan Department of Community Health is offering a certificate program to support housing subsidies for eligible persons for up to two years. The purpose of the program is to promote housing permanency/stability through the development of a plan for moving the person from a homeless or emergency situation to a stable housing situation, or through maintaining an eligible person in their current housing. An eligible person is a person with Acquired Immunodeficiency Syndrome (AIDS) or related diseases who is below 80% median income and is currently, or at immediate risk of, homelessness. Funding for this program comes from unspent prior year federal allocations and is expected to be available for three years. The certificates are valued at up to $200 per month for up to 24 months per participant and are intended for specific participants for whom a housing plan has been developed and linkage to supportive services has been made. Additional funding will be made, available for each region for housing information, resource identification services and development of a housing stabilization plan for participating individuals. Regions will be reimbursed $500 per plan developed, up to a total of $5,000 per fiscal year. The certificates are intended to be used for interim housing support until a PL1NH/A (person living with HIV/AIDS) qualifies for Section 8 housing assistance, is able to afford their own housing through a return to work or other means, or requires more intensive services that preclude living independently. Certificates may be used to fund mortgage (up to 21 weeks per year) and utility payments to prevent the homelessness of the tenant or mortgagor of a dwelling, for tenant-based rental assistance, and for operating costs. The monthly mortgage assistance may be increased above $200 per month, but total payments per person may not exceed $2,400 in a 12-month period and $4,800 in a 24-month period. "Preventing homelessness" includes maintaining mortgage or rent payments while a person is experiencing episodic hospitalization. Certificates may not be used to fund supportive or administrative services (other than for reimbursement for plan development as outlined above), and certificate payments must be made directly to the vendor. Routine follow-up with each individual served by the program is required. The follow-up should be at least once a month and address the adequacy of the housing arrangement, ongoing participation in their supportive services plan, and a check with the landlord, if applicable, to determine any problems. Each region will be awarded at least 10 certificates annually as long as funding remains available and will be eligible to apply for additional certificates based upon available funding, demonstrated need and use of the current certificates. The value of unused certificates will lapse at the end of the contract year. Certificates will be awarded by allocation letter and reimbursement to the region will be made based on the submission of a Financial Status Report (FSR) including the number of PLVVH/A's served. As supportive documentation, the provider must maintain the following for each PLWH/A served: 1. Documentation of a supportive services plan (form included with allocation letter). 2. Documentation of consideration of other funding sources (form included with allocation letter). 3.. A housing plan (form included with allocation letter). To protect recipient confidentiality, the region/service provider must provide a unique confidential client identification number for each participant when transmitting this information to MDCH. In addition to the FSR submission for reimbursement purposes, regions must also submit quarterly the data requirements specified in the contract. To apply for additional certificates, send a letter of request identifying the number of certificates requested and a completed housing 'plan, documentation of a supportive services plan and • documentation of consideration of other funding sources for each person for whom a certificate is being requested. Requests may be sent to: MDCH/CMS 7/01 Page 8 of 42 Program Administration and Consumer Resources Division Community Living, Children and Families Administration Michigan Department of Community Health 3423 North Martin Luther King, Jr. Boulevard Lansing, Michigan 48909 Attention: Carol Ogan 2. Contractor Requirements In 2001, each region must submit to the department their annual plan for providing HOPWA services. The plan should cover the period October 1, 2001 through September 30, 2002 and include both the regular HOPWA allocation and the HOPWA Certificate Program. This plan, along with quarterly reports and the region's FSR, will provide MDCH with information to satisfy most federal reporting requirements, carry out monitoring activities, and assure that departmental goals for this program can be met. This plan is due September 21. 2001 and must be submitted to: Program Administration and Consumer Resources Division Community Living, Children and Families Administration Michigan Department of Community Health 3423 North Martin Luther King, Jr. Boulevard Lansing, Michigan 48909 Attention: Carol Ogan The plan, as implemented and subject to the availability of funds and need, must assure that all persons living with HIV/AIDS (PLWH/A) have access to: A. Direct housing assistance (including rent, mortgage payments, and utilities). B: Housing advocacy staff assistance for 1. Helping a person find and maintain housing, including permanent housing placement. 2. Creating links in the community for long range housing solutions, such as participation in planning activities with continuum of care, public housing authorities, and housing coalitions. 3. Connecting persons with HIV/AIDS to generic sources of housing (such as Section 8 certificates), financial support (such as SSI), and service dollars (such as Medicaid). C. Supportive services, with HOPWA dollars limited to only those essential services which are not the . responsibility of other funding sources or service providers. Funding priorities are in the order listed above. For those regions not yet at 75% for specific housing-related activities (priorities 1 and 2), the plan must reflect movement toward using 75% of the HOPWA allocation for direct housing assistance and housing advocacy. The utilization of resources within the 75% goal and the three activities identified above are at the discretion of the region and are expected to reflect local needs and priorities. 1. Plan Components The plan consists of five components. Generally a brief description of current year activities and the region's plan for FY 2001/2002 is required. a. Needs Describe the demographic characteristics of the population with HIV/AIDS in the region in comparison to the population served by the HOPWA program. Describe the service needs of the PLVVH/A's in your region within the following three funding categories: 1. Direct housing assistance, 2. Housing advocacy, and MDCH/CMS 7/01 Page 9 of 42 3. Supportive services in relation to the population's ability to achieve and maintain a stable housing arrangement. This is a narrative component and should reflect the outcome of regional needs assessment activities and analysis of demographic information. Specifically describe any needs assessment activities carried out in FY 2000/2001. b. Coordination Information about FY 2001 achievements and the current status of coordination between HOPWA-funded staff and other service providers within the regional HIV/AIDS network, Ryan White-funded H1V/AIDS related services including outreach to mothers and infants who are HIV positive, with the "generic' housing community, and with support service providers is requested as part of the plan. Describe the anticipated relationship between the HOPWA program and other agencies providing housing assistance and health care and supportive services in your catchment area. Describe your activities for coordinating HOPWA services with other programs and planned activities for improving coordination in FY 2001/2002 along with a brief description of FY 2000/2001 activities. Provide this information in the five categories identified below. 1. HOP WA-funded staff and their role in the regional service delivery system. Specifically address children, families and mothers/infants who are HIV positive and at risk of homelessness. 2. How eligible persons "connect" or obtain HOPWA-funded services, i.e., are persons referred from other regional providers, do service providers routinely assess housing needs, etc. 3. The working relationships between HOP WA-funded staff and case managers. 4. Within the generic housing community, describe the working relationship and the liaison roles of the HOPWA-funded staff; describe participation in the local continuum of care planning activities, etc. 5. Describe how the housing needs of persons living with HIV/AIDS are assessed and how linkages with support services will be made. c. Certificate Program Provide a concise description of the use of the certificate program in FY 2000/2001. Include the number of persons/families receiving assistance, nature of the assistance provided (i.e. mortgage, utilities, rent, etc.) and whether participants were renters or home owners. To assist the Department in assessing the program, also provide: 1. The protocol, procedure or "working policy" the region implemented in order to determine when a certificate would be issued (include criteria for determining when to use certificate versus HOPWA formula funds). 2. Specification of the barriers and successes in accessing other community housing resources such as section 8 vouchers, FIA emergency assistance, or other local housing-related funds. d. Services Indicate what services are planned to be provided in FY 2002 by the three funding categories. 1. Direct Housing Assistance. 2. Housing Advocacy and Staff Assistance. 3. Supportive Services. MDCH/CMS 7/01 Page 10 of 42 With respect to housing advocacy such as linkages with the housing community, describe planned efforts. Indicate the number of individuals with HIV/AIDS to be assisted and their demographic characteristics. The plan must show that the PLVVH/A's in all parts of the region have access to the direct housing assistance and housing advocacy staff assistance. Some regional networks are also the direct service providers. However, most contract for HOPWA-funded services. Provide a list of HOPWA-funded service providers, the type of services they provide (direct housing assistance, housing advocacy, and supportive services), and the geographic area that each provider serves in a chart. In addition describe all other regional funds planned to be used for direct housing assistance and housing advocacy (using the HbPWA definitions for this purpose). Provide estimated expenditures for FY 2001/2002 as well. Finally, describe how the use of these funds is "coordinated"/or related to the use of HOPWA funds. • e. Budget Plan On the form entitled "HOPWA FY 2001/2002 Plan' provided with your allocation • letter, indicate how the funds allocated to the region will be allocated to each provider (including the region if services are provided directly) by the following categories: A. Administration A-1 Central A-2 Provider B. Direct Housing Assistance • C. Housing Advocacy Assistance - D. Supportive Services E. Certificate Program Also provide the planned number of persons to be served. Provide a brief narrative explanation as necessary. B. Reporting In addition to submitting monthly Financial Status Reports for reimbursement, reports of program activities must be submitted quarterly to the address below. The form entitled "HOPWA Quarterly Reporting Requirements" provided with your allocation letter must be used to submit this information. The Annual Progress Report for calendar year 2001 must be submitted by February 1, 2002. Quarterly Reports are due as follows: February 1 for the 10/1/2001 - 12/31/2001 quarter May 1 for the 1/1/2002 - 3/31/2002 quarter August 1 for the 4/1/2002 - 6/30/2002 quarter November 1 for the 7/1/2002 - 9/30/2002 quarter All reports should be sent to: Program Administration and Consumer Resources Division Community Living, Children and Families Administration Michigan Department of Community Health 3423 North Martin Luther King, Jr. Boulevard Lansing, Michigan 48909 Attention: Carol Ogan MDCH/CMS 7/01 Page 11 of 42 Contractor Requirements 1. All fiduciaries and project sponsors using grant funds to provide housing must adhere to the following standards: A. Ensure that qualified service providers in the area make available appropriate supportive services to the individuals assisted with housing under HOPWA. For any individual with acquired immunodeficiency syndrome or a related disease who requires more intensive care than can be provided in housing assisted under HOPWA, the project sponsor shall provide assistance in locating a care provider who can appropriately care for the individual and for referring the individual to the care provider. B. Ensure that grant funds will not be used to make payments for health services for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to that item or service: under any State compensation program; under an insurance policy; under any Federal or State health benefits program; or by an entity that provides health services. C. Operate the program in accordance with the provision of 24 CFR 574 and other applicable HUD regulations. Document the eligibility of each person receiving HOPWA benefits. D. Keep records and reports which are consistent with the information required by the Annual Progress Report (APR) for HOPWA (copy attached) by calendar year. Implement the Uniform Reporting System which includes data regarding HOPWA eligible persons and information needed for quarterly reports and the APR. Submit the annual progress report for calendar year 2001 by February 1, 2002. E. Participate with MDCH in facilitating and conducting site visits with the HOPWA project sponsors. F. Provide services in accordance with an approved plan and comply with reporting. Requirements • as spelled out in Plan Guidance (provided with the allocation letter). 2. Provide Oversight • A. Oversee process and performance for subcontracts for the provision of HIV related HOPWA services. Ensure a contractual requirement to adhere to all applicable state and federal laws and regulations for all subcontractors. B. Assure that contractors and subcontractors have developed and make available to service recipients both grievance and appeals process. C. Determine/document the unit cost per service for each funded service. Retain data supporting the per unit cost and how it was determined. D. Assess client satisfaction of services provided. Assure the confidentiality of the name of any. individual assisted and any other information regarding individuals receiving assistance. E. Assure that no fee, except tenant portion of rent, shall be charged to an eligible person for housing or services. F. Assure that contractors and subcontractors have the capacity to effectively carry out the activity and that they agree to maintain and make available to HUD for inspection financial records sufficient to ensure proper accounting and disbursing of amounts received. G. Ensure, then issues statements, press releases, RFP, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal funds, clearly state 1) the percentage or total cost of the program or project which will be funded with Federal funds; 2) the amount of Federal funds for the project or program; and 3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental resources. Provide to MDCH copies of statements and press releases issued by the Contractor, Retain copies of same on file for two (2) years. H. Ensure all services are available in the entire region. MDCH/CMS 7/01 Desna 11 n Al I. Ensure that all activities funded under the program will meet urgent needs that are not being met ' by available public and private sources. Send copy of all HOPWA required documents to: Program Administration and Consumer Resources Division Community Living, Children and Families Administration Michigan Department of Community Health 3423 North Martin Luther King, Jr. Boulevard Lansing, Michigan 48909 Attention: Carol Ogan AIDS/HIV PREVENTION COMMUNITY PLANNING SPECIAL REQUIREMENTS Contractor Requirements 1. Provide administrative and technical support for the regional HIV prevention community planning group (RCPG) in compliance with guidance issued by the Centers for Disease Control and Prevention and/or the Department. 2. Manage HIV prevention community planning resources, in consultation with the regional community planning group. 3. .Foster support for HIV prevention community planning among key community leaders. 4. Submit, according to guidance disseminated by HAPIS/MDCH, an annual work plan and budget for HIV prevention community planning activities. AIDS/HIV PREVENTION SPECIAL REQUIREMENTS Contractor Requirements 1. Promote reporting and follow-up of HIV infection and AIDS cases within jurisdiction. 2. Conduct prevention program activities in a manner consistent with applicable state and federal laws, program and quality assurance guidelines and standards issued by the Centers for Disease Control and Prevention and/or the Michigan Department of Community Health. Current laws, guidelines and standards include: A. HIV Counseling, Testing and Referral Standards and Guidelines. US Department of Health and Human Services, Public Health Service, Centers for Disease Control and.Prevention. May 1994, or subsequent revisions. B. US Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Voluntary Testing for Pregnant Women. Morbidity and Mortality Weekly Report #44 (RR-7); 1-15. July 7, 1995. C. Quality Assurance Standards and Guidelines for HIV Counseling, Testing and Referral. Michigan Department of Community Health, HIV/AIDS Prevention & Intervention Section. September 1996, or subsequent revisions. D. Protocol for HIV Counseling and Testing Using Oral Mucosal Transudate Technology. Michigan Department of Community Health, HIV/AIDS Prevention & Intervention Section. March 1997. E. HIV Partner Counseling and Referral Services Guidance, Centers for Disease Control and Prevention, National Center for HIV, STD & TB Prevention, December 1998. F. Partner Notification Guidelines. Michigan Department of Community Health, HIV/AIDS Prevention and Intervention Section. Revised, 1997, or subsequent revisions. G. Guidelines for Health Education and Risk Reduction Activities. Centers for Disease Control and Prevention, National Center for Prevention Services, Division of Sexually Transmitted Diseases, HIV Prevention Section. April 1995. MOCH/CMS 7/01 Page 13 of 42 H: HIV Prevention Case Management Guidance, US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. September 1997. • I. HIV/AIDS Outreach Workers Training and Performance Standards. Community Health Outreach Workers, Spring 1999. J. Strategies to Improve Client Failure to Return for HIV Test Results. Michigan Department of Community Health, HIV/AIDS Prevention and Intervention Section, November, 1998, or subsequent revisions. K. Michigan HIV Laws: How They Affect Physicians and Other Health Care Providers. Michigan Department of Community Health, HIV/AIDS Prevention and Intervention Section. November 1995 or subsequent revisions. • It is understood that the laws, guidelines and standards described above may be revised, supplemented or replaced at any time and that the Contractor will conduct prevention program activities in a manner consistent with the most current laws, guidelines and standards. 3. Participate in quality assurance activities conducted by and/or facilitated by DHAS-HAPIS. 4. Participate in technical assistance consultations and/or skills-enhancement opportunities as directed by MDCH/DHAS-HAPIS and/or as recommended by RCPGS. 5. Participate/cooperate in program evaluation activities conducted and/or facilitated by HAPIS/MDCH. 6. Participate in regional community-based HIV prevention planning. At a minimum, local health agencies are expected to: A. Provide HIV prevention program plans, if available, to regional community planning groups. B. Provide HIV counseling and testing and other statistical and/or epidemiologic data to regional community planning groups, as requested. C. Participate in RCPG-facilitated monitoring and quality assurance of HIV prevention activities, including HIV counseling, testing and referral (Reference Document: Contract Monitoring and Quality Assurance: Roles and Responsibilities of Regional Community Planning Groups). Local health agencies are strongly encouraged to participate in regional prevention planning activities on a regular basis to keep informed on issues affecting HIV prevention. 7. If health education and risk reduction activities are supported with formula funds the Contractor is to: A. Submit to HAPIS, within 90 days (by December 31, 2001), a description of the activities. This description is to include: 1. A description of the target population(s). • 2. Specific, time phased and measurable outcome and process objectives. 3. The process and/or mechanisms used for obtaining the input of target populations in the design, implementation and evaluation of interventions. B. Submit within 30 days following the close of each quarter, narrative and statistical reports which detail progress toward meeting process and outcome objectives. The format, content and due dates of these reports are to conform to the guidelines issued by MDCH/DHAS-HAPIS. CSHCS SPECIAL REQUIREMENTS 1. CSHCS OUTREACH AND ADVOCACY REQUIREMENTS Contractor Requirements 1. Program Representation and Advocacy A. Provide program representation which includes the provision of information regarding Childiens Special Health Care Services (CSHCS) policy on diagnostic *referrals, program MDCH/CMS 7/01 Page 14 of 42 eligibility, covered services, prior authorization, and the appeals process to providers, the community, other agencies and families. B. Inform families of their rights and responsibilities in the CSHCS program. C. Describe special CSHCS programs to families which are outside the scope of covered services but unique to the program, such as the CSHCS Trust Fund and the insurance premium payment program. D. Provide information and referral or assist persons in making applications for other programs in the community for which the child and/or family may be eligible, for such as Early On, WIC, MI-Child, Healthy Kids and Medicaid. E. Provide answers to any questions or concerns families might have and help families advocate on their own behalf if they are-unable to perform this task. F. Participate in community health assessments and community systems reform initiatives and facilitate the direct participation of families in these processes. G. Work collaboratively with the CSHCS Special Health Plans to provide information to the local provider community and solicit participation in the health plan provider networks. 2. Application and Renewal A. Arrange for diagnostic evaluation referrals or obtain Release of Information form(s) for the purpose of securing medical reports for determining medical eligibility. B. Assist any family who is referred by the CSHCS program or who comes to the local health department for assistance in applying to join the CSHCS program with completion of the CSHCS application form, including the financial assessment and third party liability forms. C. Contact and provide information about the CSHCS program and assess family needs for those persons referred by the CSHCS program that enroll in the Basic Health Plan (BHP - previously known as Fee-For-Service). D. Assist families in obtaining medical reports to establish medical eligibility for the CSHCS program in new and renewing cases. E. Obtain Release of Information forms for securing medical reports or to allow release of medical and case information to the CSHCS Special Health Plans. F. Assist in locating individuals or families who do not return on CSHCS Application after being made medically eligible. G. Assist in locating individuals or families who do not respond when requested to make a health plan choice. H. Provide additional information about CSHCS to families who choose the Basic Health Plan in counties where a Special Health Plan in available. 3. Support Services A. Link families to the CSHCS Parent Participation Program, Family Phone Line or to the Family Support Network. B. Advise families about and provide linkage to Michigan Enrolls for assistance in CSHCS health plan selection. C. Link families to Special Health Plan member services offices for health plan questions. D. Provide consultation and work collaboratively with the CSHCS Special Health Plans to identify and facilitate linkages and referrals to community-based agencies and resources. E. Provide care coordination services. MDCH/CMS 7/01 Page 15 of 42 F. Make available to CSHCS Special Health Plans and the CSHCS Plan Division a community resource directory for the counties covered by the health department. This directory shall include the names, addresses and phone numbers of the full complement of community- based services and resources available in each county. 4. General Performance Requirements All LHD/CSHCS staff should be conversant about the benefits of the CSHCS Special Health Plans versus the Basic Health Plan and should be able to explain these advantages to families. Local Health departments are asked, as they come in contact with eligible persons and/or their families, to encourage enrollment into a CSHCS Special Health Plan. In addition, LHD/CSHCS staff should be able to describe the MIChild interface with the CSHCS Special Health Plan and identify children who might be eligible and facilitate enrollment in the CSHCS Special Health Plan as well as establish MIChild eligibility. The Department's goal for 2002, for those persons eligible to enroll in the CSHCS Special Health Plan, is that 90% of newly eligible CSHCS beneficiaries voluntarily enroll into a CSHCS Special Health Plan. Further there is a minimum goal of 60% of previously eligible CSHCS beneficiaries who renew their eligibility to enroll in a CSHCS Special Health Plan. To the extent possible, local health departments will be expected to assist the Department in reaching these goals to assure continued funding of local CSHCS services. LHD/CSHCS staff are also expected to attempt to contact families when a referral is made or when asked to locate families via "Notice of Action" forms by the CSHCS Customer Support Section. The Department's goal for contacting families referred and in need of additional CSHCS information and other information about community resources is that attempts will be made for . each family referred. A minimum target of 60% has been set for LHD/CSHCS to successfully make contact to provide information to families referred for this need. The Department's goal for locating families is that attempts will be made for each family referred. A minimum target of 45% has been set for LHD/CSHCS to successfully locate families referred to complete an application or make a health plan choice. In addition, in counties where there is currently a CSHCS Special Health Plan(s) and in other counties as they become approved network services areas, health departments will be expected to sign a contractual agreement to provide services, including care coordination with CSHCS Special Health Plans as they become available in their counties. Local health departments that fail • to sign a contractual agreement with CSHCS Special Health Plans already approved in their jurisdiction by or as they become approved after October 1, 2001 will risk losing local CSHCS funding. II. Care Coordination Services Care coordination services are authorized by the CSHCS Plan Division and reimbursed as part of the CPBC contract as a "Fixed Unit Rate Reimbursement". Reimbursement for authorized care coordination services are paid for separately through the CPBC contract until available funds are depleted each fiscal year. If/when CPBC funds become depleted in advance of the end of the fiscal year, care coordination services are expected to be provided without additional remuneration under the CPBC Contract. Care coordination will be provided by qualified LHD/CSHCS staff who are registered nurses, social workers, or para-professionals, under the supervision of registered nurses who are trained in the service needs of the CSHCS population and who demonstrate skill and sensitivity in communicating with children with special health care needs and their families. A. There are two levels of coordination services 1. Level I Care Coordination 2. Level II Care Coordination MDCH/CMS 7/01 Page 16 of 42 B. Level I Care Coordination consists of identification and documentation of a beneficiary's medical, . social, educational, functional status and requirements to treat and support those needs through the development of a comprehensive plan of care or Individualized Health Care Plan (IHCP). IHCPs are developed or renewed on an annual basis. Authorization for Level I Care Coordination is communicated to the LHD/CSHCS office by either the CSHCS Plan Division or by a CSHCS Special Health Plan (SHP). Care Coordination for beneficiaries in the Basic Health Plan (BHP - previously known as Fee-for-Service) is authorized by the CSHCS Plan Division. Care Coordinator for beneficiaries in a SHP are authorized by the SHP of enrollment. Initial IHCP development may require completion of a long form, or short form. Renewal of the IHCP is required annually. IHCP renewals also require completion of a long form, or short form. Updates to an IHCP also may be requested, and authorized as needed by the appropriate authorizing agency. Level I reimbursement is based on a fixed unit rate. The rate depends upon whether the initial or renewal IHCP is completed, and whether a long or short form is required. A bonus is paid for both the long and short form if the IHCP is completed within 45 calendar days from the date of referral. Whichever authorizing agency (CSHCS Plan Division or SHP) authorizes the development of an IHCP must be notified immediately when the IHCP has been completed. The rates and procedures for Level I Care Coordination reimbursement are described below in 2.E. *Authorization, Billing and Documentation Procedures for Level I and II Care Coordination". Level I Care Coordination activities are to be provided by an authorized LHD/CSHCS staff member when delivered through the LHD. The LHD/CSHCS local care coordinator (LCC), in collaboration with the beneficiary/family, health care and support service providers, develops and distributes the plan. The LCC provides the beneficiary/family with information and clarification regarding services and care coordination. The LCC assists with the arrangement and/or follow-up of IHCP identified services as appropriate, and to document and communicate to affected parties if circumstances have changed. The LCC also provides appropriate referrals and advocacy for other services as needed. Specialized Community-Based Care Coordination (SCBCC) is not covered under this agreement. Beneficiaries receiving the CSHCS Hourly Nursing Benefit (HNB) are not eligible for Level I Care Coordination as they receive the Hourly Nursing Services IHCP/Assessment and Home Survey. SCBCC differs from Level I Care Coordination in that an Hourly Nursing Services IHCP/Assessment and Home and Family Survey are only a few of the activities that are separately reimbursed apart from the CPBC-FSR. Reimbursement is a fixed rate per beneficiary based upon Specialized Community-Based Care Coordination (SCBCC)/HNB requirements and criteria. A description of the SCBCC authorization procedures, service requirements and criteria, as well as reimbursement rates are described in a separate MSA Bulletin. Local Health Departments/CSHCS offices may participate as a SCBCC provider but are not required to do so. C. Level H Care Coordination consists of interaction with the beneficiary/family and others involved with care of the beneficiary by telephone or in person that meet Level H Care Coordination criteria. Level It Care Coordination activities include, but are not limited to, arranging for service delivery from CSHCS qualified providers, client advocacy, assisting with needed social, education, or other support services, and processing CSHCS Trust Fund applications. In addition, these services: 1) are non-routine; 2) involve multiple contacts; 3) are substantive, and 4) take more than 30 minutes. The CSHCS Plan Division is the authorizing care coordination agent for beneficiaries in the BHP. Each CSHCS Special Health Plan is the authorizing agent for their enrollees. Pre-authorization requirements regarding Level II Care Coordination are listed below. D. LH D/CSHCS staff involved in CSHCS Care Coordination activities are responsible to attend related training conducted by the CSHCS Plan Division or their agents, and remain current and informed of CSHCS program policies and procedures. E. Authorization, Billing and Documentation Procedures for Level I and II Care Coordination MDCH/CMS 7/01 Page 17 of 42 The CSHCS Plan Division provides reimbursement through the CPBC-FSR process for both Level - I and Level ll Care Coordination when provided by LHD/CSHCS office staff for both BHP and SHP beneficiaries for as long as the funding remains available. If CSHCS Care Coordination funding becomes depleted, reimbursement for SHP Care Coordination activities reverts to the contractual payment process between the SHP and local care coordination provider/agency. Level I Care Coordination activities must be authorized by the CSHCS Plan Division for beneficiaries in the BHP, or by the SHP of enrollment for beneficiaries in a SHP. After the Level I Care Coordination has been authorized and completed, a CSHCS Care Coordination Authorization For Payment Form is sent to the CSHCS Plan Division (by the SHP) who forwards a copy to the LHD/CSHCS office. The CSHCS Plan Division completes this form for BHP beneficiaries and sends a copy to the LHD/CSHCS office staff. This authorization will specify the rate to be paid, for an Initial IHCP, a Renewal IHCP, or an update to the IHCP. It will also specify if the bonus payment applies for completion of the IHCP within 45 calendar days from the date of referral. The LHD/CSHCS office completes a monthly CSHCS Fixed Unit Rate Reimbursement Form and submits it as a Supplemental Attachment to the quarterly CPBC-FSR for payment. The CSHCS Fixed Unit Rate Reimbursement Form yvill be compared to the authorization form to assure proper payment for Level I Care Coordination Services Level II Care Coordination is specific to care coordination activities not involving the development of an Individualized Health Care Plan (IHCP). Level II consists of Code A and Code B services for BHP members and Code B services only for SHP members. A maximum of ten units per . beneficiary, through any combination of Code A and/or Code B, are allowed for a single beneficiary during a fiscal year. Code A is one unit of care coordination as previously described in Section 2.0 above and refers to BHP members only. Referral/authorization for Code A Care Coordination is not required. LHD • staff must notify the CSHCS Plan Division, on a form provided by the department, when code A Care Coordination has ocurred for tracking purposes. Code B Care Coordination requires prior authorization. Code B consists of more than one Unit of Care Coordination required to complete the service. Authorization is required for BHP beneficiaries by the CSHCS Plan Division, and for SHP beneficiaries by the SHP of enrollment. A copy of a CSHCS Care Coordination Authorization for Payment Form is sent to the LHD/CSHCS office after the LHD/CSHCS office has notified the authorizing agent that the Code B service has been completed. The CSHCS Fixed Unit Rate Reimbursement Form for CSHCS Level II Code A is submitted by the LHD/CSHCS office with the Supplemental Attachment to the CPBC-FSR.' The CSHCS Fixed Unit Rate Reimbursement Form for CSHCS Level ll Care Coordination, Code B, will be compared to the Authorization Form to assure proper payment for Level II Care Coordination Services. When completing the CSHCS Fixed Unit Rate Reimbursement Form for a Level II service, check the Code A box and indicate the service date. When completing the form,for a Code B service, check the box for Code B and indicate the authorization date. If both Code A and Code B services were provided to the same beneficiary in the same billing time frame, complete both Code A and Code B information. Local CSHCS offices must maintain documentation on a paper or computer log for all Code A and Code B Care Coordination. This documentation must include: beneficiary name, ID number, • date(s) of service, level of care coordination, types of activity performed, whether in person or by phone, staff involved, resolution, and duration on contacts. CHILDHOOD IMMUNIZATION REGISTRY SPECIAL REQUIREMENTS Contractor Requirements The contractor assures that: MDCH/CMS 7/01 Page 18 of 42 1. 1. All immunizations administered by the Contractor, or by any agency or provider participating in any of the vaccine distribution programs on behalf of the Contractor, are reported to the MCIR for all children born after December 31, 1993. 2. . All providers within their jurisdiction are registered through the MCIR and that all of their activities are coordinated with the regional contractor of the Department and operated within their guidelines. 3. Existing immunization records shall be submitted to the MCI R in accordance with the instructions from the Department's regional contractor. CHILDHOOD LEAD SPECIAL REQUIREMENTS Contractor Reauirements Submit a Lead Poisoning Prevention Plan for use of allocated Childhood Lead funds as follows: Briefly describe each of the program components listed below: Description of the Problem - Describe the problem in the local jurisdiction in terms of numbers of children affected, housing stock and other sources of exposure. Identify areas within the jurisdiction where children are at high risk. 2. Jurisdiction-wide Plan for Blood Lead Screening - Develop a plan to address the screening needs in the jurisdiction, describe how and where children can be screened, specific outreach activities, types of testing provided and how the local coalition is utilized to develop the plan. 3. Jurisdiction-wide Surveillance System - Describe how data is kept in the agency and the method for ensuring that data is incorporated into the state STELLAR system. Describe the standard process for follow-up by nursing and environmental health staff and the case management activities. 4. Ensuring Screening and Follow-up - Describe how the jurisdiction will assure that children identified with elevated blood lead levels receive the appropriate medical follow-up and the nursing and environmental health visits to assess the child's health status and identify lead hazards and their clearance. 5. Public and Professional Health Education and Communication - Describe the public, professional and community education components of the program including the providers of educational services. 6. Primary Prevention - Describe any primary prevention activities the jurisdiction provides, or any coordination activities with other community agencies providing primary prevention activities. 7. Method of Evaluation - Describe how the project will be evaluated, including outcome objectives for children and families affected by lead poisoning and community collaboration for the prevention of lead poisoning. Describe any current barriers to the successful completion of all program objectives. 8. Reporting - CDC Reporting and data exercises will be required of all local health departments participating in the Lead Screening Program. 9. A Plan and Budget for the next grant year must be submitted in March. COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT SPECIAL REQUIREMENTS Contractor Reauirements 1. Facilitate a community health assessment and improvement process in .a defined geographic region consistent with written Guidelines and Plan Requirements provided by the Department. 2. Submit products in accordance with target dates established in written Guidelines provided by the Department MDCH/CMS 7/01 A. 1. Page 19 of 42 DIABETES PROGRAM SPECIAL REQUIREMENTS 1. Implement the Diabetes Program, in accordance with the FY 00/01 Annual Plan, reviewed and approved by the Department, and the guidelines of the regional Diabetes Outreach Network (DON) as provided in the MOON manual. Provide for written review and approval by the Department of any program changes during the contract period. 2. Support a Diabetes Public Health Nurse Specialist, as the central person within the health department, to be responsible for carrying out the objectives of the project, and to A. Administer the Diabetes Program. • B. Function as a diabetes resource to professionals and consumers. C. Collaborate with their DON to facilitate system change in the delivery of diabetes care and education within the health department jurisdiction. D. Train lay volunteers and utilize diabetes support groups, where requested and feasible. E. Maintain a diabetes library of patient educational materials, including books and videos. 3. Provide for the Nurse Specialist to attend two 2-day meetings per year with the Department and other project staff, and one national, annual out-of-state meeting. 4. Foster a collaborative partnership with the regional DON, including completion of the DON data forms for each client, analysis of the data feedback provided by the DON, and incorporation of appropriate measures to continuously improve services provided to clients. 5. Coordinate and staff a local, community-based Diabetes Advisory Council. 6. Annually assess community resources that enhance and maximize health outcomes for persons with diabetes within the health department jurisdiction, including providing diabetes awareness/education to the general public, resource materials for the school and workplace, and disseminating current standards and clinical recommendations/guidelines on diabetes care and education to both health professionals and consumers. 7. Partner with referring physicians to acquire needed laboratory assays for referred clients. Laboratory specimens should only be drawn for analysis when the program is unable to acquire copies of client laboratory assays from the referring physician. 8. Provide local supplemental funding that may include a sliding scale fee structure; Medicaid and Medicare or third party reimbursement of staff (e.g., dietitians, laboratory technician). DIABETES OUTREACH NETWORK SPECIAL REQUIREMENTS 1. Maintain an independently located regional office as a, non-competing, coordinating health care/education resource for the counties within the network region. The office shall be equipped with an *800" access telephone number, FAX and E-mail capability and computer equipment as specified by the Department and as needed to adequately carry out the network functions. 2. Support a competent, on-site, core staff meeting the qualifications specified by the department. The core staff will consist of a project director who manages the network program and budget, hires and trains staff, and supervises all employees and consultant staff. Remaining staff shall include at least an office manager, data analyst/manager and a diabetes educator. Additional staff may be hired by the director. All staff positions must meet the department's recommendations and the requirements, as well as the needs of the network. 3. Limit maximum of funding which may be retained by the fiduciary to the lesser of $15,000 or 5% of the contractual amount 4. Maintain an interdisciplinary and consumer-focused advisory council which represents the major diabetes interests in the network service region and which will advise the project on goals, planning, policy, technical issues, evaluation and project implementation. MDCHICMS 7/01 Page 20 of 42 5. , Coordinate participation in the network among local health departments, other department-funded diabetes projects, and other agencies in the network service region. 6.. Educate consumers, communities, health care delivery agencies, health care providers, and legislators on the importance of individual diabetes self-management, of health care providers implementing quality diabetes care and education into their practices, and of providing sufficient funding to sustain these network activities. 7. By September 15th of the current contract year, prepare and submit to the Department for review and approval, the subsequent annual year program plan including measurable goals and objectives for program planning, implementation, and evaluation which are consistent with the Department's Federal Grant and National Diabetes Objectives. 8. Utilizing model language provided by the Department, annually develop subcontracts with providers for the purpose of their providing quality diabetes care, providing diabetes in services for all professional staff; collecting data on each diabetes client served and improving care based on the analysis of the collected data. 9. Provide each subcontract agency with quarterly or semi-annual analysis of their client data. 10. Have DON representation at each MDON and MDON/MDCP meeting and on each MDON and MDON/MDCP conference call. 11. Participate in the MDON/MDCP Michigan Nurses Association Continuing Education Approval Program to provide continuing education credits to Nurses and Dietitians. 12. Provide timely DON input and feedback on all department-initiated requests for MDON and MDCP materials (such as program guidelines, evaluation data, policies/procedures, etc.) 13. Follow MDON/MDCP policies/procedures as provided in the MDON Orientation and Procedure manual, Strengthening Diabetes Care in Michigan, and/or other MDCP directives. FAMILY PLANNING/BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCCP) JOINT DEMONSTRATION PROJECT SPECIAL REQUIREMENTS Contractor Requirement The FP/BCCCP Demonstration Project is a joint program designed to provide diagnostic services to Title X (Family Planning) clients who have Pap tests indicating possible cervical cancer. Extensive data is required by the Center for Disease Control and Prevention (CDC) for each woman served by federal funds. Dates of service and results of testing are required prior to authorizing reimbursement to providers. Therefore, data about the abnormal Pap smear will have to be transmitted from the Family Planning program to the designated BCCCP agency prior to arranging diagnostic services. 1. Women eligible for this program will be Title X clients, under age 40, be uninsured or underinsured, and with income under 250% of poverty. A Family Planning client meeting these eligibility criteria will sign a release form to allow her data to be provided to the BCCCP. Forms will be provided to the Family Planning agencies for recording data required for referral to a BCCCP agency. All data required for enrollment in the BCCCP will be collected by the BCCCP agency. 2. Once the BCCCP agency accepts the Family Planning client in this project, she becomes the sole responsibility of the BCCCP agency, and the BCCCP agency must make every effort to ensure the woman receives proper services. 3. Dates and results of all diagnostic procedures must be recorded in the Michigan Breast and Cervical Cancer Information System (MBCIS) by the BCCCP agency before reimbursement can be approved. 4. The data must indicate the outcome of testing with a final diagnosis of cancer/not cancer and, if cancer, the stage and date of treatment initiation. It is expected that there will be extensive communication between the referring Title X agency and the BCCCP agency managing the diagnostic process, so that the woman will proceed seamlessly through the medical system(s). MDCHICMS 7/01 Page 21 of 42 • , 5. ' The BCCCP agency must provide results of diagnostic evaluation to the referring Family Planning agency upon request, and upon completion of the diagnostic process. 6. If cancer is diagnosed the woman will have access to the BCCCP treatment network, and the BCCCP . agency must make every effort to ensure the woman receives proper treatment. FAMILY PLANNING - LONG-TERM CONTRACEPTIVE DISTRIBUTION SPECIAL REQUIREMENTS 1. Agencies participating in the Long-Term Contraceptive Distribution Project must follow protocols as outlined by the Department. FAMILY PLANNING - PREGNANCY PREVENTION SPECIAL REQUIREMENTS Contractor Requirements 1. The funds appropriated in the current State Public Health Appropriations Act for pregnancy prevention programs shall not be used to provide abortion counseling, referrals or services. 2. All delegate agencies must serve a minimum of 95% of proposed users to access total amount of allocated funds. FAMILY PLANNING - MODEL PROJECT SPECIAL REQUIREMENTS Contractor Requirements 1. Submit quarterly and annual reports on a timely basis as directed by the Department. 2. Provide ongoing monitoring to delegate agencies as they incorporate substance abuse risk assessment into existing services. 3. Attend MDCH sponsored project coordinators meetings and participate in project evaluation. 4. Participate in activities required to assist delegate agencies in providing services to women and adolescents at risk for substance abuse and/or using substances. HEPATITIS B SPECIAL REQUIREMENTS Budget and Agreement Requirements. Approved allocations can be budgeted in CPBC underthe Family Planning, STD orAdolescent Health element (as a funding source) where the staff providing the services are being budgeted. Reimbursement must be noted as a funding source, on the Comprehensive FSR in the budgeted element. Rates are: administration of first, second or third dose of vaccine with submission of intake form or Vaccine Follow-up Form to MPHI $9.00 per dose. For specific program requirements and additional detail refer to the Guidance Document For Hepatitis B - Supplemental Attachment To The CPBC FSR. Contractor Requirements 1. Assure that all staff are trained as required by the Department. 2. Assure that Intake Forms and Vaccination Follow-up Forms are complete and submitted to MPHI on a continuous basis. Department Requirements The Department will provide payment based on the fixed unit rate reimbursement mechanism upon completion of the intake forms and submission of the Comprehensive FSR (DCH-0412). HEPATITIS C SPECIAL REQUIREMENTS • Contractor Requirements 1. Comply with the program plan submitted to and approved by the Department MDCH/CMS 7/01 Page 22 of 42 2. Integrate programming with current AIDS/HIV services ensuring that funding is not used for the purchase of HCV "home test" collection devices or vaccines for Hepatitis A (HAV) and Hepatitis B (HBV). 3. Submit the completed purple "bubble" Counseling and Testing from to the Division of AIDS/HIV-STD, with the Hepatitis Reserved Field completed. IMMUNIZATION - FIELD SERVICE REPRESENTATIVES SPECIAL REQUIREMENTS Contractor Requirements 1. Employ and supervise a full-time Immunization Field Representative for the Immunization Program who shall be acceptable to the Department and who shall be supported by this agreement. 2. Provide the Immunization Field Representative with permanent office space, including a telephone. 3. Make the Immunization Field Representative available to all local health departments in the assigned jurisdictions to provide Immunization program activities equitably and at the direction of the Department. Refer to field representation responsibilities as defined and distributed to the contractor. 4. Provide for reimbursement for telephone charges incurred in the conduct of business by the Immunization Field Representative. 5. Provide any supplies to the Immunization Field Representative necessary to the conduct of the Immunization Program, including a computer with a Pentium processor or better, a printer, as well as a modem and a car phone. 6. Provide reimbursement for any travel and subsistence expenses incurred by the Immunization Field Representative necessary to the conduct of the Immunization Program. Travel will include the annual National Immunization Conference and attendance at the MDCH Immunization staff meetings and trainings. Department Requirements 1. Provide necessary adjunct clerical services to the Immunization Field Representative for the duplicating/printing of materials and the packaging and distribution of these materials. 2. Provide program direction and definition of Immunization Field Service Representative responsibilities. IMMUNIZATION VFC AND MI-VFC SPECIAL REQUIREMENTS • Contractor Requirements Each VFC and MI-VFC provider is to be visited at least once every two years, with the minimum number of site visits being 20 for larger local health departments with 20 or more providers and at least 80 percent of the provider sites in jurisdictions with fewer than 20 providers. The format of the site visit will be based on the site visit questionnaire dated 9/98. Completed site visit questionnaires will be submitted to the Immunization Division on a continuous basis. Budaeting and Agreement Requirements Approved allocations can be budgeted in the CPBC under the Immunization element (as a funding source) where staff providing the services are being budgeted. Data from the Immunization Division regarding the number of site visits will be used to reconcile the request for reimbursement on the Comprehensive FSR (DCH-0412). The corresponding reimbursement must be noted as a funding source in the budgeted element. The rate of reimbursement is $150.00 per site visit. The Department will reimburse the local health department for site visits conducted during the fiscal year. The MDCH/CMS 7/01 Page 23 of 42 rrimum number of visits for which a local health department may request reimbursement is equal to the total number of providers in a jurisdiction or 25 sites whichever is smaller. For additional detail on the program • requirements, refer to the Resource Book For VFC and MI-VFC Providers and other guidance provided by the Department in correspondence to Immunization Action Plan (IAP) and Immunization Coordinators. Department Requirements The Department will provide payment based on the fixed unit rate reimbursement mechanism upon completion and submission of the Comprehensive FSR (DCH-0412). IMMUNIZATION - NURSE TRAINING REIMBURSEMENT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $100.00 per training session, upon completion and submission of the Comprehensive FSR (DCH-0412). Reimbursement can only be made for one training session per physician clinic site per year. Payment is based upon the completion of a training session, not the number of nurse trainers present. Contractor Requirements 1. Assure that all staff are trained as required by the Department. 2. Assure that the Immunization Update Log is complete and submitted to the Division of Immunization on a continuous basis. Department Requirements The Department will provide payment based upon the fixed unit rate reimbursement mechanism upon completion and submission of the Comprehensive FSR. Data from the Division of Immunization regarding the number of Immunization Update log entries submitted will be used to reconcile the request for reimbursement. INDIAN HEALTH SPECIAL REQUIREMENTS Contractor Requirements 1. Use the funds provided by the Department to support and provide Community Health Representative (CHR) services to and for designated Indian population groups. INFORMED CONSENT Contractor Requirements The following requirements apply to all local health departments, whether the health department operates a Family Planning Clinic or not: 1. When a woman states that she is seeking an abortion and is requesting services for that purpose the Contractor will provide the following services: A. A pregnancy test with a determination of the probable gestational stage of a confirmed pregnancy. B. An informed consent informational packet. Note: The contractor must destroy the individual "informed consent" files containing identifying information (Name,. Address, etc.) after 30 days. 2. When a woman seeks a pregnancy test and does not explicitly state that she is doing so for the purpose of obtaining an abortion, she should be directed to a family planning clinic or to her primary care provider for a pregnancy test. Materials developed under PA 133 should not be provided to a woman in a Title X funded family planning clinic. MDCH/CMS 7/01 Page 24 of 42 „ D6uartment Requirements The Department will provide funding, at the fixed rate of $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services noted in item 1 above. The number of services, rate per service and total amount due must be noted as a funding source, under the element where the staff providing the services are funded, on the Comprehensive FSR. LABORATORY SERVICES SPECIAL REQUIREMENTS Contractor Specific Reauirements ipetroit City) 1. Meet established standards of performance and objectives in the following areas: A. Perform testing for detection of foodbome disease outbreaks as specified in items 4 and 5. Perform HIV diagnostic testing using a test designated by the Department. Perform test for diagnosis of gonorrhea and chlamydia using a commercial nucleic Acid Amplification Test for family planning clinic clients and other special populations designated by the Department. B. Utilize standardized testing procedures, standards of quality assurance and quality control approved by the Department laboratory director. Assist the Department in Quality Assurance Assessment annually or as determined by the Department. C. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing. D. Test gonorrhea and chlamydia specimens from approved agencies within one working day of receipt of the specimen. Perform HIV screening tests for diagnostic specimens within one work day of receipt of specimen. Perform HIV confirmatory tests for diagnostic specimens within three . days of screening assay positive. Perform HIV seroprevalence specimens upon notification by the Department. E. Send laboratory test reports to submitters within 1 day of completing testing via a system of delivery at least as expedient as the US Postal Service. F. Establish testing personnel training program and maintain documentation of training of all testing personnel. G. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. H. Maintain an adequate inventory of test kits and reagents purchased by the Department. Communicate shipment needs to manufacturers representative if shipments supplementary to the routine shipments are needed. 2. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. 3. Provide the Bureau of Epidemiology, HIV/AIDS-STD Division, and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH (e.g., HIV, foodbome disease, chlamydia, gonorrhea, etc), all specimen submission data and reporting data will be entered and reported using EPIC software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in EPIC training activities. Training and purchase of modules for EPIC other than those modules provided by MDCH will be the responsibility of the Contractor. The Contractor is responsible for modules not directly related to testing performed under this agreement with the Bureau of Laboratories - - Initial Purchase Price (paid to MDCH) - Monthly maintenance fees (paid to MDCH) - Use of modules purchased by a Contractor will be restricted to the Contractor purchasing the module MDCH/CNIS 7/01 Page 25 of 42 3. - Use of modules purchased by one Contractor can be negotiated (formulas for payment will be based upon the percentage of total specimens entered into the module). Modules purchased by any Contractor will become available to any participating Contractor at no cost after five years. However, each Contractor using the module will share in the maintenance fees. 4. Inform Infectious Disease by June 30, 2002 if more than 19,250 DNA Probe tests will be performed. 5. Provide laboratory support (examination of food specimens) to investigate up to 12 foodbome disease outbreaks. Laboratory support includes providing test reports and food samples to the Bureau of Laboratories. 6. Provide laboratory support for examination of up to 100 stool specimens associated with foodbome. Department Requirements 1. Reimburse the Contractor $8,100 for examinations of specimens associated with foodbome outbreaks. Reimburse Contractor at the fixed rate of $2.00 for each specimen diagnosis of gonorrhea and chlamydia using a commercial Nucleic Acid Amplification assay. Reimburse Contractor $43, 454 for performing HIV Diagnostic Testing. 2. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, support and maintenance for one computer and one laser printer (excluding consumable supplies), user training for EPIC modules utilized for testing performed under contract, advanced training for EPIC liaisons for test master and Contractor specific data base support, and support for network communications between the Contractor and the EPIC server. The Department will maintain the sole contract with EPIC. Payment for 'additional modules and maintenance fees for those modules will be paid for by the Contractor through MDCH. Tape backups and maintenance of all modules Will be performed by MDCH staff. 4. Purchase and arrange for shipment of test kits and reagents for commercial DNA probe and HIV testing from manufacturer. 5. Purchase specimen collection kits for HIV testing. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. 6. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to on-going program activities. 7. Assist in technical training of testing personnel and computer software utilization. 8. Provide technical consultation and assistance with program activities. 9. Supply Contractor with a copy of the contracts associated with this program. 10. Monitor monthly utilization reports. 11. Provide reagents and culture media for food and stool specimen examination related to foodbome disease outbreaks. Contractor Specific Reauirements (Kalamazoo County) 1. Meet established standards of performance and objectives in the following areas: A. Perform tests for diagnosis of gonorrhea and chlamydia infections using a commercial nucleic acid amplification assay and perform testing for detection of foodbome disease outbreaks as specified in items 5 and 6. B. Utilize standardized testing procedures approved by the laboratory director and standards of quality assurance and quality control. Assist Department in quality assurance assessment of testing annually or as determined by Department. MDCH/CMS 7/01 Pacle 26 of 42 C.. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing. D. Test gonorrhea and chlamydia specimens from approved agencies/physicians within 1 working day of receipt of specimen. E. Send laboratory test reports to submitters within 1 day of completing testing via a system of delivery at least as expedient as the US Postal Service. F. Establish testing personnel training program and maintain documentation of training of all testing personnel. G. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. H. Maintain an adequate inventory of test kits and reagents purchased by the Department. Communicate shipment needs to manufacturer's representative if shipments supplementary to the routine shipments are needed. 2. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. 3. Provide the Bureau of Epidemiology, HIV/AIDS-STD Division and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH (e.g., HIV, foodbome disease, chlamydia, gonorrhea, etc), all specimen submission data and reporting data will be entered and reported using EPIC software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in EPIC training activities. Training and purchase of modules for EPIC other than those modules provided by MDCH will be the responsibility of the Contractor. The Contractor is responsible for modules not directly related to testing performed under this agreement with the Bureau of Laboratories - - Initial Purchase Price (paid to MDCH) - Monthly maintenance fees (paid to MDCH) - Use of modules purchased by an Contractor will be restricted to the Contractor purchasing the • module - Use of modules purchased by one Contractor can be negotiated (formulas for payment will be based upon the percentage of total specimens entered into the module); Modules purchased by any Contractor will become available to any participating Contractor at no cost after five years. However, each Contractor using the module will share in the maintenance fees. 4. Inform the Infectious Diseases Division by June 30, 2002 if more than16,125 nucleic acid amplification specimens will be performed. 5. Provide laboratory support (examination of food specimens) to investigate up to 12 foodbome disease outbreaks. Laboratory support includes providing test reports and food samples to the Bureau of Laboratories. 6. Provide laboratory support for examination of up to 100 stool specimens associated with foodbome disease outbreaks. Department Reouirements 1. Reimburse the Contractor $8,100 for the examination of specimens related to foodbome disease outbreaks to the extent outlined in Items 5 & 6 above. Reimburse the Contractor at the fixed unit rate of $2.00 for each specimen for diagnosis of gonorrhea and chlamydia infections using a nucleic acid amplification assay. Reimburse the Contractor $12,000 for administrative costs associated with operation of the CLIA umbrella certificate. 2. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. MDCH/CMS . 7/01 Pace 27 of 42 3. ' The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, support and maintenance for one computer and one laser printer (excluding consumable supplies), user training for EPIC modules utilized for testing performed under contract, advanced training for EPIC liaisons for test master and Contractor specific data base support, and support for network communications between the Contractor and the EPIC server. The Department will maintain the sole contract with EPIC. Payment for additional modules and maintenance fees for those modules will be paid for by the Contractor(ies) through MDCH. Tape backups and maintenance of all modules will be performed by MDCH staff. • 4. Purchase and arrange for shipment of test kits and reagents from manufacturer. 5. Purchase specimen collection kits. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. 6. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to on-going program activities. 7. Assist in technical training of testing personnel and computer software utilization. 8. Provide technical consultation and assistance with program activities. 9. Supply Contractor with a copy of the contracts associated with this program. 10. Monitor monthly utilization reports. 11. Provide reagents and culture media for food and stool specimen examination related to foodbome disease outbreaks. Contractor Specific Requirements (Kent County) 1. Meet established standards of performance and objectives in the following areas: A. Perform tests for diagnosis of gonorrhea and chlamydia infections using a commercial assay, perform testing for detection of foodbome disease outbreaks as specified in items 5 and 6, and perform tests for diagnosis of HIV infection using a test designated by the Bureau of Laboratories, and perform tests for epidemiological assessment of HIV incidence as specified in item 7. B. Utilize standardized testing procedures, standards of quality assurance and quality control approved by the laboratory director. Assist Department in quality assurance assessment of testing annually or as determined by the Department. C. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing. D. Test gonorrhea and chlamydia specimens from approved agencies/physicians within one working day of receipt of specimen. Perform HIV screening tests within one work day of receipt of specimen. Perform HIV confirmatory test within three days of screening assay positive results. E. Send laboratory test reports to submitters within one day of completing testing via a system of delivery at least as expedient as the US Postal Service. F. Establish testing personnel training program and maintain documentation of training of all testing personnel. Arrange on-site training of personnel with test kit manufacturer's representative. G. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. ' H. Maintain an adequate inventory of test kits and reagents purchased by the Department. Communicate shipment needs to manufacturer's representative if shipments supplementary to the routine shipments are needed. 2. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. MDCH/CMS 7/01 Paae 28 of 42 3. , Provide the Bureau of Laboratories, the Bureau of Epidemiology, and the Divisions of HIV-AIDS/STD records and reports as required. For all testing services performed under contract by the Contractor for MDCH (e.g., HIV, foodbome disease, chlamydia, gonorrhea, etc), all specimen submission data and reporting data will be entered and reported using EPIC software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in EPIC training activities. Training and purchase of modules for EPIC other than those modules provided by MDCH will be the responsibility of the Contractor. The Contractor is responsible for modules not directly related to testing performed under this agreement with the Bureau of Laboratories - - Initial Purchase Price (paid to MDCH) - Monthly maintenance fees (paid to MDCH) - Use of modules purchased by an Contractor will be restricted to the Contractor purchasing the module - Use of modules purchased by one Contractor can be negotiated (formulas for payment will be based upon the percentage of total specimens entered into the module). Modules purchased by any Contractor will become available to any participating Contractor at no cost after five years. However, each Contractor using the module will share in the maintenance fees. 4. Inform the Infectious Diseases Division by June 30,2002, if more than 54,297 Nucleic Acid Amplification specimens will be performed. 5. Provide laboratory support (examination of food specimens) to investigate up to 12 foodbome disease outbreaks. Laboratory support includes providing test reports and food samples to the Bureau of Laboratories. 6. Provide laboratory support for examination of up to 100 stool specimens associated with foodbome disease outbreaks. 7. Perform tests for epidemiological assessment of HIV incidence rates using a test designated by the Bureau of Laboratories. A. Utilize testing procedures, standards of quality assurance and quality control approved by the Centers for Disease Control and Prevention and the laboratory director. B. Test monthly up to 1,000 serum specimens previously tested by standard HIV diagnostic methods. Specimens to be tested will be determined by Bureau of Epidemiology or out-of-state public health agencies. C. Submit testing results and demographic information as designated by the Bureau of Epidemiology (weekly/monthly) electronically in a format compatible with Bureau of Epidemiology database. D. Hire and train one medical technologist/microbiologist and one laboratory technician to perform testing, quality control and quality assurance, enter demographic data and prepare electronic result transmission. Participate in training or meetings to be determined by the Bureau of Laboratories. E. Arrange for equipment shipment, installation and training as described in the approved methods. F. Coordinate and pay for shipment of specimens from laboratory of initial diagnosis. G. Purchase and maintain adequate inventory of test kits, supplies, and materials needed for testing and reporting. Department Requirements 1. Reimburse the Contractor $8,100 for the examination of specimens related to foodbome disease outbreaks to the extent outlined in items 5 & 6 above. Reimburse the Contractor at the fixed rate of $2.00 for each specimen for diagnosis of gonorrhea and chlamydia infection using a commercial assay. Reimburse Contractor $12,000 for administrative costs associated with operation of the CLIA umbrella certification. MDCH/CMS 7/01 Page 29 of 42 2. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. 3. The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, support and maintenance for one computer and one laser printer (excluding consumable supplies), user training for EPIC modules utilized for testing performed under contract, advanced training for EPIC liaisons for test master and Contractor specific data base support, and support for network communications between the Contractor and the EPIC server. The Department will maintain the sole contract with EPIC. Payment for additional modules and maintenance fees for those modules will be paid for by the Contractor(ies) through MDCH. Tape backups and maintenance of all modules will be performed by MDCH staff. 4. Purchase and arrange for shipment of test kits and reagents from manufacturer as outlined in items 1, 5 and 6. 5: Purchase specimen collection kits for diagnostic testing. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. 6. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to on-going program activities. 7. Assist in technical training of testing personnel and computer software utilization. 8. Provide technical consultation and assistance with program activities. 9. Supply Contractor with a copy of the contracts associated with this program. 10. Monitor monthly utilization reports. 11. Provide reagents and culture media for food and stool specimen examination related to foodbome disease outbreaks. Contractor Specific Requirements (Saginaw County) • • 1. Meet established standards of performance and objectives in the following areas: A. Perform tests for diagnosis of gonorrhea and chlamydia infections using a commercial nucleic acid amplification assay and perform testing for detection of foodbome disease outbreaks as specified in items 5 and 6. B. Utilize standardized testing procedures approved by the laboratory director and standards of quality assurance and quality control. Assist Department in quality assurance assessments of testing annually or as determined by Department. C. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing. D. Test gonorrhea and chlamydia specimens from approved agencies/physicians within 1 working day • of receipt of specimen. E. Send laboratory test reports to submitters within 1 day of completing testing via a system of delivery at least as expedient as the US Postal Service. F. Establish testing personnel training program and maintain documentation of training of all testing personnel. G. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. H. Maintain an adequate inventory of test kits and reagents purchased by the Department. Communicate shipment needs to manufacturer's representative if shipments supplementary to the routine shipments are needed. 2. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement. MDCH/CMS 7/01 Pane 30 of 42 A`, • 3. Provide the Bureau of Epidemiology, HIV/AIDS-STD Division and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH (e.g., HIV, foodbome disease, chlamydia, gonorrhea, etc), all specimen submission data and reporting data will be entered and reported using EPIC software. The Contractor will designate one staff member as a liaison to the Bureau of Laboratories. Each Contractor must designate appropriate staff to take part in EPIC training activities. Training and purchase of modules for EPIC other than those modules provided by MDCH will be the responsibility of the Contractor. The Contractor is responsible for modules not directly related to testing performed under this agreement with the Bureau of Laboratories - - Initial Purchase Price (paid to MDCH) - Monthly maintenance fees (paid to MDCH) - Use of modules purchased by a Contractor will be restricted to the Contractor purchasing the module - Use of modules purchased by one Contractor can be negotiated (formulas for payment will be based upon the percentage of total specimens entered into the module). Modules purchased by any Contractor will become available to any participating Contractor at no cost after five years. However, each Contractor using the module will share in the maintenance fees. 4. Inform the Infectious Diseases Division by June 30, 2002 if more 13,036 nucleic acid amplification specimens will be performed. 5. Provide laboratory support (examination of food specimens) to investigate up to 12 foodbome disease outbreaks. Laboratory support includes providing test reports and food samples to the Bureau of Laboratories. 6. Provide laboratory support for examination of up to 100 stool specimens associated with foodbome disease outbreaks. Department Requirements 1. Reimburse the Contractor $8,100 for the examination of specimens related to foodbome disease outbreaks to the extent outlined in Items 5 & 6 above. Reimburse the Contractor at the fixed unit rate of $2.00 for each specimen for diagnosis of gonorrhea and chlamydia infections using a nucleic acid amplification assay. Reimburse the Contractor $12,000 for administrative costs associated with operation of the CLIA umbrella certificate. 2. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. 3. The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, Support and maintenance for one computer and one laser printer (excluding consumable supplies), user training for EPIC modules utilized for testing performed under contract, advanced training for EPIC liaisons for test master and Contractor specific data base support, and support for network communications between the Contractor and the EPIC server. The Department will maintain the sole contract with EPIC. Payment for additional modules and maintenance fees for those modules will be paid for by the Contractor(ies) through MDCH. Tape backups and maintenance of all modules will be performed by MDCH staff. 4. Purchase and arrange for shipment of test kits and reagents from manufacturer. 5. Purchase specimen collection kits. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. 6. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to on-going program activities. 7. Assist in technical training of testing personnel and computer software utilization. MDCH/CMS 7/01 Page 31 of 42 8. Provide technical consultation and assistance with program activities. 9. Supply Contractor with a copy of the contracts associated with this program. 10. Monitor monthly utilization reports. 11. Provide reagents and culture media for food and stool specimen examination related to foodbome disease outbreaks. LEAD HAZARD REMEDIATION PROGRAM SPECIAL REQUIREMENTS Contractor Reauirements Provide lead-based paint hazard control activities for eligible families residing in high risk homes containing lead-based paint. Lead Hazard Remediation Program (LHRP) requirements are divided into the following categories: 1) Education and Outreach; 2) Identification of Candidate Housing Units; 3) Lead Hazard Control Activities; 4) Follow-up Activities; and 5) Post Remediation Client Surveys and Data Collection. These procedures are to be adhered to and should not be interpreted to be inclusive of all present and future program requirements. • 1. Education and Outreach It is expected that each county will provide a minimum of 2 local presentations on lead poisoning paint issues per year. •A. Develop new partnerships with other affiliated housing and non-profit agencies in the jurisdiction. B. Assist LHRP in identifying and accessing private sector funding mechanisms for lead hazard control activities. C. Obtain and provide information on Healthy Homes issues D. Conduct local education and outreach activities targeting remodelers, renovators, maintenance personnel, painters, rental property owners, and other segments of the population. E. Plan and implement local activities for Michigan's Lead Poisoning Prevention Week education campaign. F. Act as a local lead information liaison with Michigan State Housing Development Authority, local housing authorities, housing rehabilitation organizations, and rental property owners; especially regarding HUD 24 CFR part 35 requirements. G. Attend regularly scheduled Subgrantee meetings. • 2. Identification of Candidate Housing Units A. Per the Lead Abatement Act, perform combination Lead Inspection/Risk Assessment to identify all present and potential lead-based paint hazards and document accordingly. Use this information to develop abatement specifications. B. Follow HUD Policy and Procedures Field Guide. C. Assist in lead hazard control activities. This includes field investigations, working with families (serve as household liaison for lead hazard control activities), and verifying program requirements. Submit to LHRP accurate and complete documentation on each unit. Field investigation reports must include digital photos of lead hazards found within the interior and exterior of the unit. D. Obtain and verify blood levels of children residing in units. E. Collaborate with local housing rehabilitation organizations, if necessary. F. Address historic preservation issues, if necessary. 3. Lead Hazard Control Activities MDCH/CMS 7/01 Page 32 of 42 • A.. Draft specifications in conjunction with the homeowner. The specification report should include all lead hazard control activities which are required to make the residence a lead-safe home using the most cost-effective measures. The specification report will also document the lead hazard control activities that are to be performed. B. Perform pre-bid walk-through on units. C. Process bid documents and addendums and provide to LHRP office. D. Ensure home and families are prepared for lead-hazard control activities. E. If necessary, assist the residents of the home in arranging for temporary lodging while lead hazard control work is being completed. F. Participates in project oversight. Spend a minimum of 50% of on-site supervision during lead hazard control work for each project to ensure that work is being done according to project specifications and in compliance with LHRP work standards. Documentation of oversight hours is required by LHRP. • 4. Follow-up Activities A. Conduct a visual inspection and obtain clearance dust wipe samples of all work areas according to LHRP protocol and submit for analysis to MDCH Lead Laboratory. B. Upon achieving appropriate clearance sample levels, document the unit is ready to be re-occupied, and contact the residents and abatement contractor. C. Develop a lead-based paint hazard control activities performance report and close-out documentation for submission to LHRP within 30 days of completion of work. D. Conduct a 6-month follow-up which includes a visual and dust wipes of all work areas. Address any contractor warranty issues. E. Conduct a 14-month visual certification to address contractor warranty issues. F. Perform proper maintenance on the XRF unit. 5. Post-Remediation Client Surveys and Data Collection A. Assist LHRP in monitoring the quality and cost effectiveness of lead hazard control projects. B. Assist LHRP in implementation of the Client Satisfaction Survey. • C. Conduct ongoing data collection and quarterly reporting to LHRP. Budget and Aoreement Requirements • As an established contractor (a contractor who has been awarded a Lead-Based Paint Hazard Control Grant before) agree to coordinate lead-based paint hazard control activities in approximately 19 homes funded through the HUD Grant and 25 homes funded with the Clean Michigan Initiative Bond funds. Additionally, all contractors are required to appoint a full-time equivalent individual to provide all program requirements as stated in this contract. The contractor will provide a quarterly report in accordance with format and instructions from LHRP. The report must be submitted by the fifteenth of the month following the end of each quarter. In addition, monthly reports must be electronically submitted to LHRP prior to sub-grantee meetings. Reference Documents The following reference documents are essential to performing the stated requirements in this contract: LHRP quarterly report guidance HUD policy and procedure field guide CMI policy and procedure field guide HUD 2000 Grant Proposal Lead Abatement Act and corresponding rules XRF Performance Characteristics Sheets Lead Hazard Remediation Project Procession and accompanying MDCH form MDCH/CMS wni Dons qq nf 42 LOCAL MATERNAL AND CHILD HEALTH BLOCK GRANT SPECIAL REQUIREMENTS General Performance Requirements For fiscal year 2002, there are two separate components for the Local Maternal and Child Health Block Grant, those being: 1) CSHCS Outreach and Advocacy and 2) Local MCH. A separate allocation for each of these components is made to each local health department in Michigan. It is still necessary that the specific funds designated for each component be used to address the general purposes for which they are appropriated. 1. CSHCS OUTREACH AND ADVOCACY REQUIREMENTS For specific contractor requirements see detailed instructions under "CSHCS Outreach and Advocacy page 16 of this document. 2. LOCAL MATERNAL AND CHILD HEALTH Local MCH funds are intended to be flexible and available to local health departments to address locally identified needs related to the health of women and children in their jurisdictions. It is expected that each local health department will use a defined needs assessment process (in most cases the Community Health Assessment and Improvement Process) to determine and identify its MCH needs. In addition, local health departments are asked to examine, (to the extent data is available) their status on each of 27 MCH related indicators. Eighteen of these indicators have been established by the MCH Bureau (MCHB) of the federal Department of Health and Human Services as mandated reporting requirements for all states. An additional 9 indicators have been selected as optional State indicators by MDCH for annual monitoring and reporting. It is important that local jurisdictions review these performance measures and assure that efforts are being made where there is significant negative variation from stated HP 2000 (or 2010 goals) or from State averages. It is left to local health departments to determine how Local MCH funds are to be used to address MCH needs. Contractor Requirements 1. Submit a Maternal and Child Health Community Plan for use of allocated Local MCH Block funds. For specific program requirements and additional detail, refer to "Instructions for the Local Maternal and Child Health Block Grant". Budget Recuirements The total Local MCH Block grant allocation has two separate funding categories for purposes of planning and budgeting. CSHCS Outreach and Advocacy Funds related to CSHCS outreach and advocacy shall be labeled as such under a column of the CPBC budget. These funds are restricted for use by the CSHCS local office at the local health department. Local MCH - Local MCH (previously M&IC and Local MCH funds) - funds are to be budgeted as a funding source under any appropriate program element(s) (i.e. Adolescent health, CSHCS Outreach & Advocacy, Child Health, Family Planning, Immunization, Maternal & Infant Health Advocacy Services, Maternal & Infant Support, Healthy Kids Outreach & Advocacy, Oral Health, Prenatal Care Clinic Services, Prenatal Care Outreach & Advocacy and Primary Care). This funding source cannot be used under the VVIC element except in extreme circumstances where a waiver is requested in advance of the expenditures and evidence is provided that the expenditures satisfy all funding requirements. Local MCH funds used to provide health care services (except Family Planning) to non-pregnant women should be budgeted under Primary Care. If funds are to be used for a program other than those outlined above, local health departments are asked to consult with their Division of Family and Community Health assigned agency consultant first. Local MCH funds may not be used to supplant available/billable program income such as Medicaid fees or additional funding under the Medicaid Cost-Based Reimbursement process. Local effort for program elements supported by Local MCH funds must not be reduced in instances in which added Medicaid has been generated through enhanced collection of Medicaid fees and/or funding under the Medicaid Cost-Based Reimbursement process. MDCH/CMS 7/01 On". 'IA tsf LOCAL PUBLIC HEALTH OPERATIONS (LPHO) SPECIAL REQUIREMENTS • Budget and Agreement. Requirements 1 State funding for LPHO shall support and the agency shall provide for all of the following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act No. 336, of 1998 Section 909. Drinking Water Supply* Immunization Food Service Sanitation On-Site Sewage Treatment Management* General Communicable Disease Control Sexually Transmitted Disease Hearing Vision State funding for LPHO can support administrative cost for the eight required services including allowable indirect cost, or an agency's cost allocation plan. (*Services funded under a separate agreement with the Michigan Department of Environmental Quality.) 2. LPHO funding can also be used to fund other core health functions including: Community Health Assessment & Improvement, Public Policy Development, Health Services Administration, Quality Assurance, Creating & Maintaining a Competent Work Force and Local Public Health Accreditation. These services could be budgeted separately as part of the Administrative Budget element. 3. Net allowable expenditures are the authorized actual/allowable expenditures (total costs less specified exclusions). Available funding is also limited by state appropriations. 4. • First and second party fees earned in each required service program may be used only in that required service program. 5. State LPHO funding is subject to local maintenance of effort compliance, in that full distribution of state LPHO funds shall only be made to agencies with total local general fund public health services spending in FY 99/00 of at least the amount expended in FY 92/93. To be eligible for any of the State funding increases from FY 94/95 through FY 99/00 the FY 92193 Local Maintenance of Effort Level must be met. 6. A final statewide cost settlement will be performed to assure that all available 'LPN° funds are fully distributed and applied for required services. Contractor Requirements 1. Assure the availability and accessibility of services for the following basic health services: Prenatal Care; Immunizations; Communicable Disease Control; Venereal Disease Control; Tuberculous Control; Health/Medical Annex of Emergency Preparedness Plan. 2. Fully comply with the Minimum Program Requirements for each of the required services. 3. Contractor will be. held to accreditation standards and follow the accreditation process and schedule established by the Department for the required services to achieve full accreditation status. Agencies designated as "not accredited" may have their Department allocations reduced for Departmental costs incurred in the assurance of service delivery. The accreditation process is based upon the Minimum Program Standards and scheduled on a three year cycle. The Minimum Program Standards include the majority of the required Department reviews. Some additional reviews, as mandated by the funding agency, may not be included in the Program Standards and may need to be scheduled at other times. Department Requirements 1. Whenever the Department delivers direct services within the Contractor's area, it shall provide summary reports of those activities upon the request of the local health officer. LOCAL TOBACCO REDUCTION SPECIAL REQUIREMENTS Budget and Agreement Requirements No funds may be expended for lobbying as defined in Act No. 472 of the Public Acts of 1978, being sections 4.411 to 4.431 of the Michigan Compiled Laws. Under this law, "lobbying, means communicating directly with an official in the executive branch of state government or an official in the legislative branch of state government for the purpose of influencing legislative or administrative action." MDCH/CMS 7/01 Page 35 of 42 Agency Reauirements 1. Maintain a local tobacco reduction coalition to help mobilize community awareness and interest in addressing the problems of tobacco use. 2. Distribute tobacco related educational materials and serve as an information and referral resource for organizations, businesses, health professionals, and the general public. 3. Emphasize multi-cultural inclusiveness and outreach to diverse groups as appropriate within the community. 4. Undertake activities focusing on protecting non-smokers from secondhand smoke. 5. Prepare and implement an annual agency tobacco reduction work plan. 6. Submit to Health Promotions and Publications all plans involving paid media for approval prior to • issuance of contracts or expending funds for this purpose. 7. Submit quarterly reports and other required program documentation to Tobacco Program Consultant . on a timely basis. 8. • Submit all new publications and newsletters to Health Promotion and Publications Office for approval prior to printing. 9. Attend Department regional and statewide coalition coordinator training. MICHIGAN CHILDHOOD IMMUNIZATION REGISTRY (MCIR) REGIONAL SPECIAL REQUIREMENTS (Delta-Menominee District Health Department, District Health Department#10, Genesee County Health Department, Kalamazoo County Health Department, and Mid-Michigan District Health Department) Contractor Reauirements The Contractor shall perform the following activities on behalf o the Department to support the Michigan Childhood Immunization Registry. 1. Conduct reminder/recall for all children in the Contractor's region that are not being recalled directly by a provider. The Contractor should work with the local health departments and providers in the Contractor's region to develop a reminder/recall schedule and generate notices per that schedule. 2. Support regional MCIR users by operating the regional help desk in accordance with Department approved procedures. 3. Monitor and develop strategies to increase private provider enrollment and participation in the MCIR. Develop strategies to encourage all providers to fully participate with the MCIR. 4. Duplicate and distribute software, manuals, and related material to new MCIR users. 5. Process all user/usage agreements, according to Department approved procedures, to create user accounts. 6. Continue to implement and update marketing plans in support of increased provider and parent acceptance and use of the MCIR. 7. Keep regional users updated on MCIR status and system changes. 8. Assure that records submitted via paper forms are entered in a timely fashion and according to Department approved procedure. 9. Conduct ad hoc reporting and querying on behalf of MCIR users. 10. Monitor infant death announcements in the region that appropriately mark MCIR records. Develop a mechanism to assure the records of children who have died in the region are appropriately flagged in the MCIR. 11. Maintain a listing of private and public immunization providers according to the format prescribed by the Department The listing should be as comprehensive as possible and should include all providers in the region. MDCH/CMS 7/01 Page 36 of 42 • 12. Conduct regular de-duplication activities to assure that duplicate records are removed from the MCIR as quickly as possible. 13. Process user petitions to change MCIR data according to Department approved procedures. 14. Hold advisory group meetings on at least a quarterly basis to set regional policy and set regional implementation and maintenance priorities. 15. Monitor ongoing immunization data submission for all local health departments and private providers. 16. Conduct training functions as needed to assure that local health department staff can provide assistance to providers on how to access and submit data into the MC1R. 17. Maintain a policy/procedure manual, approved by the regional advisory group and the Department. 18. Process and file all "opt out" forms according to Department approved procedures. 19. Attend regular MCIR regional Contractor/coordination meetings. 20. Perform quality assurance checks on the MCIR data for the region as prescribed by the Department. 21. Assist local health departments and private providers with methodologies to "clean up" their data. 22. Conduct training functions as needed to assure that staff in private provider offices receive education • and training on how to access and submit data into MCIR. 23. The Contractor shall submit quarterly status reports on the progress of this program. Reports are due within 30 days of the end of each quarter. This report shall be submitted to: Robert Swanson, MPH Michigan Department of Community Health Division of Communicable Disease and Immunization P.O. Box 30195 Lansing, Michigan 48909 • • Phone: (517) 335-8159 24. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the project as determined by the Contract Consultant. MINORITY HEALTH SPECIAL REQUIREMENTS Contractor Reauirements 1. Develop an evaluation tool which identifies the process and outcome indicators of the project. 2. Submit quarterly progress reports and a final report within 30 days of the completion of the project to the Office of Minority Health. 3. Submit completed Community Based Organization (CB0) Funded Projects Report within 30 days of the completion of the project to the Office of Minority Health. 4. Ensure delivery of services to all populations as applicable including African American, Arab/Chaldean, Asian and Pacific Islander, Hispanic, Native American, Eastern European and other multicultural refugee and rural populations. 5. Ensure that programs targeting multicultural populations are culturally competent. Cultural competency is defined as: A set of academic and interpersonal skills that allow individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups. This requires a willingness and ability to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing focused interventions, communications, and other supports. 6. Services provided are linguistically appropriate to meet the needs of the respective client population. MDCH/CMS 7/01 Page 37 of 42 7. Data collected on clients served will reflect the multicultural racial and ethnic clients served consistent with the law and Department recommendations stated in Public Acts 88 and 89. 8. Health care providers should reflect the racial and ethnic groups served to the extent that such providers can be reasonably recruited and utilized. 9. The request for proposal (RFP) and the Contractor's technical proposal, as amended, is made a part of this agreement by reference. 10. The data collection form updated in 1997 and approved by the joint Local Health and MDCH Forms Committee can be collected quarterly for Contractor tracking purposes, but the year long data must be submitted with the final report to the Office of Minority Health. NOTE: Ten percent (10%) of the agreement amount will be deferred for payment pending the Department's receipt of the final report from the LHD which includes completed CB0 Funded Projects Report and the required evaluation. Department Requirements 1. Provide technical assistance in the development of RFP's, if applicable. OUTREACH FOR MEDICAID AND MI-CHILD-SPECIAL REQUIREMENTS Contractor Reauirements 1. Target geographic areas within the community where low income families reside. 2. Collaborate with other community organizations within that geographic area for the purpose of making contacts with low income families who may be eligible for Medicaid or MIChild. 3. Provide information to low income families within local community based sites such as churches, schools, day care facilities, community centers, hospital emergency rooms, physicians offices, etc., on the Medicaid and MIChild programs and the application assistance services that are available within the local health department. 4. Assist families in the completion of a Medicaid and/or MIChild application. 5. Obtain Verifications, including necessary copies of proof of specified in Medicaid program policy. 6. Obtain a signature that permits the transmitting of the application for processing. 7. Prepare, assemble and submit information, verification of Medicaid applications for pregnant women (with no other children) and families directed to the local Family Independence Agency office. Submit the MIChild/Health Kids/Notification form to DCH for processing simultaneously. 8. Prepare and assemble and submit the information, verification and the Medicaid and/or MIChild application for submission to Maximus along with Notification Form. Department Reauirements • 1. Provide initial and ongoing training to the contractor. 2. Provide current information on health and dental plans to contractor. 3. Notify the contractor of policy, program and process changes affecting the scope of work. 4. Process Medicaid/MIChild Outreach Notification forms to generate a quarterly payment to contractor. Contractor will be reimbursed by Direct Voucher, based on the accurate completion of these forms, at a rate of $25 per person enrolled (no standard CPBC FSR reimbursement). 5. Provide contractor with Department requirements for forms and publications. 6. Make Medicaid and MIChild applications available to the contractor. • 7. Collaborate with the Local Health Department to improve application assistance services. 8. Monitor compliance with program requirements. 9. Conduct site visits for performance auditing purposes. PRIMARY CARE DENTAL SPECIAL PROJECT Contractor Requirements 1. Carry out the intent of the Funding Announcement in accordance with the CPBC Minimum Program Requirements for the Primary Care Dental element. 2. Provide preventive and remedial dental services to persons not eligible for any other programs and with incomes under the 200% of the Federal Poverty Level. 3. Provide the services without supplanting existing funding or patients. 4. Submit the following reports as indicated: MDCH/CMS 7/01 Page 38 of 42 A. Monthly Billing Worksheet and FSR The Monthly billing Worksheet (to be provided by the Department) must be completed each month to report the numbers of each service provided. This will determine the reimbursement amount that is then submitted on the FSR for payment. A running total of unduplicated persons served will also be requested each month. B. Michigan Oral Data (MOD) Each funded agency must participate in the Michigan Oral Data (MOD) Project for all of the patients served in their clinic. Special forms will be provided by the Department to record the funding source for each patient so comparisons can be made between the disease patterns of the various population groups. The monthly forms will be submitted with the Billing Worksheet and FSR. The data will be compiled and analyzed by the Department. C. Final Report At the end of the grant period, each funded agency will be required to submit the following data: 1. Unduplicated number of patients served by age. 2. Average cost of providing dental care by age. 3. Impact of program - this could include , studies with before and after pictures or may be anecdotal stories, e.g. patient was able to get a job or a better job after the dental work was complete, a child's grades improved because they weren't missing school because of dental pain. The intent of this requirement is to document what impact the program had • and to evaluate the value of continuation. NOTE: agencies serving multiple counties shall indicate numbers from each county. Reports and information shall be submitted to: Jacqueline A. Tallman, RDH, MPA Oral Health Program Coordinator Michigan Department of Community Health P.O. Box 30195 3423 N. Martin Luther King, Jr., Blvd. Lansing, Michigan 48909 Telephone: (517) 335-8909 Fax: (517) 335-8294 tallmanjacestate.mi.us The Contractor shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. Department Requirements 1. Provide administrative direction and technical assistance. 2. Reimbursement for services provided to target population as stipulated in the Funding Announcement 3. Provide master copies of the billing and MOD forms. 4. Evaluate the reports submitted as described above for their completeness and accuracy. SIDS SPECIAL REQUIREMENTS Contractor Requirements 1. Assure local dissemination of risk reduction information including Back-to-Sleep and Safe Infant Sleep Guidelines. 2. Provide family support services to families and other caretakers of infants who have died suddenly and unexpectedly. Family support includes bereavement support, assessment of other needs, referral for services, anticipatory guidance regarding future pregnancies. Eligible infants include any age infant whose cause of death was determined to be SIDS. Other infants that may be eligible for service include any between 1 month and 1 year of age who died suddenly and unexpectedly. •Infant deaths which are excluded are those attributed to an intentional cause such as homicide or abuse/neglect. 3. Assure potential family support providers are certified in SIDS and Infant Death family support. Assure providers have inservice and updates on relevant maternal child health issues. MDCH/CMS 7/01 Page 39 of 42 4. Complete a referral to the Michigan SIDS Alliance for bereavement literature and information on program activities. Department Requirements 1. Provide payment of $70 for each family support visit. A maximum of 6 visits is reimbursable per infant death. 2. Provide forms for referral to the SIDS Alliance, documenting family support visits and for ordering risk reduction literature. 3. Provide training for certification of family support providers. 4. Provide referral of new infant deaths from central surveillance database. TB CONTROL (DOT) SPECIAL REQUIREMENTS Contractor Requirements I. The outreach worker position shall be under the direction of a supervisor experienced in TB control. 2. Submit the Directly Observed Therapy Registration form for each new patient, update the status of the patient every 60 days and complete the bottom half of the registration form when terminating DOT activity. 3. Strive for continuous improvement in tuberculosis case completion rates within 12 months, utilizing current CDC recommendations. 4. Seek consultation with the Department whenever necessary. WIC SPECIAL REQUIREMENTS Contractor Requirements I. Provide for security of coupon stock stored in the local Contractor prior to issuance. The Contractor must notify the WIC Division in writing of any lost, stolen, inappropriately issued or otherwise unaccounted for coupons, immediately upon recognition of such condition. 2. • Comply with the requirements of the WIC program as prescribed in the Code of Federal Regulations (7CFR, Part 246) including the following special provisions: A. If a local Contractor operates a WIC Program within a hospital or has a cooperative agreement with one or more hospitals, the hospital is required to advise the potentially eligible individuals that receive inpatient or outpatient prenatal, maternity, or postpartum services or accompany a child under age 5 years who receives well-child services, of the availability of WIC benefits t246.6(F)(1)]. 3. Maintain an inventory of all equipment.purchased with WIC program funds and maintain such inventory at each WIC clinic location. 4. Assure each Contractor employee authorized for or requesting access to the automated WIC system complete and sign a security agreement (Form MIS-176) which will then be returned to MDCH. WIC INCREASED PARTICIPATION SPECIAL REQUIREMENTS Budget and Agreement Requirements The funding described below for WIC Increased Participation is to be shown separately from VVIC regular allocated funding under the WC element and is to be designated as "Increased Participation Funds". The "Increased Participation Funds" are budgeted on a cumulative basis at a rate of $8.50 per month for each planned additional participant in excess of the "Allocated Base Caseload". This additional funding is contingent on the Contractor meeting the following conditions: 1. To earn and retain the entire additional "Increased Participation Funds", the Contractor must serve the entire "Net Over Base" caseload by September 30, MDCH/CMS 7/01 Page 40 of 42 . And The Contractor's actual, final WIC expenditures through September 30, must not be less than the amount of the regular WIC allocation plus the additional Increased Participation Funds and Computer Maintenance Funds. Any reduced level of participation and/or reduced level of actual expenditures would reduce final WIC "Increased Participation Funds" reimbursements accordingly. Contractor Requirements Include the amounts in and attach a "Local Contractor Participation Level Plan" to the Annual Comprehensive Budget. Department Requirements 1. Upon WIC Division approval, reimburse the Contractor based on the number of cumulative actual participants served in excess of the "Allocated Base Caseload" on a fixed unit rate basis, as reported by the Contractor on the Comprehensive Financial Status Report. 2. Perform year-end cost settlement to assure that the cumulative actual number of increased participants reported on the Comprehensive Financial Status Report is in agreement with the Department's Priority Status Participation by WIC Code Closeout Report (P16111). WELL-INTEGRATED SCREENING AND EVALUATION FOR WOMEN ACROSS THE NATION (WISEWOMAN) PROJECT SPECIAL REQUIREMENTS Contractor Requirements WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) is a program designed to screen women for cardiovascular disease risk factors, counsel them about lifestyle changes to reduce risk factors, and refer them for medical treatment of hypertension and/or hyperlipidemia. This program will be based within Michigan's Breast and Cervical Cancer Control Program. Extensive data is required by the Centers for Disease Control and Prevention (CDC) for each women served by federal funds. Dates of service and results of testing are required prior to authorizing reimbursement to providers. Therefore, for care provided off-site, data about screening tests and abnormal lab work will need to be transmitted to the BCCCP agency. 1. Women eligible for this program will be BCCCP clients: ages 40-64 (target: 75% 50-64), uninsured or underinsured, and with income under 250% of poverty. 2. Participation in this program will be optional, not mandatory, for participants in the BCCCP. 3. Dates and results of all diagnostic procedures must be recorded in the Michigan Breast and Cervical Cancer Control Information System (MBCIS) by the BCCCP agency. 4. Women with abnormal screening results ("urgent," "emergent," "high") will be referred for medical management as indicated. 5. The LCA will notify the MOCH staff about clients with abnormal screening results requiring case management. 6. Women with abnormal screening results will have their follow-up care coordinated (or "case managed") by identified LCA staff. 7. Women will be appointed to a "lifestyles counselor" who will refer them to risk factor appropriate education in their community or at the local agency. 8. Follow-up visits (at least two) will be scheduled to check blood pressure, weight and cholesterol as indicated. MDCH/CMS 7/01 Page 41 of 42 ' DenartMent Requirements The Department will provide payment based on the fixed unit rate reimbursement mechanism upon completion and submission of the Comprehensive FSR (DCH-0411) and required attachments. MDCH/CMS 7/01 Page 42 of 42 CHSCS Care Coordination CSHCS OUTREACH & ADVOCACY CARDIOVASCULAR DISEASE PREVENTION CHILDHOOD LEAD Service Delivery COMMUNITY HEALTH ASSESSMENT & IMPROVEMENT FAMILY PLANNING General Services' FAMILY PLANNING - Model Projects HEPATITIS B HEPATMS C IMMUNIZATIONS Immunization Action Plan (IAP) lmrn. Nurse Training VFC Provider Site Visits INFORMED CONSENT- PA 133 LEAD HAZARD REMEDIATION Reg. Akre. - Calm Amt. Reg. Alloc. Reg. Ark= Reg. Mac. Reg. Mot Reg. Moo. Reg. AUoc. Reg. Mom Reg. Mot Reg. Mot Calc. Amt. Calm Amt. Cale. Ant Reg. Moc. N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 75% N/A N/A N/A N/A $515,418 $100/Each $150/Each $50/Each $80,000 Staffing (9) Fixed Unit Rate (10) Fixed Unit Rate (10) Fixed Unit Rate (10) Staffing (9) $2,695,911 LPHO (7) $863,087 Performance N/A N/A N/A N/A N/A $215,794 Performance $48,495 Staffing (9) $109,698 Performance $70/Each Fixed Unit Rate (15) $89,820 Staffing (9) $93,898 Fixed Unit Rate I Unduplicated Women and Infants Discharged 90% N/A N/A 90% N/A N/A N/A N/A N/A N/A N/A N/A * Persons Examined NIA N/A N/A N/A N/A N/A N/A N/A N/A N/A • Oakland County HiaIth Department ATTACHMENT IV FP( 2001-2002 CPBC AGREEMENT MDCH Funding Allocations/Reimbursement Mechanisms Matrix Program Element/ P11.110..ft ;94!5•..(1. ).. Program for Local MCH to be determined based on pion approval. MDCH Funding Source Amount Local MCH $332.964 State (4) Performance Total (3) Funded Reimbursement Target Output Perform. Target Mechanism (21_ Measure Expect Perform. After Program approval, applicable Local MCH funding WM be incorporated under the program selected in the plan, along with approved output performance measures, via amendment. State Funded Minimum Performance Percent Number (5) elements AIDS/HIV PREVENTION Targeted Areas LOCAL PUBLIC HEALTH OPERATIONS MOCH Reg. Alla. MOA Reg. Alloc. $388.801 Performance Various Fixed Unit Rate (10) (17) $151.600 Staffing (9) 3227,260 Staffing (9) $40,000 Staffing (9) $68,418 Staffing (9) 3217,775 Staffing (9) 39/Each Fixed Unit Rate (10) (16) $50,000 Staffing (9) High/Low Risk Persons. Tested and Post-Test Counseled In Anonymous or Confidential Public Heath Clinics NIA NIA N/A NIA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Percentage of Food Service N/A licensees receiving required Inspections. 90% N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 95% N/A N/A N/A N/A N/A N/A N/A N/A N/A 3302,589 Performance (8) (11). 1 Unduplicated Clinic N/A Users Served N/A N/A N/A N/A N/A N/A N/A MATERNAL & CHILD Reg. Alloc. OUTREACH ENROLLMENT & COORDINATION $354,439 Staffing (9) N/A N/A N/A N/A N/A MATERNAL & INFANT HEALTH/ADVOCACY Reg. Mot (MIHAS) MINORITY HEALTH Reg. Mac.. SEXUALLY TRANSMITTED DISEASE (STD) CONTROL Reg. Allot SIDS Cale. Amt. TB CONTROL Directly Observed Therapy (DOT) VACCINE REPLACEMENT/ Cale. Amt. HANDUNG Reg. Alloc. WIC Resident Services Reg. Moe. $1,213,608 Performance (11) TOTAL MDCH FUNDING 38.037.371 a • SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT. 97% I Avg.Mo.Participation N/A (1) Refer to Plan and Budget Framework for element definitions. (!:1). Refer to master comprehensive agreement and program and budget instructions package for further explanation of applicability of these reimbursement mechanisms. (3) Negotiated starting from the average of the past two complete years' actual numbers where available. (4) Calculated by multiplying the "Total Performance Expectation" column by the ratio of the elements total State funding (DCH 0410, Line 24) to "Total Expenditures" (DCH 0410, line 17). Prior to calculation, adjustments will be made for unallowable cost, equipment funded by local funds, and MDCH reimbursement not performance based (i.e. fixed unit rate, staffing). (5) Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. (6) State funds are first source (after fees and other earmarked sources) as long as 20% match (hard or soft) is met (7) Funding Source (not a single element). (8) Subject to statewide maintenance of effort requirement for Title X. (9) State funding is first source (after fees and other earmarked sources). (10) Fixed unit rate subject to actual costs. (11) Performance reimbursement target will be the base target caseload established by MDCH. (12) Subject to a match requirement (hard or in-kind) of 81 for each 84 of MDCH agreement funding. • (13) Fixed unit rate limited to contract amount (14) BCCCP Capitation category is mutually exclusive to the Coordination and Direct Services categories. Agencies must choose either a.) BCCCP Capitation, or b.) Coordination and Direct Services. (15) Up to 6 visits per family. (16) Local health departments will receive the following amounts for services rendered to patients seen in family planning, STD, and adolescent clinics: Administration of first, second or third dose of vaccine with submission of intake or vaccination follow up form to MPHI: 89.00 (17) CSHCS Care Coordination 1. LEVEL I CARE COORDINATION A. Initial IHCP 1. Long Form 8150, plus 850 Bonus for timely completion ." 2. Short Form 8125, plus $25 Bonus for timely completion ." 3. Update to IHCP $30 B. Renewal 1HCP 1. Long Form 875, plus $25 Bonus for timely completion .** 2. Short Form $65, plus $25 Bonus for timely completion .** 3. Update to IHCP $30 2. LEVEL II CARE COORDINATION A. Code A or B unit $30/Unit (10 unit limit per beneficiary per year) ** Timely completion is defined as 45 days from the date of referral. (18) Noted as a funding source on the CPBC Budget Summary under the Coordination or Capitation program element as applicable. Settlement with MDCH Accounting will take place for any agencies with women found to be not eligible. NOTE: Some footnotes may not apply to this agency. Oakland County Health Department . ATTACHMENT IV Program Element/ Funding Bowels (1) Program for Local MCH to be determined based on plan approval. AIDSIHIV PREVENTION MDCH Funding Source Amount Local MCH $232,964 Reg. Moe. Cale. Ant Reg. Moe. Reg. Moe. Reg. Moe. Reg. Aloe. Rag. Moe. $388,801 Performance Various Fixed Unit Rate (10) (17) $151.600 Staffing (9) 3227,280 Staffing (9) $40,000 Staffing (9) $88,416 Staffing (9) $302,589 Performance (8) (11) $354.439 Staffing (9) $215,794 Performance $48,495 Staffing (9) $109.696 Performance 570/Each Fixed Unit Rate (15) $89,820 Staffing (9) $93,898 Fixed Unit Rate $1,213,808 Performance (11) FAMILY PLANNING - Model Projects Reg. Moe. HEPATITIS B Reg. Moe. HEPATITIS C Rag. Moe. IMMUNIZATIONS Immunizadon Action Plan (tAP) Reg. Moe. Inint Nurse Training Calm Amt. VFC Provider Site %sits Calm Ant INFORMED CONSENT- PA 133 Cale. Amt. LEAD HAZARD REMEDIATION Reg. Mot LOCAL PUBUC HEALTH OPERATIONS MDCH Reg. Moe. MDA Reg. Moe. MATERNAL & CHILD Reg. Moe. OUTREACH ENROLLMENT & COORDINATION MATERNAL & INFANT HEALTH/ADVOCACY Reg. Moe. (MIHAS) MINORITY HEALTH Reg. Moe.. SEXUALLY "TRANSMITTS3 DISEASE (STD) CONTROL Reg. Mom SIDS Cale. Ant TB CONTROL Directly Observed Therapy (DOT) Reg. Aloe. VACCINE REPLACEMENT/ Cale. Amt HANDUNG • VAC Resident Setvises Req. Mae. $515,418 $100/Each 3150/Each $50/Each $80,000 Staffing (9) NIA N/A Fixed Unit Rate (10) N/A N/A Fixed Unit Rate (10) N/A N/A Fixed Unit Rate (10) N/A N/A Staffing (9) N/A N/A 32,595.911 LPHO (7) N/A N/A $863,087 Performance Percentage of Food Service N/A licensees receiving required Inspections. N/A N/A N/A 95% N/A N/A N/A 75% N/A • N/A N/A N/A NIA N/A N/A N/A. N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 90% N/A N/A N/A 90% N/A N/A N/A WA N/A NIA NIA NIA NIA 97% N/A N/A N/A N/A N/A N/A N/A N/A NIA N/A N/A N/A N/A NIA N/A N/A NIA 90% N/A N/A N/A 3217.775 Staffing (9) N/A N/A $9/Each Fixed Unit Rate (10) (le) N/A N/A $50,000 Staffing (9) . N/A N/A N/A NIA NIA N/A NIA N/A N/A N/A N/A • , FP/ 2001-2002 CPBC AGREEMENT HOCH Funding AllocatIonelReimbursament Mechanisms Matrix • State (4) State Funded . Performance Total (3) Funded Minimum Reimbursement Target Output Perform. Target Performance ' Mechanism (2) Measure • Expect perform.. Percent Number (5) After Program approval. applicable Local MCH funding will be incorporated under the program elements — selected in the plan, along with approved output performance measures, via amendment. Targeted Areas CHSCS Cars Coordination CSHCS OUTREACH & ADVOCACY CARDIOVASCULAR DISEASE PREVENTION CHILDHOOD LEAD Service Delivery COMMUNITY HEALTH ASSESSMENT & IMPROVEMENT FAMILY PLANNING General Service* * High/Low Risk Persons Tested and Post-Test Counseled in Anonymous or Confidential Public Heath Clinics N/A N/A N/A N/A N/A # Unduplicated CHIC NIA Users Served N/A NIA ft Unduplicated Women and Infants Discharged N/A N/A * Persons Examined N/A N/A N/A Avg.Mo.Participation N/A TOTAL MDCH FUNDING 2,2,E371 . " SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT. Resolution #01280 October 25, 2001 The Chairperson referred the resolution to the Finance Committee. There were no objections. FISCAL NOTE (M.R. 01280) November 8, 2001 BY: FINANCE COMMITTEE, SUE ANN DOUGLAS, CHAIRPERSON IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - 2001/2001 COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) 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 Community Health (MDCH) has awarded Oakland County Comprehensive Planning, Budgeting and Contracting (CPBC) funding in the amount of $7,987,371 for the period of October 1, 2001 through September 30, 2002. This award reflects a 0.94% ($75,356) decrease from the FY 2000/2001 amended funding allocation of $8,062,727. 2. Changes from the previous award have been made by the MDCH, including: • Funding from Women, Infants, and Children (WIC) has been decreased by $80,389. • Child Well Being funding has been eliminated from this year's agreement, which is a decrease of $20,000. • Funding from the Hepatitis C program has also been eliminated, which is a decrease of $50,000. • Maternal and Infant Health Advocacy Services has been increased $49,621. • Funding for Aids/HIV Prevention has been increased by $10,773. • Funding for Family Planning General Services has been increased by $12,456. • Funding for the Lead Hazard Remediation Program has been increased $5,000. 3. Acceptance of this grant does not obligate the County to any future commitment. 4. The impact of this agreement was included in the FY 2002 Adopted Budget. No amendments are required. FINANCE COMMITTEE FINANCE COMMITTEE Motion carried unanimously on a roll call vote with Patterson absent. E FOREGOING RESOLI /1/01 iam Caddell, County Clerk Miscellaneous Resolution #01280 November 8, 2001 Moved by Coleman supported by Buckley the resolutions on the Consent Agenda be adopted (with accompanying reports being accepted). AYES: Brian, Buckley, Causey-Mitchell, Coleman, Crawford, Dingeldey, Douglas, Galloway, Garfield, Gregory, Law, McPherson, Melton, Moffitt, Moss, Obrecht, Palmer, Patterson, Sever, Suarez, Taub, Webster, Amos, Appel. (24) NAYS: None. (0) A sufficient majority having voted therefore, the resolutions on the Consent Agenda were adopted (with accompanying reports being accepted). STATE OF MICHIGAN) COUNTY OF OAKLAND) I, G. William Caddell, 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 November 8, 2001 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 8th day of November, 2001.