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
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GENERAL GOVERNMENT COMMITTEE:
Motion carried unanimously on a roll call vote.
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Department: Human Services
Telephone #: 41.52-2.15 I
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CONTRACTIPROGFIAM SYNOPSIS:
The CPBC Agreement provides funding for severalHealth Division progams. Signed agreement is due to MDCH by
September 15, 2001.
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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.
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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.
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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
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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.
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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.
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A.
B.
C.
D.
E.
F.
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• 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.
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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:
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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
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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.
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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
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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.
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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.
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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
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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.
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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
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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
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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:
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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
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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.
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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).
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• ,
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
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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
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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.
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„
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
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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.
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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.
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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.
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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.
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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.
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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.
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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
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• 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
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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.
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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."
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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
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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
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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
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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
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. 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
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' 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.