Loading...
HomeMy WebLinkAboutResolutions - 2004.11.18 - 27619MISCELLANEOUS RESOLUTION 104320 November 18, 2004 BY: General Government Committee, William R. Patterson, Chairperson IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - 2004/2005 COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) AGREEMENT ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Michigan Department of Community Health (MDCH) has awarded the Oakland County Health Division funding in the amount of $7,247,845, which is an 11.28% ($817,719) decrease from the Fiscal Year 2003/2004 amended allocation of $8,065,364; 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 2005 Budget when details are finalized; and WHEREAS MDCH has communicated to the Health Division that an additional $394,149 has been allocated for Emergency Preparedness purposes, and will be incorporated into the FY 2004/2005 CPBC Agreement by the first amendment to this agreement; and WHEREAS this agreement is for the period of October 1, 2004 through September 30, 2005; and WHEREAS the CPBC Agreement has been submitted through the County Executive Review Process and is recommended for approval. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby accepts the 2004/2005 Comprehensive Planning, Budgeting, and Contracting (CPBC) agreement for funding in the amount of $7,247,845 for the period of October 1, 2004 through September 30, 2005. 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 and approve any changes or extensions to the agreement, not to exceed fifteen percent (15%), which is consistent with the agreement as originally approved. BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its Chairperson to execute this Agreement subject to the following additional condition: That the County's approval for entering into this Agreement is specifically conditioned and premised upon the acceptance, approval and execution of the Agreement containing Addendum A, by the Michigan Department of Community Health, and that the failure of the Michigan Department of Community Health to execute the Agreement as specified shall, without any further act of the Oakland County Board of Commissioners, automatically negate and void the County's approval and/or acceptance of this agreement as provided for in this resolution. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. I A' General Government Committee Vote: Motion carried on a roll call vote with Hatchett absent. GENERAL GOVERNMENT COMMITTEE 4,44""A .1 I Tom Fockler From: Greg Givens [givensg@co.oakland.mi.us ] Sent: Wednesday, September 22, 2004 9:27 AM To: Doyle, Larry; Fackler, Tom Cc: Pearson, Linda; Smith, Laverne; Frederick, Candace; Worthington, Pam; Pardee, Mary; Hanger, Helen Subject: CONTRACT REVIEW — Health Division CONTRACT REVIEW - Health Division GRANT NAME: FY04-05 Comprehensive Planning, Budgeting, and Contracting (CPBC) Agreement FUNDING AGENCY: Michigan Department of Community Health DEPARTMENT CONTACT PERSON: Tom Fockler / 2-2151 STATUS: Acceptance DATE: September 22, 2004 Pursuant to Misc. Resolution #01320, please be advised the captioned grant materials have completed internal contract review. Below are the comments returned by review departments. Please note the comments from Human Resources Department. The captioned grant materials and grant acceptance package (which should include the Board of Commissioners' Liaison Committee Resolution, the grant agreement/contract, Finance Committee Fiscal Note, and this email containing grant review comments) may be requested to be placed on the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. Department of Management and Budget: Approved.- Laurie Van Pelt (8/27/2004) Department of Human Resources: Please consider this HR approval for the CPBC grant application. No personnel implications with the understanding that we will hold the EH Lead Abatement position vacant for up to one year while additional funding is being sought. - Nancy Scarlet (9/2/2004) Risk Management and Safety: Approved. - Gerald Mathews (8/31/2004) Corporation Counsel: Yesterday (9/21/04), Tom Fockler receiver a revised Addendum from the State for the 2004-2005 CPBC Contract. I have reviewed this Addendum and find it satisfy the needs of the County. Since I have no other legal issues with the CPBC Contract I approve it for signature. - John Ross (9/21/2004) 1 Agreement Between Michigan Department of Community Health hereinafter referred to as the "Department" and County of Oakland hereinafter referred to as the 'Local Governing Entity" 1200 North Telegraph Road, Department 432 Pontiac, Michigan 48341-0432 38-6004876 hereinafter referred to as the "Contractor" for The Delivery of Public Health Services under the Comprehensive Planning, Budaeting 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, 2004 and continue through September 30, 2005. 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. M DCH/CMS 6/04 Page 1 of 21 3. Program Budget and Agreement Amount A. Agreement Amount: In accordance with Attachment IV - Funding/Reimbursement Matrix, the total State budget and amount committed for this period for the program elements covered by this agreement is $7,247,845. 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 $10,000 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 C.1, including any related adjustment to the total state amount of the budget, must be made in writing through a formal amendment executed by all parties to this agreement in accordance with Section VIII. A. of Part II. 3. The C.1 and C.2 provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the Department shall be recovered proportionately from each local Contractor that, during the course of the agreement period, chose to reduce or transfer local funds from the Family Planning program. MDCH/CMS 6/04 Page 2of 21 4. Agreement Attachments: A. The following documents are attachments to this Agreement Part I and Part ft - General Provisions, which are part of this agreement through reference: 1. Attachment I - Annual Budget 2. Attachment II - Output Measures 3. Attachment III - Program Specific Assurances and Requirements 4. Attachment IV - Funding/Reimbursement Matrix B. The attachments are added into this Agreement as follows: 1. Original Agreement (Part 1 and Part II) - Attachment III, IV 2.. First Amendment - Attachment I, H 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 part of this agreement through reference. 6. Method of Payments and Financial Reports: The payment procedures shall be followed as described in Part II and Attachment I - Annual Budget and Attachment IV - Funding/Reimbursement Matrix, which are part of this agreement through reference. 7. Performance/Progress Report Requirements: The progress reporting methods, as applicable, shall be followed as described in Attachments II - Output Measures and IV - Funding/Reimbursement Matrix, which are part of this agreement through reference. 8. General Provisions: The Contractor agrees to comply with the General Provisions outlined in Part II, which are part of this agreement through reference. 9. Administration of Agreement: The person acting for the Department in administering' this Agreement (hereinafter referred to as the Contract Consultant) is: Richard McCubbin, Consultant, 517-241-2493, McCubbinR©rnichigan.gov (Contract Consultant Name) Title Phone E-mail Address MDCH/CMS 6/04 Page 3 ri 21 10. Special Conditions: A. This agreement is valid upon approval by the State Administrative Board as appropriate and approval and execution by the Department. B. The Department and Contractor, under the terms of this agreement shall, subject to availability of funding and other applicable conditions, provide resources and continuous services throughout the period of this agreement as shown in Attachment I - Annual Budget 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 COUNTY OF OAKLAND Name and Title Signature Date For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH . Michael Ezzo, Ed.D., Chief Deputy Director Date MDCH/CMS 6/04 Page 4 of 21 Version:C PBC MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 04/05 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; and adds the following changes to CPBC Agreement for 10/01/04 through 9/30/05 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. Version:CPBC 2. This addendum modifies the following sections of Part II, General Provisions: Part H 1. Responsibilities-Contractor 1. Software Compliance. 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 computer systems problems. III. Assurances A. Compliance with Applicable Laws. This first sentence of this paragraph will be stricken in its entirety and replaced 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. J. Health Insurance Portability and Accountability Act. The provisions in this section shall be deleted in their entirety and replaced with the following language: Contractor agrees that it will comply with the Health Insurance Portability and Accountability Act of 1996, and the lawfully enacted and applicable Regulations promulgated there under. IX. Liability. Paragraph A. will be deleted in its entirety and replaced with the following language: A. Except as otherwise provided 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. Version:CPBC Special Certification: 3. 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. 4. Signature Section: For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Michael Ezzo, Ed.D., Chief Deputy Director Date For the CONTRACTOR Name and Title Signature Date Part II 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 of 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 1 and 3f d 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 records, files and documentation related to this agreement, to the extent authorized by applicable state or federal law, rule or regulation. G. Audits 1. Single Audit Provide, consistent with the regulations set forth in the Single Audit Act Amendments of 1996, P.L. 104-156, and Section .320 of the Office of Management and Budget (OMB) Circular A-133, "Audits of States, Local Governments, and Non-Profit Organizations," a copy of the annual Single Audit reporting package of the Contractor to the Department. The Contractor must assure that each of its subcontractors comply with the above Single Audit requirements as applicable, and provide for other subcontractor monitoring procedures as deemed necessary. The Contractor must assure that the Schedule of Expenditures of Federal Awards includes expenditures for all federally-funded grants. 2. Other Audits The Department or federal agencies, may also conduct or arrange for 'agreed upon procedures" or additional audits to meet their needs. 3. Due Date The Single Audit reporting package and management letter, if one is issued, shall be submitted to the Department within nine months after the end of the Contractors fiscal year. The Single Audit reporting package and management letter shall be filed with the Department even if there are no findings or disclosures reported in the audit pertaining to Department programs. 4. Penalty Failure to submit the required Single Audit reporting package and management letter by the due date will result in the deferral of Department payments until the required Single Audit reporting package is received. 5. Where to Send A copy of the Single Audit reporting package and management letter, if one is issued, must be forwarded to: MDCH/CPAS 6/04 Page 6 of 21 Michigan Department of Community Health Office of Audit Quality Assurance and Review Section P.O. Box 30479* Lansing, Michigan 48909-7979 Or *Capital Commons Center 400 S. Pine Street Lansing, Michigan 48933 6. Management Decision The Department shall issue a management decision on findings and questioned costs contained in the Contractors Single Audit within six months after the receipt of a complete and final audit report. The management decision shall include whether or not the audit finding is sustained; the reasons for the decision; and the expected Contractor action to repay disallowed costs, make financial adjustments, or take other action. Prior to issuing the management decision, the Department may request additional information or documentation from the Contractor, including a request for auditor verification related to the documentation, as a way of mitigating disallowed costs. 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, funding or compliance with operational procedures. Software Compliance The Contractor must ensure that software compliance and compatibility with the Department's data systems for services provided under this agreement including but not limited to: stored data, databases, and interfaces for the production of work products and reports. All required data under this agreement shall be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Contractors business operations for processing date/time data. 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. IADC11/1;04 6104 Pap 7 at 21 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 by the 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 the current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part I. O. 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. 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. I. Technical Assistance To make technical assistance available to the Contractor for the 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 Act, 31 USC 1352 as revised by the Lobbying Disclosure Act of 1995, 2 USC 1601 et seq, and Section 503 of the Departments of Labor, Health and Human Services and Education, and Related Agencies 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, subgrants, and contracts under grants ) loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. C. Non-Discrimination 1. The Contractor agrees not to discriminate against any employee or applicant for employment or service delivery and access, with respect to their hire, tenure, terms, conditions or privileges of employment, programs and services provided or any matter directly or indirectly related to employment, because of race, color, religion, national origin, ancestry, age, sex, height, weight, marital status, physical or mental disability unrelated to the individual's ability to perform the duties of the particular job or position or to receive services. The Contractor further agrees that every subcontract entered into for the performance of any contract or purchase order resulting herefrom will contain a provision requiring non-discrimination in employment, service delivery and access, as herein specified binding upon each subcontractor. This covenant is required pursuant to the Elliot Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2201 et seq, and the Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et seq, and any breach thereof may be regarded as a material breach of the contract or purchase order. 2. Additionally, assurance is given to the Department that efforts will be made to identify and encourage the participation of minority owned and women owned businesses, and businesses owned by handicapped persons in contract solicitations. The Contractor shall incorporate language in all contracts awarded: (1) prohibiting discrimination against minority owned and women owned businesses and businesses owned by handicapped person in subcontracting; and (2) making discrimination a material breach of contract. D. Debarment and Suspension Assurance is hereby given to the Department that the Contractor will comply with Federal Regulation 45 CFR Part 76 and certifies to the best of its knowledge and belief that the Contractors local health department or an official of the Contractors 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; MDCHICIAS 6/04 Page 10 a/ 21 2. Have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in section 2, and; 4. Have not within a three-year period preceding this agreement had one or more public transactions (federal, state or local) terminated for cause or default. E. Federal Requirement: Pro-Children Act 1. Assurance is hereby given to the Department that the 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 chiidren's services. 2. The Contractor also assures, in addition to compliance with Public Law 103-227, any service or activity funded in whole or in part through this agreement will be delivered in a smoke-free facility or environment. Smoking shall not be permitted anywhere in the facility, or those parts of the facility under the control of the Contractor. If activities or services are delivered in facilities or areas that are not under the control of the Contractor (e.g., a mall, restaurant or private work site), the activities or services shall be smoke-free. Page 1 1 of 21 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 Contractors 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). . 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 WIDC1-1/CMS 6104 Pape 12 of 21 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 Contractors 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 subgrants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Contractor shall include a provision: a. For compliance with the Copeland "Anti-Kickback" Act (18 USC 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b. For compliance with the Davis-Bacon Act (40 USC 276a to a- 7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). c. For compliance with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, Part 5). This provision also applies to all other contracts in excess of $2,500 that involve the employment of mechanics or laborers. 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 Circular A-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 under this agreement, the Contractor assures that it is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements including the following: 1 The Contractor must not share any protected health data and information provided by the Department that falls within HIPAA requirements except to a subcontractor as appropriate under this agreement. 2. The Contractor must require the subcontractor not to share any protected health data and information from the Department that falls under HIPAA requirements in the terms and conditions of the subcontract. 3. The Contractor must only use the protected health data and information for the purposes of this agreement. 4. The Contractor must have written policies and procedures addressing the use of protected health data and information that falls under the HIPAA requirements. The policies and procedures must meet all applicable federal and state requirements including the HIPAA regulations. These policies and procedures must include restricting access to the protected health data and information by the Contractor's employees. 5. The Contractor must have a policy and procedure to report to the Department unauthorized use or disclosure of protected health data and information that falls under the HIPAA requirements of which the Contractor becomes aware. 6. Failure to comply with any of these contractual requirements may result in the termination of this agreement in accordance with Part II, Section V. Termination. MDCH/C1AS 6/04 Page 14 ci 21 7. In accordance with HIPAA requirements, the Contractor is liable for any claim, loss or damage relating to unauthorized use or disclosure of protected health data and information received by the Contractor from the Department or any other source. 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. 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 dose of the first three fiscal quarters. The reports are due 1/30/XX, 41301XX, and 71301XX. All FSR's must be submitted to: Michigan Department of Community Health, Bureau of Finance, Accounting Division, 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: 1. 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 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 MOCHA:MS MM Page 16 of 21 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 based on annual guidelines and due date using the format provided by the Department. The Contractor must provide, by program, an estimate of total expenditures forthe entire agreement period (October 1 through September 30). This report must represent the Contractor's best estimate of total program expenditures for the agreement period. The information on the report will be used to record the Department's year-end accounts payables and receivables by program for this Agreement The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Contractor in the monthly prepayments and quarterly fee-for-service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of agreement amendments, the Contractor may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of a program at fiscal year-end. Within 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 Report: The final total contractor FSR and Output Measures report (H-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 LIDCH/CMS 6/04 Pape 17 at 21 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. Penalties for Reporting Noncomplianye 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: 1. 1% - 1 day to 30 days late; 2. 2% - 31 days to 60 days late; 3. 3% - over 60 days late with a maximum of 3% reduction in the Contractors LPHO allocation 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 Contractors local health department, is convicted of any activity referenced in Part II, Section III.D, of this agreement during the term of this agreement or any extension thereof. MDCH/CLIS 61134 Paw la ci 21 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. 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. MDCH/CIAS 6/04 Page 19 of 21 Any changes proposed by the Department must be agreed to in writing by the Contractor and upon such written agreement, the Department shall initiate any necessary formal amendment as above. 2. Other amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Contractor at any time prior to June 2nd. The Department will provide a written response within thirty (30) calendar days. All amendments must be submitted to the Department by June 2nd 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 subcontractor, anyone directly or indirectly employed by the Contractor, provided that nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Contractor or its employees by statute or court decisions. B. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as the provision of policy and procedural direction, to be carried out by the Department in the performance of this agreement shall be the responsibility of the Department, and not the responsibility of the Contractor, if the liability, loss, or damage is caused by, or arises out of, the action or failure to act on the part of any Department employee or agent, provided that nothing herein shall be construed as a waiver of any governmental immunity by the State, its agencies (the Department) or employees as provided by statute or court decisions. C. In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Contractor and the Department in fulfillment of their responsibilities under this agreement, such liability, loss, or damage shall be borne by the Contractor and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein shall be construed as a waiver of any governmental immunity by the Contractor, the State, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. 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. Funding A. State funding for this agreement shall be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds shall be as , stated in the approved Annual Budget - Attachment I, the Program Specific Assurances and Requirements - Attachment HI, and as outlined in the Funding/Reimbursement Matrix - Attachment IV. B. The funding provided through the Department for this agreement shall not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Contractor must advise the Department in writing by May 1 if the amount of Department funding may not be used in its entirety or appears to be insufficient for any program element. LPHO transfer requests between MDCH, MDA and MDEQ must also be requested in writing by May I. 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. LIDO-I/CMS 6104 Pape 21 of 21 ATTACHMENT III MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 04105 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 (PA. 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 requirement, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on-site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Many program specific assurances and other requirements are defined within the referenced documents including Minimum Program Requirements established for the following program elements as of October 1, 2004:. a. b. C. d. e. f. g. h. AIDS/HIV Prevention Breast and Cervical Cancer Control Childhood Lead Childhood Immunization Registry Family Planning Food Service Sanitation General Communicable Disease Control Hearing Immunization — (Local Public Health Operations & Categorical) j. LHD/CSHCS Services k. Maternal and Infant Support I. Primary Dental Care m. Sexually Transmitted Disease n. Vaccine Handling o. Vision p. WIC 1 OAKLAND COUNTY HEALTH DIVISION For FY 04/05, special requirements are applicable for the remaining program elements and funding sources listed in the attached pages and checked below: - AIDS/HIV CARE A1DS/HOPWA (Housing Opportunities for Persons Living with HIV/AIDS) - AIDS/H1V Pediatric X - AIDS/HIV Prevention X - Bioterrorism (Focus A) — Coordinators - Bioterrorism (Focus A) — SNS Planner Workspace X - Bioterrorism (Focus B) Regional Epidemiology Support - Bioterrorism (Focus E) Information Technology - Bioterrorism (Focus F) — Risk Communication - Bioterrorism (Focus G) — Education and Training X - CSHCS X - Childhood Immunization Registry - Childhood Lead - Diabetes Outreach Network - Family Planning/BCCCP Joint Project - Family Planning-Pregnancy Prevention - Fetal Alcohol Syndrome (FAS) X - Immunization Action Plan X - Immunization Assessment Feedback Incentive Exchange (AFIX) Provider Site Visit - Immunization - Field Service Representatives X - Immunization Vaccine For Children (VFC) Provider Site Visit X - Immunization - Nurse Training Reimbursement X - Informed Consent X - Laboratory Services X - Lead Hazard Remediation Program X - Local Maternal and Child Health (MCH) X - Local Public Health Operations (LPHO) - Local Tobacco Reduction - Michigan Abstinence Program (MAP) - Michigan Childhood Immunization Registry (MCIR) X - Nurse Family Partnership (NFP) - Primary Care Dental Special Project - Rape and Sexual Assault Prevention Education (RSAPE) X -SIDS X - TB Control (DOT) X - WIC Services - WIC Special Increased Participation - WISEWOMAN 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. lir 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. &UWE vi lIENISIMARQUE= DLEIEAL10 DEPARTMENT, DISTRICT HEALTH EALTh AIDS/FIN CARE SPECIAL REQUIRE DETROIT DEPARTMENT OF DEPARTMENT #10} Contractor Specific Reauirements 1. Adhere to all Ryan White CARE Act Title ll and MDCH/DHAS-HAPIS Continuum of Care Policies and Guidelines, as identified in the current CPBC "Applicable Laws, Rules, Regulations, Policies, Procedures and Manuals," or as issued by MDCH/DHAS-HAPIS during 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 II and Michigan Health Initiative (MHI) resources are used as payor of last resort. Develop written procedures to document and ensure that clients have been screened for eligibility for Medicaid, Medicare, veteran's health benefits, private health insurance or other programs to ensure that CARE Act funds are the payor of last resort. 4. Document that clients receiving services are eligible beneficiaries of services (documented HIV status). 5. Conduct quality assurance activitiesand participate in contract monitoring conducted and/or facilitated by MDCH/DHAS-HAPIS. 6. Annually monitor 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. 7. Participate in oversight of all remediation efforts for subcontractors found in non-compliance with established MDCH/DHAS-HAPIS program and practice standards, policy directives and program guidance. 8. The following requirements must be included in all subcontracts with service providers: 1-5, 9-23, and 31-35. 9. 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 (iRS 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 10. Provide immediate notification to the Department, in writing, of any formal grievance procedures initiated by a service recipient and subsequent resolution of that grievance. 11. 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. 12. Establish a workplan that includes client-level outcome objectives for each service funded with Ryan White Title II and MH I resources and conduct outcome evaluation based on those objectives. 13. Assess client satisfaction annually and use methods, instruments and analysis that minimize bias and ensure confidentiality of responses. 3 Date Ranoe of Services Provided October 1—December 31, 2004 January 1, 2004— December 31, 2004 January 1-March 31, 2005 April 1-June 30, 2005 July 1-September 30, 2005 October 1, 2004-September 30, 2005 Date Due to MDCH January 15, 2005 January 30, 2005 April 15, 2005 July 15, 2005 October 15, 2005 October 30, 2005 14. Utilize results of client satisfaction assessments and other evaluation activities to make appropriate program level changes and monitor the effects of these changes. 15. Demonstrate appropriate expenditure of funds consistent with the contract, HRSA regulations and MDCH/DHAS-HAPIS regulations and guidelines. 16. Demonstrate that the agency provides opportunity and fiscally supports on-going staff development and training. 17. The health department and all HIV care service sub-contractors funded by the health department must collect and maintain client-level Uniform Reporting System (URS) data to track HIV care services delivered and the clients receiving the services. Electronic client- level URS data files must be submitted to MDCH according to the following schedule and must comply with the standards outlined in a) and b) below. The CARE Act Data Report (CADR) for the calendar year must also be submitted by January 30th from each entity that receives Title II resources. Description FY Quarter 1 CY Annual & CADR FY Quarter 2 FY Quarter 3 FY Quarter 4 FY Annual a. The submitted URS data files must conform to the export format defined by HRSA in documents found at the HRSA web site (htto://hab.hrsa.govicareware/) including "Instructions for Export Formarl , "Header Export Format°2, and "Client Record Export Format" 3, or be exported directly from RW CARE-Ware 3.x. b. Submitted URS electronic data files must include all clients who received any CARE Act eligible service (regardless of the source of funding for the services) and must include all CARE Act eligible services delivered to HIV-infected or affected clients during the specified time range. 18. URS data is the property of MDCH/DHAS-HAPIS. In the event that services are no longer delivered under this agreement, electronic gate files must be returned to MDCH/DHAS- HAPIS. 19. Maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease, in accordance with Section 2617 (bX6)(G) of the CARE Act. Key points of access include, but are not limited to, emergency rooms, substance abuse treatment programs, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters and community health centers. 20. When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) the dollar amount of Federal funds for the project or program, and (3) 4, 1 iip://ftv.hrsa.gov/hablundup iostmapdf 2 fto://ftv.hrsa.eov/hab/CWV02031%2011eader%20ExnnrteA0OFcrrmarreif 3 thrigiv.hrsa.govhab/CW%2031 %20Client%20Reconi%21)Expnrt df 4 Quarter October-December, 2004 January-March, 2005 April-June, 2005 July-September, 2005 FSR December FSR March FSR June FSR September FSR percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 21. Assure that STD and HIV secondary prevention practices for the purposes of reducing risk of transmittal and re-infection are integrated into the delivery of HIV/AIDS care services. 22. Utilize sound accounting methods to distribute and monitor expenditures of funds for HIV Care services, ensuring expenditure of funds is in accordance with approved workplan and budget(s). 23. Submit separate budgets and financial status reports by funding sources. 24. Submit original FSRs to MDCH-Budget and Finance Administration, as detailed in Part ll General Provisions, and submit one copy to MDCH/DHAS-HAPIS to the attention of Traci Goulding. Report administrative expenditures, for each preceding quarter, consistent with budgeted costs. Attach a separate page, identifying this quarterly expenditure, to your HIV/AIDS care FSRs, according to the following schedule: 25. Submit the "Allocations and Expenditures by Service Category" Table to MDCH/DHAS- HAPIS by January 15, 2005 and April 15, 2005. 26. Submit program Progress Reports in accordance with the following dates and reporting format Period Covered October 1 - December 31, 2004 January 1 - March 31, 2005 April 1 — June 30, 2005 July 1 — September 30, 2005 Progress Report Format Due to MDCH/DHAS-HAPIS January 15, 2005 April 15, 2005 July 15, 2005 October 15, 2005 Submit quarterly progress reports that include all of the following components in the order listed: A. Fiscal Accountability and Contract Monitoring 1. Identify any cost saving efforts. 2. Summarize any subcontract monitoring and oversight activities conducted during the report period. Attach relevant findings. 3. Provide updates on any remediation activities and/or corrective action plans initiated with subcontractors in this report period. 4. List and attach copies of any new or amended subcontracts and/or formal vendor agreements, or written agreements with "key points of access" executed during this report period. B. 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. Identify any new services provided during the report period, and/or new access points to existing services. 4. Identify and describe your relationships with "key points of access," as required in #19. 5. Describe the progress made towards achieving goals, objectives, and service outcomes as described in your workplan. 6. Discuss any issues at the agency level that impact abilibi to achieve stated goals and objectives. 7. Describe staff development and training activities related to client-level service provision. 8. Describe any technical assistance needs related to programmatic and fiscal administration. C. Submit Progress Reports electronically to SzwejdaD(41,michigan.gov, cc: GouldingTQmichigan.gov. Materials that cannot be emalled should be sent to: Debra L. Szwejda, Manager HIV/AIDS Prevention and Intervention Section Division of HIV/AIDS-STD 2479 Woodlake Circle, Suite 300 Okemos, Michigan, 48864 27. Provide one copy of all fully signed subcontracts to MDCH/DHAS-HAPIS by October 15, 2004 or within 30 days of execution. Include a listing of the following information: A. Corporate name, address, telephone, fax numbers and project director of each organization. B. Amount awarded to each organization. C. Type of service and the amount budgeted for each service to be provided. D. Beginning anq end dates of each contract and subcontract E. Amount and source of other federal, state and local funds for the same service. F. Minority provider status. 28. By October 15, 2004 provide to MDCH/DHAS-HAPIS a programmatic, categorical budget and narrative justification (by funding source) for each contract and subcontract Use these budget categories: Personnel, Fringe Benefits, Travel, Supplies, Equipment, Contractual, Other and Indirect. Base the budgets on the State Fiscal year. Budgets should be prepared on MDCH budget forms. 29. Document by October 15, 2004, in a format provided by MDCH/DHAS-HAPIS, that administrative expenditures will not exceed the 10% cap authorized by HRSA for "first-line entities' receiving Ryan White CARE Act Title II funds. If requested, document compliance with HRSA's 'Issue Paper: Administrative Costs." 30. When issuing requests for proposals or bid solicitations, clearly state that the resources are open for availability to faith-based organizations. 4, 31. Assist MDCH/DHAS-HAPIS in appropriate needs assessment activities, and maintain a mechanism to obtain input about needed services from infected and affected persons. 6 32. Participate in MDCH/DHAS-HAPIS care-related trainings and conferences, as appropriate. 33. Establish written client grievance procedures, and assure that those procedures are consistent with any guidance issued by HRSA or MDCH/DHAS-HAPIS, including following MDCH/DHAS-HAPIS' mediation process. 34. Maintain, for a minimum of three (3) years, program and fiscal records and files including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 35. Assure that any subcontractors maintain the organizational, administrative and fiscal capacity necessary for provision of services supported under this agreement. At a minimum, the subcontractor shall: A. Establish and maintain appropriate organizational governance, guided by written by- laws. B. Convene and maintain a Board of Directors. Board members must possess expertise and experience appropriate and necessary to provide general oversight, develop organizational policy and work in partnership with the Executive Director to ensure achievement of its mission. C. Establish and main appropriate fiscal management of the agency consistent with generally accepted accounting principles. D. Establish and maintain written personnel policies and procedures. E. Ensure that all staff, including executive directors and program coordinators: i. Possess the knowledge, skills, abilities and credentials essential to assigned responsibilities; ii. Are hired or discharged through fair and objective processes which are appropriately documented. 36. Use the Counselor-Assisted Referral . Form (CARF), DCH-1225 to refer consenting HIV- positive individuals, identified through counseling and testing activities, to appropriate case management providers. AIDS/HOPWA SPECIAL REQUIREMENTS (Housing Opportunities for Persons Living with HIV/AIDS) 1. Budget and Agreement Requirements A. HOPVVA Eligibility An eligible person means a person with acquired immunodeficiency syndrome or related diseases who is below 80% median income. A family member regardless of income is eligible to receive housing information services. Any person living in proximity to a community residence is eligible to participate in that residence's community outreach and educational activities regarding AIDS or related diseases. Within the population eligible for this program, nondiscrimination and equal opportunity regulations must be followed, including fair housing and affirmative outreach. A project sponsor and all contractors and subcontractors must adopt procedures to ensure that 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. 7 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 assistance through tenant based rental assistance, short-term rental assistance, mortgage and utility payments. 2. Case management, housing advocacy and permanent housing placement, client advocacy, and assistance with access to benefits. This can include 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. 3. Supportive services including, but not limited to, outreach, life management, education, 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 4. Administrative expenses (general management, oversight, coordination, evaluation, and reporting on eligible activities). Such costs do not include costs directly related to carrying out eligible activities, since those costs are eligible as part of the activity delivery costs of such activities. Fiduciaries who are not also Project Sponsors may use 3% of the total Expenditures for administrative costs. Project Sponsors, and Fiduciaries who are also Project Sponsors, may use 7% of their total Expenditures for administration. Fiduciaries who are also Project Sponsommav not collect the 3%_plus the 7%. For more information, please check the HOPWA regulations (24 CFR 574) 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 8 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 PLWH/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 2. Contractor Reouirements In 2004, each region must submit to the department their annual plan for providing HOPWA services. The plan should cover the period October 1, 2004 through September 30,2005 and include both the regular HOPWA allocation and the HOP WA 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, 2004 and must be submitted to: 9 Community Living Division Michigan Department of Community Health 3423 North Marlin Luther King, Jr. Boulevard, Room 303 Lansing, Michigan 48909 Attention: Sue Eby 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. Case management, housing advocacy, client advocacy 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, are 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. The total expenditures for items A & B above should exceed 75% of all expenditures. 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 04105 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 PLWH/A's in your region within the following three funding categories: 1. Direct housing assistance, 2. Case management, client advocacy, access to benefits, permanent housing placement, and 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 4" 10 b. Coordination Information about FY 04/05 achievements and the current status of coordination between HOPWA-funded staff and other service providers within the regional HIV/AIDS network, Ryan White-funded HIV/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 04/05 along with a brief description of FY 03/04 activities. Provide this information in the five categories identified below. 1. HOPWA-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 HOPWA-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 03/04. 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 hornamners. 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. 13. d. Services Indicate what services are planned to be provided in FY 04105 by the three funding categories. I. Direct Housing Assistance. 2. Case management, client advocacy, access to benefits, permanent housing placement. 3. Supportive Services. 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 PLWH/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 HOP WA-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 HOPVVA definitions for this purpose). Provide estimated expenditures for FY 04105 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 04105 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 Fiduciary (3% Limit) A-2 Project Sponsor (each) and/or Fiduciary-Project Sponsor (7% Limit each) B. Direct Housing Assistance - Certificate Program C. Case Management, Advocacy Services D. Supportive Services Also provide the planned number of persons to be served. Provide a brief narrative explanation as necessary. D. Reporting In addition to submitting quarterly Financial Status Reports with an attachment breaking down the HOPWA expenditures according to the four main categories listed above, quarterly demographic and financial data must be submitted by email to 4. the addresses provided below. The forms entitled "DCH HOPWA Quarterly Report" and 'Data for the HOPWA Annual Report' are provided with your allocation letter. 12 Excel versions have been provided to all regions and must be used to submit this information. It is important that the breakdown of costs according to the categories listed above submitted with the quarterly reports match the FSR figures. It is important to understand that the contract year and calendar year to not coincide. The quarters that aggregate for the final contract reconciliation are not the same quarters that aggregate for the Annual Progress Report The Annual Progress Report for calendar year. 2004 must be submitted by February 15, 2005, and will include data from the quarterly report for the period 10/1/2004-12/31/2004. Quarterly Reports are due as follows: February 15 for the 10/1/2004 - 12131/2004 quarter May 15 for the 1/1/2005 - 3/31/2005 quarter August 15 for the 4/1/2005 - 6/30/2005 quarter November 15 for the 7/1/2005 - 9/30/2005 quarter. Note: The data for the annual report and the narrative portion of the annual report are due on February 15, 2006, for the 2005 calendar year. This is the same due date as the 10/0112005-12/31/2005 quarterly report, and this data is included in the annual report totals. All reports should be sent to: Ebysarrnichigan.gov IversonB ©Michigan.gov If necessary, hard copies can be sent to: Division of Community Living Michigan Department of Community Health Lewis Cass Bldg., 5th Floor North 320 S. Walnut Lansing, Michigan 48913 Attention: Sue Eby or Brian Iverson Contractor Requirement4 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 HOPVVA benefits. 13 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 2004 by February 1, 2005. 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 processes. 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. Ensure, then issue statements, press releases, RFP, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal funds, clearly state 1) the percentage or total cost of the program or project which will be funded with Federal funds; 2)1he 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. G. Ensure all services are available in the entire region. H. Ensure that all activities funded under the program will meet urgent needs that are not being met by available public and private sources. I. Send copy of all HOPWA required documents to: Division of Community Living Michigan Department of Community Health Lewis Cass Building, 5th Floor North320 S. Walnut Lansing, Michigan 48913 Attention: Sue Eby 14 AIDS/HIV PEDIATRIC — DETROIT DEPARTMENT OF HEALTH AND WELLNESS Contractor Requirements 1. Provide 1.0 full-time Health Educator to the program with Ryan White Title IV funds. This person will provide health education services as outlined in the job description. 2. Provide 1.0 full-time Risk Reduction Counselorto the program with the division of Substance Abuse Quality and Planning funds. This person will provide risk reduction counseling and health education services at the Detroit Medical Center — Hutzel Hospital (obstetrics). Provide necessary training and technical support to the person to assure services are provided in a family-centered manner. 3. Actively participate and maintain management level representation on the Executive Committee established for project oversight, implementation, and evaluation of Title IV programming. Participate in other Title IV activities across the service area through attendance at partner network meetings. 4. Obtain consumers' consent to collect and share person-based data with agencies receiving funding from the MDCH Ryan White Title IV program. 5. Support the coordination and comprehensiveness of the Ryan White Title IV program by requiring Title IV supported staff and others as appropriate to attend scheduled coordination meetings convened by the Program Coordinator and other related meetings as necessary to serve women, children, adolescents and families. 6. Submit quarterly narrative and statistical data reports as outlined in the reporting requirement section. 7. Encourage consumer involvement in Title IV program activities. Department Requirements 1. Provide administrative, professional, and technical consultation to the program. 2. Provide administrative direction, program coordination, and data management for statewide reporting of Title IV activities. 3. Support the development and support of a comprehensive infrastructure to provide coordinated, family-centered care under the Maternal Child HIV/AIDS program (Ryan White Title IV) at Title IV subcontracted agencies. 4. Convene monthly a Ryan White Title IV Executive Committee for the purposes of program oversight and implementation. The board will consist of executive level staff from eachof the Ryan White Title IV-funded agencies, and a consumer. 5. Convene quarterly, a Partner Network meeting to include all Ryan White Title IV-funded agencies and agencies who provide services to women, children, adolescents and families. 6. Use Ryan White Title IV dollars to fund 1.0 full-time Health Educator position. Provide funds from the Substance Abuse Quality and Planning for 1.0 full-time Risk Reduction Counselor position. Reporting Requirements 1. The Contractor shall submit reports on the following dates: 15 Due Date April 15 July 15 October 15 January 15 Type of Report and timeframe 1st Quarterly Data Report (fa- period Jan 1 — March 31) 214 Quarterly Data Report (for period April 1— June 30) 311c Quarterly Data Report (for period July 1— September 30) Annual Data Report (for period January 1— December 31) The Annual Data Report is an aggregate calendar year report. 2. Any such other information as specified in the Contractor requirements shall be developed and submitted by the Contractor as required by the Contract Manager. 3. Reports and information shall be submitted to the Contract Manager at Michigan Department of Community Health Division of Family and Community Health Maternal Child HIV/AIDS Program 3056 W. Grand Blvd., Suite 3-350 Detroit MI 48202 4. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. 5. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the projects as determined by the Contract Manager. AIDS/HIV PREVENTION SPECIAL REQUIREMENTS Contractor Reouirements 1. Promote reporting and follow-up of HIV infection and AIDS cases within the jurisdiction, pursuant to state statute and Department guidelines. 2. Assure adequate capacity for partner counseling and referral services (F'CRS) such that at least one staff is dedicated to such activities. Dedicated staff must have PCRS included as a primary job responsibility. 3. Conduct HIV counseling, testing and referral (CTR) and PCRS in accordance with state law. Relevant statutes are summarized in the document Michigan HIV Laws: How They Affect Physicians and Other Health Care Providers. Michigan Department of Community Health. September 2002 4. Establish, maintain and document linkages with community resources that are necessary and appropriate to addressing the needs of clients and that are essential to the success and effectiveness of services supported under this agreement. 5. Conduct HIV counseling, testing and referral and partner counseling and referral services in accordance with guidelines and standards issued by the Michigan Department of Community Health and/or the US Centers for Disease Control and Prevention. Current guidelines and standards include: a. Revised Recommendations for HIV Screening of Pregnant Women. US Department of Health and Human Services. November 2001. b. Quality Assurance Standards for HIV Prevention Interventions. Michigan Department of Community Health. May 2003. c. Protocol for HIV Counseling and Testing Using Oral Mucosa! Transudate Technology. Michigan Department of Community Health. March 1997. 16 d. Strategies to Improve Client Failure to Return for HIV Test Results. Michigan Department of Community Health. July 2002. e. Quality Assurance for Rapid HIV Testing. Michigan Department of Community Health. March 2003. f. Revised Guidelines for HIV Counseling, Testing and Referral US Centers for Disease Control and Prevention. November 2001. g. Partner Notification Guidelines. Michigan Department of Community Health. January 2000. h. HIV Partner Counseling and Referral Service Guidelines, US Centers for Disease Control and Prevention. December 1998. I. Michigan Local Public Health Accreditation Standards. 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 program activities in a manner consistent with the most current laws, guidelines and standards. 6. Conduct quality assurance of CTR and PCRS activities. Such activities are to be guided by written quality assurance policies and procedures. Policies and procedures associated with evaluation of staff providing CTR and PCRS staff are to include mechanisms for direct observation of provision of services. 7. Participate in quality assurance activities conducted by and/or facilitated by the Division of HIV/AIDS — STD. 6. Participate in technical assistance, training and/or skills-enhancement opportunities as recommended or required by the Division of HIV/AIDS— STD. 9. Participate in program evaluation activities conducted by or required by the Division of HIV/AIDS — STD. 10. Submit all educational materials (e.g. brochures, posters, pamphlets and videos) used in conjunction with program activities to the Department's Program Review Panel for review and approval prior to their use. 11. Submit process and outcome monitoring data to the Division of HIV/AIDS — STD via the HIV Event System. The time line and procedures for submitting these data are to conform to guidelines issued by the Division of HIV/AIDS STD. 12. Maintain the technological capacity necessary to comply with monitoring, reporting and evaluation requirements associated with this agreement and to ensure timely and efficient communication with the Department 13. By August 30, 2004, submit to the Division of HIV/AIDS — STD for review and approval, a detailed proposed budget, associated narrative justification of the proposed budget and staffing plan associated with activities supported under this agreement ASTHMA COALITION — KALAMAZOO COUNTY HEALTH AND HUMAN SERVICES Contractor Requirements 1. Maintain a local Asthma coalition to help mobilize community awareness and interest in Asthma related community needs. 2. Provide Asthma educational activities (Asthma 101, Community Presentations, etc.) for appropriate community audiences (health fairs, schools, etc.) 17 3. Search for and apply for appropriate funding for coalition strategies and activities. 4. Maintain, up-date and continue implementation of the coalition's strategic plan. 5. Review current coalition web site and make recommendations. 6. Participate in National and State Coalition committees and initiatives (Coalition Coordinator and members). 7. Submit all contract required reports and documents. BIOTERRORISM FOCUS__AREASAILE-Eand_G Contractor Requirements Funded activities under these Focus Areas must be consistent with MDCFVOPHP approved work plans and budgets. BIOTERRORISM - FOCUS AREA A Contractor Requirements Each local health department, as a sub-recipient of funding through the CDC Public Health Emergency Preparedness and Response for Bioterrorism Cooperative Agreement U90/CCU517018, shall conduct activities to build preparedness and response capacity as defined by the Cooperative Agreement and consistent with their approved FY 04/05 work plan and budget on file with the MOCH, Office of Public Health Preparedness (OPHP). In addition to these broad requirements, the LHD will: 1. Designate an Emergency Preparedness Coordinator, to the OPHP, as a Point of Contact and individual through whom, in addition to the LHD Health Officer, collaborative capacity building activities of the Public Health Emergency Preparedness and Response Program/Cooperative Agreement are communicated, coordinated and implemented. 2. Develop, submit for approval and implement an annual Public Health Emergency Preparedness and Response for Bioterrorism work plan and budget to the OPHP, which defines the activities under this contractual agreement and this specific program. (See specific CRI requirements below). 3. Coordinate response activities with the MDCH OPHP and any other response partners, consistent with the LHD response plan, during a public health emergency. 4. Assure LHD staff are appropriately trained and knowledgeable about local public health response to biological, chemical and/or radiological agents whether occurring naturally, accidentally, or as a result of a terrorism event, to assure rapid and effective public health agency response in collaboration and coordination with local, state and federal response agencies and to the specific contents and requirements of the LHD's individualized Public Health Emergency All Hazard Response Plan. 5. Design and deliver trainings on the role of the LHD in emergency public health response to external disciplines, agencies and the community at large. 6. Assure that the EPC represents the LHD and actively participates in at least 75% of the OPHP teleconferences/ conferences/ and joint meetings. 7. Assures that the LHD is represented and serves as an active participant in at least 75% of the Regional Advisory Meetings. OPHP encourages Health Officer, Medical Director, and EPC participation in the regional meetings. 18 8. Plan and conduct internal and external public health response exercises as outlined in the workplan and assure that the LHD participates in a functional exercise with local, regional and/or state partners. 9. All sub-recipients of this funding will be required to report expenditures by Focus Area or as defined by the written guidance from the Centers for Disease Control & Prevention Cooperative Agreement (Budget Period 5). 10. LHD must assure full participation in continuing SNS planning and implementation at the local, regional and state level. in anticipation of re-audit by CDC SNS program in December 2004, revise and update local SNS plans based on defined corrective action plans and OPHP review. Submit revised plan by November 30, 2004 to OPHP. CMES OF READINESS INITIATIVE - $1,000,000 FOR DETROIT DEPARTMENT OF HEALTH AND WELLNESS ALL BUDGETS AND CRI WORK PLANS DEVELOPED BY THE DETROIT DEPARTMENT OF HEALTH AND WELLNESS MUST BE SUBMITTED AND APPROVED BY MDCH/OPHP BEFORE THEY ARE USED Budget and Agreement Reguirements These monies may not be re-directed between focus areas during the year. Funds under this program may not be used to purchase vehicles; or, supplant any current local expenditures. Supplantation means using Federal funds to replace local expenditures. Detroit Department of Health and Wellness must use these funds to coordinate activities with relevant efforts currently underway within the jurisdiction or proposed under the various focus areas identified by OPHP and also coordinate activities within the jurisdiction between local agencies, among local agencies, with hospitals and major health care entities, with any Metropolitan Medical Response Systems in the jurisdiction, and as appropriate, with adjacent states and countries. Develop a budget and accompanying narrative justification, using a budget template and format supplied by the MDCH Office of Public Health Preparedness, indicating how the Detroit Department of Health and Wellness proposes to use the targeted funds. Within the budget, include: 1. 1 FTE coordinator, city level 2. 1 FTE asst. coordinator, city level 3. Distribution contracts 4. Training (dispension and distribution staff and volunteers) 5. Public Information (local) 6. Exercise (dispensing and local distribution only) 7. Call down system 8. Point Of Distribution equipment (computers, printing contact, signage, communications, etc.) 9. Travel (Instate coordination and out-state training Targeted funds may be allocated by the Detroit Department of Health and Wellness within its own jurisdiction and, as appropriate, within adjacent jurisdictions that make up the metropolitan area for staff, fringe benefits, travel, training, supplies, call down equipment, contracts [including distribution (if needed), training, public information, and dispensing exercising], and Point of Distribution equipment (computers, printers, signage, communications, etc.). Medications and medical supplies may not be purchased with these funds. The Detroit Department of Health and Wellness budget template must be completed and submitted for review and approval to the MDCH Office of Public Health Preparedness by September 15, 2004. 19 Contractor Requirements: 1. The contractor will develop a plan to ensure that the Detroit Department of Health and Wellness is prepared to provide oral medications during an event to 100 percent of its affected populations. This generally will entail enhancing the city's capability to establish a network of points of dispensing (PODs) staffed with trained/exercised paid and volunteer staff. In the wake of a catastrophic bioterrorism event, even the largest POD network that the jurisdiction is capable of mounting on its own may be insufficient to protect its citizens — in which case, the Detroit Department of Health and Wellness plan will include the process by which it will request staff and other resources from the State and/or Federal Government to augment the POD network or to deploy elements of the United States Postal Service to complement the POD network with direct delivery of antibiotics to residences. 2. To ensure that all preparedness activities are coordinated and integrated at all response levels, Detroit Department of Health and Wellness will submit a comprehensive work plan, including recipient activities specific to the Cities Readiness Initiative, to the MDCH Office of Public Health Preparedness for review and approval that demonstrates its public health preparedness activities funded under the CDC Public Health Preparedness and Response for Bioterrorism fall within the existing framework of critical program capacities required for an adequate response to bioterrorism and other public health emergencies. The OPHP will supply the Detroit Department of Health and Wellness with a unique comprehensive work plan template and provide guidance/instruction as to completion of the document. Deadline for submission of the comprehensive work plan is September 15, 2004. Any work plan amendment/s required, following completion of the CDC CRI Assessment of Detroit Department of Health and Wellness, must be submitted to OPHP for review and approval within 30 days of release of the report findings to the DDHW by CDC. 3. Detroit Department of Health and Wellness shall coordinate, in collaboration with the Michigan Department of Community Health, planning and program implementation activities to ensure that local health departments, hospitals, other health care entities, public safety and emergency management agencies are able to mount a collective response featuring seamless interaction of their event-specific capabilities in the following areas: a. Oral Dispensing of Medications at the PODs b. Providing Oral Medications to First Responders & Critical Infrastructure Personnel c. Public Information and Communications d. Dispensing of Medical Material to Treatment Centers e. Tactical Communications between Command and Control Elements 4. Detroit Department of Health and Wellness will provide a statement of assurance that its leadership and staff will cooperate fully with MDCH, CDC staff and other participants in successive applications of the SNS Assessment Tool — as described below. 5. Summarize the current plans for antibiotic distribution within the designated city — indicating the number of Points of Distribution (PODs) that the city currently is able to establish, the number of personnel (paid staff and volunteers) that are likely to be available for this purpose, and the estimated number of individuals to whom the PODs can provide antibiotic prophylaxis over a 48-hour period. 6. Describe the role of the local public health department in the city's incident management system. 7. Describe how the city's incident management system would facilitate the mass distribution and dispensing of antibiotics. 4° 20 Deliverables: Within 6 months following the first application of the SNS Assessment Tool, Detroit Department of Health and Wellness should be able, in the wake of a bioterrorism event for which antibiotics are an appropriate countermeasure, to provide such prophylaxis to the known and potentially affected population within 48 hours of the time of the decision to do so. The local SNS plan should be designed so that it can accommodate an influx of state and/or federal government assets — especially the United States Postal Service — in any particular instance wherein the combined assets of the city and State are likely to be inadequate to dispense the antibiotics in sufficient time to protect their citizens. Contractor Special Requirements City SNS Assessment Tool — Critical Capacities The City SNS Assessment Tool that will be used to conduct the initial assessment and follow-up assessments is based on thirteen critical capacities. An overall preparedness score is based on the weighted scores of the thirteen elements. The Detroit Department of Health and Wellness will be expected and assisted to master each of these critical capacities except when the critical capacity resides at the State. The Critical Capacities and highlights of essential elements are as follows: 1. Developing a Detroit Department of Health and Wellness SNS Plan. Includes having a specific SNS Preparedness Plan incorporated into the overall State Emergency Response Plan that is updated at least annually. Both Plans feature clear points of interface with potential local, regional, state, federal and international government partnerships and assets such as the United States Postal Service, the U.S. Public Health Service Commissioned Corps Readiness Force, and the National Disaster Medical System. 2. Command and Control. Includes using an Incident Command System structure coordinated with essential state and local agencies and departments and with the federal government when necessary. An Incident Commander and back-up are identified, procedures for apportionment of SNS materiel have been developed, and agreements are in place between appropriate agencies and organizations. 3. Requesting SNS assets. Includes a procedure for the Detroit Department of Health and Wellness to request SNS materiel consistent with the State SNS Plan. 4. Management of SNS Assets. Includes identification of critical position leads with back-up and contact information. Azurrent call-down roster is maintained. 5. Tactical Communication. Includes development of a job action sheet and training for the Communications Lead, having networks and a back-up system between command and control locations, a plan for rapid communications network repair, and maintenance of call- down lists on the local level. 6. Public information. Includes development of a job action sheet and training for the Public Information Lead. Clinical and drug information has been compiled and public information campaigns have been developed. There are plans for coordinating local media efforts and disseminating information to the public and health care professionals, consistent with the State SNS Plan. 7. Security. Includes development of a job action sheet and training for the Security Lead and a plan for securing SNS assets. Security plans for dispensing sites and treatment centers must include protection of staff and volunteers, crowd control, and credentialing staff. Security arrangements are consistent with security arrangements associated with any federal government assets, such as the United States Postal Service, that may be needed to augment local capabilities. 2]. 8. Receipt and Storing of SN,S materiel Includes development of job action sheets and training of Leads and back-ups, identification and training of volunteers, and maintenance of call-down rosters. Appropriate office and material handling equipment is available. Facilitates the work of postal officials, who will be responsible for picking up SNS materiel at designated location/s and managing the subsequent delivery and distribution of this SNS materiel in those instances when the United States Postal Service is called upon to effect residential delivery of antibiotics, 9. Controlling SNS Inventory. Includes development of a job action sheet and training for an Inventory Lead, an inventory management system is in place with back-up, staff are identified and trained, and a call-down roster is maintained. 10. Distribution. Includes development of a job action sheet and training for a Distribution Lead, a plan is in place for coordinating delivery of SNS materiel to treatment facilities and dispensing sites. Agreements are in place with organizations, including the United States Postal Service, that will perform this function, there is a plan for recovery and repair of vehicles, and the appropriate material handling equipment is available. 11. Dispensing Oral Meds. Includes development of a job action sheet and training for Dispensing Site Managers and back-up for each dispensing site. Leads and back-ups are identified for safety, security, communications, and logistics. There is a plan to dispense medications to the public, including standard operating procedures and protocols, requesting and receiving SNS materiel, and providing interpretation/translation services. Call-down rosters are maintained and core personnel have been identified and trained for each site. 12. Treatment Center Coordination. Includes development of a job action sheet and training for a Treatment Center Lead and contact persons have been identified and are documented in the Detroit Department of Health and Wellness SNS Plan. 13. Training. Exercise and Evaluation. Includes development of a job action sheet and training for a Training/Exercise/Evaluation Lead, development and implementation of plans for Training, Exercise and Evaluation. Measurement The ability of the Detroit Department of Health and Wellness to distribute and dispense SNS materiel will be assessed at baseline, three months and six months during the Cities Readiness Initiative. With a view to catastrophic incidents that may overwhelm even the largest POD network the city can establish, the assessment also will seek to determine whether the local plan is structured adequately to accommodate the deployment of complementary state and federal government assets such as the United States Postal Service for direct residential delivery of antibiotics. In each case information will be gathered during on-site visits and will include interviews, document review, and facility tours. The information will be used to complete the Local SNS Assessment Tool and establish a baseline measurement of the current level of readiness to receive, distribute, and dispense the SNS assets to individuals in need of these life saving pharmaceuticals and medical supplies. SNS Planner Workspace For those local health departments receiving additional funds to provide workspace for SNS Planners, the contractor must provide: 1. Adequate office space, supplies and materials, communication materials (publication/printing), telephone related expenses, high-speed Internet, fax and photocopier access and miscellaneous computer/printing supplies and equipment. 2. Funding may be used to provide additional clerical support 22 3. Conference registrations, meeting expense, and/or miscellaneous expenses as funding permits. 4. These expenses must be itemized by category on your budgets for CPBC reimbursement BIOTERRORISM — FOCUS AREA B Contractor Requirements Each local health department, as a sub-recipient of funding through the CDC Public Health Emergency Preparedness and Response for Bioterrorism Cooperative Agreement U90/CCU517018, shall conduct activities to build preparedness and response capacity as defined by the Cooperative Agreement and consistent with their approved FY 04/05 work plan and budget on file with the MDCH, Office of Public Health Preparedness (OPHP). In addition to these broad requirements, the LHD will: In coordination with Focus Area A Activity #2, develop, submit for approval and implement a workplan and budget to OPHP which defines the activities funded under this Focus Area. All sub-recipients of this funding will be required to report expenditures by Focus Area or as defined by the written guidance from the Centers for Disease Control & Prevention Cooperative Agreement (Budget Period 5). Regional Epidemiology Support: For those local health departments receiving additional funds to provide workspace for Regional Epidemiologists, the contractor must provide adequate office space, telephone connections, and high-speed Internet access. The position must also have access to fax and photocopiers. BIOTERRORISM — FOCUS AREA E Michigan Health Alert Network - Communications & Information Technology Contractor Requirements Each local health department, as a sub-recipient of funding through the CDC Public Health Emergency Preparedness and Response for Bioterrorism Cooperative Agreement U90/CCU517018, shall conduct activities to build preparedness and response capacity as defined by the Cooperative Agreement and consistent with their approved FY 04/05 work plan and budget on file with the MDCH, Office of Public Health Preparedness (OPHP). In addition to these broad requirements, the LHD will: Many local health departments (LHDs) have already used their Focus Area E funds to update their connections to the Internet to the highest speed, most reliable connections they can afford to support. The Focus E funds have also been utilized to enhance the interconnectivity of multi-office, local health department jurisdictions by utilizing innovative approaches like Virtual Private Networks, (VPN). The first priority for Local Health Department Focus E grant funding should continue to be to increase Internet and local area network connectivity and security. Those LHDs that have achieved these goals should use Focus E funds to increase the redundancy and continuity of critical IT and communications systems during this funding period. • Budoet and Agreement Reouirements: 1. LHDs that do not have high speed, broadband connections to the Internet must first use their grants to upgrade their Internet connections. The high speed, broadband connections to the Internet should include appropriate firewalls and virus protection software. Each LHD should have a reliable back-up connection to the Internet 23 2. Multi office LHDs should develop local area networks which assure interconnectivity of the computers within the LHD and to the Internet from as many office locations as feasible. 3. Computers used to access the Michigan Health Alert Network must have the capability of running the most recent versions of the Microsoft operating systems, browsers and Office Suite software. 4. LHDs should pursue activities that increase the redundancy and continuity of critical IT and communications systems. Contractor Specific Requirements: 1. The optimum solution will be obtaining service through an Internet Service Provider (ISP) that is capable of delivering a T1 circuit of 1.54Mbps or greater capacity. Examples of ISP providers that can meet this standard include Merit, SBC, MCI, Sprint, and Verizon. (LHDs should consider whether the costs of a Ti connection can be supported without Health Alert Network grant funding in future years.) 2. LHDs with multiple office locations within their jurisdictions should provide local area network connectivity and Internet connectivity to as many office locations as feasible. This may include the use of innovative connectivity solutions like Virtual Private Networks etc. 3. LHD staff persons that use their computers for sending alerts and document sharing on the Michigan Health Alert Network system must have computers with adequate capacity to run the most recent versions of the Microsoft operating systems, browsers and Office Suite. The minimum requirements are the Windows 2000 operating system, Internet Explorer 6.0 and Office Suite 2000. The most recent versions of these products are preferred and licenses that provide automatic updates should be considered. 4. LHDs should develop redundant communications capacity ideally through the use of 800MZ radios which are interoperabie with the Michigan Department of Community Health radios and with critical local and regional preparedness partners. 5. LHDs should develop business continuity plans like the provision of generators at key LHD offices to enable computers and other IT, communications and mission critical functions to continue during power outages etc. 6. In coordination with Focus Area A Activity #2, develop, submit for approval and implement a workplan and budget to OPHP which defines the activities funded under this Focus Area. 7. All sub-recipients of this funding will be required to report expenditures by Focus Area or as defined by the written guidance from the Centers for Disease Control & Prevention Cooperative Agreement (Budget Period 5). FOCUS AREA F Contractor Requirements Each local health department, as a sub-recipient of funding through the CDC Public Health Emergency Preparedness and Response for Bioterrorism Cooperative Agreement U90/CCU517018, shall conduct activities to build preparedness and response capacity as defined by the Cooperative Agreement and consistent with their approved FY 04105 work plan and budget on file with the MDCH, Office of Public Health Preparedness (OPHP). In addition to these broad requirements, the LHD will: In coordination with Focus Area A Activity #2, develop, submit for approval and implement a workplan and budget to OPHP which defines the activities funded under this Focus Area. 24 All sub-recipients of this funding will be required to report expenditures by Focus Area or as defined by the written guidance from the Centers for Disease Control & Prevention Cooperative Agreement (Budget Period 6). FOCUS AREA G Contractor Requirements Each local health department, as a sub-recipient of funding through the CDC Public Health Emergency Preparedness and Response for Bioterrorism Cooperative Agreement U90/CCU517018, shall conduct activities to build preparedness and response capacity as defined by the Cooperative Agreement and consistent with their approved FY 04/05 work plan and budget on file with the MDCH, Office of Public Health Preparedness (OPHP). In addition to these broad requirements, the LHD will: In coordination with Focus Area A Activity #2, develop, submit for approval and implement a workplan and budget to OPHP which defines the activities funded under this Focus Area. All sub-recipients of this funding will be required to report expenditures by Focus Area or as defined by the written guidance from the Centers for Disease Control & Prevention Cooperative Agreement (Budget Period 5). CSHCS SPECIAL REQUIREMENTS CSHCS OUTREACH AND ADVOCACY REQUIREMENTS Contractor Requirements A. Program Representation and Advocacy 1. Provide program representation which includes the provision of information regarding Children's Special Health Care Services (CSHCS) policy on diagnostic referrals, program eligibility, covered services„ prior authorization, and the appeals process to providers, the community, other agencies and families. 2. Inform families of their rights and responsibilities in the CSHCS program. 3. Describe special CSHCS programs to families, such as the Children with Special Needs (CSN) Fund the insurance premium payment program, skilled nursing respite, hospice and transportation as applicable. 4. 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. 5. Provide answers to any questions or concerns families might have and help families advocate on their own behalf. 6. Assure that the strengths and priorities of families are integrated into all aspects of the health care system by facilitating the direct participation of families in program development, implementation, evaluation and policy formation. B. Application and Renewal 1. Arrange for diagnostic evaluation referrals or obtain Release of Information form(s) for the purpose of securing medical reports for determining medical eligibility in new and renewal cases. 25 2. 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. 3. Annually contact CSHCS enrolled clients by either mail or phone and provide information about the CSHCS program and assess family needs. (If this annual contact becomes substantive [30 or more minutes in duration may be used as a guide to determine substantive], care coordination can be billed for this service. If only a letter was sent or a short telephone conversation that did not require follow-up, care coordination should not be billed). 4. Assist in locating individuals or families who do not return a CSHCS Application after being made medically eligible. C. Support Services 1. Link families to the CSHCS Parent Participation Program, Family Phone Line or to the Family Support Network. 2. Facilitate transition through the Medicaid Health Plan (MHP) process and into the MHP environment for C.SHCS/Medicaid clients prior to aging out of CSHCS (at age 21). (This service can be billed through care coordination and can be offered up to six months after the client ages off the CSHCS program at age 21). D. General Performance Requirements 1. LHD/CSHCS staff are expected to contact families when a referral is made or when the Customer Support Section initiates a "Notice of Action" request .to locate or assist a family. 2. Case Management Families eligible for case management services typically have complex medical care and/or complex psycho-social situations which require that intervention and direction be provided by an outside, independent professional. Eligible beneficiaries include but are not limited to the Private Duty Nursing (PDN) population. Case management requires the development of a comprehensive care/service plan meeting the minimum elements as determined by MDCH/CSHCS. All services must relate to objectives/goals documented in the comprehensive plan of care. . Case management will be reimbursed through the CPBC/FSR system. Case management will be based on the `fixed unit rate" method. The fee for case management is $201.58 per service which requires that services be provided in the home setting (or other settings based on family preference), and be provided face-to-face. Case management service reimbursement includes the costs of travel, planning, documentation, completion of a Home Environment Needs Survey and service coordination. Case management cannot be billed for beneficiaries also receiving Level I/IHCP or Level II Care Coordination services during the same billing period. To be reimbursed, costs associated with the services rendered must be included on the CSHCS Case Management and Care Coordination Supplemental Attachment to the CPBC FSR. Total costs for Case Management should be included on line 24 of the FSR as "CSHCS Case Management" and should reconcile with the costs detailed on the Supplemental Attachment for Case Management. Clients are eligible for a maximum of six (6) services per eligibility year. PDN clients must 26 receive a minimum of four (4) services per eligibility year. Any services above six would require approval by MDCH by sending a detailed request including documentation and the rationale for additional services to: Michigan Department of Community Health Customer Support Services Section P.O. Box 30734 Lansing, MI 48909 Documentation of the types of activities, the staff involved and the resolution must be maintained in the client's case file. Local CSHCS offices must maintain documentation on a paper or computer log for all case management services. This documentation must include at a minimum: beneficiary name, CSHCS ID number, date(s) of service, date of the FSR and Supplemental Attachment on which the services were billed. 3. Care Coordination Services Care coordination services are reimbursed as part of the CPBC contract as a "Fixed Unit Rate Reimbursement." Care coordination will be provided by qualified LHD/CSHCS staff who are registered nurses, social workers, or para-professionals, under the direction and 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. There are two levels of coordination services Level I Care Coordination Level II Care Coordination A. Level UPlan of Care consists of identification and documentation of a client's medical, social, educational, functional status and requirements to treat and support those needs through the development of a care plan. Care plans are developed or renewed on an annual basis when families agree to the need for a Plan of Care. Level I/Plan of Care Care Coordination activities are to be provided by a nurse employed by a local health department. The LHD/CSHCS care coordinator in collaboration with the client/family, health care and support service providers, develops and distributes the plan. The family must indicate their approval of the Plan of Care by signing and dating the plan. The LHD/CSHCS care coordinator provides the client/family with information and clarification regarding services and care coordination. The LHD/CSHCS care coordinator assists with the arrangement and/or follow-up of the care plan identified services as appropriate, and to document and communicate to affected parties if circumstances have changed. The LHD/CSHCS care coordinator also provides appropriate referrals and advocacy for other services as needed. Fixed unit reimbursement rates for the Plan of Care development only (the actual care coordination to implement the plan is billed under Level II Care Coordination) are as follows: Annual care plan conducted in person $150.00 Annual care plan conducted by telephone $100.00 Level II Care Coordination consists of interaction with the client/family and others involved with care of the client by telephone, in person or in writing that meet Level II Care Coordination criteria. Level ll Care Coordination activities include, but are not limited to, implementation of the plan of care as outlined above in A, arranging for service delivery from CSHCS qualified providers, client advocacy, assisting with 27 needed social, education, or other support services, facilitating transitional services to Medicaid Health Plan process for CSHCS/Medicaid beneficiaries at age 21 and processing CSN Fund applications. In addition, these services: 1) are non-routine; 2) involve multiple contacts; and 3) are substantive (30 minutes may be used as a gauge in determining if the service meets the intent of the substantive).Level II Care Coordination is reimbursed at $30.00 per unit. A maximum of 10 units per beneficiary per eligibility year will be reimbursed. Authorization, Billing and Documentation Procedures for Level I and II Care Coordination The CSHCS Division provides reimbursement through the CPBC-FSR process for both Level I and Level II Care Coordination when provided by LHD/CSHCS staff for CSI-ICS enrollees. A supplemental attachment to the FSR, as provided by the program, is required for reimbursement. Total costs for Care Coordination should be included on Line 24 of the FSR and labeled "CSHCS Care Coordination." Level II Care Coordination is specific to care coordination activities not involving the development of an Individualized Health Care Plan (IHCP). Local CBHCS offices must maintain documentation on a paper or computer log for all Care Coordination. This documentation must include: beneficiary name, CSHCS ID number, date(s) of service, date of the FSR and Supplemental Attachment on which the services were billed. CHILDHOOD IMMUNIZATION REGISTRY SPECIAL REOUIREMENTS Contractor Requirements The contractor assures that: 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. Basting immunization records shall be submitted to the MCIR in accordance with the instructions from the Department's regional contractor. 4. Each local health department will document and maintain records of in-kind and/or local costs associated with utilizing MCIR and will report these inkind and/or local costs on a quarterly basis to the MC1R regional agency. 5. lnkind and/or local costs reported to the MC1R regional agency cannot be reported on the Medicaid cost-based reimbursement report submitted annually to the Department CHILDHOOD LEAD SPECIAL REQUIREMENTS Contractor Requirements 1. Each funded entity will provide regional case management for a group of 58-60 children with blood lead levels of 20 mg/dL. Case management for each region will encompass a number of counties and health jurisdictions. 28 2. Each funded entity will provide primary prevention in the assigned regions. Primary prevention activities will include actions that will require certified Lead Inspector/Risk Assessor status. 3. All funded agencies/individuals in the program will be required to participate in program evaluation. 4. CDC reporting and state-based data exercises will be required of all funded entities. DIABETES OUTREACH NETWORK (BRANCH-HILLSDALE-ST. JOSEPH COMMUNITY HEALTH AGENCY) Contractor Requirements Diabetes Outreach Network Structure and Function 1. Maintain an independently located regional office as a non-competing, coordinating health care/education resource for the counties within the network region. Coordinate participation in the network among local health departments, other department-funded diabetes projects, as well as other health care and community-based agencies in the network service region. 2. Develop collaborative partnerships with the Community Health Centers (CHC) in the DON region by establishing contact with CHCs, promoting the DON Diabetes Care Improvement Project (DCIP), and supporting the center's participation in the national Health Disparities Collaborative, as appropriate. 3. Collaborate and partner as needed with: National Kidney Foundation of Michigan (NKFM), American Heart Association (AHA), American Diabetes Association (ADA), Michigan Association of Health Plans (MAHP), Michigan Organization of Diabetes Educators (MODE), and other key partners. 4. Educate consumers, communities, health care delivery agencies, health care providers, and legislators on the importance of prediabetes, diabetes self-management, implementation of quality diabetes care and education, and of the need to have sufficient funding to sustain these network activities. 5. Annually sign letters of agreement or memorandums of understanding with Diabetes Care Improvement Project (DC IP) agencies prior to entering client data from the agency into the DC1P electronic database. These participating agencies must provide medical care to people with diabetes. For purposes of evaluation of the DON/DCIP continuous quality improvement objectives and targets, agency data collected and analyzed will not include data from the certified diabetes self-management training programs (DSMTPs). 6. The DON may continue to assist the DSMT programs in using the DCIP forms to compile and report the DSMTP intake and outcome data. The DONs are encouraged to continue other partnership activities with the DSMTPs. 7. Visit each participating agency at least once a year to discuss their DCIP data and strategize on ways to improve the quality of care. Provide each participating agency with a quarterly report and analysis of their client data; reports may be submitted less frequently upon the request of the participating agency. 8. Support and actively participate in consumer-driven or consumer-focused initiatives, such as Joining People with Diabetes, Stanford Chronic Disease Self-Management Program, lay health educator or other related initiatives. 9. Participate in the Michigan Nurses Association Continuing Education Approval Program to provide continuing education contact hours to Nurses and Dietitians. 29 10. Participate in National and State Initiatives including the CDC Flu/Pneumococcal Vaccination Campaign, National Diabetes Education Program (NDEP), and Diabetes Detection Initiative (DDI), as directed by the MDPCP. 11. Support a competent, core staff meeting the qualifications specified by the department. The core staff will consist of a project director, an office manager, and a diabetes educator. The director will manage the network program and budget; hire, train, and supervise all employees; and direct consultant staff. All funded staff must be qualified to meet the established standards for the Diabetes Outreach Network. Advisory Council Maintain an interdisciplinary advisory council that represents the major diabetes interests in the network region to advise the project on goals, planning, policy, technical issues, evaluation, strategic plan, and other project implementation. The advisory council must include people with diabetes and at least one representative from the Lion's Club. The DON will conduct no fewer than three (3) advisory meetings annually. Funding Limit maximum of funding that may be retained by the fiduciary to the /esserof $15,000 or 5% of the contractual amount. No more than one-third of DON resources/funding will be used to partner with or participate in regional primary prevention activities to address obesity, physical activity, smoking, school health, or related activities. Michigan Diabetes Prevention and Control Program Interface 1. Follow DON/DPCP policies/procedures as provided in the DON Orientation and Procedure manual, Strengthening Diabetes Care in Michigan, CEAP Procedure Manual and/or other MDPCP directives. 2. Have DON representation at each MDON and MDON/MDPCP meeting and on each MDON and MDON/MDPCP conference call. 3. Provide DON input and feedback by due dates on all department-initiated request for MDON & MDPCP materials (such as program guidelines, evaluation data, policies/procedures, etc.) 4. Notify and submit to the MDPCP copies of all abstracts priorto submitting to conference or meeting planners for approval of participation at conferences or other types of presentations. 5. Assure all primary prevention messages, campaigns, and initiatives are consistent with those implemented by the MDCH Cardiovascular Health, Nutrition and Physical Activity Section, the Michigan Surgeon General's Healthy Lifestyle campaign, and the Michigan Department of Education. Plan and Report Requirements 1. By 11/28/04 submit to the department for review and approval, the annual program plan for FY 04-05. This plan will include measurable goals, objectives, and target numbers. These shall be consistent with the objectives specified in this contract, the Department's CDC Federal Grant and National Diabetes Objectives, the Michigan Diabetes Strategic Plan, and the Regional DON Strategic Plan. 2. Complete quarterly reports, annual reports, annual plan & strategic plan reports, using MDCH-developed forms and instructions. Information on progress toward meeting the DON region strategic plan recommendations will be integrated into the quarterly and annual report. Report due dates are: 30 1122/05, 4/22/05, and 7/22/05: Quarterly Reports 10122/05: 4th quarter and annual report (may be combined) 3. Complete the Program Numerical Report Summary each quarter according to the MDPCP procedure and submit to MDCH with quarterly reports. Provide examples as needed of consumer awareness activities, professional education, advocacy efforts and other pertinent activities. Contractor Specific Reouirements 1. By September 30, 2005, provide diabetes continuous quality improvement (COI) data and direct consultation with at least 7 Diabetes Care Improvement Process (DC1P) participating agencies in an effort to improve quality of care for people with diabetes. 2. By September 30, 2005, partner with at least three DCIP/electronic medical record participating agencies4 to provide extensive consultation, professional education, and CQ1 tools/strategies to enable each agency to achieve a 10% increase for the following diabetes quality indicators: eye exams, immunizations, HbA1c tests, and foot exams. 3. By September 30, 2005, disseminate and promote use of all NDEP campaigns and materials to its regional partners and through local media channels. These campaigns are: A. Small Steps. Big Rewards. Prevent type 2 Diabetes. B. Be Smart About Your Heart. Control the ABCs of Diabetes. C. Control Your Diabetes. For Life. 4. By September 30, 2005, utilize Taking on Diabetes program materials at one or more events for consumers or health professionals. 5. By September 30, 2005, implement a member-oriented or professional education initiative with at least two managed care plans in the region. 6. By September 30, 2006, co-sponsor at least one consumer-driven initiative, such as Joining People with Diabetes Support Group Leader Training, Stanford Chronic Disease Self.. Management Program, lay health educator initiative, or other related initiative. 7. By September 1, 2005, provide UPDON with an annual update to reflect additions or changes in support groups for posting on the website support group directory. 8. By September 30, 2005, prOvide MNA pre-approved group presentations to 400 health care professionals, with a special emphasis being placed on implementing presentations targeting diabetes clinical indicators that fall below the DON clinical indicator target. 9. By September 30, 2005, 100 health care professionals from the DON region will have successfully completed a MNA/CDR pre-approved self-study module. 10. By September 30, 2005, work collaboratively with the MDPCP, MNA, and CDR to revise or create the following self-study modules for pre-approved continuing education contact hours: A. Eye Care B. Type 2 Diabetes C. Diabetes and Hypertension D. Foot Care E. DON Guidelines (new) 4 These agencies will be those who are curreniy falling well below the DON iegional target brat least three of the five diabetes care quality indicators. 31. 11. By September 30, 2005, facilitate at least one project, in partnership with the American Diabetes Association, the local Lion's chapters, optometrists, or ophthalmologists, to promote the importance of annual eye exams for people with diabetes. 12. By September 30, 2005,25 health professionals from the DON region will have successfully completed the self-study eye module or participated in one of the ED1 modules featuring eye disease. 13. By August 31, 2005, work in partnership with the MDPCP to disseminate federal or state campaign materials and promote annual flu and pneumococcal immunization for people with diabetes and their families. 14. By September 30, 2005, exhibit and provide educational material at one of the state's regional Immunization Conferences in an effort to promote the need to target immunization messages and services to reach people with diabetes. 15. By September 30, 2005, increase by 10 percent the FY03-04 number of DCIP clients served who were members of Michigan's racial and ethnic minority populations. 16. By January 1, 2005, assist at least one federally qualified health center currently not involved in a Diabetes Collaborative to assess their diabetes quality improvement plan. 17. By September 30, 2005, actively serve on one of the DON region's Access to Care Coalitions. 18. By September 30, 2005, implement two public awareness activities, using the National Diabetes Education Program's Small Steps, Big Rewards campaign materials specific to one racial and ethnic minority population. 19. By September 30, 2005, implement, in partnership with minority- and community-based agencies, four consumer-focused or professional education initiatives with specific strategies designed to reduce health disparities for diabetes, its complications, and its risk factors among Michigan's racial and ethnic minority or other underserved populations. 20. By September 30, 2005, actively partner with other state- and federally-funded diabetes initiatives reaching high-risk populations, as applicable (e.g., AIM-H1, REACH, Diabetes Detection Initiative, and Intertribal Council's STEPs project). 21. By September 30, 2005, establish or maintain a level three or higher5 partnership with each of the Diabetes Collaborative projects in their region. 22. By September 30, 2005, feature the message and media materials for the Michigan Surgeon General's Healthy Lifestyle campaign (Michigan Steps Up. Eat better. Move More. Stop Smoking. It's Just That Simple.) in at least one regional, major media or public relations campaign or community awareness event. FAMILY PLANNING/BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCCP) JOINT PROJECT SPECIAL REQUIREMENTS Contractor Requirements 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. 5 The Bureau of Primary Health Care Health Disparities projects have developed a parbership classification identifying criteria to be met at specific partnership levels; this will be used to define the level of partnership. 4' 32 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). 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 - PREGNANCY PREVENTION SPECIAL REQUIREMENTS Contractor Reauirements 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. FETAL ALCOHOL SYNDROME (FAS) COMMUNITY PROJECT (Delta-Menominee District Health Department, Kent County Health Department) Contractor Requirements (Delta-Menominee District Health Department Only) 1. In accordance with the general purposes and objectives of this agreement will: A. Maintain a FAS Advisory Committee to plan and help implement appropriate community services. B. Conduct activities to promote awareness and prevention of FAS, including distribution of materials and provision of educational activities and trainings. C. Conduct or facilitate outreach, prescreening and screening. 4. Contractor Requirements (Kent County Only) 1. In accordance with the general purposes and objectives of this agreement will: 33 A. Community Project: 1. Conduct activities to promote awareness and prevention of Fetal Alcohol Syndrome (FAS), including distributing materials to 75 individuals, providing educational presentations and trainings to 30 groups and coordinating a speakers' bureau for youth education. 2. Maintain the Kent County FAS advisory committee through monthly meetings and correspondence. The committee will plan and help implement appropriate community projects. 3. Information on the use of FAS pre-screening tool will be included in 20 of the 30 educational presentations with the Healthy Kent 2010 Infant Health Implementation Team Prenatal Care Core Concepts Subcommittee to initiate support for substance abuse screening among pregnant women. 4. Assist with conducting a support group for families affected by FAS through the provision of monthly meetings with childcare, continuing education opportunities for support group members and the coordination of "Parenting Differently" classes. B. Consultant Convene and provide staffing to the statewide FAS Workgioup to building community capacity for FAS awareness and prevention initiatives. 2. Publish a quarterly newsletter for FAS Community Projects and Diagnostic Clinics. 3. Arrange and provide consultation for Community Projects and Diagnostic Clinics. 4. Participate in the semi-annual National Taskforce on FAS/FAE meetings to maintain awareness of national FAS activities and support connections with the field's national leaders. Reporting Reauirements (for both health departments) 1. Submit the following reports as required by the Contract Manager A. Financial Status Reports (FSRs) as required in the Contract. B. Six month progress report. C. Year-end report on the year's activities toward meeting the objectives. D. Notification by June 15 of anticipated under spencing of grant monies. Financial Reports shall be submitted as directed by the contract. Other reports, including six month progress report, community presentation reports and year end report shall be submitted to: Cheryl Lauber Michigan Department of Community Health Division of Family and Community Health P.O. Box 30195 Lansing, Michigan 48909 2. Shall permit the Department or its designee to visit and to make an evaluation of the project. 34 IMMUNIZATION ACTION PLAN SPECIAL REQUIREMENTS Contractor Requirements 1. Adhere to all federal and state appropriation laws pertaining to use of programmatic funds. 2. Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993 and other related documents pertaining to the Vaccines For Children (VFC) %gram. A. The VFC 'Basic" Program serves only eligible children who meet the following criteria: are enrolled in Medicaid, have no health insurance, are American Indian or Alaskan Native, are served at a Federally Qualified Health Center (FQHC), a Rural Health Center (RHC) or a public health clinic affiliated with a FQHC and are also under-insured. B. Ensure state-supplied vaccines (VFC Expanded coverage) provided to your jurisdiction are administered only to eligible children. This program allows for the immunization of children who are underinsured and not served at a FQHC, RHC, or a public health immunization clinic affiliated with a FQHC. C. Ensure that all providers receiving vaccine from the state screen children for VFC eligibility. 3. Adhere to all Federal and Michigan Laws pertaining to immunization administration and reporting including reporting to the MCIR. 4. Ensure that federally procured vaccine is administered to eligible children only and properly documented per VFC guidelines. 5. Monitor any provider receiving federally procured vaccine at least once every 3 years, and preferable at least once every 2 years. 6. Ensure attendance at two (2) Immunization Action Plan (IAP) meetings each year. 7. Submit original FSR's to MDCH on a quarterly basis. 8. Develop, implement, and submit program IAP Reports to the MDCH Immunization Program in accordance with the following dates: Period Covered Date Due 10/01/2004 — 0313112005 April 15, 2005 04/01/2005 — 09130/2005 October 15, 2005 9. By February 15 of each year provide one copy of the provider enrollment and profile for each provider who receives vaccine from the state. One profile should also be submitted summarizing the entire population of children 18 years of age and younger by eligibility status for the health jurisdiction. These documents must be postmarked no later than February 15. Facsimile copies will not be accepted. 10. Michigan Childhood Immunization Registry (MCIR) responsibilities: A. Ensure that all immunizations administered to children born after December 31, 1993 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. B. Ensure that all providers within the Contractor's jurisdiction are registered through the MCIR and that all of their activities are coordinated with the regional contractor of the Department and operated within their guidelines. 35 11. The contractor implements Perinatal Hepatitis B program activities to prevent the spread of Hepatitis B Virus (HBV) from mother to newborn. A. Ensure that protocols for the Hepatitis B Perinatal activities are in place and adhered to through collaboration between communicable disease and immunization divisions. B. Report all Hepatitis B surface antigen (HBsAg) positive pregnant women to the state health department. C. Ensure that all susceptible infants, household and sexual contacts associated with women who are HBsAg + are given appropriate doses of Hepatitis B vaccine series in a timely manner, and they receive pre or post serology testing as recommended. D. Ensure that infants, household and sexual contacts associated to HBsAg+ women receive testing, vaccination, and support services. 12. Surveillance of vaccine preventable disease (VPD) activities: A. Ensure that all reportable diseases are reported to MDCH in the time specified in the public health code and appropriate case investigation is completed. B. Conduct active surveillance when indicated (i.e. during an outbreak) and contact hospitals, laboratories, and/or other providers on a regular basis. 13. School and Day Care Requirements: A. Ensure that 100% of the schools are reported to MDCH by December 15 th and March 15th of each year. B. Ensure that 100% of the licensed childcare centers are reported to MDCH by February 15m of each year. 14. Service Delivery: A. Collaborate with public and private sector organizations to promote adult immunization activities in the county: 1. Inform providers that pneumoccocal and influenza vaccine and their accompanying administrative costs are Medicare covered benefits. 2. Provide and implement strategies for addressing the immunization rates of special adult populations (i.e., college students, educators, health care workers, and child care employees). B. Assign an appropriate individual to serve as an immunization liaison for WIC. Department Requirements 1. The department will receive and review IAP reports. 2. Provide program direction and definition of Immunization Action Plan coordinator responsibilities. 3. Provide technical assistance in establishing and operating immunization action plans. 4. Provide supportive services and resource identification when needed. 5. Provide financial support for LHD and Community! Migrant Health Centers for immunization in pocket of need (PON) areas. 36 IMMUNIZATION ASSESSMENT FEEDBACK INCENTIVE EXCHANGE JAM) PROVIDER SITE VISIT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $50 per site visit, not to exceed the maximum set for each individual Contractor. Contractor Requirements 1. The goal is to conduct an Assessment Feedback Incentive Exchange (AFIX) with 75% of the maximum number of VFC site visits for each Contractor. There is no minimum number of AM visit set for each Contractor. 2. The format of the AFIX site visit will be based on a section of the VFC site visit questionnaire distributed at the most recent Fall IAP meeting and the guidance provided by the department Completed site visit questionnaires will be submitted to the MDCH/Immunization Program on a continuous basis. 3. Data from the MDCH/Immunization program regarding the number of AFIX site visits will be used to reconcile the request for reimbursement of the Comprehensive FSR (DCH-0412). The corresponding reimbursement must be noted as a funding source in requirements, refer to the guidance provided by the MDCH/Immunization Program in correspondence to the Immunization Action Plan (IAP) and Immunization Coordinator. 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 — FIELD SERVICE REPRESENTATIVES SPECIAL REOUIRFMFNTS (District Health Department #10, Marquette County Health Department, Saginaw County Health Department, St. Clair County Health Department, VanBuren/Cass District Health Department) 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 and supplies, including, but not limited to: a telephone, general office supplies, a computer with Pentium III processor or better, a printer, a modem, a cellular telephone and a use of vehicle or reimbursement mechanism for transportation unless otherwise arranged. 3. Make the Immunization Field Representative available to all local health departments in the assigned jurisdictions to provide Immunization Program activities equitable and at the direction of the Department. Refer to field representative responsibilities as defined and distributed to the contractor. 4. Provide for reimbursement for reasonable telephone charges incurred in the conduct of business by the Immunization Field Representative unless otherwise arranged. 5. Provide reasonable reimbursement for any travel and subsistence expenses incurred by the Immunization Field Representative necessary to the conduct of the Immunization Program. Travel will include the annual National Immunization Conference or other professional immunization related conferences, attendance at the MDCH Immunization staff meetings and trainings, and accreditation visits made in other areas of the state. 37 Department Requirements 1. As financially feasible, provide necessary adjunct clerical services to the Immunization Field Representatives for the duplicating/printing of materials and the packaging and distribution of these materials. 2. Provide program direction and definition of Immunization Field Service Representative responsibilities. IMMUNIZATION VACCINE FO_R CHILDREN (VFC) PROVIDER SITE VISIT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $200 per site visit, not to exceed the maximum set for each individual Contractor. Contractor Requirements 1. The goal is to visit each recipient of state-supplied and federally funded vaccine at least once every three years. More frequent visits are preferred. The minimum number of site visits to be performed each calendar year by each Contractor is: 20 for Contractors with more than 20 providers receiving federally funded vaccine and at least 80% of the total provider sites within jurisdictions with 20 or fewer providers receiving vaccine from the Contractor. 2. The format of the site visit will be based on the site visit questionnaire distributed at the most recent Fall IAP meeting and the guidance provided by the department. Completed site visit questionnaires will be submitted to the MDCH/Immunization Program on a continuous basis. 3. Data from the MDCH/Immunizafion Program regarding the number of site visits will be used to reconcile the request for reimbursement. The minimum number of site visits must be submitted by April 30 to qualify. For additional detail on the program requirements, refer to the Resource Book for Vaccine For Children Providers and other guidance provided by the MDCH/Immunization Program in correspondence to Immunization Action Plan (LAP) and Immunization Coordinators. Department Requirements 1. The Department will provide payment annually based upon the fixed unit rate reimbursement mechanism upon completion and submission of the questionnaires. IMMUNIZATION — NURSE TRAINING REIMBURSEMENT SPECIAL REQUIREMENTS Budget and Agreement Requirements The rate of reimbursement is $100 per training session per day to the Contractor, upon completion and submission of Provider Contracts and Report Forms. Reimbursement can only be made for one in-service per module session per physician clinic site per year. Contractor Requirements 1. Ensure that all Immunization Nurse Educators are trained as required by the Department 2. Ensure that the Provider Contract and Report Form is complete and submitted to MDCH/Immunization Program within 5 days after the presentation. 38 Department Requirements The Department will provide payment annually based upon the fixed unit rate reimbursement mechanism upon completion and submission of the Provider Contracts and Report Fcrnis. 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: A pregnancy test with a determination of the probable gestational stage of a confirmed pregnancy. Note: The contractor must destroy the individual "informed consent" files containing identifying information (Name, Address, etc.) after 30 days. 2. When a woman seeks a pregnancy test and does not explicitly state that she is doing so for the purpose of obtaining an abortion, she should be directed to a family planning clinic or to her primary care provider for a pregnancy test. Services to comply with PA 345 of 2000 should not be provided to a woman in a Title X funded family planning clinic. Department Requirements The Department will provide funding, at the fixed rate of $50 per woman served, far 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 — DETROIT DEPARTMENT QE HEALTH AND WELLNESS. KALAMAZOO COUNTY. KENT COUNTY AND Arziktew COUNTY HEALTH DEPARTMENTS Contractor Reauirements 1. Contractor Specific Reauirements - All Contract/Ill A. Meet established standards of performance and objectives in the following areas: 1. Bioterrorism: a. Make one FTE available to participate in training and exercises associated with Bioterrorism (BT). b. Train additional staff to perform Level A and B procedures. c. Secure and maintain Select Agent Registration. d. Maintain competency and proficiency for testing procedures described in the LRN protocols. e. Temporarily assign one FTE to MDCH or another Level B laboratory as surge capacity for emergency situations if needed. f. Develop a plan to provide laboratory services 24 hours a day, 7 days a week for a BT event. 4- g. Provide secure facilities to store reagents, quality control organisms and patient isolates. 39 2. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing and maintain select agent registration. 3. Establish submission procedures for designated agencies/physicians for the timely transport of appropriate specimens to the laboratory. 4. 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. B. Purchase and maintain adequate inventories of any supplies needed for testing and reporting, not specifically supplied by the Department in this agreement C. Provide the Bureau of Epidemiology, and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH all specimen submission data and reporting data will be entered and reported using 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. D. 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. Specimenswill be processed within 36 hours of collection, except fish, which will be processed within 6 hours of collection. E. Provide laboratory support for examination of up to 100 stool specimens associated with foodbome disease outbreaks. Specimens will be processed within one hour of receipt if not in preservative or 24 hours if preserved. 2. Contractor Requirements — Detroit Department of Health and Wellness Only A. Meet established standards of performance and objectives in the following areas: 1. Perform testing for detection of food borne disease outbreaks as specified in items 1.121 and I.E. Perform HIV diagnostic testing using a test designated by the Department. Perform test for diagnosis of gonorrhea and chlamydia using commercial nucleic Acid Amplification Test for family planning clinic clients and other special populations designed by the Department. 40 2. Utilize standardized testing procedures, standards of quality assurance and quality control approved by the Department laboratory director. Assist the Department in Quality Assurance Assessment semi-annually or as determined by the Department (including test and report turn-around times, indeterminate rate). 3. Test gonorrhea and chlamydia specimens from approved agencies within one working day of receipt of specimen. Perform HIV-1/2 screening tests for diagnostic specimens within one workday of receipt of specimen. Perform HIV-1 confirmatory tests for diagnostic specimens within three days of screening assay positive. Submit specimens for HIV-2 testing to Department within one day of HIV-1 testing completion. Establish Quality Assurance Monitor to investigate and correct situations when HIV testing is not complete within 10 working days. 4. 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. Establish and maintain confidential fax for HIV-2 reports and other laboratory reports from Department laboratory. 5. Establish testing personnel training program and maintain documentation of training of all testing personnel. B. Maintain an adequate inventory of tests kits and reagents purchased by the Department. Communicate shipment needs to manufacturer's representative if shipments supplementary to the routine shipments are needed. C. Inform the Infectious Disease Division by May 15, 2005 if more than 9,627 commercial nucleic acid amplification specimens for chlamydia/gonorrhea will be performed. 3. Contractor Reouirements - Kalamazoo, Kent and Saginaw County Health Departments Only A. Administration of the Michigan Region Laboratory System. 1. Administer the regional laboratories as specified: a. Kalamazoo County Health Department will administer Region 3 in the Michigan Region Laboratory System. b. Kent County Health Department will administer Region 4 in the Michigan Region Laboratory System. c. Saginaw County Health Department will administer Region 2 in the Michigan Region Laboratory System. 2. Provide a qualified (as defined by CLIA) Technical Consultant for their region. 3. Technical Consultants will: a. Assist the Laboratory Director in the administration of the operational needs of their region. b. Meet with local personnel from health departments on a regular basis including onsite visits to major sites at least annually. c. Act as a resource person to facilitate effective laboratory testing according to accepted procedures and quality assurance guidelines. 4]. Ir Supply the laboratory procedures to the local site and instruct personnel in their use. e. Assist in planning and participate in training exercises related to Regional Laboratory procedures. f. Review quality assurance procedures, quality control logs, assure adherence to adopted procedures and evaluate corrective actions. 9. Review and perform competency evaluations, as needed. h. . Review and collate internal proficiency testing results and report scores to submitting sites in a timely manner. 4. Provide information on specimen submission to local health jurisdictions to assure that specimens are submitted to Agency regional laboratory, or nearest laboratory as determined by the Department 4. Contractor Reauirements lamazoo County Hal Department and Saginaw County Health Department Only A. Meet established standards of performance and objectives in the following areas: 1. Perform tests for diagnosis of gonorrhea and chlamydia infections using commercial nucleic acid amplification assay and perform testing for detection of foodbome disease outbreaks as specified in items 1.D and I.E. 2. 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 3. Test gonorrhea and chlamydia specimens from approved agencies/physicians within one working day of receipt of specimen. 4. 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. 5. Establish testing personnel training program and maintain documentation of training of all testing personnel. • B. Inform the Infectious Diseases Division by May 15, 2005 if the health department performs more nucleic acid amplification specimens than specified: C. Kalamazoo County Health Department performs more than 13,693 nucleic acid amplifications prior to May 15, 2005. D. Saginaw County Health Department performs more than 14,85915,875 nucleic acid amplifications prior to May 15, 2005. 5. Contractor Requirements - Kent County Health Department Only A. Meet established standards of performance and objectives in the following areas: 1. 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 1.D and 1.E, 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 5.C. 42 2. Utilize standardized testing procedures, standards of quality assurance and quality control approved by the laboratory director. Assist Department in quality assurance assessment of testing semi-annually or as determined by the Department (including test and report turn-around times, indeterminate rate). 3. Test gonorrhea and chlamydia specimens from approved agencies/physicians within one working day of receipt of specimen. Perform HIV-1/2 screening tests within one workday of receipt of specimen. Perform HIV confirmatory test within three days of screening assay positive results. Submit specimens for HIV-2 testing to Department within one day of HIV-1 testing completion. Establish Quality Assurance Monitor to investigate correct situations when HIV testing is not completed within 10 working days. 4. 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. Establish and maintain confidential fax for HIV-2 and other laboratory reports from Department. 5. 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. B. Inform the Infectious Diseases Division by May 15, 2005, if more than 19,932 Nucleic Acid Amplification specimens will be performed. Department Requirements 1. Department Requirements [for All Contractors): A. Reimburse the Contractor for the examination of specimens related to foodbome disease outbreaks to the extent outlined in items 1.D & 1.E above. Reimburse the Contractor at the fixed unit rate for each swab specimen and for each urine specimen for diagnosis of gonorrhea and chlamydia infections using a nucleic acid amplification assay B. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. C. The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, provide one computer, 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(s) through MDCH. Tape backups and maintenance of all modules will be performed by MDCH staff. D. Analyze data from reports submitted from Contractor. Supply timely feedback of statistical analysis and other data related to on going program activities. E. Assist in technical training of testing personnel and computer mftware utilization. F. Supply Contractor with a copy of the contracts associated with this program. G. Monitor monthly utilization reports. H. Provide reagents and culture media forfood and stool specimen examination related 43 to foodbome disease outbreaks. 2. Department Requirements — Detroit Department of Health and Wellness Only A. Reimburse the Contractor for performing HIV Diagnostic Testing. B. Purchase and arrange for shipment of test kits and reagents from manufacturer. C. Purchase specimen collection kits. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. D. Perform Quality Assurance Assessment for HIV testing semi-annually. E. The Department will provide funding for one FTE and provide training at MDCH for up to two individuals in Level A and Level B procedures. The Department will provide access to LRN protocols on a secure website and funding for supplies used to train for or to handle a potential BT event. The Department will provide proficiency testing materials on a semi-annual basis and funding for equipment necessary to perform Level B protocols. 3. Department Requirements (for Kalamazoo County, Kent County and Saginaw County Health Departments) A. The Department will provide funding for one FTE and provide training at MDCH for up to two individuals in Level A and Level B procedures. The Department will provide access to LRN protocols on a secure website and funding for supplies used to train for or to handle a potential BT event. The Department will provide proficiency testing materials on a semi-annual basis and funding for equipment necessary to perform Level B protocols. Michigan Department of Community Health (MDCH): 1. Reimburse the Contractor for administrative costs associated with operation of the CLIA umbrella certification. 2. Designate and assign personnel who meet the qualifications required as a high complexity laboratory director in CLIA '88. 3. Laboratory Directors will: a. Sign the appropriate CMS paperwork for CLIA certification for their region as needed. b. Visit Agency Laboratory at least twice a year and participate in annual site coordinator's meeting. c. Be available for consultation to the Agency laboratory by telephone, email, and other communication methods. d. Provide laboratory guidelines, testing procedures, quality control methods and quality assurance in accordance with CLIA requirements. e. Review Quality Assurance program with attention to effective quality control activity and corrective action. f. Review and perform, as needed competency evaluations. g. Review external proficiency testing results in a timely manner. h. • Review and sign procedure manual(s) annually, and any new procedure prior to its implementation. 44 4. Notify Agency of funding changes for state supported tesing initiatives. 5. Provide training for state-funded initiatives. 6. Provide information on specimen submission to local health jurisdictions to assure that specimens are submitted to Agency laboratory, or nearest Regional laboratory as determined by the Department. 4. Department Requirements - Kalamazoo County and Saginaw County Health Departments only A. Purchase and arrange for shipment of test kits and reagents from manufacturer. B. Purchase specimen collection kits. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. 5, Department Requirements - Kent County Health Department on Purchase and arrange for shipment of test kits and reagents from manufacturer as outlined in items 1.A, 1.D. and I.E. B. Purchase specimen collection kits for diagnostic testing. Ship collection kits to designated agencies/physician submitters. Monitor specimen collection kit utilization. C. Perform Quality Assurance Assessment for HIV testing semi-annually. LABORATORY SERVICES SPECIAL REQUIREMENTS (OAKLAND COUNTY HEALTH DEPARTMENT AND NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY) Contractor Specific Requirements - All Departments 1. Meet established standards of performance and objectives in the following areas: A. Make one FTE available to participate in training and exercises associated with Bioterrorism (BT). B. Train additional staff to perform Level A and B procedures. C. Secure and maintain Select Agent Registration. Maintain Clinical Laboratory Improvement Amendments of 1988 certification for high complexity testing and maintain select agent registration. D. Maintain competency and proficiency for testing procedures described in the LRN protocols. E. Temporarily assign one FTE to MDCH or another Level B laboratory as surge capacity for emergency situations, if needed. F. Develop a plan to provide laboratory services 24 hours a day, 7 days a week for a BT event G. Provide secure facilities to store reagents, quality control organisms and patient isolates. 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 and Bureau of Laboratories records and reports as required. For all testing services performed under contract by the Contractor for MDCH (e.g. BT), all specimen submission data and reporting data will be entered and reported A. 45 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 can be negotiated (formulas for payment will be based upon the percentage of total specimens entered into the module). Models 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. Department Requirements — All Departments 1. Notification and explicit instruction for stop and start days to Contractor laboratory regarding this contractual arrangement prior to its implementation. 2. The Department will provide access to EPIC, support for EPIC hardware (UNIX server) and software, support and maintenance for one computer, user training for EPIC modules utilized for testing performed under the 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. 3. Assist in technical training of testing personnel and computer software utilization. 4. Provide technical consultation and assistance with program activities. 5. Supply Contractor with a copy of the contracts associated with this program. Department Requirements - Northwest Michigan Health Agency only 6. Provide CLIA director and QA program, training, monitoring and oversight. Department Requirements — All Departments The Department will provide funding for one FTE and provide training at MDCH for up to two individuals in Level A and Level B procedures. The Department will provide access to LRN protocols on secure website and funding for supplies used to train for or to handle a potential BT event. The Department will provide proficiency testing materials on a semi-annual basis and funding for equipment necessary to perform Level B protocols. LEAD HAZARD REMEDIATION PROGRAM SPECIAL REQUIREMENTS Contractor Requirements Provide lead-based paint hazard control activities for eligible families residing in high-risk homes containing lead-based paint. Lead Hazard Remediafion 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. 46 1. Education and Outreach It is expected that each county will provide a minimum of 10 local presentations on lead poisoning paint issues per year. A. Develop new partnerships with oter 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. H. Each county is expected to promote the Michigan State Housing Development Authority's (MSHDA) Property Improvement Loan Program (PIP) to public and private entities, including but not limited to homeowners, rental property owners, non-profit organizations and rehabilitation/remodeling sections of local government groups. 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. G. Each county will act as MSHDA PIP loan agent to distribute loan application, pre- screen applicant, gather application documents (application W2's, pay stubs, proof of ownership, etc.) and determine preliminary eligibility in loan program. Each county will assist homeowners in this process. County will then forward , loan documents to MSHDA Lender for loan processing and closing. H. Each county will receive $300 paid from MSHDA for each PIP loan successfully originated, approved and closed. 47 3. Lead Hazard Control Activities 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 time for onsite supervision of lead abatement contractors that are new b the program in your county and 25% of time for on-site supervision of lead abatement contractors that are established within your county during lead hazard control work for each project to ensure that work is being done according to project specificatiors 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. Process contractor payment invoice and authorization to LHRP after visual inspection of project has been completed. C. Develop a lead-based paint hazard control activities performance report and closeout documentation for submission to LHRP within 30 days of completion of wsork. 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 Agreement 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 30 homes for the period. Additionally, all contractors are required b appoint a full-time equivalent individual to provide all program requirements as stated in this contract. The contractor will provide 48 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. The contractor will provide to LHRP during the semi-annual site visits a summary of all expenditures related to this agreement in excess of $500 in a format specified by the department, including contracted services. Expenditures for salaries and fringe benefits of staff as provided in monthly FSRs are excluded from this requirement, as well as equipment expenditures in excess of $5,000 as provided in Part I, Section_3. Equipment Purchases and Title of the contract 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 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* Food Service Sanitation General Communicable Disease Control Hearing Immunization On-Site Sewage Treatment Management* Sexually Transmitted Disease 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 04/05 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 04105 the FY 92/93 Local Maintenance of Effort Level must be met 49 6. A final statewide cost settlement will be performed to assure that all available LPHO funds are fully distributed and applied for required senices. 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; Tuberculosis Control; Health/Medical Annex of Emergency Preparedness Plan. 2. Fully comply with the Minimum Program Requirements for each of the required services. 3. Contractor will be held to accreditation standards and follow the accreditation process and schedule established by the Department for the required services to achieve full accreditation status. Agencies designated as "not accredited may have their Department allocations reduced for Departmental costs incurred in the assurance of service delivery. The accreditation process is based upon the Minimum Program Standards and scheduled on a three-year cycle. The Minimum Program Standards include the majority of the required Department reviews. Some additional reviews, as mandated by the funding agency, may not be included in the Program Standards and may need to be scheduled at other times. Department Requirements 1. Whenever the Department delivers direct services within the Contractor's area, it shall give prior notification and provide summary reports of those activities upon the request of the local health officer. Contractor Specific Reouirements — Food Service Sanitation Budget and Agreement Requirement MDA Agrees to: Food Service Establishment Licensing 1. Furnish pre-printed food service establishment license applications and pre-printed licenses to the local health department for each licensing year (May 1 through April 30) using previous year active license data. 2. Provide a count of all licenses sent to the local health department titled "Record of Licenses Received.' a Reprint any licenses requiring correction and send corrected copies to the local health department 4. Bill the local health department for state fees upon notification by the local health department that the license has been approved and issued. Temporary Food Service Establishment Licensing: 1. Furnish blank temporary food service license application forms (forms Fl-231, Fl- 231A) and blank Combined License/Inspection forms (Fl-229) upon request from the local health department. 2. Furnish a "Record of Licenses Received" with each order of Combined Licenses/Inspection forms. 3. Periodically reconcile temporary food service establishment licenses sent to the local health department with the licenses that have been issued (copy returned to MDA). Request payment of state fees for any temporary food service establishment license that cannot be accounted for. 4. Bill the local health department for state fees upon notification by the local health department that the license has been approved and issued. 50 Contractor Requirements The local health department agrees to: Food Service Establishment Licensing 1. Accept responsibility for all licenses specified in the "Record of Licenses Received." 2. Issue licenses in accordance with the Michigan Food Law 2000, as amended. 3. Provide updates to MDA on the 1. and 15th of each month, as necessary to: a. Provide a list of food service establishments approved for licensure/license issued. b. Provide a list of food service establishment licenses that have not been approved for licensure and are considered voided or deleted. c. Return the actual licenses to MDA that are to be voided or deleted. d. Return renewal license applications and licenses that require correction. Mark the corrections on the renewal application. Temporary Food Establishment Licensing 1. Upon receipt, sign and return the "Record of Licenses Received' to MDA. 2. Issue licenses in accordance with the Michigan Food Law 2000, as amended. 3. Make every effort to issue temporary food establishment licenses in numerical order. 4. Provide updates to MDA on theis t and 15th of each month, as necessary, to provide: a. A copy of each temporary food establishment license issued. b. A list of lost or voided licenses by license number. 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." Agency Requirements 1. Maintain a local tobacco reduction coalition to help mobilize community awareness and interest in addressing the problems of tobacco use. 2. Emphasize multi-cultural inclusiveness and outreach to diverse groups as appropriate within the community. 3. Undertake activities focusing on protecting non-smokers from secondhand smoke. 4. Prepare and implement an annual agency tobacco reduction work plan. 5. Submit triannual reports and other required program documentation to Tobacco Program Consultant on a timely basis. 6. Attend Department regional and statewide coalition coordinator training. 51 MATERNAL AND CHILD HEALTH (MCH) PROGRAM SPECIAL REQUIREMENTS General Performance Requirements 1. LOCAL MATERNAL AND CHILD HEALTH Local MCH funds are intended to be flexible and available to local health departments to address locally identified needs related to the health of women and children in their jurisdictions. It is expected that each local health department will use a defined needs assessment process to determine and identify its MCH needs. In addition, local health departments are asked to examine, (to the extent data is available) their status on each of 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 Submit a Local Maternal and Child Health Community Plan for use of the funds allocated for Local MCH Programs. 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., CSHCS Outreach & Advocacy, CSHCS Case Management and/or Care Coordination, Child Health, Family Planning, Immunization, Maternal & Infant Support, Healthy Kids Outreach & Advocacy, Oral Health, Prenatal Care Clinic Services and Primary Care). This funding source cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of the expenditures and evidence is provided that the expenditures satisfy all funding requirements. Local MCH funds 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 the Division of Family and Community Health. Local MCH funds may not be used to supplant available/billable program income such at 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. MICHIGAN ABSTINENCE PROGRAM (MAP) SPECIAL REQUIREMENTS—DISTRICT HEALTH DEPARTMENT #10 Contractor Requirements 1. Objectives A. The primary objectives under this agreement are outlined in the grant application submitted by the Contractor and on file at the Department and with the MAP Community Health Consultant at Michigan Public Health Institute. This grant application is incorporated by reference upon signature of this agreement. 52 2. Conditions: A. By signing this agreement, the Contractor assures that the grant application and subsequent activities will follow the criteria outlined in the current MDCH appropriation act governing abstinence education funding, and will work within the framework of the Michigan Abstinence Program (MAP) guidelines/requirements as outlined in the Request For Community Action Plans (RFCAP). By agreeing to this, the Contractor also understands that no contraceptives may be distributed to minors and no safer sex message/information may be delivered with either state funding or the local matching dollars. The community-selected abstinence education and parent education curricula must be prior-approved by MDCH/MAP to assure compliance with state and federal regulations. B. Funds will be released pending receipt/agreement of all required work plan revisions. Beginning October 1, 2004, funding is only authorized up to $48,241 for FY 05 MAP programming, until further written notice. C. The Contractor must agree and abide by the following conditions: 1. Project activities will comply with the abstinence education definition in Section 510 of Title V of the Social Security Act. 2. MDCH's appropriation boilerplate will be followed. 3. Federal funds will not be expended for sectarian instruction, worship, prayer, or proselytization in project activities. If a grantee is a faith-based or religious organization and offers such activities, these activities shall be voluntary for the individuals receiving services and offered separately from MAP. 4. Any discussion of other forms of sexual conduct or provision of services will be conducted in a setting different from where and when the abstinence-only education is being conducted. 5. The Contractor will work with the MAP Evaluation Consultant to develop effective evaluation tools including a required set of standardized questions to be supplied by MDCH/MAP. 3. Projected Outputs: A. Rebord projected outputs on the Performance Output Measures report and return with the signed agreements and budget. 4. Reporting Requirements: A. The Contractor shall prepare quarterly narrative Performance/Progress Reports following the format provided by MDCH/MAP. These quarterly narrative reports must be submitted no later than January 14,2005, April 15,2005 and July 15, 2005. The year-end report, which includes both the last quarter and an annual summary, is due November 15, 2005. Unduplicated and duplicated counts must be submitted no later than fifteen (15) days after the close of each quarter. These counts must be included on the Unduplicated form and the Total Encounters form as provided by MDCH. A copy of the Contractor's most recently submitted Financial Status Report (FSR) must accompany these data report forms. B. Any other information as specified should be developed and submitted by the Contractor as required by the Community Health Consultant or the MAP Coordinator. C. Performance/Progress Data Reports and a copy of the FSR described in #1 above should be submitted to the Community Health Consultant at the address below: 53 Michigan Public Health Institute 2438 Woodlake Circle, Suite 240 Okemos, MI 48864 D. The Community Health Consultant shall evaluate the reports submitted as described in #1 and #2 above, for completeness and adequacy. E. The Department or its designee shall conduct site reviews and make an evaluation of the project as determined by the Program Coordinator. F. Final actual outputs as defined are due no later than 120 days following the end of the fiscal year. The final output reports shall be submitted to: MAP Coordinator Michigan Department of Community Health Division of Family & Community Health PO Box 30195 Lansing, MI 48909 MICHIGAN CHILDHOOD IMMUNIZATION REGISTRY (MCIR) REGIONAL SPECIAL REQUIREMENTS (Public Health Delta and Menominee Counties, District Health Department #10, Genesee County Health Department, Kalamazoo County Health Department, Mid-Michigan District Health Department, Muskegon County Health Department) Contractor Requirements -Muskegon County Only 1. Support the statewide scanner, fax server, and any other related systems that contain childhood immunization records. Collaborate with the scan form software support company, Teleform, on an as needed basis. 2. Provide ongoing development and technical assistance for statewide scan forms and Teleform software. 3. Provide data quality and data entry support staff for scan center services. 4. Provide monthly reports to regions and MDCH on doses entered per user. Contractor Requirements - All Other Departments The regional contractor shall perform the following activities on behalf of the Michigan Department of Community Health to support the Michigan Childhood Immunization Registry: 1. Promote and train providers on all features of the MCIR Web application. 2. Support regional MCIR users by operating the regional help desk in accordance with MDCH 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. (such as sites of excellence awards). 4. Process all user/usage agreements, according to MDCH approved procedures, to create user accounts. 5., Continue to implement and update marketing plans in support of increased provider and parent acceptance and use of the MCIR. 6. Keep regional users updated on MC1R status and system changes. 54 7. Assure that records submitted via paper forms are entered in a timely fashion and according to MDCH approved procedure. 8. Conduct ad hoc reporting and querying on behalf of MC1R users. Monitor infant death announcements in the region that appropriately mark MCIR records. 9. Develop a mechanism to assure children who have died with in the region are appropriately flagged in the MC1R. 10. Maintain a listing of private and public immunization providers. This listing should be as comprehensive as possible and should include all providers in the region. 11. Conduct regular de-duplication activities to assure that duplicate records are removed from the MCIR as quickly as possible. 12. Process user petitions to change MCIR data according to MDCH approved procedures. 13. Hold advisory group meetings on at least a quarterly basis to set regional policy and set regional implementation and maintenance priorities. 14. Monitor ongoing immunization data submission for all local health departments and private providers. 15. Conduct training functions as needed to assure that local health department staff can train and educate providers on how to access and submit data into MC1R. 16. Maintain a policy/procedure manual, approved by the regional advisory group and MDCH. 17. Process and file all "opt our forms according to MDCH approved procedures. 18. Attend regular MCIR regional contractor/coordinator meetings. 19. Perform quality assurance checks on the MC1R data for the region as prescribed by MDCH. 20. Assist local health departments and private providers with methodologies to "clean up" their data. 21. Report in-kind dollars from Local Health Departments or Jurisdictions on a quarterly basis to MDCH 22. Assure that any additional allocation received because of in-kind reporting be utilized by the regional MCIR office to support MCIR activities These funds may not be distributed as reimbursement Contractor Performance/Progress Report Requirements 1. 1n-kind reports from Local Health Departments are due on a quarterly basis to MDCH. Reports are due within 30 days of the end of each quarter. (January 31, April 30, July 31, October 31) Submit quarterly status reports on work plan progress. Reports are due within 30 days of the end of each quarter. (January 31, April 30, July 31, October 31) 3. Final quarterly report shall be an annual report The annual report will be distributed to Regional Advisory members and MDCH. The report shall include: a. summary of provider enrollment (breakdown by role) b. the amount of data submitted to the region during the fiscal year c. summary of staff resources d. regional advisory meeting review e. sites of excellence award recipients 55 4. Any other information as specified in the special requirements shall be developed and submitted by the contractor as required by the contract manager. Reports and information should be submitted to: Robert Swanson, MPH Michigan Department of Community Health Immunization Division P.O. Box 30195 Lansing, MI 48909 Phone: (517)335-8159 The contract manager shall evaluate the reports submitted as described above for their completeness and adequacy. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the project as determined by the contact manager. NURSE FAMILY PARTNERSHIP (NFP) PROJECT- (DETROIT DEPARTMENT OF HEALTH AND WELLNESS, BERRIEN COUNTY, KENT COUNTY, AND OAKLAND COUNTY HEALTH DEPARTMENTS1 1. Adhere to the Nurse Family Partnership (NFP) National Office program standards and operate the program with fidelity to the requirements. 2. NFP program recipients must be a resident of one of the specified areas: A. For Berrien County Health Department, NFP program recipients must be a resident of Benton Harbor or Benton Township, Michigan at the initiation of services. B. For the Detroit Department of Health and Wellness_NFP program recipients must be a resident of the City of Detroit at the initiation of services. C. For Kent County Health Department, NFP program recipients must be a resident of Grand Rapids, Michigan at the initiation of services. D. For Oakland County Health Department, NFP program recipients must be a resident of Pontiac, Michigan at the initiation of services. 3. The primary target population is, low-income, first time African American pregnant women living in the specified area: A. Benton Harbor and Benton Township, Michigan for Berrien County Health Department B. Detroit, Michigan for Detroit Department of Health and Wellness. C. Grand Rapids, Michigan for Kent County Health Department D. Pontiac, Michigan for Oakland County Health Department. 4. NFP home visiting nursing staff will reflect the community served. Submit a staff roster for the fiscal year and within 30 days of a change. 5. Authorize the Michigan Department of Community Health (MDCH) access to the community's NFP Clinical Information System (CIS) and provide all necessary information for client identification, such as clients' demographic information and NFP or local identification numbers used in the CIS database. The Nurse Family Partnership reimbursement will use the staffing grant mechanism subject to a match requirement (hard or in-kind) of two dollars for each ten dollars for MDCH agreement funding. 56 7. Provide MDCH consultant or authorized contractor program access. 8. Build upon and maintain diverse community and target population collaboration and support. 9. Develop and maintain a broad-based NFP community advisory committee. The committee shall consist of at least 50% consumers/community leaders from the target population and the remainder from referring/partnering/supporting agencies. Additional members would include appropriate health department staff. Meetings will be held once per quarter in coordination with the Michigan NFP Consultant or an MDCH designee, who will serve as an ad hoc member. Submit all required reports in accordance with the MDCH reporting requirements. Reporting Reauirements 1. The contractor shall adhere to the NFP National Office program reporting requirements. 2. Submit to MDCH the broad-based community advisory committee minutes and attendance records 45 days after the end of the quarter. Attendance records should include attendees' names and reflect their advisory committee representation as a consumer/community leader, referring/partnering/supporting agency staff or implementing agency staff. 3. Reports and information shall be submitted to: Nurse Family Partnership Division of Family and Community Health Michigan Department of Community Health P.O. Box 30195 Lansing, Michigan 48909 Or via e-mail to: Paulette Dobynes Dunbar at dunbarpamichigan.gov . (Please put "Nurse Family Partnership Reports FY 05" in the subject line.) PRIMARY CARE DENTAL SPECIAL PROJECT Contractor Requirements 1. Carry out the intent of the Funding Announcement in accordance with the CPBp 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 patbnts. 4. Submit the following reports as indicated: 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 patent so comparisons can be 57 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. Brenda Fink Michigan Department of Community Health P.O. Box 30195 3423 N. Martin Luther King, Jr., Blvd. Lansing, Michigan 48909 Telephone: (517) 335-8928 Fax: (517) 335-8294 finkb@michigan.gov The Contractor shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. Northwest Community Health Agency and Western UP. District Health Department have a staffing reimbursement mechanism. 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 biling and MOD forms. 4. Evaluate the reports submitted as described above for their completeness and accuracy. RAPE AND SEXUAL ASSAULT PREVENTION EDUCATION SPECIAL REQUIREMENTS— KENT COUNTY HEALTH DEPARTMENT Contractor Requirements 1. Submit continuation application no later than 5/30/2004. 2. Ensure that the continuation application contains a viable work plan, measurable Objectives, and a budget requesting no more than $56,000 in state funds. 3. Submit performance/progress reports as listed below: A. The Contractor shall submit the following reports on the following dates: Financial Status Report (FSR) Monthly Report 1 (Oct. 2004-Jan. 2005) February 15, 2005 Report 2 (Feb. 2005— May 2005) June 15, 2005 Comprehensive Final Report (Nov. 2005-Sept. 2005) October 15,2005 Evaluation Report October 15, 2005 B. My such other information as specified in the Contract Requirements shall be developed and submitted by the Contractor as required by the Contract Manager. C. Reports and information shall be submitted to the Contract Manager at Grzywaczi@_michigan.gov. D. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. E. The Contractor shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. SIDS AND OTHER INFANT DEATH - SPECIAL REQUIREMENTS Contractor Requirements 1. LHD personnel will maintain current expertise in infant death research, bereavement counseling and surveillance techniques through educational in-service and/or personal professional development 2. The LHD will update current curriculum and materials and child health programs to incorporate SIDS and other infant death risk reduction information. 3. Facilitate bereavement support services to families and other caretakers of infants experiencing an infant death. 4. Complete a referral to the Tomorrow's Child (formerly Michigan SIDS Alliance) for bereavement literature and information on program activities. 5. Encourage all infant deaths to be reviewed in the local Child Death Review team process or Fetal-Infant Mortality Review process (if available) to improve the consistency of death scene investigation, autopsy, death certificate documentation and accurate SIDS diagnosis. Department Requirements 1. Provide payment of $85 for each family support visit. A maximum of 6 visits is reimbursable per infant death. 2. Provide forms for referral to Tomorrow's Child (formerly Michigan SIDS Alliance) for documenting family support visits and for ordering risk reduction literature. 3. Provide training for certification of family support providers. 4. Provide technical assistance for bereavement support through Tomorrow's Child (formerly Michigan SIDS Alliance). TB CONTROL (DOT) SPECIAL REQUIREMENTS General Requirements Directly Observed Therapy (DOT) is defined by the Core Curriculum on Tuberculosis 2000 as: 'a health care worker on another designated person watching the patient swallow each dose of TB medication". It is the most effective strategy to ensure patient adherence to treatment DOT should be used with all intermittent regimens. Multi-drug resistant Ta (MDR TB) should always be treated with a daily regimen and under direct observation. Requirements for eligibility in this program include providing DOT at least 5 days/weeks (excluding holidays) for daily regimens, and 2 or 3 days/week for intermittent regimens. Specific Requirements I. Submit an enrollment form (DOT registration form) for each TB case (including cases transferred into the county) enrolled in DOT to the MDCH TB Program. 2. For each patient enrolled in DOT, submit evidence (i.e. DOT logs) monthly to the MDCH TB Program that DOT was accomplished. 3. For each patient enrolled in DOT, submit RVCT II forms (Completion of Therapy) to the MDCH TB Program upon completion or termination of thermy. 4. Achieve a minimum of 80% of TB cases enrolled annually in DOT (October Ito September 30). ft 5. Achieve an 80% adherence rate for each DOT case enrolled. Patients will take at least 80% of their prescribed doses of medication. 59 6. Achieve >95% completion rate for treatment of all TB cases. WIC SPECIAL REQUIREMENTS Contractor Requirements 1. 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 [246.6(FX1)]. 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. 5. The Agency in accordance with the general purposes and objectives of this agreement, will comply with the federal regulations requiring that any individual that embezzles, willfully misapplies, steals or obtains by fraud, any funds, assets or property provided, whether received directly or indirectly from the USDA, that are of a value of $100 or more, shall be subject to a fine of not more than $25,000. 1NIC INCREASED PARTICIPATION SPECIAL REQUIREMENTS Budget and Agreement Requirements The funding described below for WIC Increased Participation is to be shown separately from WIC regular allocated funding under the WIC 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, And 2. 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. 60 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 Requirement 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. For specific WISEWOMAN Program requirements, refer to the most current WISEWOMAN Program Policies and Procedures Manual. 61 Attachment IV Oakland County Health Division FY 2004-2006 CPBC AGREEMENT MDCH Funding Allocations/Reimbursement Mechanisms Matrix Total (c) State (d) State Funded Minimum MOCH Funding Reimbursement Performance Target Perform. Funded Target Performance Percent Program Element/Funding Source (a) Source Amount Mechanism (b) Output Measurement Expect Perform. Number (e) After Program approval, applicable Local Mal funding will be Incorporated under the program elements selected In the plan, along Program for Local MCH to be determined based on plan approval Local Mal (3) $332,954 with approved output performance measures, via amendment AIDS1HIV Prevention Reg. Alloc. $508,575 Performance # Persons Post-Test * 90% Counseled in Anonymous or Confidential Public Health Clinics Bioterrorism Emergency Preparedness . Focus Area A Preparedness Coordinator Reg. Ake. $100,000 Staffing (6) MA N/A N/A N/A N/A SNS Planner Work Space Reg. Ail= $0 Staffing (6) N/A N/A N/A NIA N/A Focus Area B Epidemiology Reg. Alloc. $0 Staffing (6) N/A N/A NIA NIA N/A Regional Epidemiology Support Reg. Mac. $10,000 Staffing (6) N/A NIA N/A N/A N/A Focus Area E Reg. Alloc. $0 Staffing (6) N/A N/A N/A N/A N/A Focus Area F Reg. Ailoc, $0 Staffing (6) N/A N/A N/A N/A N/A Focus Area 0 ReilyAlloc. $0 Staffi . (6) N/A NIA N/A N/A N/A CSHCS Care Coordination Calc. Amt. Various Fixed Unit Rate (1),(7) N/A N/A N/A N/A N/A CSHCS Outreach & Advocacy Reg. Mac. $151,600 Staffing (6) N/A N/A N/A N/A N/A Immunizations Assessment Feedback Incentive Exchange (AF(X) Cale. Amt. 50/each Fixed Unit Rate (2), N/A N/A N/A N/A N/A (7) Immunization Action Plan Reg. Ailoc. $513,533 Staffing (6) NIA N/A N/A N/A N/A Vaccine Replacement/Handling Reg. Mac. $116,109 Staffing (6) N/A NIA N/A N/A N/A VFC Provider Site Visits Cab, Amt. $200/each Fixed Unit Rate (2),(7) WA N/A N/A N/A N/A Visits Nurse Training Calc. Amt. $100/each Fixed Unit Rate (2),(7) N/A N/A N/A N/A N/A MDCH/CMS 4/04 Page 1 TOTAL MDCH FUNDING $7,247,846 .1n11.118nINIMMIC Oakland County Health Division FY 2004-2006 CPBC AGREEMENT MDCH Funding Allocations/Reimbursement Mechanisms Matrix Attachment iv Total (c) State (d) State Funded Minimum MDCH Funding Reimbursement Performance Target Perform. Funded Target Performance Percent Program Element/Funding Source (a) Source Amount Mechanism (b) Output Measurement Expect Perform. Number (e) , Informed Consent Calc. Amt. $50/each Fixed Unit Rate (2),(7) NIA N/A N/A N/A N/A Laboratory Services . Bioterrorism Lab Reg. Alloc. $155,992 Staffing (6) N/A NIA NIA NIA N/A Poodbome Training Reg. Ake. $15,000 Staffing (6) N/A N/A N/A N/A N/A Local Public Health Operations _ MDCH Reg. Alloc. $2,666,254 LPHO (4) N/A NIA N/A N/A N/A MDA Reg. Alloc. $853,593 Performance % of Food Service N/A 75% N/A N/A Licensees receneing required Inspections i ' Nurse Family Partnership Reg. Alloc. $331,324 Staffing (6) N/A N/A N/A N/A N/A Sexually Transmitted Disease (STD) Control -.* * Reg. Alloc. $109,696 Performance # Persons Examined or 90% investigated n . SIDS Calc. Amt. $85 each 1 Fixed Unit Rate N/A N/A N/A N/A N/A . (2),(11) .. TB Control (DOT) Reg. Alloc. $49,771 Performance Number of persons who . 90% * have been enrolled in DOT and who have , completed treatment for active tuberculosis ' WIC Resident Services Reg. Alioc. $1,333,434 Performance (8) *Average Monthly N/A 97% • Participation `SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT MDCH/CMS 4/04 Page 2 (c) (d) NOTES: (a) Refer to Plan and Budget Framework for element definitions. (b) Refer to master comprehensive agreement and program and budget Instructions package for further explanation of applicability of these reimbursement mechanisms. Negotiated starting from the average of the past two complete years' actual number where available. 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). Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. (1) CSHCS Care Coordination 1. Case Management A. Maximum of six (6) services per year B. PDLI Clients must receive a minimum of four (4) services per eligibility year C. Reimbursement - $201.58 per service provided in the house setting and face-to-face 2. LEVEL I CARE COORDINATION A, Annual Care Plan 1. Annual Care Plan Conducted in Person $160 2. Annual Care Plan Conducted by Telephone $100 3. LEVEL il CARE COORDINATION A. Level II Care Coordination is reimbursed at $30.00 per unit B. A maximum of 10 units per beneficiary per eligibility year will be reimbursed. (2) Reimbursement Chart for Fixed Rates Assessment Feedback IcentIve Exchange $50 per site visit, not to exceed the maximum set for each individual contractor. Immunization Nurse Training $100 per session, upon completion and submission of Provider Contracts and Report Forms. Reimbursement can only be made for one inservice module session per physician clinic site per year. Immunization VFC Provider Site Visits $200 per site visit, not to exceed the maximum set for each individual Contractor. informed Consent $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services. Laboratory Services - STD & AIDS $2.45 for each swab specimen and $3.98 for each urine specimen for diagnosis of gonorrhea and chiamydia infections using a nucleic acid amplification assay. Dental - Special Project Provide reimbursement for services provided to the target population as stipulated In the Funding Announcement. SIDS $85 for each family support visit. A maximum of six (6) visits per infant death is reimbursable. WIC increased Participation $8.50 per month for each planned additional participant in excess of the "Allocated Base Caseload." 3) Allocation to be reflected In individual programs during budgeting process. 4) Funding Source (not a single element). 5) Subject to Statewide Maintenance of Effort requirement for Title X. 5) State funding is first source (after fees and other earmarked sources). 7) Fixed unit rate subject to actual costs. 8) Performance reimbursement target will be the base target caseload established by MDCH. 9) Subject to a match requirement (hard or in-kind) of $1 for each $4 of MDCH agreement funding. 10) Fixed unit rate limited to contract amount. 11) Up to six (8) visits per family. 12) Subject to match requirement (hard or in-kind) of 50% of MDCH agreement funding. 13) Subject to match requirement (hard or in-kind) of $1 for each $4 of MDCH agreement funding for coordination, and direct service funding paid by the program third party administrator to the local health department and/or the local health department's contracted providers. (14) Subject to a match requirement (hard or in-kind) of $2 for each $10 of MDCH agreement. (15) Western UP District Health Department's and Northwest Community Health Department's reimbursement mechanisms are staffing; at! others are subject to a fixed unit rate funding mechanism. NOTE: Some footnotes may not apply to this agency. FISCAL NOTE (MISC. #04320) November 18, 2004 BY: FINANCE COMMITTEE, CHUCK MOSS, CHAIRPERSON IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - 2004/2005 COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC) AGREEMENT ACCEPTANCE TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced resolution and finds: 1. The Michigan Department of Community Health (MDCH) has awarded Oakland County Health Division funding in the amount of $7,247,845 for the period of October 1, 2004 through September 30, 2005. This award reflects a 11.28%; ($817,719) decrease from the FY2003/2004 amended funding allocation of $8,065,564. 2. Total Health Fund Revenue is as follows: Michigan Dept. of Community Health $2,666,254 Food Protection 853,593 Sexually Transmitted Disease 109,696 Total Health Fund 3,629,543 3. Total Grant Fund Revenue is as follows: Aids Prevention $ 508,575 Bioterror Coordinator 100,000 EPI Planner Workplace 10,000 Immunization Action Plan 513,533 CSHCS Outreach & Advocacy 151,600 Maternal & Infant Support 294,519 Child Health Conference 38,445 TB Control 49,771 Laboratory Program 155,992 Vaccine Replacement/Handling 116,109 Foodborne Training 15,000 Nurse Family Partnership 331,324 WIC Residential Services 1,333,434 Total Grant 3,618,302 Grand Total $7,247,845 4. Acceptance of this grant does not obligate the County to any future commitment. 5. The FY2005 Adopted Budget will be amended after finalization of the CPBC funding structure. FINANCE COMMITTEE FINANCE COMMITTEE Motion carried unanimously on a roll call vote. Resolution #04320 November 18, 2004 Moved by Wilson supported by Hatchett the resolutions on the Consent Agenda be adopted (with accompanying reports being accepted). AYES: Coleman, Crawford, Douglas, Gregory, Hatchett, Jamian, Knollenberg, KowaII, Law, Long, McMillin, Middleton, Moffitt, Moss, Palmer, Patterson, Potter, Rogers, Scott, Suarez, Webster, Wilson, Zack, Bullard. (24) NAYS: None. (0) A sufficient majority having voted therefore, the resolutions on the Consent Agenda were adopted (with accompanying reports being accepted). APPROVE THE WRING IESOLUTION 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 18th, 2004 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 18th day of November, 2004. G. William Caddell, County Clerk