HomeMy WebLinkAboutResolutions - 2005.09.01 - 27989MISCELLANEOUS RESOLUTION #05160 August 18,2005
BY: General Government Committee, William R. Patterson, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/CHILDREN'S VILLAGE
DIVISION - FY 2005-2006 CHILDREN'S VILLAGE SCREENING PROJECT GRANT
ACCEPTANCE
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
WHEREAS in FY 2004-2005 the Michigan Department of Community Health (MDCH)
awarded a grant to the Department of Health and Human Services — Children's Village Division in the
amount of $73,000 for the purpose of screening, compiling data, and treating at-risk adolescents for
sexually transmitted diseases (STD's); and
WHEREAS the MDCH is providing a sixth year of funding for the Adolescent Screening
Project; and
WHEREAS the special revenue, part-time, non-eligible General Staff Nurse position will be
continued; and
WHEREAS the MDCH has awarded a grant in the amount of $73,000 for FY 2005-2006; and
WHEREAS Children's Village and the Health Division have worked collaboratively in
identifying, screening, and treating at-risk adolescents in special settings including juvenile detention, the
County jail, the Frank Greenan Detention Facility, Crossroads for Youth, Common Ground Sanctuary, the
Oakland County Juvenile Drug Court, and the two Pontiac School District's Teen Health Centers; and
WHEREAS this grant is 100% federally funded with no County match; and
WHEREAS there are no additional personnel requested; and
WHEREAS acceptance of this grant award does not obligate Oakland County to future funding
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners
approve acceptance of the continuation of this grant award in the amount of $73,000 to the Department
of Health and Human Services — Children's Village Division
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute the Grant
Agreement and approve changes and extensions not to exceed fifteen percent (15%), which is consistent
with the acceptance as originally approved.
Chairperson, on behalf of the General Government Committee, I move the adoption of the
foregoing resolution.
dL
GENERAL GOVERNMENT COMMITTEE
General Government Committee Vote:
Motion carried on a roll call vote with Long. Kowall and Coulter.
GRANT REVIEW — Children's Village
GRANT NAMEE: 2005-2006 Children's Village Screening Project
FUNDING AGENCY: Michigan Department of Community Health
DEPARTMENT CONTACT PERSON: Jody Overall! 8-1164 Tom Gordon /8-1293
STATUS: Acceptance
DATE: August 2, 2005
Pursuant to Misc. Resolution #01320, please be advised the captioned grant materials
have completed internal grant review. Below are the comments returned by review
departments.
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 (7/27/2005)
Department of Human Resources:
Approved. — Nancy Scarlet (7/31/2005)
Risk Management and Safety:
Approved. - Gerald Mathews (7/28/2005)
Corporation Counsel:
I have reviewed the documents for the above referenced Grant, and with the inclusion by
the State of our required 'Addendum A', I approve the Grant for signature. - John Ross
(8/2/2005)
Department of Health and Human Services —Children's Village Division
Children's Village Screening Project
August 2005
• MDCH, through federal funds from the U.S. Centers for Disease Control (CDC), intends to
continue a grant to Children's Village for FY2005-2006. The funds are intended to facilitate
a sixth year of screening of adolescents for sexually transmitted infections. The grant total is
$73,000. There is no County match.
Salaries and Fringe Benefits Offset. $64,894.00
Other Expenditures (include travel, equipment, and supplies) $8,106.00
• The grant objective is to continue to compile data and enhance disease detection and health
services to high-risk adolescent (ages 13 through 19). Clinical experience and literature
review reveals that adolescent females are at an increased risk for sexually transmitted
infections due to their biological vulnerability, their risk-taking behavior and their perceived
lack of consequences. Additionally, sexually transmitted diseases are mostly asymptomatic.
The project presents significant opportunity for Children's Village to continue to collaborate
with other service providers dealing with at-risk adolescents. The Project sites includes:
Children's Village, Oakland County Main Jail, Frank Greenan Male Detention Facility,
Crossroads for Youth, Common Ground Sanctuary, the two Pontiac School District's Teen
Health Centers, and the Juvenile Drug Court.
• During the first five years of funding over 5528 adolescents were screened under the auspices
of the project. Positivity rates (3% for gonorrhea, 14% for chlamydia) are significant and,
>94% of the adolescents testing positive were treated. All released adolescents testing
positive receive confidential communications regarding test results and the follow-up needed.
• MDCH (through federal awards) will fund 100% of the grant. Funding for the Children's
Village Screening Project will be utilized to offset personnel costs, supplies, material, travel
and other logistics. Any funding for personnel costs is strictly for the life of the grant with no
County obligation to continue once the grant period has expired. Likewise, all participating
agencies are aware that the project is funded for an additional year only.
• Positivity rates for sexually transmitted infections for chlamydia and gonorrhea will be
compiled and presented to the Oakland County Health Division and MDCH. The screening
project is part of Children's Village's effort to address the Focused Infant Mortality
Reduction Plan.
Contract #:
Grant Agreement Between
Michigan Department of Community Health
hereinafter referred to as the "Department"
and
Oakland County Children's Village
1200 N. Telegraph Rd., Det. 444 - Bldg 63 West
Pontiac, Ml 48341-0444
Federal l.D.#: 38-6004876
hereinafter referred to as the "Contractor"
for
Children's Village Screening Project
Part!
1. Period of Agreement: This agreement shall commence on October 1, 2005 and
continue through September 30, 2006. This agreement is in full force and effect for
the period specified.
2. Program Budget and Agreement Amount
A. Agreement Amount
The total amount of this agreement is $ 73,000. The Department under the
terms of this agreement will provide funding not to exceed $ 73,000. The
federal funding provided by the Department: is $ $73,000 or approximately
100%; the Catalog of Federal Domestic Assistance (CFDA) number is 93-977
and the CFDA Title is Preventive Health Services STD (CSPS); the federal
agency name is CDC/NCHSTP/DSTDP; the federal grant award number is
H25/CCH504341-14 and federal program title is Sexually Transmitted Diseases
CSPS). The grant agreement is designated as a:
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E vendor relationship.
B. Equipment Purchases and Title
Any contractor equipment purchases supported in whole or in part through this
agreement must be listed in the supporting Equipment Inventory Schedule.
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 items having a unit acquisition cost of less than $5,000 shall vest with
DCH-0565FY2006 2/05 (W) 1 of 19
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. Deviation Allowance
A deviation allowance modifying an established budget category by $10,000 or
15%, whichever is greater, is permissible without prior written approval of the
Department. Any modification or deviations in excess of this provision,
including any adjustment to the total amount of this agreement, must be made
in writing and executed by all parties to this agreement before the modifications
can be implemented. This deviation allowance does not authorize new
categories, subcontracts, equipment items or positions not shown in the
attached Program Budget Summary and supporting detail schedules.
3. Purpose: The focus of the program is to: test adolescents at Children's Village,
Pontiac Teen Health Centers, Common Ground Sanctuary, Crossroads for Youth,
Oakland County Main Jail, Frank Greenan Male Detention, and Juvenile Drug Court
(using urine-based amplified tests for chlamydia and gonorrhea), obtain data on STDs
and assess reproductive health needs.
4. Statement of Work: The Contractor agrees to undertake, perform and complete the
services described in Attachment A, which is part of this agreement through reference.
5. Financial Requirements: The financial requirements shall be followed as described
in Part II of this agreement and Attachments B, D and E, which are part of this
agreement through reference.
6. Performance/Progress Report Requirements: The progress reporting methods, as
applicable, shall be followed as described in Attachment C, which is part of this
agreement through reference.
7. General Provisions: The Contractor agrees to comply with the General Provisions
outlined in Part II, which is part of this agreement through reference.
8. Administration of the Agreement:
The person acting for the Department in administering this agreement (hereinafter
referred to as the Contract Manager) is:
Mark k Miller. Manager, STD Section, Division _of Health * Wellness and Disease
Control, 2479 Woodlake Circle, Suite 380; Okemos, Ml, 48864. PH 517/241-0870,
millerm1@michigan.gov
Name, Location/Building Title Telephone No. Email Address
9. Contractor's Financial Contact for the Agreement:
The person acting for the Contractor on the financial reporting for this agreement is:
Laurie VanPelt , Director - Oakland County Dept. of Management and Budget
Name Title
vanpelt@co.oakland.mi.us 2481858-0487
DCH-0665FY2006 2105 (W) 2 of 19
E-Mail Address Telephone No.
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. This agreement is conditionally approved subject to and contingent upon the
availability of funds.
C. The Department will not assume any responsibility or liability for costs incurred
by the Contractor prior to the signing of this agreement.
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 CONTRACTOR
Bill Bullard, Jr, Chairperson, Oakland County Board of Commissioners
(Please print) Name Title
Signature Date
For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Mary Jane Russell, Director, Bureau Of Budget And Audit Date
DCH-0565FY2005 2/05 (W)
Part II
General Provisions
Responsibilities - Contractor
The Contractor in accordance with the general purposes and objectives of this
agreement will:
A. Publication Rights
1. 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.
2. 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.
3. The Contractor shall give recognition to the Department in any and all
publications papers and presentations arising from the program and
service contract herein; the Department will do likewise.
B. Fees
Make reasonable efforts to collect 1 st and 3rd party fees, where applicable, and
report these as outlined by the Departments 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 and audit findings have been resolved.
DCH-0665FY2006 2/05 (W) 4 of
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.
Audits
This section only applies to Contractors designated as subrecipients.
Contractors designated as vendors are exempt from the provisions of this
section.
1. Single Audit
Provide, consistent with regulations set forth in the Single Audit Act
Amendments of 1996, P.L. 104-156, and Section .320 of Office of
Management and Budget (OMB) Circular A-133, "Audits of States, Local
Governments, and Non-Profit Organizations," (as revised) a copy of the
Contractor's annual Single Audit reporting package, including the
Corrective Action Plan, to the Department.
The federal OMB Circular A-133 requires either a Single Audit or
program-specific audit (when a contractor is administering only one
federal program) of agencies that expend $500,000 or more in federal
awards during the Contractor's fiscal year.
Contractors who have a Single Audit conducted as a result of $500,000
or more in expenditures of Federal awards must submit the Single Audit
reporting package, management letter, if issued, and Corrective Action
Plan to the Department even if Federal funding received from the
Department results in less than $500,000 in expenditures.
The Contractor must also assure that the Schedule of Expenditures of
Federal Awards includes expenditures for all federally funded grants.
2. Financial Statement Audit
Contractors exempt from the Single Audit requirements that receive
$500,000 or more in total funding from the Department in State and
Federal grant funding must submit a copy of the Financial Statement
Audit prepared in accordance with generally accepted auditing standards
(GAAS), and management letter, if one is issued. Contractors exempt
from the Single Audit requirements that receive less than $500,000 of
total Department grant funding must submit a copy of the Financial
Statement Audit prepared in accordance with GAAS if the audit includes
disclosures that may negatively impact MDCH-funded programs,
including, but not limited to fraud, going concern uncertainties, financial
statement misstatements, and violations of contract and grant provisions.
DCH-0665FY2006 2/05 (W) 5 of 19
3. Other Audits
The Department or federal agencies may also conduct or arrange for
"agreed upon procedures" or additional audits to meet their needs.
4. Notification
When a Contractor is exempt from both the Single Audit requirements
and the Financial Statement Audit requirements because funding is
below the thresholds described above and there are no disclosures that
may negatively impact MDCH-funded programs, the Contractor must
submit an Audit Status Notification Letter that certifies these exemptions.
The Audit Status Notification Letter must be signed by the Contractor's
Financial Director or their designee. Attachment E contains the required
Audit Status Notification Letter. Contractors should not send the
completed letter to the Department with their signed agreement, but
should submit as directed in item 7.
5. Due Date
The Single Audit reporting package, management letter, if one is issued,
and Corrective Action Plan; Financial Statement Audit and management
letter, if one is issued; or Audit Status Notification Letter shall be
submitted to the Department within nine months after the end of the
Contractor's fiscal year.
6. Penalty
a. Delinquent Single Audit or Financial Statement Audit
If the Contractor does not submit the required Single Audit
reporting package, management letter, and Corrective Action
Plan; or the Financial Statement Audit and management letter
within nine months after the end of the Contractor's fiscal year, the
Department may withhold from the current funding an amount
equal to five percent of the audit year's grant funding (not to
exceed $100,000) until the required filing is received by the
Department. The Department may retain the amount withheld if
the contractor is more than 120 days delinquent in meeting the
filing requirements.
b. Delinquent Audit Status Notification Letter
Failure to submit the Audit Status Notification Letter, when
required, may result in withholding from the current funding an
amount equal to one percent of the audit year's grant funding until
the Audit Status Notification Letter is received.
7. Where to Send
A copy of the Single Audit reporting package, management letter, if one
is issued, and Corrective Action Plan; Financial Statement Audit and
management letter, if one is issued; or the Audit Status Notification Letter
must be forwarded to:
Michigan Department of Community Health
DCH-0655FY2006 2/05 (W) r,f 13
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
As an alternative to paper filing, the audit report and related
documentation may be submitted to the above address on a CD-ROM in
a Portable Document Format (PDF) compatible with Adobe Acrobat
(read only). The audit report and related documentation should be
assembled as one document in the following order:
a. Financial Statement Audit Report/Single Audit Report,
b. Corrective Action Plan or other information as applicable to MDCH
grants, and
c. Management Letter (Comments and Recommendations).
Another alternative is to send notification to the above address that the
required audit materials may be accessed, in Adobe PDF, from the
Contractor's website.
8. Management Decision
The Department shall issue a management decision on findings and
questioned costs contained in the Contractor's 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 of documentation,
as a way of mitigating disallowed costs.
H. SubrecipientNendor Monitorino
The Contractor must ensure that each of its subrecipients comply with the
Single Audit Act requirements. The Contractor must issue management
decisions on audit findings of their subrecipients as required by OMB Circular
A-133.
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The Contractor must also develop a subrecipient monitoring plan that
addresses "during the award monitoring" of subrecipients to provide
reasonable assurance that the subrecipient administers Federal awards in
compliance with laws, regulations, and the provisions of contracts, and that
performance goals are achieved. The subrecipient monitoring plan should
include a risk-based assessment to determine the level of oversight, and
monitoring activities such as reviewing financial and performance reports,
performing site visits, and maintaining regular contact with subrecipients.
The Contractor must monitor vendors for performance of contract
requirements.
Notification of Modifications
Provide timely notification to the Department, in writing, of any action by its
governing board or any other funding source that would require or result in
significant modification in the provision of services, funding or compliance with
operational procedures.
J. Software Compliance
The Contractor must ensure that software compliance and compatibility with the
Department's data systems for services provided under this agreement
including but not limited to: stored data, databases, and interfaces for the
production of work products and reports. All required data under this
agreement shall be provided in an accurate and timely manner with out
interruption, failure or errors due to the inaccuracy of the Contractor's business
operations for processing date/time data.
K. Human Subjects
The Contractor agrees to submit all research involving human subjects, which is
conducted in programs sponsored by the Department, or in programs that
receive funding from or through the State of Michigan, to the Department's
Institutional Review Board (IRB) for approval prior to the initiation of the
research.
Responsibilities - Department
The Department in accordance with the general purposes and objectives of this
agreement will:
A. Reimbursement
Provide reimbursement 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 provide to the Contractor any new
report forms and reporting formats proposed for issuance thereafter at least
ninety (90) days prior to their required usage in order to afford the Contractor an
opportunity to review and offer comment.
DCH-0665FY2006 2/05 (W) 8 of 19
III. Assurances
The following assurances are hereby given to the Department:
A. Compliance with Applicable Laws
The Contractor will comply with applicable federal and state laws, guidelines,
rules and regulations in carrying out the terms of this agreement. The
Contractor will also comply with all applicable general administrative
requirements such as OMB Circulars covering cost principles, grant/agreement
principles, and audits in carrying out the terms of this agreement.
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. In the performance of any contract or purchase order resulting herefrom,
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 proactive efforts
will be made to identify and encourage the participation of minority
owned and women owned businesses, and businesses owned by
persons with qiiesdalativauin contract solicitations. The Contractor shall
incorporate language in all contracts awarded: (1) prohibiting
discrimination against minority owned and women owned businesses
and businesses owned by persons with disabilities in subcontracting; and
(2) making discrimination a material breach of contract.
DCH-0665FY2006 2/05 (W) 9 of 19
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 it, its employees and its subcontractors:
1. Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any federal department or contractor;
2. Have not within a three-year period preceding this agreement been
convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (federal, state, or local)
transaction or contract under a public transaction; violation of federal or
state antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements,
or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a
government entity (federal, state or local) with commission of any of the
offenses enumerated in section 2, and;
4. Have not within a three-year period preceding this agreement had one or
more public transactions (federal, state or local) terminated for cause or
default.
E. Federal Requirement: Pro-Children Act
1. Assurance is hereby given to the Department that the Contractor will
comply with Public Law 103-227, also known as the Pro-Children Act of
1994, 20 USC 6081 et seq, which requires that smoking not be permitted
in any portion of any indoor facility owned or leased or contracted by and
used routinely or regularly for the provision of health, day care, early
childhood development services, education or library services to children
under the age of 18, if the services are funded by federal programs either
directly or through state or local governments, by federal grant, contract,
loan or loan guarantee. The law also applies to children's services that
are provided in indoor facilities that are constructed, operated, or
maintained with such federal funds. The law does not apply to children's
services provided in private residences; portions of facilities used for
inpatient drug or alcohol treatment; service providers whose sole source
of applicable federal funds is Medicare or Medicaid; or facilities where
Women, Infants, and Children (WIC) coupons are redeemed. Failure to
comply with the provisions of the law may result in the imposition of a
civil monetary penalty of up to $1,000 for each violation and/or the
imposition of an administrative compliance order on the responsible
entity. The Contractor also assures that this language will be included in
any subawards which contain provisions for children's services.
2. The Contractor also assures, in addition to compliance with Public Law
103-227, any service or activity funded in whole or in part through this
agreement will be delivered in a smoke-free facility or environment.
DCH-0665FY2006 2/05 (W) 10 of 19
Smoking shall not be permitted anywhere in the facility, or those parts of
the facility under the control of the Contractor. If activities or services are
delivered in facilities or areas that are not under the control of the
Contractor (e.g., a mall, restaurant or private work site), the activities or
services shall be smoke-free.
F. Hatch Political Activity Act and Intergovernmental Personnel Act
The Contractor will comply with the Hatch Political Activity Act, 5 USC 1501-
1508, and the Intergovernmental Personnel Act of 1970, as amended by Title VI
of the Civil Service Reform Act, Public Law 95-454, 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. 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 within 30 days of
execution of the agreement.
2. That any executed subcontract to this agreement 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;
b. Restates provisions of this agreement to afford the Contractor the
same or substantially the same rights and privileges as the
Department; or
c. Requires the subcontractor to perform duties and/or services in
less time than that afforded the Contractor in this agreement.
3. That the subcontract does not affect the Contractor's accountability to
the Department for the subcontracted activity.
4. That any billing or request for reimbursement for subcontract costs is
supported by a valid subcontract and adequate source documentation on
costs and services.
5. That the Contractor will submit a copy of the executed subcontract if
requested by the Department.
H. 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
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applicable portions of the associated "Common Rule" as promulgated by
responsible federal contractor(s), or OMB Circular A-110 as amended, as
applicable, and that records sufficient to document the significant history of all
purchases are maintained for a minimum of three years after the end of the
agreement period.
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 H1PAA 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
H1PAA requirements. The policies and procedures must meet all
applicable federal and state requirements including the HIPAA
regulations. These policies and procedures must include restricting
access to the protected health data and information by the Contractor's
employees.
5. The Contractor must have a policy and procedure to report to the
Department unauthorized use or disclosure of protected health data and
information that falls under the HIPAA requirements of which the
Contractor becomes aware.
6. Failure to comply with any of these contractual requirements may result
in the termination of this agreement in accordance with Part II, Section V.
Termination.
7. In accordance with HIPAA requirements, the Contractor is liable for any
claim, 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. Financial Requirements
A. Operating Advance
An operating advance may be requested by the Contractor to assist with
program operations. The request should be addressed to the Contract
Manager identified in Part 1, Item 8. The operating advance will be
administered as follows:
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1. The advance amount requested must be reasonable in relationship to
the program's requirements, billing cycle, etc.; and in no case may the
advance exceed the amount required for 60 days operating expense.
Operating advances will be monitored and adjusted by the Department
according to total Department agreement amount.
2. The advance must be recorded as an account payable to the
Department in the Contractor's financial records. The operating advance
payable must remain in the Contractors financial records until fully
recovered by the Department.
3. The monthly Financial Status Report (FSR) reimbursement for actual
expenditures by the Department should be used by the Contractor to
replenish the operating advance used for program operations.
4. The advance must be returned to the Department within 30 days of the
end date of this agreement unless the Contractor has a recurring
agreement with the Department, and may not be held pending
agreement audit. Subsequent Department agreements may be withheld
pending recovery of the outstanding advance from a prior agreement. If
the Contractor has a recurring agreement with the Department, the
Department requires an annual confirmation of the outstanding operating
advance.
The Department may obtain the Michigan Department of Treasury's
assistance in collecting outstanding operating advances. The
Department will comply with the Michigan Department of Treasury's Due
Process procedures prior to forwarding claims to Treasury. Specific Due
Process procedures include the following:
a. Department offer of a hearing to dispute the debt, identifying the
time, place and date of such hearing.
b. A hearing by an impartial official.
c. An opportunity for the Contractor to examine department's
associated records.
d. An opportunity for the Contractor to present evidence in person or
in writing.
e. A hearing official with full authority to correct errors and make a
decision not to forward debt to Treasury.
f. Contractor representation by an attorney and presentation of
witnesses if necessary.
5. At the end of either the agreement period or Department's fiscal year,
whichever is first, the Contractor must respond to the Department's
request for confirmation of the operating advance. Failure to respond to
the confirmation request may result in the Department recovering all or
part of an outstanding operating advance.
13 of 19 DCH-0665FY2006 2/05 (W)
B. Reimbursement Method
The Contractor will be reimbursed in accordance with the staffing grant
reimbursement method as follows:
Reimbursement from the Department is based on the understanding that
Department funds will be paid up to the total Department allocation as agreed to
in the approved budget. Department funds are first source after the application
of fees and earmarked sources unless a specific local match condition exists.
C. _Financial Status Report Submission
Financial Status Reports (FSRs) shall be prepared and submitted to:
Michigan Department of Community Health,
Bureau of Finance
Accounting Division, Expenditure Operations Section,
P.O. Box 30720, Lansing, Michigan 48909
FSRs must be submitted on a monthly basis, no later than thirty (30) days after
the close of each calendar month. The monthly FSRs must reflect total actual
program expenditures, regardless of the source of funds, Attachment D
contains the FSR form. The FSR form and instructions for completing the FSR
form are available through your Contract Manager or the Department's web
site:
• http://www.michigan.gov/documents/DCH-0384-
Financial_Status_Report_8214_7.pdf and
• http://www.michigan.gov/documents/DCH-0384-
Financial_Status_Report_Instructions_8216_7.pdf.
Failure to meet financial reporting responsibilities as identified in this agreement
may result in withholding future payments.
El Reimbursement Mechanism
All contractors must sign up through the on-line vendor registration process to
receive all State of Michigan payments as Electronic Funds Transfers
(EFT)/Direct Deposits. Vendor registration information is available through the
Department of Management and Budget's web site:
• http://www.cpexpress.state.mi.us/
E. Final Obligations and Financial Status Report Requirements
1. Preliminary Close Out Report
A Preliminary Close Out Report, based on annual guidelines, must be
submitted by the due date using the format provided by the Department's
Accounting Division. The Contractor must provide an estimate of total
expenditures for the entire agreement period. The information on the
report will be used to record the Department's year-end accounts
payables and receivables for this agreement.
14 of 19 DCH-0665FY2006 2105 (W)
2. Final FSRs
Final FSRs are due sixty (60) days following the end of the fiscal year or
agreement period. The final FSR must be clearly marked "Final". Final
FSRs not received by the due date may result in the loss of funding
requested on the Preliminary Close Out Report and may result in the
potential reduction in the subsequent year's agreement amount.
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.
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 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 or an official of
the Contractor or an owner is convicted of any activity referenced in Section
lli.D. of this agreement during the term of this agreement or any extension
thereof.
VI. Final Reporting Upon Termination
Should this agreement be terminated by either party, within thirty (30) days after the
termination, the Contractor shall provide the Department with all financial, performance
and other reports required as a condition of this agreement. The Department will
make payments to the Contractor for allowable reimbursable costs not covered by
previous payments or other state or federal programs. The Contractor shall
immediately refund to the Department any funds not authorized for use and any
payments or funds 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.
DCH-0665FY2006 2/05 (W) 15 of 19
VIII. Amendments
Any changes to this agreement will be valid only if made in writing and accepted by all
parties to this agreement. Any change proposed by the Contractor which would affect
the Department funding of any project, in whole or in part in Part 1, Section 2.0. of the
agreement, must be submitted in writing to the Department for approval immediately
upon determining the need for such change.
IX. Liability
A. Al) 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.
X. Conflict of Interest
The Contractor and the Department are subject to the provisions of 1968 PA 317, as
amended, MCL 15.321 et seq, MSA 4.1700(51) et seq, and 1973 PA 196, as
amended, MCL 15.341 et seq, MSA 4.1700 (71) et seq.
XI. 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
DCH-0665FY2006 2/05 (W) 16 of 19
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.
DCH-0665FY2006 2105 (W) 17 of 19
Version: All Other
Programs
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
FY 05/06 AGREEMENT ADDENDUM A
1. This addendum modifies the following sections of Part II, General Provisions:
Part II
I. Responsibilities-Contractor
J. Software Compliance. This section will be deleted in its entirety and
replaced with the following language:
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 replace with the following language:
The Contractor will comply with applicable Federal and State laws, and lawfully
enacted administrative rules or regulations, in carrying out the terms of this
agreement.
I. Health Insurance Portability and Accountability Act. The provisions in this
section shall be deleted in their entirety and replaced with the following
language:
Contractor agrees that it will comply with the Health Insurance Portability and
Accountability Act of 1996, and the lawfully enacted and applicable Regulations
promulgated there under.
IX. Liability. Paragraph A. will be deleted in its entirety and replaced with the following
language.
A. Except as otherwise provided 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 of 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.
2. Special Certification:
Version All Other
Programs
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.
3. Signature Section:
For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Nick Lyon, Deputy Director Date
Operation Administration
For the CONTRACTOR
Bill Bullard, Jr., Chairperson, Oakland County Board of Commissioners
Name and Title Date
Signature Date
Attachment A
Statement of Work
Project Summary: Nine Oakland County sites serving adolescents will be utilized to
obtain data on STDs and assess reproductive health needs:
I) Oakland County Children's Village Detention
2) Oakland County Children's Village Shelter Care
3) Oakland County Main Jail
4) Oakland County Male Detention — Frank Greenan
5) Pontiac Teen Health Center - Pontiac Central High School
6) Pontiac Teen Health Center - Pontiac Northern High School
7) Common Ground Sanctuary — County Runaway Shelter
8) Crossroads for Youth — Private Funded Correctional Site
9) Juvenile Drug Court — Community-based Intensive Treatment Program
Adolescents and young adults will be interviewed using a brief computerized sexual
questionnaire and testing, treatment and counseling provided. This year the Project will
expand to include young adults through age 24, and compare positivity for infections
with adjusted age parameters. Data will be collected, analyzed and forwarded to MDCH
during the project year. Special data analysis of clients with repeat infections will be
conducted throughout year. Project Director will work with an Oakland County
epidemiologist for more detailed data analysis. Project Data will be presented to Oakland
County Human Services, Michigan Infertility Prevention Alliance, Michigan Juvenile
Detention Association and other professional associations.
Utilizing the nine identified project sites
1. Test at least 100 adolescents and young adults per month, using urine based tests for
gonorrhea and chlamydia.
2. Complete computerized sexual questionnaire on all clients tested.
3. Refer females for reproductive health services if indicated.
4. Develop a client centered risk reduction plan, promoting abstinence.
5. Treat and obtain partner notification information on positive clients
6. Enter data from test results and questionnaire into Microsoft Access.
7. Analyze and forward data to MDCH every three months.
8. Develop data into presentations and present at various professional meetings.
9. Continue to promote awareness of prevalence of STDs within adolescent and young
adult population.
Statement of Work Contractor agrees to test and treat adolescents and young adults
in the above nine sites for chlamydial and gonococcal infections.
ATTACHMENT A
Fill In Form
EiSubrecipient
OVendor
STATEMENT OF WORK
Goal: Reach at-risk adolescents and young adults, provide screening and education, to
help reduce the prevalence of gonorrhea and chlamydia within the community
Methodology: Activities, Responsible Individual(s), Timeline and Deliverable(s
I Activity(ies) Responsible Timeline Deliverable(s)
_ Individual(s)
Objective Test at least 100 adolescents and young adults for chlamydia and gonorrhea at 9 at-risk adolescent
sites in Oakland County
Project Coordinator Monthly Data updates
& Project Nursing
Staff
,
; Objective Complete computerized sexual questionnaire on all clients tested and sync into database
Project Coordinator Throughout Data Updates
& Project Nursing project year
Staff
_
,
Objective Treat and obtain partner notification information on positive clients
Project Nursing Throughout Report positive tests to MDCH
Staff project
year
L
. Objective Analyze and forward data to MDCH
Project Quarterly Quarterly Reports
Coordinator
Objective Present findings to various professional groups
Project Throughout Written and Oral Presentations
Coordinator project
_ year
1 I
OCH-0665FY2006 2105 (W)
12. STATE AGREEMENT $73,000
13. LOCAL
14. FEDERAL
15. OTHER(S)
1 16. TOTAL FUNDING $73,0001
View at 100% or Larger
Use WHOLE DOLLARS Only
PROGRAM BUDGET SUMMARY
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
ATTACHMENT B.1
PROGRAM 'DATE PREPARED Page Of
Children's Village Screening Project , 612912005 1 1
CONTRACTOR NAME BUDGET PERIOD
Oakland County Children's Village From: 10/1/2005 To: 9/30/2006
MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT #
1200 N. Telegraph Rd. Dept. 444 El ORIGINAL III AMENDMENT
CITY STATE ZIP CODE FEDERAL ID NUMBER
Pontiac Michigan 48341
EXPENDITURE CATEGORY TOTAL BUDGET
_ fUse Whole Dollars)
' 1. SALARIES & WAGES $58,595 _ . .
. 2. FRINGE BENEFITS - - $6,299
3. TRAVEL $2,000
4. SUPPLIES & MATERIALS
$506 - 5. CONTRACTUAL (Subcontracts/Subrecipients)
$5,000 - 6. EQUIPMENT
7. OTHER EXPENSES
$600
- _
. -
8. TOTAL DIRECT EXPENDITURES
(Sum of Lines 1-7) $73,000
9. INDIRECT COSTS: Rate #1 % - - - INDIRECT COSTS: Rate #2 %
10. TOTAL EXPENDITURES
-
$73,006
SOURCE OF FUNDS:
11. FEES & COLLECTIONS
AUTHORITY: P.A. 368 of 1978
COMPLETION: Is Voluntary, but is required as a condition of funding,
The Department of Community Health is an equal opportunity
employer, services and programs provider.
OCH-0385(E) (Rev. 02-05) (Excel) Previous Edition Obsolete. Also Replaces FIN-110
PROGRAM BUDGET - COST DETAIL
View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Use WHOLE DOLLARS Only
ATTACHMENT B.2
Of Page
PROGRAM BUDGET PERIOD DATE PREPARED
Children's Village Screening Project From: To:
10/1/2005 9/30/2006 6/2912005
CONTRACTOR NAME BUDGET AGREEMENT AMENDMENT #
Oakland County Children's Village J ORIGINAL ['AMENDMENT
1. SALARIES & WAGES: POSITIONS
IPOSITION DESCRIPTION COMMENTS REQUIRED TOTAL SALARY
General Staff Nurse PTNE 100% Funded 0.500 $27,600.00 ,
Program Coordination Part-time Position -
General Staff Nurse 100% Funded 0.600 $30,995.00 1 (Multi-filled) Part-time Position
- 1. TOTAL SALARIES and WAGES: 1.100 $ 58,595
2. FRINGE BENEFITS: (Specify) Composite Rate %
i FICA DLIFEINS DDENTALINS 10.75% $6,299.00
In UNEMPLOY INS 0 VISION El WORK COMP
II RETIREMENT II HEARING INS $6,299.00
HOSPITAL INS 0 OTHER:specify- 2. TOTAL FRINGE BENEFITS: $ 6,299
3. TRAVEL: (Specify If category exceeds 10% of Total Expenditures)
$2,000
3. TOTAL TRAVEL: $ 2,000
4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures)
$506.00
4. TOTAL SUPPLIES & MATERIALS: $ 506
5. CONTRACTUAL: (Subcontracts/Subrecipients)
Name Address Amount
North Oakland Medical 461 West Huron St.
Center Pontiac, MI 48341 $5,000.00
Teen Health Center
5. TOTAL CONTRACTUAL: $ 5,000
'. 6. EQUIPMENT: (Specify) Amount
6. TOTAL EQUIPMENT: $ -
7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures) Amount
Communication:
Space Cost:
Others (explain): Penbae Computer Tech Support and Equipment
$600.00
7. TOTAL OTHER EXPENSES: $ 600
8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1 -7) 8. TOTAL DIRECT EXPENDITURE $ 73,000
9. INDIRECT COST CALCULATIONS:
Rate #1 Base $ x Rate = $ -
Rate #2 Base $ x Rate = $ -
B. TOTAL INDIRECT EXPENDITURES: $ -
10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9) $ 73,000
AUTHORITY: PA 3158 of 1978 The Depirtment of Community Health is in liquid opportunity employer, services and
prowler. COMPLETION: Is Voluntary, but is required as a condition of funding. Proiroms
.
DCF1-0384(E) (Rev 2-05) (EXCEL) Previous Edition Obsolete Use Additional Shona as Naadocl
Contractor's Signature: Date:
ATTACHMENT 5.3
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
CONTRACT MANAGEMENT SECTION
EQUIPMENT INVENTORY SCHEDULE
Please list equipment items that were purchased during the grant agreement period as specified in the
grant agreement budget, Attachment B.2. Provide as much information about each piece as possible,
including quantity, item name, item specifications: make, model, etc. Equipment is defined to be an
article of non-expendable tangible personal property having a useful life of more than one (1) year and
an acquisition cost of $5,000 or more per unit. Please complete and forward to this form to the MDCH
contract manager with the final progress report.
Contractor Name: Contract #: Date:
Quantity Item Name Item Specification Tag Number Purchased
Amount
$
$
1
$
$
$
$
$
$
$
Total $ 0
DCH-0665FY2006 2105 (W)
'ATTACHMENT C
PERFORMANCE / PROGRESS REPORT REQUIREMENTS
A. The Contractor shall submit the following reports on the following dates:
Quarter Due
Oct. 1 - Dec. 31, 2005 Jan. 15, 2006
Jan. 1 - Mar. 31, 2006 April 15, 2006
April 1 - June 30, 2006 July 15, 2006
July 1 - Sept. 30, 2006 Oct. 15, 2006
Reporting Format:
1. Agency name, address, telephone and fax number;
2. Name and title of contact person;
3. Any program level changes, including changes in staff, services, catchment
areas, etc. ;
4. Narrative description of progress toward established contract objectives.
Specifically, list each programmatic objective and a description of progress
toward that objective;
5. Narrative description of major program and service accomplishments not
directly related to the established goals and objectives;
6. Narrative discussion of any issues at the agency level that impact ability to
achieve stated goals and objectives;
7. New services added during the quarter;
8. Cost saving efforts, including areas where cost savings were achieved and
how this was accomplished;
9. Staff development and training activities related to client-level service
provision.
B. Any such other information as specified in the Statement of Work, Attachment A
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:
Mark Miller, STD Program Manager, Division of Health, Wellness and Disease
Control, 2479 Woodlake Circle, Suite 380; Okemos, MI 48864
D. The Contract Manager shall evaluate the reports submitted as described in
Attachment C, Items k and B. for their completeness and adequacy.
OCH-0655FY2005 2/05 (W)
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.
DCH-0665FY2006 2/05 (W)
FINANCIAL STATUS REPORT ' -
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
ATTACHMENT
Contract Number Page i Of
I
Local Agency Name Program Code
_ Street Address Report Period Date Prepared
Thru Final
City, State, ZIP Code Agreement Period FE ID Number
Thru
, Expenditures Agreement Category Curre • • lance
1. Salaries & Wages
2. Fringe Benefits
3. Travel
4. Supplies & Materials ...._
5. Contractual (Sub-Contracts)
6. Equipment
7. Other Expenses _
,
8. TOTAL DIRECT
9a.Indirect Costs Rate #1:_%
9b.Indirect Costs Rate #2:_%
10. TOTAL EXPENDITURES
SOURCE OF FUNDS:
11. State Agreement _
12. Local ...
13. Federal _
14. Other
15. Fees & Collections
16, TOTAL FUNDING
CERTIFICATION: I certify that I am authorized to sign on behalf of the local agency and that this is an accurate statement of expenditures and collections for
the report period. Appropriate documentation is available and will be maintained for the required period to support costs and receipts reported. _
Authorized Signature Date Title
Contact Person Name - Telephone Number
FOR STATE USE ONLY . . , ..
Advance Outstanding
Advance Issued or Applied
. Balance
Message
Authority: P.A. 368 of 1978 1The Department of Community Health is an equal opportunity,
Completion: is a Condition of Reimbursement employer, services, and programs provider,
DCH-0384(E) (Rev. 4/04) (W) Previous Edition Obsolete
DC1-1-0565FY2006 2105 (W)
; ATTACHMENT E
AUDIT STATUS NOTIFICATION LETTER
(Required for subrecipient Contactors claiming exemption from audit submission requirements)
Please fill in the following information, sign after the statement below and mail this form to: Michigan
Department of Community Health, Office of Audit, Quality Assurance and Review Section, P.O. Box
30479, Lansing, MI 48909-7979 or fax it to: (517) 338-5443. Form is due to the Department within
nine months after the end of the Contractor's fiscal year. Please do not submit this form with your
signed agreement.
Agency Name:
Address:
Federal ID Number:
For Agency's Fiscal Year Ended (month/date/year):
Agency Contact Person (Name, Title, Phone #):
The purpose of this letter is to comply with Michigan Department of Community Health (MDCH) grant
contract audit requirements. I certify that the agency listed above expended less than $500,000 in
federal awards from all funding sources, and expended less than $500,000 total MDCH funding. I
also certify that our agency's financial statement audit did not include any disclosures related to
current or prior years that could negatively impact MDCH-funded programs. Therefore, we are not
required to submit either a Single Audit or Financial Statement Audit to MDCH.
Signature
Print Name/Title
Date
DCH-0565FY2006 2/05 (W)
Salaries
Fringe Benefits
Miscellaneous
Travel & Conf.
Professional Svs.
Supplies
TOTAL
58,595
6,299
600
2,000
5,000
506
$73,000
FISCAL NOTE (M.R. #05160) September 1, 2005
BY: FINANCE COMMITTEE, CHUCK MOSS, CHAIRPERSON
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/CHILDREN'S VILLAGE DIVISION -
FY 2005-2006 CHILDREN'S VILLAGE SCREENING PROJECT GRANT-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
funding in the amount of $73,000 to the Oakland County Children's
Village for use in monitoring sexually transmitted diseases in
adolescents in special settings.
2. The special revenue, part-time non-eligible General Staff Nurse
(position #09652) will continue to be funded by this grant.
3. The grant will also reimburse for costs associated with 1,000
hours for a Program Coordinator as assigned.
4. The grant period is from October 1, 2005 through September 30,
2006.
5. The County is expected to incur indirect costs of $7,113 for FY
2006, which are not included in the FY 2006 Grant Budget.
6. The future level of service including personnel will be
contingent upon the level of funding available from the State.
7. A budget amendment is recommended to the Fiscal Year 2006 Special
Revenue grant budget to reflect the latest award.
HUMAN SERVICE GRANTS (FUND #275)
REVENUE
1-16-275-501251-25010-0171 Grants-State
FY 2006
$73,000
EXPENDITURES
2-16-275-501252-25010-2001
2-16-275-501252-25010-2075
2-16-275-501252-25010-3196
2-16-275-501252-25010-3756
2-16-275-501252-25010-3348
2-16-275-501252-25010-4252
FINANCE COMMITTEE
FINANCE COMMITTEE:
Motion carried unanimously on a roll call vote.
Resolution #05160 August 18, 2005
The Chairperson referred the resolution to the Finance Committee. There were no objections.
Resolution #05160 September 1, 2005
Moved by Nash supported by Long the resolutions on the Consent Agenda be adopted (with
accompanying reports being accepted).
AYES: Coleman, Coulter, Crawford, Douglas, Gershenson, Gregory, Hatchett, Jamian, KowaII,
Long, Melton, Middleton, Molnar, Moss, Nash, Palmer, Patterson, Rogers, Scott, Suarez, Wilson,
Woodward, Zack, Bullard. (24)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions on the Consent Agenda, were adopted (with
accompanying reports being accepted).
9 (1&EA-)-
.1. APPROVE TIE FOREGONG RESOIIMM
P--L* 3 eA- 1 .11
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Ruth Johnson, 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 September 1, 2005
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 1st day of September, 2005.
Ruth Johndein, County Clerk