HomeMy WebLinkAboutResolutions - 2006.10.19 - 28291GENERAL GOVERNMENT COMMITTEE VOTE:
Motion carried on a roll call vote with Patterson absent.
a
MISCELLANEOUS RESOLUTION 106200 October 19, 2006
BY: General Government Committee, William R. Patterson, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2006/2007
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 $8.316,949, which is a 3.05% ($261,603) decrease from the Fiscal
Year 2005/2006 amended allocation of $8,578,552; 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 2006 Budget when details are finalized; and
WHEREAS with MR04131, the Nurse Family Partnership Program, which is designed to reduce infant
mortality in the city of Pontiac was approved; and
WHEREAS the cost of four (4) GF/GP Public Health Nurse III positions is reimbursed through the
Nurse/Family Partnership program; and
WHEREAS the Nurse Family Partnership program was to be funded for three years; and
WHEREAS the Nurse Family Partnership has had a positive impact on the problem of African-
American infant mortality; and
WHEREAS the Nurse Family Partnership program has been extended for one year; and
WHEREAS funding for this program from the State of Michigan has not increased commensurate with
the cost of living; and
WHEREAS the Nurse Family Partnership program requires a match of 25%, or $81,039; and
WHEREAS additional funding in the amount of $91,441 will be required to continue this program at its
current level of service; and
WHEREAS this agreement is for the period of October 1, 2006 through September 30, 2007; 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 2006/2007 Comprehensive Planning, Budgeting, and Contracting (CPBC) agreement for funding
in the amount of $8,316,949 for the period of October 1, 2006 through September 30, 2007.
BE IT FURTHER RESOLVED that the grant match of 25%, or $81,039, is approved for the Nurse
Family Partnership program.
BE IT FURTHER RESOLVED that additional General Fund resources are approved in the amount of
$91,441 to continue the Nurse Family Partnership Program,
BE IT FURTHER RESOLVED that the future level of service, including personnel, be contingent upon
the level of funding for this program,
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute this agreement,
any changes and extensions to the agreement not to exceed fifteen percent (15%), which is consistent with
the agreement as originally approved.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its
Chairperson to execute this Agreement subject to the following additional condition: That the County's
approval for entering into this Agreement is specifically conditioned and premised upon the acceptance,
approval and execution of the Agreement containing Addendum A, by the Michigan Department of Community
Health, and that the failure of the Michigan Department of Community Health to execute the Agreement as
specified shall, without any further act of the Oakland County Board of Commissioners, automatically negate
and void the County's approval and/or acceptance of this agreement as provided for in this resolution.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
I. 4
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COUNTY OF OAKLAND
DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH DIVISION
FY 2006/2007 COMPREHENSIVE PLANNING, BUDGETING, AND
CONTRACTING AGREEMENT (CPBC) ACCEPTANCE
• The Oakland County Health Division (OCHD) is accepting funding through the CPBC
Agreement from the Michigan Department of Community Health (MDCH) in the total amount of
$8,316,949. The Agreement is for the period October 1, 2006 through September 30, 2007.
• The Agreement provides for categorical grant funding and partial reimbursement for services
provided in accordance with the Public Health Code (P.A. 368 of 1978, as amended). Changes
included in the FY 2006/07 Agreement include:
• Funding for the Emergency Preparedness Coordinator position continues through Fiscal Year
2006/07.
• Funding in the amount of $133,484 has been awarded to equip and staff the laboratory to
maintain "Level B" status, which will allow the laboratory to examine potential bioterrorism-
related materials.
• Other Bioterrorism-related funding includes $268,234 for the Cities Readiness Initiative, a
program to dispense medications to large populations in very short time frames in the event
of an emergency, and $10,000 to defray the costs of housing the Regional Epidemiologist.
• Funding in the amount of $130,000 has been continued to support the Infant Mortality
Coalition program.
• Grant funding for the Nurse Family Partnership has been continued at the previous year's
level of $324,155.
• Funding for the Women. Infants, and Children (WIC) Program has been increased $1,027
due to an increased case load.
lh 4 . Page I of 2
Tom Fockler
From: Greg Givens [givensg@oakgov,corn]
Sent: Tuesday, September 26, 2006 10:35 AM
To: Doyle, Larry; 'Tom Fockler'; 'Linda Pearson'
Cc: 'Worthington, Pam'; 'Candace Frederick': Greg Givens; 'Hanger, Helen': 'Johnston, Brenthy';
'Mitchell, Sheryl': 'Pardee, Mary', 'Smith, Laverne': 'Wenzel, Nancy'
Subject: GRANT REVIEW SIGN OFF - Health Division / CPBC
GRANT REVIEW SIGN OFF — Health Division
GRANT NAME: FY 2007 Comprehensive Planning, Budgeting, and Contracting Agreement
FUNDING AGENCY: Michigan Department of Community Health
DEPARTMENT CONTACT PERSON: Tom Fackler / 2-2151
STATUS: Acceptance
DATE: September 26, 2006
Pursuant to Misc. Resolution #01320, please be advised the captioned grant materials have completed internal grant review.
Below are the returned comments.
The captioned grant materials and grant acceptance package (which should include the Board of Commissioners' Liaison
Committee Resolution, the grant agreement/contract, Finance Committee Fiscal Note, and this Sign Off email containing
grant review comments) may be requested to be placed on the appropriate Board of Commissioners' committee(s) for grant
acceptance by Board resolution.
DEPARTMENT REVIEW
Department of Management and Budget:
Approved. — Laurie Van Pelt (9/8/2006)
Department of Human Resources:
Approved. — Nancy Scarlet (9/14/2006)
Risk Management and Safety:
Approved By Risk Management - Andrea Plotkowski (9/6/2006)
Corporation Counsel:
I have reviewed the above referenced Agreement and approve same for signature. - John Ross (9/25/2006)
COMPLIANCE
The grant agreement references a number of specific federal and state regulations. Below is a list of these specifically cited
compliance related documents for this grant.
• Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II)
http.;//www.cms.h hs.gov/11 I PA A Gen n fo/Down loads/HIPAAla.wdeta I .pd f
• Federal Office of Management and Budget (OMB) Circular No. A-133. This Circular sets forth standards for
obtaining consistency and uniformity among Federal agencies for the audit of States, local governments, and non-
profit organizations expending federal awards. http://www.wh itehouse.gov/ornb/circtitars/a133/a133.11trn1
• Michigan - Minimum Program Requirements - Public Health Code (Excerpt) Act 368 of 1978, Sec .2472 Services
eligible for cost sharing; criteria and procedures for additional services; minimum standards for delivery of services.
http.;//www.legislature.mi.gov/(tiq3 xseitthrj5z55z2uiwv45)/mileg.aspx?page=getabject&objectname=mc1-333-
2472&queryid=15189839
• Federal Anti-Lobbying Act — "31 USC 1352" http://atincethics.wpafballiniUstatutes/31-1352.htm
9/29/2006
4. 6 Pap 2 of 2
• Michigan Elliott-Larsen Civil Rights Act — "Act 453 of 1976" http://www.legislature.mi ,gov/
(uq3lxgeltmrj5z55z2uiwv45)/m ileg.aspx ?page=getobject&objectname—mcl-Act-453-of-1976&queiy id=147 I 8540
• "Michigan Persons with Disabilities Civil Rights Act" http://www.michigan.gov/documents/act-220-of -
1976 8771_7,Pdf
• Federal Government-Wide Debarment and Suspension — Non-procurement - Date 11/2003 FR
http://www.whitehousevy/omb/fedreg/2004/0311,26.pdf#search —%22GOVERNMENTWIDE%20DEBARMENT%
20AND%20SUSPENSION%22 45 CFR Part 76 http://www ,access.gpo.govinara/cfr/waisidx_05/45cfr76_05,html
• Federal Environmental Tobacco Smoke —Pro-Children Act of 1994"
http://www.cdc.gov/tobacco/research_data/youth/464 119, htm
• Federal Hatch Act - Political Activity of Certain State and Local Employees http://www.osc.gov/hatchact.htm
• Federal - The Copeland "Anti-Kickback" Act 18 USC 874 http://www.dol.govidol/compliance/com_p-copeland.htm
• Federal Davis-Bacon Act http://www ,dol.goviesa/programs/dbra/
• Federal - The Contract Work Hours and Safety Standards Act 40 USC 327-330
http//www,doLgov/dol/compliance/coinp-cwhssa.htm
• Michigan — Conflict of Interest - Contracts of Public Servants with Public Entities — "Act 317 of 1968"
http://www.legislature ,m i.gov/(uci3lxgeltm d5z55z2uiwv45)/m ileg.aspx?page-letobject&objectname=mc I-Act-
317-of-1968&qusryid=14761946
9/29/2006
Contract #:
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, Budgeting and Contract (CPBC) Agreement
Part I
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. 2006 and
continue through September 30, 2007. This agreement is full force and effect for
the period specified. The Department has the option to assume no responsibility
for costs incurred by the Contractor prior to the signing of this agreement.
MDCH/CMS
07/06 Page 1 of 24
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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 $8,316,949.
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.
MDC H/CMS
07/06 Page 2 of 24
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4. Agreement Attachments:
A. The following documents are attachments to this Agreement Part I and Part
II - General Provisions, which are part of this agreement through reference:
1. Attachment 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 I and Part II) - Attachment III, IV
2. First Amendment - Attachment I, II and IV (Revised)
5. Statement of Work: The Contractor agrees to undertake, perform and complete
the services described in Attachment III - Program Specific Assurances and
Requirements and the other applicable attachments to this agreement which are
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. PerformancelProgress 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, CPBC Consultant 517-241-2493 McCubbinR@michigan.gov
(Contract Consultant Name) Title Phone E-mail Address
MDCH/CMS
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•
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
Nick Lyon, Deputy Director, Date
Operations Administration
MDCH/CMS
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mt. •
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
FY 06/07 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 10/1/06 Through 9/30/07:
Part I
11. Agreement Exceptions and Limitations
Notwithstanding any other term or condition in this Agreement including, but not limited to,
any provisions related to any services as described in the Annual Action Plan,
any Contractor (Oakland County) services provided pursuant to this Agreement,
or any limitations upon any Department funding obligations herein, the Parties
specifically intend and agree that the Contractor may discontinue, without any penalty
or liability whatsoever, any Contractor services or performance obligations under this
Agreement when and if it becomes apparent that State or Department funds for any
such services will be no longer available. Notwithstanding any other term or
condition in this Agreement, the Parties specifically understand and agree that no
provision in this Agreement shall operate as a waiver, bar or limitation of any kind, on any
legal claim or right the Contractor may have at any time under any Michigan constitutional
provision or other legal basis (e.g., any Headlee Amendment limitations) to challenge
any State or Department program funding obligations; and, the parties further agree
that no term or condition in this Agreement is intended and no such provision shall
be argued to state or imply that the Contractor voluntarily assumed or undertook to
provide any services as described in the Annual Action Plan, and thereby, waived any
rights the Contractor may have had under any legal theory, in law or equity,
without regard to whether or not the Contractor continued to perform any services
herein after any State or Department funding ends.
2. This addendum modifies the following sections of Part 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 identify and overcome potential data
incompatibility problems.
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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.
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 thereunder.
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.
3. This Addendum modifies the following sections of Attachment III-C, Special
Program Requirements:
Child Lead Poisoning Prevention —Contractor Required Activity Toward
Community Partnership /Collaboration Outcomes
Item # 2. shall be amended to read, "The contractor must be actively involved
in a local partnership/collaboration working to, among other activities, identify a
sustainable funding stream for home repair, using public and private funds, in a systematic
process customized to the jurisdiction."
4. Special Certification
•
The individual or officer signing this agreement certifies by his or her signature
that he or she is authorized to sign this agreement on behalf of the
Department or the Contractor.
Signature Section:
For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Date
For the CONTRACTOR
Bill Bullard, Jr., Chairman, Oakland County Board of Commissioners
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 st and 3rd party fees, where applicable,
and report these as outlined by the Department's fiscal procedures. Any
underrecoveries of otherwise available fees resulting from failure to bill for
eligible services will be excluded from reimbursable expenditures.
C. Program Operation
Provide the necessary administrative, professional, and technical staff for
operation of the program.
D. Reporting
Utilize all report forms and reporting formats required by the Department at
the effective date of this agreement, and provide the Department with timely
review and commentary on any new report forms and reporting formats
proposed for issuance thereafter.
E. Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source
documentation to support program activities and all expenditures made
under the terms of this agreement, as required.
MDCH/CMS
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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 Contractor's annual Single Audit reporting package, including the
Corrective Action Plan, and management letter (if one is issued) with
a response to the Department.
The 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, management letter (if one is
issued) with a response and Corrective Action Plan shall be submitted
to the Department within nine months after the end of the Contractor's
fiscal year. The Single Audit reporting package, management letter,
and Corrective Action Plan shall be filed with the Department even if
there are no findings or disclosures reported in the audit pertaining to
Department programs.
4. Penalty
If the Contractor does not submit the required Single Audit reporting
package, management letter (if one is issued) with a response, and
Corrective Action Plan within nine months after the end of the
Contractor's fiscal year and an extension has not been approved by
the cognizant or oversight agency for audit, the Department may
withhold from the current funding an amount equal to five percent of
the audit year's grant funding (not to exceed $200,000) until the
required filing is received by the Department. The Department may
MDCH/CMS
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retain the amount withheld if the Contractor is more than 120 days
delinquent in meeting the filing requirements and an extension has
not been approved by the cognizant or oversight agency for audit. The
Department may terminate the current grant if the Contractor is more
than 180 days delinquent in meeting the filing requirements and an
extension has not been approved by the cognizant or oversight
agency for audit.
5. Where to Send
A copy of the Single Audit reporting package, management letter (if
one is issued) with a response, and Corrective Action Plan must be
forwarded to:
Michigan Department of Community Health
Office of Audit
Quality Assurance and Review Section
P.O. Box 30479*
Lansing, Michigan 48909-7979
*For Express Delivery
Capital Commons Center
400 S. Pine Street
Lansing, Michigan 48933
Alternatives to paper filing may be viewed at
www.michioan.qov/mdch by selecting Inside Community Health -
Office of Audit.
H. Subrecipient/Vendor Monitoring
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.
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 establish requirements to ensure compliance by for-
profit subrecipients as required by OMB Circular A-133, Section .210(e).
The Contractor must ensure that transactions with vendors comply with laws,
regulations and provisions of contracts or grant agreements in compliance
with OMB Circular A-133, Section .210 (f).
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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.
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 without
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 which 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.
L. Terms
To abide by the terms of this agreement including all attachments.
M. 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.
N. 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.
O. 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.
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P. Accreditation
1. All Contractors 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.
Contractors that fail to meet all accreditation requirements and/or
implement corrective plans of action within the prescribed time period
will receive the status of "Not Accredited." Contractors designated as
"Not Accredited" may have their Department allocations reduced for
costs incurred in the assurance of service delivery.
Contractors that disagree with on-site review findings or their
accreditation status may request an inquiry through written request to
the Department. The request must identify the disagreement and
resolution sought. The inquiry participants will be comprised of
Contractor staff, Department staff, the Accreditation Commission
Chair, and the Accreditation Coordinator as needed. Participants will
clarify facts, verify information and seek resolution.
2. Consent Agreements/Administrative Compliance
Orders/Administrative Hearings for "Not Accredited" Contractors:
a. Contractors designated as "Not Accredited", will receive a
Consent Agreement Package from the Department.
Contractors and their local governing entities shall be given 75
days to review the package, meet with the Department, and
sign/return the Consent Agreement.
b. Fulfillment of the terms and conditions of the Consent
Agreement will not affect accreditation status, but impacts the
Contractors' ability to fulfill its contractual obligations under the
Comprehensive Planning, Budgeting and Contracting
Agreement. Contractors designated as "Not Accredited", will
retain this designation until the subsequent accreditation cycle.
c. Contractor failure to fulfill the terms and conditions of the
Consent Agreement within the prescribed time period will result
in the issuance of an Administrative Compliance Order by the
Department.
d. Within 60 working days after receipt of an Administrative
Compliance Order and proposed compliance period, a local
governing entity may petition the Department for an
administrative hearing. If the local governing entity does not
petition the Department for a hearing within 60 days after
receipt of an Administrative Compliance Order, the order and
proposed compliance date shall be final. After a hearing, the
Department may reaffirm, modify, or revoke the order or
modify the time permitted for compliance.
MDCH/CMS
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e. If the local governing entity fails to correct a deficiency for
which a final order has been issued within the period permitted
for compliance, the Department may petition the appropriate
circuit court for a writ of mandamus to compel correction.
Q. Medicaid Outreach Activities Reimbursement
The Contractor agrees to report allowable costs and request reimbursement
for the Medicaid Outreach activities it provides in accordance with OMB
Circular A-87 and the requirements in Medicaid Bulletin number: MSA 05-29.
The Contractor agrees to submit a Cost Allocation Plan Certification to the
Department to bill for the Medicaid Outreach Activities. The Cost Allocation
Plan Certification is valid until a change is made to the cost allocation plan or
the Department determines it is invalid.
The Contractor will submit quarterly FSRs for the Medicaid Outreach
activities and an annual FSR for the Children with Special Health Care
Services Medicaid Outreach activities in accordance with the instructions
contained in Attachment I.
In accordance with the Medicaid Bulletin, MSA 05-29, the Contractor agrees
to target their Medicaid outreach effort toward Department established
priorities. For FY 06107, the Department priorities are: lead testing, outreach
and enrollment for the Family Planning waiver, and outreach for pregnant
women, mothers and infants for the Maternal and Infant Health Program.
The Contractor will submit a narrative report describing their outreach
activities targeting the priorities 30 days after the end of a fiscal year quarter
to the Division of Family and Community Health, Michigan Department of
Community Health, P.O. Box 30195, Lansing, MI 48909.
IL 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.
MDCH/CMS
07/06 Pagel° of 24
D. Notification of Modifications
To notify the Contractor in writing of modifications to Federal or State laws,
rules and regulations affecting this agreement.
E. Identification of Laws
To identify for the Contractor relevant laws, rules, regulations, policies,
procedures, guidelines and State and Federal manuals, and provide the
Contractor with copies of these documents to the extent they are not
otherwise available to the Contractor.
F. Modification of Funding
To notify the Contractor in writing within thirty (30) calendar days of
becoming aware of the need for any modifications in agreement funding
commitments made necessary by action of the Federal Government, the
Governor, the Legislature or the Department of Management and Budget on
behalf of the Governor or the Legislature. Implementation of the
modifications will be determined jointly by the Contractor and the
Department.
G. Monitor Compliance
To monitor compliance with all applicable provisions contained in federal
grant awards and their attendant rules, regulations and requirements
pertaining to program elements covered by this agreement.
H. Reimbursement
To reimburse local agencies for costs based upon timely, accurately
completed Financial Status Reports in accordance with Section IV.
Technical Assistance
To make technical assistance available to the Contractor 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.
K. Accreditation
The Department agrees to adhere to the accreditation requirements including
the process for "Not Accredited" Contractors. The process includes
developing and monitoring consent agreements, issuing and monitoring
administrative compliance orders, participating in administrative hearings and
petitioning appropriate circuit courts.
L. Medicaid Outreach Activities Reimbursement
The Department agrees to reimburse the Contractor for all allowable
Medicaid Outreach activities that meet the standards of the Medicaid _
Bulletin: MSA 05-29 including the cost allocation plan certification and that
are billed in accordance with the requirements in Attachment I.
MDCH/CMS
07/06 Page 11 of 24
In accordance with the Medicaid Bulletin, MSA 05-29, the Department will
identify each fiscal year the Medicaid Outreach priorities and establish a
reporting requirement for the Contractor.
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-Lobbyinq 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 persons
with disabilities in contract solicitations. The Contractor shall
incorporate language in all contracts awarded: (1) prohibiting
MDCH/CMS
07/08 Page 12 of 24
discrimination against minority owned and women owned businesses
and businesses owned by persons with disabilities in subcontracting;
and (2) making discrimination a material breach of contract.
D. Debarment and Suspension
Assurance is hereby given to the Department that the Contractor will comply
with Federal Regulation 45 CFR Part 76 and certifies to the best of its
knowledge and belief that the Contractor's local health department or an
official of the Contractor's local health department and the Contractor's
subcontractors:
1. Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions
by any federal department or Contractor;
2. Have not within a 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
MDCH/CMS
07/06 Page 13 of 24
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. Smoking shall not be permitted anywhere in the facility,
or those parts of the facility under the control of the Contractor. If
activities or services are delivered in facilities or areas that are not
under the control of the Contractor (e.g., a mall, restaurant or private
work site), the activities or services shall be smoke-free.
F. Hatch Political Activity Act and Intergovernmental Personnel Act
The Contractor will comply with the Hatch Political Activity Act 5,USC 1501-
1508 and the Intergovernmental Personnel Act of 1970, as amended by Title
VI of the Civil Service Reform Act, Public Law 95-454, Section 42 USC 4728.
Federal funds cannot be used for partisan political purposes of any kind by
any person or organization involved in the administration of federally-assisted
programs.
G. Home Health Services
If the Contractor provides Home Health Services (as defined in Medicare
Part B), the following requirements apply:
1. The Contractor shall not use State LPHO or categorical grant funds
provided under this agreement to unfairly compete for home health
services available from private providers of the same type of services
in the Contractor's service area.
2. For purposes of this agreement, the term "unfair competition" shall be
defined as offering of home health services at fees substantially less
than those generally charged by private providers of the same type of
services in the Contractor's area, except as allowed under Medicare
customary charge regulations involving sliding fee scale discounts for
low-income clients based upon their ability to pay.
3. If the Department finds that the Contractor is not in compliance with
its assurance not to use state LPHO and categorical grant funds to
unfairly compete, the Department shall follow the procedure required
for failure by local health departments to adequately provide required
services set forth in Sections 2497 and 2498 of 1978 PA 368 as
amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15
(2497) and (2498).
H. Subcontracts
Assure for any subcontracted service, activity or product:
1. That a written subcontract is executed by all affected parties prior to
the initiation of any new subcontract activity. Exceptions to this policy
may be granted by the Department upon written request.
MDCH/CMS
07/06 Page 14 of 24
2. That any executed subcontract shall require the subcontractor to
comply with all applicable terms and conditions of this agreement. In
the event of a conflict between this agreement and the provisions of
the subcontract, the provisions of this agreement shall prevail. A
conflict between this agreement and a subcontract, however, shall not
be deemed to exist where the subcontract:
a. Contains additional non-conflicting provisions not set forth in
this agreement; or
b. Restates provisions of this agreement to afford the Contractor
the same or substantially the same rights and privileges as the
Department; or
c. Requires the subcontractor to perform duties and/or services in
less time than that afforded the Contractor in this agreement.
3. That the subcontract does not affect the 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.
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).
MDCH/CNIS
07/06 Page 15 of 24
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 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.
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
MDCH/CMS
07/06 Page 16 of 24
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.
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 pre-payment reimbursement method, no additional operating
advances will be issued.
B. ComDrehensive 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
MDCH/CMS
07106 Page 17 of 24
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-0412 must be submitted for all
programs listed on Attachment IV. All FSR's must be prepared in
accordance with the Department's FSR instructions and submitted not later
than thirty (30) days after the close of the first three fiscal quarters. The
reports are due 1/30/XX, 4130/XX, and 7/301XX. 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
methods for applicable program elements described as follows:
1. Performance Reimbursement - A reimbursement method 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
MDCH/CMS
07/08 Page 18 of 24
percentage, the State maximum allocation will be reduced equivalent
to actual performance in relation to the minimum performance.
2. Staffing Grant Reimbursement - A reimbursement method by which
local health departments are reimbursed based upon the
understanding that State dollars will be paid up to total costs in
relation to the State's share of the total costs and up to the total State
allocation as agreed to in the approved budget. This reimbursement
approach is not directly dependent upon whether a specified level of
performance is met by the local health department. Department
funding under this reimbursement method is allocable as a source
before any local funding requirement unless a specific local match
condition exists.
3. Fixed Unit Rate Reimbursement - A reimbursement method by which
local health departments are reimbursed a specific amount for each
output actually delivered and reported.
4. LPHO - A reimbursement method 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. 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/
G. 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.
H. 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 for the entire agreement period
(October 1 through September 30). This report must represent the
Contractor's best estimate of total program expenditures for the agreement
period. The information on the report will be used to record the
Department's year-end accounts payables and receivables by program for
this Agreement. The report assists the Department in reserving sufficient
funding to reimburse the final expenditures that will be reported on the Final
FSR without materially overstating or understating the year-end obligations
for this agreement. The Department compares the total estimated
expenditures from this report to the total amount reimbursed to the
Contractor in the monthly prepayments and quarterly fee-for-service
payments to establish accounts payable and accounts receivable entries at
fiscal year-end. The Department recognizes that based upon payment
MDCH/CMS
07/06 Page 19 of 24
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 90 days after the agreement fiscal year-end, the Contractor must
liquidate any unpaid year-end commitments and obligations. Any obligation
remaining unliquidated after 90 days from the end of the agreement period
shall revert to the Department for disposition in accordance with applicable
state and/or federal requirements, except as specifically authorized in writing
by the Department.
Final Total Contractor FSR and Output Measure Report
The final total Contractor FSR and Output Measures report (H-977) is due
December 31, after the agreement period end date. WIC financial data
reporting and final FSR must be received by January 15. Upon receipt of the
final FSR and output measures report including final actual service outputs,
the Department will determine by program, if funds are owed to the
Contractor or if the Contractor owes funds to the Department. If funds are
owed to the Contractor, payment will be processed. However, if the
Contractor underestimated their year-end obligations in the preliminary close
out report as compared to the final FSR and the total reimbursement
requested does not exceed the agreement amount that is due to the
Contractor, the Department will make every effort to process full
reimbursement to the Contractor per the Final FSR. Final payment may be
delayed pending final disposition of the Department's year-end obligations.
If funds are owed to the Department, it will generally not be necessary for
Contractor to send in a payment. Instead the Department will make the
necessary entries to offset other payments and as a result the Contractor
will receive a net monthly prepayment. When this does occur, clarifying
documentation will be provided to the Contractor by the Department's
Accounting Division.
J. Penalties for Reporting Noncompliance
For failure to submit the final total Contractor FSR and Output Measures
report by December 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
Contractor's LPHO allocation.
MDCH/CMS
07/06 Page 20 of 24
V. Agreement Termination
The Department may cancel this agreement without further liability or penalty to the
Department for any of the following reasons:
A. This agreement may be terminated by either party by giving thirty (30) days
written notice to the other party stating the reasons for termination and the
effective date.
B. This agreement may also be terminated on thirty (30) days prior written
notice upon the failure of either party to carry out the terms and conditions of
this agreement, provided the alleged defaulting party is given notice of the
alleged breach and fails to cure the default within the thirty (30) day period.
C. This agreement may be terminated immediately if the Contractor's local
health department, or an official of the Contractor's local health department,
is convicted of any activity referenced in Part II, Section 111.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 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.
MDCH/CMS
07/06 Page 21 of 24
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.
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.
MDCH/CMS
07/06 Page 22 of 24
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 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.
MDCH/CMS
07/06 Page 23 of 24
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 Ill, 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 1. All LPHO required services must be
maintained throughout the entire period of the agreement.
C. The Department may periodically redistribute funds between agencies during
the agreement period in order to ensure that funds are expended to meet the
varying needs for services. Such redistributions will be based upon
projections obtained in consultation with the Contractor. Any redistributions
will be effected through the established amendment process.
MDCH/CMS
07/06 Page 24 of 24
LHD/CSHCS Services
Maternal and Infant Health Program
Michigan Care Improvement
Registry
Primary Dental Care
Sexually Transmitted Disease
Vision
WIC
J.
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ATTACHMENT III
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
FY 06107 CPBC AGREEMENT
PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS
Local health service program elements funded under this agreement will be administered by the
Contractor and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as
amended), rules promulgated under the Code, minimum program requirements and all other applicable
Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the
following approach:
A. Development and issuance of minimum program requirements, further describing the objective
criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or
practices for the purpose of ensuring the quality, availability and effectiveness of services and
activities.
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
1,2006:
a. AIDS/HIV Prevention
b. Breast and Cervical Cancer Control
c, Childhood Lead
d. Clinical Laboratory
e. Family Planning
f. Food Service Sanitation
9. General Communicable Disease Control
h. Hearing
Immunization — (Local Public Health
Operations & Categorical)
ATTACHMENT III Page 1 of 66 MDCH/CMS n-y /ma
OAKLAND COUNTY HEALTH DEPARTMENT • •
For FY 06/07, special requirements are applicable for the remaining program elements and funding sources listed
in the attached pages and checked below:
- AIDS/HIV CARE
- AIDS/HIV Maternal and Child Program
X - AIDS/HIV Prevention
- AIDS/HIV Prevention Rapid Testing
- AIDS/HIV Provider Education
- AIDS/HOPWA (Housing Opportunities for Persons Living with HIV/AIDS)
- Asthma Coalition
X - Bioterrorism
X - Bioterrorism - Cities of Readiness Initiative (CRI)
X Bioterrorism Regional Epidemiology Support
X - Childhood Lead Poisoning Prevention
X - Children's Special Health Care Services (CSHCS)
- Colorectal Cancer Early Detection
- Diabetes Outreach Network
- Diabetes Primary Prevention in WISEWOMAN
- Family Planning/BCCCP Joint Project
- Family Planning - Pregnancy Prevention
- Fetal Alcohol Syndrome Disorders (FASO) Community Projects
- Health Disparities Reduction
- Healthy Communities Cardiovascular
- HIV/STD Partner Counseling and Referral Services
X - Immunization Action Plan
X - Immunization Assessment Feedback Incentive Exchange (AFIX) Provider Site Visit
- Immunization - Field Service Representatives
X - Immunization - Nurse Education Reimbursement
X - Immunization Vaccine For Children (VFC) Provider Site Visit
X - Infant Mortality Coalition Support
X - Informed Consent
X - Laboratory Services
- Laboratory Services - STARHS & VARHS
- Lead Safe Home Program
X - Local Maternal and Child Health (MCH)
X - Local Public Health Operations (LPHO)
- Local Tobacco Reduction
- Michigan Abstinence Program (MAP)
X - Michigan Care Improvement Registry
- Michigan Care Improvement Registry - Regional
X - Nurse Family Partnership (NFP)
- Primary Care Dental Special Project
X -SIDS
X - TB Control (DOT)
X - WIC Services
- WIC Services - Breast - Feeding Peer Counselor
- WIC Services - Electronic Benefit Transfer (EBT)
- WIC - USDA Infrastructure Grant
- 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.
Ill. 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.
MDCH/CMS ATTACHMENT III Page 3 of 66
07/06
AIDS/HIV CARE SPECIAL REQUIREMENTS
(MARQUETTE COUNTY HEALTH DEPARTMENT, DETROIT DEPARTMENT OF HEALTH AND
WELLNESS PROMOTION AND DISTRICT HEALTH DEPARTMENT #10)
Contractor Specific Requirements
1. Adhere to all Ryan White CARE Act Title II and MDCH/DHVVDC-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/DHVVDC-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 for services (documented HIV status).
5. Conduct quality assurance activities and participate in contract monitoring conducted and/or
facilitated by MDCH/DHWDC-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/DHWDC-HAPIS.
7. Participate in oversight of all remediation efforts for subcontractors found in non-compliance with
established MDCH/DHWDC-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 URS Client Level Data 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 MHI resources and conduct outcome evaluation based on those
objectives,
13. Assess client or participant satisfaction annually and use methods, instruments and analysis that
minimize bias and ensure confidentiality of responses.
14. Utilize results of client or participant satisfaction assessments and other evaluation activities to
make appropriate program level changes and monitor the effects of these changes.
MDCH/CMS ATTACHMENT III Page 4 of 66
07106
15. Demonstrate appropriate expenditure of funds consistent with the contract, HRSA regulations and
MDCH/DHWDC-HAPIS regulations and guidelines.
16. Document 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.
Date Range of Services Provided Date Due to MDCH Description
FY Quarter 1
CV Annual & CADR
FY Quarter 2
FY Quarter 3
FY Quarter 4
FY Annual
October 1-December 31, 2006
January 1-December 31, 2006
January 1-March 31, 2007
April 1-June 30, 2007
July 1-September 30, 2007
October 1, 2006-September 30, 2007
January 15, 2007
January 30, 2007
April 15, 2007
July 15, 2007
October 15, 2007
October 30, 2007
A. The submitted URS data files must conform to the export format defined by HRSA in
documents found at the HRSA web site (http://hab.hrsa.00v/careware/) including
"Instructions for Export Forman., "Header Export Format"2, and "Client Record Export
Format" 3, or be exported directly from RW CARE-Ware 4.0x or subsequent versions.
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/DHWDC-HAPIS. In the event that services are no longer
delivered under this agreement, electronic data files must be returned to MDCH/DHWDCHAPIS.
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 (b)(6)(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. Relationships with
key points of access must be specified in written agreements.
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) 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, as well as HIV medication adherence practices, are integrated into the
delivery of HIV/AIDS care services.
1 110://fto.hrsatiovfhab/unduo instruct.pdf
2 fta://ftp.hrsa.aovihab/CW%2031%20HPRCiPr%?nFxnnricA2nFnrmmt prif
3 tba://fto.hrsa.ciov/hab/CW%2031%20Client%20Renord%2DPIennrt nrtf
MDCH/CMS ATTACHMENT III Page 5 of 66
07/06
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 II General
Provisions, and submit one copy to MDCH/DHWDC-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:
Quarter FSR
October-December, 2006 December FSR
January-March, 2007 March FSR
April-June, 2007 June FSR
July-September, 2007 September FSR
25. Submit reports of allocations and expenditures by service category to MDCH/DHWDC-HAPIS as
requested.
26. Submit program Progress Reports in accordance with the following dates and reporting format:
Period Covered Due to MDCH/DHWDC-HAPIS
October 1 - December 31, 2006 January 15, 2007
January 1 - March 31, 2007 April 15, 2007
April 1 — June 30, 2007 July 15, 2007
July 1 — September 30, 2007 October 15, 2007
Progress Report Format
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, including areas where cost savings were achieved
and how this was accomplished.
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, title, telephone number and e-mail
address of contact person.
2. Identify any program level changes, including changes in staff, services, catchment
area, etc.
3. Identify any new services added 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., e.g., linkage of care and prevention services through staff assignments, joint
staff meetings that include emergency room representatives, counseling and
testing staff and case managers, etc.
MDCH/CMS ATTACHMENT III Page 6 of 66
07/06
5. Describe the progress made towards achieving goals, objectives, and service
outcomes as described in your workplan. (This may be done in a table format.)
6. Discuss any issues at the agency level that impact ability to achieve stated goals
and objectives.
7. Describe major program and service accomplishments not directly related to the
established goals and objectives.
8. Describe how services during this reporting period demonstrate the integration of
STD and HIV secondary prevention, and HIV medication adherence practices into
HIV/AIDS care services.
9. Describe staff development and training activities related to client-level service
provision.
10. Describe any technical assistance needs related to programmatic and fiscal
administration.
C. Submit Progress Reports electronically to SzweidaDAmichicran.qov, cc:
GouldinoT@michioan.00v. Materials that cannot be emailed should be sent to:
Debra L. Szwejda, Manager
HIV/AIDS Prevention and Intervention Section
Division of Health, Wellness and Disease Control
2479 Woodlake Circle, Suite 300
Okemos, Michigan, 48864
27. Provide one copy of all fully signed subcontracts to MDCH/DHWDC-HAPIS by October 15, 2006 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 and end dates of each subcontract.
E. Amount and source of other federal, state and local funds for the same service.
F. Minority provider status.
28. By October 15, 2006 provide to MDCH/DHWDC-HAPIS a programmatic, categorical budget and
narrative justification (by funding source) for each 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. Administrative costs, including direct and indirect costs, cannot exceed 10% of the allocation. On
request, document compliance with this requirements, as defined in the "HAMS Administrative
versus Service/Program Cost Budget Guidance" issued by MDCH-DHWCD-HAPIS.
30. When issuing requests for proposals or bid solicitations, clearly state that the resources are open
for availability to faith-based organizations.
31. Assist MDCH/DHWDC-HAPIS in appropriate needs assessment activities, and maintain a
mechanism to obtain input about needed services from infected and affected persons.
32. Participate in MDCH/DHWDC-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/DHWDC-HAPIS, including following
MDCH/DHWDC-HAPIS' mediation process.
MDCH/CMS ATTACHMENT !II Page 7 of 66
07/06
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:
1. Establish and maintain appropriate organizational governance, guided by written by-laws.
2. 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.
3. Establish and maintain appropriate fiscal management of the agency consistent with
generally accepted accounting principles.
4. Establish and maintain written personnel policies and procedures.
5. Ensure that all staff, including executive directors and program coordinators:
a. Possess the knowledge, skills, abilities and credentials essential to assigned
responsibilities;
b. 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.
37. Assure that the agency and its employees, volunteers and subcontractors (if applicable), maintain
confidentiality of all records. No information obtained in connection with individuals served by the
contractor will be released without the expressed written consent of the individual client.
AIDS/HIV MATERNAL AND CHILD PROGRAM
(DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION)
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 and in the Title IV Work
Plan. Provide necessary training and technical support to the person to assure services are
provided in a family-centered manner.
2. 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.
3. Obtain consumers' consent to collect and share person-based data with agencies receiving
funding from the MDCH Ryan White Title IV program.
4. 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.
5. Submit quarterly narrative and statistical data reports as outlined in the reporting requirement
section.
MDCH/CMS ATTACHMENT III Page 8 of 66
07/06
6. Encourage consumer involvement in Title IV program activities.
7. 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(b)(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.
8. 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 of 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 sources.
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 quarterly, a Ryan White Title IV Executive Committee for the purposes of program
oversight and implementation. The board will consist of executive level staff from each of the Ryan
White Title 1V-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.
Reporting Requirements
1. The Contractor shall submit reports on the following dates:
Type of Report and timeframe Due Date
1 8t Quarterly Data Report (for period Jan 1 — March 31) April 15
2nd Quarterly Data Report (for period April 1 — June 30) July 15
3rd Quarterly Data Report (for period July 1 — September 30) October 15
Annual Data Report (for period January 1 — December 31) January 15
The Annual Data Report is an aggregate calendar year report.
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.00v/careware/) including
"Instructions for Export Format"1 , "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.
2. URS data is the property of MDCH/DHWDC-HAPIS. In the event that services are no longer
delivered under this agreement, electronic data files must be returned to MDCH/DHWDC-HAP1S.
3. Any such other information as specified in the Contractor requirements shall be developed and
submitted by the Contractor as required by the Contract Manager.
MDCH/CMS ATTACHMENT UI Page 9 of 66
07/06
Reports and information shall be submitted to the Contract Manager at:
Michigan Department of Community Health
Division of Health, Wellness and Disease Control
Maternal Child HIV/AIDS Program
3056W. Grand Blvd., Suite 3-150
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 Requirements - Categorical
1. 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.
2. Submit process and outcome monitoring data to the Division of Health, Wellness and Disease
Control via the HIV Event System. The time line and procedures for submitting these data are to
conform to guidelines issued by the Division of Health, Wellness and Disease Control.
3. 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.
4. By August 30, 2006, submit to the Division of Health, Wellness and Disease Control 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.
5. Participate in quality assurance and technical assistance activities conducted by the Division of
Health, Wellness and Disease Control.
Special Requirements HIV Prevention — Non-Categorical
Local Health Departments that do not receive categorical AIDS/HIV prevention funds may request
reimbursement for performing HIV tests. Agencies will be reimbursed at a rate of $8.50 per test, not to
exceed $2,000 for fiscal year 200612007. Reimbursement requests must be submitted quarterly on the
financial status reports. Requests for reimbursement will be verified based on data submitted to the
Department via the HIV Event System (H ES).
AIDS/HIV PREVENTION RAPID TESTING SPECIAL REQUIREMENTS
(KENT COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY HEALTH DEPARTMENT AND
DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION)
Contractor Requirements:
Conduct HIV counseling, testing and referral, using rapid test technologies, according to guidelines and
standards issued by the Michigan Department of Community Health and/or the US Centers for Disease
Control and Prevention. Local health agencies must:
1. Conduct quality assurance activities, guided by written protocol and procedures. Quality
assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing. Michigan
Department of Community Health (March 2003, or subsequent revisions).
2. Enroll in the Model Performance Evaluation Program (MPEP), CDC's external proficiency testing
program.
MDCH/CMS ATTACHMENT UI Page 10 of 66
07/06
3. Submit a photocopy of the local health department's CLIA certificate to Division of Health,
Wellness and Disease Control.
4. Report anomalous test results to the Division of Health, Wellness and Disease Control, pursuant to
established protocol.
5. Submit quality control and daily patient logs on a monthly basis.
6. Ensure that staff performing counseling and testing with rapid test technologies have completed,
successfully, rapid test counselor certification courses, test device training, and proficiency testing.
Staff who serve as "site supervisors" must complete, successfully, laboratory quality assurance
training, blood borne pathogens training and test device training.
AIDS/HIV PROVIDER EDUCATION
(KENT COUNTY HEALTH DEPARTMENT)
Contractor Requirements
In carrying out the terms of this agreement, the Contractor shall:
1. Maintain the organizational, administrative, fiscal and programmatic capacity necessary for
provision of services supported under this agreement. At minimum, the Contractor 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 the management and operation of the agency
and essential to ensuring achievement of its mission.
C. Establish and maintain 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/managers:
1. Possess the knowledge, skills, abilities and credentials essential to assigned
responsibilities; and
2. Are hired or discharged through fair and objective processes, which are
appropriately documented.
2. Establish implement and maintain policies and procedures designed to assure services supported
under this agreement are delivered pursuant to applicable federal and state laws, policies and
established standards.
3. Maintain the technological capacity necessary to comply with monitoring, reporting and evaluation
requirements associated with this agreement and to assure timely and efficient communication
with HAPIS/DHWDC.
4. Establish and maintain mechanisms to obtain, on an ongoing basis, the input of target populations
regarding the design, implementation and evaluation of prevention interventions. Progress reports
submitted by the contractor are to describe the process and/or mechanisms for obtaining such
input.
5. Establish, maintain and document linkages with community resources that are necessary and
appropriate to addressing the needs of targeted populations(s) and that are essential to the
success and effectiveness of services supported under this agreement. At minimum:
A. Programs targeted to communities at sexual risk for HIV are to establish, maintain and
document linkages to community resources for the prevention, screening and treatment of
sexually transmitted diseases.
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B. Programs targeted to communities at risk through injecting drug use are to establish,
maintain and document linkages to community resources for substance abuse prevention
and treatment.
Programs targeted to or serving HIV-infected persons are to establish, maintain and
document linkages to appropriate care/treatment, case management and partner
counseling and referral services.
6. Conduct prevention program activities in a manner consistent with applicable federal and state
laws and program and quality assurance guidelines and standards issued by the Michigan
Department of Community Health. Current referent documents include:
A. Quality Assurance Standards for HIV Prevention Interventions. HIV/AIDS Prevention &
Intervention Section, Division of HIV/AIDS - STD, Michigan Department of Community
Health. (Revised: May 2003)
B. Protocol for HIV Counseling and Testing Using Oral Mucosal Transudate Technology.
(March 1997)
C. Michigan HIV Laws: How They Affect Physicians and Other Health Care Providers.
Michigan Department of Community Health, HIV/AIDS Prevention and Intervention
Section. (Revised 2002)
It is understood that the laws, guidelines and standards described in the referent documents above
may be revised, supplemented or replaced at any time and that the Contractor will conduct
prevention program activities in a manner consistent with the most current laws, guidelines and
standards.
7. Participate in contract monitoring and quality assurance activities conducted by and/or facilitated
by HAPIS/DHWDC.
8. Adhere to time lines, work plans, budgets and staffing plans submitted to and approved by
HAPIS/DHWDC. Deviations from approved time lines, work plans, budgets, and staffing plans
must receive advanced authorization from HAPIS/DHWDC.
9. Participate in technical assistance, training, and/or skills-enhancement opportunities as
recommended or required by HAPIS/DHWDC.
10. Participate in program evaluation activities conducted and/or required by HAPIS/DHWDC.
11. Submit all educational materials (e.g. brochures, posters, pamphlets and videos) used in
conjunction with HIV prevention activities to the MDCH Program Review Panel for review and
approval prior to their use.
12. Submit preliminary agendas to HAPIS/DHWDC for review and approval, for conferences, trainings,
workshops and similar activities supported wholly or in part under this agreement.
13. Submit program manuals, intervention curricula, training curricula and similar documents to
HAPIS/DHWDC for review and approval prior to publication and use if development and
implementation is supported wholly or in part under this agreement or if such documents are to be
used in conjunction with activities supported under this agreement.
14. Provide HIV testing using test technologies as approved and authorized by HAP1S/DHVVDC.
Agencies may not utilize funding provided under this agreement to support adoption of rapid HIV
test technologies without prior approval from HAPIS/DHWDC.
15. Submit a copy of the financial status report (FSR, FIN-130) to HAPIS/DHWDC simultaneous to
submission to Budget and Finance Administration, pursuant to established protocol.
16. All sub-contracts issued under this funding agreement are to include the above requirements [1-
121 and are subject to prior approval by DHWDC/HAPIS/MDCH.
MDCH/CMS ATTACHMENT III Page 12 of 66
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Reporting Period
October - December 2006
January - March 2007
April - June 2007
July - September 2007
Narrative Report Due
January 31, 2007
April 30, 2007
July 31, 2007
October 31, 2007
Contractor Specific Requirements
Process Objective 1: By September 30, 2007 conduct four (4) New Responses to Old Infections: HIV and
Sexually Transmitted Infections trainings reaching 120 health care professionals. Three trainings will be
conducted in Southeast Michigan and one will be conducted in West Michigan.
Process Objective 2: By September 30, 2007 conduct three (3) Prevention with Positives: Sharing the
Responsibility trainings reaching 60 health professionals. Two trainings will be conducted in Southeast
Michigan and one will be conducted in out-state Michigan.
Process Objective 3: By September 30, 2007 conduct eight (8) health professional student trainings
reaching 240 individuals. Five trainings will be conducted in Southeast Michigan and three trainings will be
conducted in out-state Michigan.
Outcome Objective 1: By September 30, 2007, 80% of participants in the Prevention with Positives:
Sharing the Responsibility for healthcare providers will report that they are better prepared to conduct HIV
risk assessment and risk reduction education as a result of the training.
Outcome Objective 2: By September 30, 2007, 85% of participants in HIV, STI and sexual health
discussion trainings will report that they are more knowledgeable about the need to discuss HIV and STI
testing with patients as a result of the training.
Outcome Objective 3: By September 30, 2007, 85% of participants will report that they feel better
prepared to initiate sexual health discussion with patients as a result of this training.
Outcome Objective 4: By September 30, 2007, 85% of participants will report that they are more
knowledgeable about the need to conduct comprehensive sexual histories with patients.
Reporting Requirements
The Contractor shall submit:
1. Narrative Progress Reports. A narrative report detailing progress toward meeting process and
outcome objectives. The format and content of these reports are to conform to the guidelines
issued by HAPIS/DHWDC. Narrative reports are due 30 days after the close of each quarter:
The original and one copy of the quarterly narrative report are to be submitted by the Contractor to
the designated HAPIS/DHWDC contract monitor.
Process and Outcome Mon itorina Data. Applicable process and outcome monitoring data are to be
submitted via the HIV Event System. The time line and protocol for submitting these data are to
conform to guidelines issued by HAPIS/DHWDC.
It is understood that the reports described above may be revised, supplemented or replaced at any
time and that the agency will provide information and/or data responsive to modified reporting
requirements.
Any such other information as specified in the Program Goals and Objectives or Program
Requirements shall be developed and submitted by the Contractor as required by the Contract
Manager.
2. The Contract Manager shall evaluate the reports prior to submission to HAPIS/DHWDC.
3. The Contractor shall permit the Department and/or its designee to visit and to make an evaluation
of the project as determined by Contract Manager.
MDCH/CMS ATTACHMENT III Page 13 of 66
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AIDS/HOPWA SPECIAL REQUIREMENTS
(Housing Opportunities for Persons Living with HIV/AIDS)
1. Budget and Agreement Requirements
A. HOPWA Eligibility
An eligible person means a person with acquired immunodeficiency syndrome or related
diseases who is below 80% median income. A family member regardless of income is
eligible to receive housing information services. Any person living in proximity to a
community residence is eligible to participate in that residence's community outreach and
educational activities regarding AIDS or related diseases. Within the population eligible for
this program, nondiscrimination and equal opportunity regulations must be followed,
including fair housing and affirmative outreach. A project sponsor and all contractors and
subcontractors must adopt procedures to ensure that all persons who qualify for the
assistance, regardless of their race, color, religion, sex, age, national origin, familial status,
or handicap, know of the availability of the HOPWA program, including facilities and
services accessible to persons with a handicap, and maintain evidence of implementation
of the procedures.
B. Allowable Use of Funds
Funds may be used to assist all forms of housing designed to prevent homelessness. This
includes emergency housing, shared housing arrangements, apartments, single room
occupancy (SRO) dwellings, and community residences. It includes assistance to remain
in current homes, whether owned or rented, and assistance in relocating to another home,
whether owned or rented. The following activities may be carried out with HOP WA funds:
1. HOUSING ASSISTANCE Tenant Based Rental Assistance (TBRA): Subsidy torus
on the open rental market. Tenant holds lease to unit rented at or under Fair
Market rent (FMR) and meets Housing Quality Standards (HQS). Short-Term Rent,
Mortgage and Utility (STRMU) payments: Subsidy to prevent homelessness of
mortgagers or renters in their current place of residence. Limited to 21-weeks in
any 52-week period.
2. SUPPORT SERVICES. Case management: Client advocacy, and assistance with
access to benefits, counseling and help to develop a housing service plan to
establish stable permanent 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. Other Support
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 individuals. Limited to services not already available
through other agencies or funding sources.
3. HOUSING PLACEMENT ASSISTANCE Housing Information Services: Information
and referral services to assist eligible persons with locating, acquiring, financing
and maintaining housing. May include housing counseling, housing advocacy,
• housing search assistance, etc. Permanent Housing Placement: Expenditures
that help establish a household in a housing unit. May include application fees,
related credit checks, reasonable security deposits (limited to amount equal to two
months rent.
MDCH/CMS ATTACHMENT III Page 14 of 66
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4. HOUSING DEVELOPMENT, ADMINISTRATION AND MANAGEMENT SERVICES
Resource Identification: Activities to establish, develop and coordinate housing
assistance resources. Includes attending Continuum of Care meetings.
Administration: 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 with project sponsors
receiving up to the remaining portion of the 7%. Project Sponsors, and Fiduciaries
who are also Project Sponsors, may use 7% of their total Expenditures for
administration. Fiduciaries who are also Project Sponsors may not collect thA 3%
plus the 7%.
For more information, please check the HOP WA regulations (24 CFR 574)
2. Contractor Requirements
In 2006, each agency must submit to the department their annual plan for providing HOPWA
services. The plan, along with the budget, should cover the period October 1, 2006 through
September 30, 2007. This plan, along with quarterly reports and the agency FSR Supplemental
Form, 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, 2006 and must be submitted to:
Community Living Division
Michigan Department of Community Health
320 S. Walnut, Lewis Cass 5th Floor N
Lansing, Michigan 48913
Attention: Brian Iverson
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. Support Services: Case management, client advocacy and access to benefits; and Other
Support Services. HOPWA funded support services are limited to only those essential
services which are not the responsibility of other funding sources or service providers.
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. Housing Placement Assistance — Housing Information and preparations for securing
Permanent Housing placement.
Funding priorities are to provide housing assistance and related housing activities.
1. Plan Components
The plan consists of the following components. Generally a brief description of
current year activities and the agency's plan for FY 06/07 is required.
MDCH/CMS ATTACHMENT III Page 15 of 66
07106
a. Needs
Describe the demographic characteristics of the population with HIV/AIDS
in the agency's service area in comparison to the population served by the
HOPWA program. Describe the service needs of the PLWH/A's in your
agency's service area within the following three funding categories:
1. Direct housing assistance,
2. Support Services: Case management, client advocacy, access to
benefits, and Other supportive services in relation to the
population's ability to achieve and maintain a stable housing
arrangement.
3. Housing Placement Assistance: Providing Housing Information
services and Permanent Housing Placement services.
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.
b. Coordination
Information about FY 06/07 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 05/07
along with a brief description of FY 05/06 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.
To assist the Department in assessing the program, also provide:
c. Services
Indicate what services are planned to be provided in FY 06/07 by the three
funding categories.
MDCH/CMS ATTACHMENT III Page 16 of 66
07/06
1. Direct Housing Assistance.
2. Support Services; Case management, client advocacy, access to
benefits, and Other support services.
3. Housing Placement Assistance; Housing Information Services and
Permanent Housing placement.
With respect to housing resource identification 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
service area have access to the direct housing assistance and housing
advocacy staff assistance.
Some regional networks are also the direct service providers. However,
most contract for HOPWA-funded services. Provide a list of HOPWA-
funded service providers, the type of services they provide (direct housing
assistance, housing placement assistance, 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 (using the HOPWA definitions for this purpose).
Provide estimated expenditures for FY 06/07 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 06/07 Plan" provided with your allocation
letter, indicate how the funds allocated to the agency will be allocated to
each provider (including the agency if services are provided directly) by the
following categories:
A. Type of direct housing assistance
1.a. Tenant Based Rental Assistance
1.b. Short-Term Rent, Mortgage and Utility Payments
B. Support Services
2.a Case Management (Housing related)
2.b Other Support Services
C. Housing Placement Assistance
3.a. Housing Information Services
3.b Permanent Housing Placement
D. Housing Development, Administration and Management Services
4.a. Resource Identification
4.b. Administration (Fiduciary only)
4.c. Administration (Fiduciary that is also Project Sponsor)
4.d. Administration (Project Sponsor only)
Also provide the planned number of persons to be served. Provide a brief
narrative explanation as necessary.
MDCH/CMS ATTACHMENT III Page 17 of 66
07/06
D. Reporting
In addition to submitting the FSR Supplemental Form which breaks down the HOPWA
expenditures according to the four main categories and 10 sub-categories listed above,
quarterly demographic and financial data must be submitted by email to the addresses
provided below. The forms entitled "DCH HOPVVA Quarterly Report" and "Data for the
HOP WA Annual Report" are provided with your allocation letter. Excel versions have been
provided to all agencies 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 Supplemental Form figures. NOTE: HUD has begun to
implement (4-2006) new requirements for Measuring Performance Outcomes for 2006.
DCH will begin to implement this system beginning July 1, 2006. This will require changes
in data collection and reporting. 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 2006 must be submitted by January 31,
2007, and will include data from the quarterly report for the period 10/1/2006-12/31/2006.
Quarterly Reports (including a copy of the FSR Supplemental Form Attachment) are due
as follows:
NEW** January 31, 2007 for the 10/1/2006-12/31/2006 quarter
May 15 for the 1/1/2007 - 3/31/2007 quarter
August 15 for the 4/1/2007- 6/30/2007 quarter
November 15 for the 7/1/2007- 9/30/2007 quarter.
Note: The data for the annual report and the narrative portion of the annual report are due
on January 31, 2007, for the 2006 calendar year.
All quarterly and annual reports should be sent via Email to:
iversonb@michioan.gov
If necessary, hard copies can be sent to:
Division of Community Living
Michigan Department of Community Health
Lewis Cass Bldg., 5 th Floor North
320 S. Walnut
Lansing, Michigan 48913
Attention: HOPWA PROGRAM
Contractor Specific Requirements
1. All fiduciaries and project sponsors using grant funds to provide housing must adhere to the
following standards:
A. Ensure that qualified service providers in the area make available appropriate supportive
services to the individuals assisted with housing under HOPWA. For any individual with
acquired immunodeficiency syndrome or a related disease who requires more intensive
care than can be provided in housing assisted under HOPWA, the project sponsor shall
provide assistance in locating a care provider who can appropriately care for the individual
and for referring the individual to the care provider.
B. Ensure that grant funds will not be used to make payments for health services for any item
or service to the extent that payment has been made, or can reasonably be expected to be
made, with respect to that item or service: under any State compensation program; under
an insurance policy; under any Federal or State health benefits program; or by an entity
that provides health services.
MDCH/CMS ATTACHMENT HI Page 18 of 66 07/06
C. Operate the program in accordance with the provision of 24 CFR 574 and other applicable
HUD regulations. Document the eligibility of each person receiving HOPWA benefits.
D. Keep records and reports, which are consistent with the information required by the Annual
Progress Report (APR) for HOP WA, by calendar year. Implement the Uniform Reporting
System which includes data regarding HOP WA eligible persons and information needed
for quarterly reports and the APR. Submit the annual progress report for calendar year
2006 by January 31, 2007.
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) the amount of Federal funds for the project or program; and 3) percentage and
dollar amount of the total costs of the project or program that will be financed by non-
governmental resources. Provide to MDCH copies of statements and press releases
issued by the Contractor. Retain copies of same on file for two (2) years.
G. Ensure all services are available in the entire agency service area.
H. Ensure that all activities funded under the program will meet urgent needs that are not
being met by available public and private sources.
Send copy of all HOP WA required documents to:
Division of Community Living
Michigan Department of Community Health
Lewis Cass Building, 5th Floor North, 320 S. Walnut
Lansing, Michigan 48913
Attention: HOPWA Program
MDCH/C MS ATTACHMENT III Page 19 of 66
07/06
Reporting Special Requirements
Sponsors must implement HUD's newly approved Measurement of Performance Outcomes reporting
requirements. See the HOP WA Consolidated Annual Performance and Evaluation Report (CAPER) HUD-
40110-D (1/2006) available through the HUD website. Changes include;
1. Use of a Revised 'IFSR Supplemental for HOPWA" form dated 5/19/06. This form requires a more
extensive breakdown (up to 10 categories) of expenditures reported to DCH/HUD. An electronic
and hard copy versions are available from DCH Division of Community Living.
2. Beginning July 1, 2006, collect and report data for the Quarterly/Annual report using the Revised
DCH HOP WA Quarterly/Annual report. An electronic and hard copy versions are available from
DCH Division of Community Living.
3. Copies of all HOPWA required documentation, such as the Quarterly-Annual report, the Annual
Plan for providing services, and a copy of the FSR and FSR Supplemental for HOP WA forms must
be emailed to Brian Iverson at iversonbamichigan.gov . Materials that can not be emailed,
should be sent to:
Division of Community Living
Michigan Department of Community Health
Lewis Cass Building, 5 th Floor North
320 S. Walnut
Lansing, MI 48913
4. Reimbursement: The original FSR and the FSR Supplemental for HOP WA form are to be sent to
MDCH-Bureau of Finance, Accounting Division. Reimbursement will be based on expenditures
reported in the FSR accompanied by the FSR Supplemental form. FSRs without the proper FSR
Supplemental form breakdown will not be reimbursed.
5. Begin implementation of the Homeless Management Information System in co-operation of DCH.
ASTHMA COALITION SPECIAL REQUIREMENTS
(KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES)
Contractor Requirements
1. Maintain a local Asthma coalition to help mobilize community awareness and interest in Asthma
related community needs.
2. Choose and complete asthma modules as determined by contractor and contract manager.
3. Participate in scheduled Summit of Asthma Coalition activities.
4. Submit trimester progress reports and a year-end summary of activities report.
Department Requirements
1. Provide administrative professional and technical consultation to the program.
2. Convene bi-annual Summit of Asthma Coalitions meetings and quarterly Consortium of Asthma
Coalitions Steering Team meetings.
Reporting Requirements
'1. The Contractor shall submit reports on the following dates:
Type of Report and Timeframe Due Date
1 st Tr-Annual Report (for period Oct 1 — Jan 31) February 15
2nd Tri-Annual Report (for period Feb 1 — May 31) June 15
3rd Tr-Annual Report (for period June 1 — September 30) October 15
Summary of Activities Report (Oct 1 — September 30) October 15
MDCH/CMS ATTACHMENT III Page 20 of 65
07/06
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:
Tisa Vorce, Asthma Consultant
Michigan Department of Community Health
Division of Chronic Disease and Injury Control
Diabetes, Kidney, and Other Chronic Diseases
109 Michigan Avenue, 7th Floor, P.O. Box 30195
Lansing, MI 48909
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.
BIOTERRORISM
Contractor Requirements
Each local health department, as a sub-recipient of funding through the CDC Public Health Preparedness
and Response on Bioterrorism Cooperative Agreement, shall conduct activities to build preparedness and
response capacity as defined by the Cooperative Agreement 06/07, all Cooperative Agreement guidance
issued by the CDC and MDCH and consistent with all approved FY06/07 work plan/s and budget/s on file
with the MDCH, 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 an
individual through who, 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. Special Initiatives, Projects and Supplemental activities under this Cooperative Agreement — there
are a number of special initiatives, projects and/or supplementals that are required of this
Cooperative Agreement from time to time. Activities that are beyond the base expectations include
but are not limited to, the Cities Readiness Initiative and Pandemic Influenza Supplemental, for
example. Some special activities are funded for the entire period of the 06/07 Cooperative
Agreement period, some for only a portion. Each local health department that is designated to
participate in any "special" initiative, project or supplemental is required to comply with all CDC and
MDCH guidance issued to define the activities of that segment of the agreement and comply with
all accompanying work plan and budgeting requirements implemented for the purpose of sub-
recipient monitoring and accountability. Some or all "special" initiatives, projects or supplementals
may require separate recordkeeping of expenditures. If so, this separate accounting will be
evidenced in additional columns in the CPBC budget form.
3. Funds under this program may NOT be used to purchase vehicles, or, supplant any current local
expenditure. Supplantation means using federal funds to replace local expenditures.
BIOTERRORISM REGIONAL EPIDEMIOLOGY SUPPORT
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.
MDCH/CMS ATTACHMENT III Page 21 of 66
07106
CHILDHOOD LEAD POISONING PREVENTION - SPECIAL REQUIREMENTS
Contractor Required Activity Toward Community Partnership/Collaboration Outcomes
1. Contractor must collaborate with the medical home provider to assure adequate follow-up of each
child in the jurisdiction with a blood lead level --r->20 micrograms.
2. The contractor must be actively involved in a local partnership/collaboration working to, among
other activities, identify a sustainable, local funding stream for home repair (e.g. Community
Development Block Grants, HUD grants and community banking programs).
3. Contractor must participate in target community partnership/collaboration meetings and MDCH
Lead Advisory Committee meetings.
4. Contractor must work actively with local stakeholders to identify or develop local ordinances related
to property maintenance.
Required Reporting
Quarterly narrative report to describe activities; include county data and outcomes where appropriate.
Please send reports to:
Mary Scoblic, Child Health Supervisor
Childhood Lead Program
P.O. Box 30195
Lansing, MI 48909
Contractor Special Requirements
1. Case Management
A. Objective:
1. All children in the jurisdiction with a confirmed blood lead level equal to or greater
than 20 micrograms per deciliter receive case management services.
2. Required components include: tailored nutritional evaluation and guidance, EBLL
investigation that includes secondary site inspection and non-housing source
identification, developmental evaluation, linkage to appropriate housing, financial,
education, nutrition, transportation, medical home and medical follow-up.
3. A child-specific plan of care is developed.
4. Children with BLLs 20 micrograms per deciliter demonstrate decreasing blood
lead values.
B. Activities/Strategies (REQUIRED)
1. Children with BLLs .?..20 micrograms per deciliter must receive comprehensive,
family-centered case management services.
2. Children with BLLs a 20 micrograms per deciliter are followed regardless of age
until they have two BLLs < 10 micrograms per deciliter in six months.
3. The MDCH-CLPPP protocol must be followed for case management activities.
C. Performance Measures
1. Number of new cases of children with BLLs 20 micrograms per deciliter receiving
comprehensive nursing and environmental follow-up completed for each case
within timeframes specified by MDCH and CDC.
2. Types of referral and community linkages made by the local public health agency.
3. Number and percentage of children who receive appropriate follow-up testing
MDCH/CMS ATTACHMENT III Page 22 of 66
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D. Reporting Requirements:
1. Case management and outcomes must be reported to MCDH CLPPP monthly.
2. MDCH CLPPP standard forms must be used to report all case management
activities.
3. Contractor must describe barriers encountered and identify strategies planned to
address them.
2. Testing
A. Objective: To increase blood lead testing for at-risk children 6 years of age and younger,
as per the Statewide Testing/Screening Plan.
B. Required Activities
1. A testing workplan for the jurisdiction must be developed.
2. Outreach to providers occurs re: identifying high-risk children in their practices and
targeting them for testing; and testing and retesting at appropriate ages and/or
results.
3. Outreach activities to high-risk children and families for both primary prevention
and blood lead testing occur.
4. Workplan for eliminating unconfirmed capillary tests is developed.
5. Children with increasing BLLS are tracked and appropriate responses are made
and documented.
C. Performance Measures
1. An annual increase in testing of high-risk children < six years old (target of 10% per
year).
2. An annual increase in testing of high-risk children one and two years old (target of
25% per year).
D. Reporting Requirements
1. Quarterly direct testing and testing outreach activities must be reported to MDCH-
CLPPP.
2. MDCH-CLPPP standard forms must be used to report testing progress.
3. Quarterly reports must include testing strategies, strategies to respond to children
with increasing blood lead levels and plans for the next quarter.
3. Primary Prevention
A. Objectives
1. Increase public and professional awareness through intensive community outreach and
education activities.
2. Prevent initial lead poisoning through early identification and
remediation/abatement or interim controls of hazards in at-risk housing.
B. Required Activities to Support the Community Collaboration Strategic Plan
1. Environmental investigations are completed for children with BLLs 20 micrograms
per deciliter.
2. Environmental investigations are strongly recommended for children with BLLs 10
micrograms per deciliter.
MDCH/CMS ATTACHMENT HI Page 23 of 66
07/06
3 Complete arid timely environmental investigation reports are provided to the
appropriate public agencies.
4. Leadsafe work practice trainings are facilitated at least twice yearly or as needed in
the jurisdiction.
5. Home visits by public health nurses (PHNs) are provided for all children with BLLS
10 micrograms per deciliter.
6. Outreach activities occur for children ages one and two years with BLLs between 5
and 9 micrograms per deciliter.
7. Outreach activities for pregnant women residing in pre-1978 housing occur
monthly.
8. Risk education is provided for: Primary care providers regarding testing and follow-
up (monthly); parents and general public (quarterly); day care providers (quarterly);
and targeted risk education for high-risk populations, including refugees,
immigrants, migrants and pregnant women.
9. Education about low interest loans for remediation/abatement, such as MSHDA's
Property Improvement Program (PIP) is provided.
10. Educate local public health agency staff about monies available in specific
geographic areas through the Lead and Healthy Housing Section (LHHS) and
specific lead funding available through Community Development Block Grants
(CDBG), LEAP, Weatherization and others.
C. Performance Measures
1. Number and type of professional and targeted educational activities occurring in
the target community.
2. Number of homes identified as at-risk through inspection or sampling.
3. Number of PHN home visits completed.
4. Number of referrals to PIP, LHHS, local HUD programs, CDBG and LoanPlus.
5. Number of contacts with pregnant women residing in pre-1978 homes.
6. Number of contacts with families of one-and-two-year olds with BLLS between 5
and 9 micrograms per deciliter.
7. Number and audience type for risk education sessions.
D. Reporting Requirements:
1. Quarterly reporting to MDCH, using format specified and developed by MDCH
regarding all required activities.
4. Surveillance
A. Objective: Assure appropriate follow-up of children with elevated blood lead levels.
B. Required Activities
1. The Stellar data system is actively used (by nursing and environmental health) for
determining environmental status, including information regarding any inspection
and/or interim controls performed and clearance status.
2. The Stellar data system is actively used (by nursing and environmental health) for
monitoring the health status of an affected child.
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3. Outreach occurs to children who are Medicaid enrolled but not tested using
surveillance data.
4. Rental property owners of housing where children with elevated BLLs reside are
reported to the county prosecutor for failure to meet the requirements of PA 434 of
2004.
C. Performance Measures
1. Monthly reports to MDCH-CLPPP contain information about both environmental
and health status of children with elevated BLLs.
2. Number of children under the age of six years, enrolled in Medicaid and not
previously tested, who are identified and tested.
3. Number of rental property owners reported to county prosecutors for failure to
respond to the requirements of PA 434 of 2004.
D. Reporting Requirements
1. A monthly report of caseload and activities for children in the jurisdiction with BLLs
20 micrograms per deciliter is submitted to MUCH.
2. A quarterly narrative report addressing the outcomes, activities and performance
measures listed above will be submitted to MDCH. The quarterly narrative report
will also include a written action plan for the next quarter.
CSHCS SPECIAL REQUIREMENTS
Contractor Requirements
All of the following activities must be implemented according to CSHCS issued policy.
1. Program Representation and Advocacy
A. Actively promote outreach and program representation which includes, but is not limited to
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 local hospitals, providers, the community, other agencies and
families.
B. Inform families of their rights and responsibilities in the CSHCS program.
C. Describe I CSHCS benefits to families, including, but not limited to, the Children with
Special Needs (CSN) Fund, the insurance premium payment benefit, skilled nursing
respite, hospice and out-of-state care, and assist as needed.
D. Actively promote and provide information, referral, and assist persons in making
applications for other programs in the community for which the child and/or family may be
eligible, such as Early On, WIC, MI-Child, Healthy Kids, Medicaid, and Medicare.
E. Actively promote and provide assistance to help families advocate on their own behalf.
Serve as a liaison with service providers as needed.
F. Assure that family centered care is integrated into the local CSHCS system of care by
facilitating the direct participation of families in program development, implementation,
evaluation and policy formation.
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2. Application and Renewal
A. Assist with medical eligibility determination by arranging diagnostic evaluation referrals or
obtaining Release of Information form(s) for the purpose of securing medical reports for
determining medical eligibility.
B. Assist any family who is referred or who contacts the local health department for
assistance with completion of the CSHCS application form, Income Review/Payment
Agreement form, and third party liability forms.
C. Initiate a welcome contact to newly enrolled CSHCS families.
D. Contact CSHCS enrolled families at least annually to provide information about the
CSHCS program, assess family needs and update client information.
E. Locate individuals or families who do not return a CSHCS Application within 30 days after
being made medically eligible, and offer assistance with application completion.
3. Support Services
A. Refer families to the CSHCS Parent Participation Program, and actively promote the
Family Phone Line and the Family Support Network.
B. Facilitate transition through the Medicaid Health Plan (MHP) process and into the MHP
environment for CSHCS/Medicaid clients prior to and up to six months after aging out of
CSHCS (at age 21) if needed.
C. Assist and authorize in-state travel assistance for CSHCS families as needed.
D, 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.
E. Provide care coordination to CSHCS families as needed, according to current CSHCS
policy and procedures.
4. Case Management Requirements
When local health departments provide CSHCS case management services, the most current
case management policy and procedures as established by CSHCS must be followed.
5. Reporting Requirements:
A. A brief annual narrative report is due by November 15 following the end of the fiscal year,
describing CSHCS successes, challenges and any technical assistance needs the LHD is
requesting the State to address. Also, if your agency allocated any local MCH funds to
CSHCS, briefly describe how those funds are used (e.g., CSHCS salaries, outreach
materials, mailing costs, etc.)
B. Report the number of diagnostic referrals completed, the number of families directly
assisted in the CSHCS enrollment process, and the number of families directly assisted in
the CSHCS renewal process through Attachment II (H-977) of the CPBC.
COLORECTAL CANCER EARLY DETECTION PILOT SPECIAL REQUIREMENTS
Contractor Requirements
1. Create an approved statement of work that contains the following elements:
A. Identify Geographic Area and Target Population
B. Development of Collaborative Partnerships
C. Provision of Early Detection Services
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D. Provider Care Network
E. Options for Uncompensated Care
F. Data Collection and Quality Control
G. Billing and Reimbursement
H. Project Coordination and Management
I. Budget
2. Approval by MDCH of necessary elements must also be addressed in the statement of work
including:
A. All products and deliverables;
B. Human subjects committee (IRB), as applicable;
C. All publications, articles, brochures, flyers, presentations, and press releases generated by
the project, as applicable;
D. All health behavior messages regarding colorectal cancer early detection, as applicable.
3. Submit quarterly progress reports, including budget amendments and outstanding invoices.
4. Participate with MDCH, Michigan Public Health Institute (MPHI), expert consultants, and other
contractors in discussions, information sharing and problem solving. This will include at least three
meetings/conference calls.
5. Submit a final project report and invoice for Phase II: Implementation. The final report, which is
due 11/01/07, will include evidence that the agency:
A. BCCCP local coordinating agencies that did not offer early detection services to men
during the pilot must include a plan for provision of these services to men;
B. Maintained relationships with providers needed in order to provide screening, diagnostic
and treatment services;
C. Conducted a pilot program for colorectal cancer early detection using the Michigan Cancer
Consortium's Guidelines to provide services to 150 uninsured people, who are at or below
250% poverty, within a high mortality county;
D. Maintained a record of screenings, with diagnostic, treatment, and genetic counseling and
testing as appropriate, that was used by the funded agency and shared with MDCH/MPHI
staff for quality control purposes;
E. Maintained a record of clinical expenses for each client by CPT code, that was used by
funded agencies and shared with MDCH/MPHI staff for evaluation purposes;
F. Participated in evaluation of the overall pilot program and each funded site.
G. Provided aggregated patient and clinical expense data to evaluate the project, using the
specified format and frequency.
H. Supplied evaluation data to MDCH/MPHI via other reporting mechanisms (i.e., quarterly
reports).
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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, 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), Diabetes Self-
Management Training (DSMT) Programs, and other key partners.
4. Educate consumers, communities, health care delivery agencies, health care providers, and
legislators on the importance of pre-diabetes, diabetes self-management, implementation of quality
diabetes care and education, and of the need to have sufficient funding to sustain these network
activities.
5. 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.
6. Participate in the Michigan Nurses Association Continuing Education Approval Program and the
Commission on Dietetic Registration Program (CDR) to provide continuing education contact
hours to Nurses and Dietitians.
7. Participate in National and State Initiatives including the CDC Flu/Pneumococcal Vaccination
Campaign, National Diabetes Education Program (NDEP), and Diabetes Detection Initiative (DDT),
as directed by the MDPCP.
8. 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 lesser of $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.
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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 MDPCP
conference call.
3. Provide DON input and feedback by due dates on all department-initiated requests for MDON &
MDPCP materials (such as, evaluation data, policies/procedures, etc.)
4. Notify and submit to the MDPCP copies of all abstracts prior to 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 11/30/06 submit to the department for review and approval, the annual program plan for FY
06/07. 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:
1/21/07, 4122/07, and 7/22/07: Quarterly Reports
10/21/07: 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.
4. Submit a copy of quarterly Financial Status Reports (FSR), at the time originals are submitted to
Accounting, to:
Olga DeLaCruz
Diabetes and Other Chronic Disease Section
Michigan Department of Community Health
109 Michigan Avenue, 7°1 Floor
PO Box 30195
Lansing, Michigan 48909
Contractor Specific Requirements
1. By September 30, 2007, 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.
Includes promotion of at least one of the campaigns reaching racial and ethnic minority
populations.
B. Be Smart About Your Heart. Control the ABCs of Diabetes.
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C. Control Your Diabetes. For Life.
2. By September 30, 2007, utilize Taking on Diabetes program materials at one or more events for
consumers or health professionals.
3 By September 30, 2007, partner with at least two managed care plans to facilitate their
implementing a member-oriented or professional education initiative. (NOTE- UPDON contract
will reflect one managed care plan).
4. By September 30, 2007, 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.
5 By September 1, 2007, update the website support group directory to reflect additions or changes
in the support groups in their region.
6. UPDON will track the number of website hits to the support group directory and include the number
of hits in each FY 07 MDPCP quarterly report.
7. By September 30, 2007, provide MNA pre-approved group presentations to 400 health care
professionals, with a special emphasis on presentations aimed at improving diabetes clinical
indicators.
8. By September 30, 2007, 100 health care professionals from the DON region will have successfully
completed self-study module pre-approved for contact hours through the Michigan Nurses
Association and the Commission for Dietetic Registration.
9. By September 30, 2007, 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. Diabetes and Hypertension (5/06)
B. Foot Care (9/06)
C. Basic Nutrition (9/06)
D. Type 1 (3/07)
10. By September 30, 2007, facilitate at least one project, in partnership with the American Diabetes
Association, the American Heart Association, the American Cancer Society, or other voluntary
health association, to increase awareness of the association of diabetes to other chronic health
conditions (e.g. cardiovascular disease, cancer, depression, etc.)
11. By September 30, 2007, 25 health professionals from the DON region will have successfully
completed the basic nutrition self-study module.
12. By August 31, 2007, 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.
13. By September 30, 2007, 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. (Not in ECDON contract).
14. By September 30, 2007, partner with the National Kidney Foundation of Michigan (NKFM) to
facilitate the NKFM implementation of the Healthy Hair Starts with a Healthy Body program in the
DON region. (SEMDON, TENDON, and ECDON contracts only)
15. By September 30, 2007, actively participate in the DON region's access to care coalition or
projects.
16. By September 30, 2007, 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.
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17. By September 30, 2007, actively partner with other state- and federally-funded diabetes initiatives
reaching high-risk populations, as applicable (e.g., AIM-HI, REACH, Diabetes Detection Initiative,
and Intertribal Council's STEPs project).
18. By September 30, 2007, establish or maintain a level three or higher' partnership with each of the
Diabetes Collaborative projects in their region. (NOTE - not in UPDON contract, as they do not
have a collaborative in their region).
19. By September 30, 2007, 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.
DIABETES PRIMARY PREVENTION PROJECT IN WISEWOMAN
(LENAWEE COUNTY HEALTH DEPARTMENT)
Contractor Requirements
1. Conduct a one (1) year pilot project to integrate diabetes primary prevention into the Lenawee
County WISE WOMAN program.
2. Use the MDCH Diabetes Primary Prevention in W1SEWOMAN Integration Plan to guide the pilot.
3. Screen 375 WISEWOMAN participants for pre-diabetes.
4. Provide lifestyle modification counseling and support to each woman diagnosed with pre-diabetes
as defined in the integration plan.
5. Provide medical care case management to each participant based on WISEWOMAN protocol.
6. Provide referrals to medical care, community resources and other support services as defined in
the integration plan.
7. In each quarterly report, provide information on process and outcome measures, to include:
A. Number of women screened for pre-diabetes
B. Number of women diagnosed with pre-diabetes
C. Percent of those diagnosed with pre-diabetes who completed lifestyle intervention sessions
D. Percent of those in lifestyle intervention who achieved behavioral modification goals,
including weight loss.
8. At the conclusion of the pilot, the contractor will evaluate the MDCH Diabetes Primary Prevention
in W1SEWOMAN Integration Plan and its efficacy in guiding the successful detection of pre-
diabetes and provision of diabetes prevention lifestyle modification.
Report Requirements
The Contractor shall submit a progress report on the following dates:
January 15, 2007
April 15, 2007
July 15, 2007
October 15, 2007 (4th Quarter & Annual Report)
to:
Olga DeLaCruz
Diabetes and Other Chronic Diseases Section
4 The Bureau of Primary Health Care Health Disparities projects have developed a partnership classification identifying criteria to be
met at specific partnership levels; this will be used to define the level of partnership.
MDCH/CMS ATTACHMENT III Page 31 of 66
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Michigan Department of Community Health
109 Michigan Avenue, 7" Floor
P.O. Box 30195
Lansing, Michigan 48909
FAMILY PLANNING/BREAST AND CERVICAL CANCER CONT_RQL PROGRAM (BCCCP)
JOINT PROJECT SPECIAL REQUIREMENTS
Contractor Requirements
The FP/BCCCP Demonstration Project is a joint program between Family Planning and BCCCP
designed to provide diagnostic services to Title X (Family Planning) clients who have Pap tests indicating
possible cervical cancer.
Extensive data is required by the Center for Disease Control and Prevention (CDC) for each woman
served by federal funds. Dates of service and results of testing are required prior to authorizing
reimbursement to providers. Therefore, data about the abnormal Pap smear will have to be transmitted
from the Family Planning program to the designated BCCCP agency prior to arranging diagnostic services.
1. Women eligible for this program will be Title X clients, 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, as well as the type of treatment. 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. Women
diagnosed with cervical cancer or pre-cancer (CIN 2) in the FP/BCCCP Joint Project are eligible to
apply for Medicaid to pay for treatment.
FAMILY PLANNING - PREGNANCY PREVENTION SPECIAL REQUIREMENTS
Contractor Requirements
1. The funds appropriated in the current State Public Health Appropriations Act for pregnancy
prevention programs shall not be used to provide abortion counseling, referrals or services, unless
contradicts Title X Federal Law (Title X of the Public Health Service Act).
2. All delegate agencies must serve a minimum of 95% of proposed users to access total amount
of allocated funds.
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3. Title X Family Planning agencies must collect Medicaid and Plan First! User data. The information
must be reported on the Michigan Table 15, as provided by program, and must be submitted
quarterly along with Family Planning Annual Report (FPAR).
FETAL ALCOHOL SYNDROME DISORDERS (FASD) COMMUNITY PROJECTS
(BERRIEN COUNTY HEALTH DEPARTMENT AND
PUBLIC HEALTH AGENCY, DELTA-MENOMINEE COUNTIES)
Contractor Requirements
The Contractor in accordance with the general purposes and objectives of this agreement will:
1. Use an evidence-based screening tool such as T-ACE to screen childbearing age or pregnant
women for alcohol use.
2. Advise women drinking at risk levels about related health risks (at risk levels are more than seven
drinks per week or more than three drinks in one day).
3. Determine the consistency of contraceptive user for these women.
4. Document maternal alcohol history in pregnancy (either current or past pregnancies where FASD
may be suspected).
5. Provide a primary care intervention (brief intervention, follow-up and treatment) to women at risk
for delivering children with FASD.
6. Provide children of women who have a positive history of alcohol use during pregnancy with
prescreening for FASD using reporting form provided by program.
7. Refer children with suspected FASD for further diagnostic testing (FAS Diagnostic Centers, school
systems or ISD, Developmental Center, Genetic Clinics.)
Department Requirements
1. Provide training and technical assistance regarding state FAS/D services, including alcohol use
screening, Brief Motivational Interviewing, FASD screening, diagnostic services and treatment
resources.
2. Analyze project data reports and provide feedback.
Contractor Special Requirements
Objective 1: Screen or facilitate screening women of childbearing age for alcohol use, including women
who are pregnant or nursing, women who are planning a pregnancy, and women who are
sexually active and not using contraception. (Target women who have had a previous
alcohol exposed pregnancy because of their increased risk).
Objective 2: Facilitate training of physicians, nurses and other allied health professionals to screen
women of childbearing age for possible alcohol use, to understand the detrimental effects of
prenatal alcohol exposure, to understand alcoholism as a treatable disorder, and to be
familiar with treatment services.
Objective 3: Provide a brief motivational intervention for women who are at-risk of an alcohol-exposed
pregnancy to reduce alcohol use and/or improve the effective use of contraception for birth
control.
Objective 4: Provide FASD prescreening for children of women who are at-risk drinkers or other
suspected children. (Facilitate further evaluation through knowledgeable professionals
and/or FAS Diagnostic Clinics).
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Objective 5: Facilitate diagnosed children and their families in accessing appropriate community services.
Depending on need, help facilitate involvement with enrollment in Early On (FAS provides
presumptive eligibility even without significant developmental delay), physical therapy,
speech and language therapy, occupational therapy, social skills training, respite care, family
counseling, support groups/support network, vocational and transitional services, daily living
and employment skills training, and job, housing, money assistance (SSI), section 8
housing).
Objective 6: Provide access to educational programming for caregivers of individuals with FASD on
understanding differences for a child with FASD and advocacy skills (educational cunicula
for various audiences about fetal alcohol syndrome (FA S) and other prenatal alcohol-related
disorders and how to access appropriate services for children with FAS and their families
can be found at http://wwwcdc.govincbddd/faslawareness.htm.)
Reporting Requirements
The Contractor shall submit the following reports as required by the Program Manager:
1. Financial Status Reports (FSRs) sent to the address noted
Reimbursement Section.
2. Data Reports every six-months and Year End Report using
to the Program Manager at the address below:
FASD Program Manager
Michigan Department of Community Health
109 W. Michigan, 3rd Floor, P.O. Box 30195
Lansing, Ml 48909
3. The Contractor shall permit the Department or its designee to visit and to make an evaluation
of the project.
HEALTH DISPARITIES REDUCTION PROGRAM - SPECIAL REQUIREMENTS
• (GENESEE COUNTY HEALTH DEPARTMENT)
Contractor Requirements
1. Programs are required to be staffed and operational within 45 days of receipt of award, and direct
client services are required to begin no later than ninety 90 days after receipt of award.
2. Failure to make reasonable progress in program development may result in revocation or reduction
of award.
3. Submit quarterly narrative reports as specified to MDCH in accordance with the following dates
and reporting formats:
Quarter Covered Due Date to MDCH/HDRP
October 1 2006 —December 30, 2006 January 30, 2007
January 1, 2007 —March 30, 2007 April 30, 2007
April 1, 2007 — June 30, 2007 July 30, 2007
Final report October 30, 2007
4. Quarterly reports shall adhere to the format and guidelines established by HDRP for minimum
program reporting requirements (See Attachment D of REP).
5. Agencies awarded under this RFP will be required to implement services in accordance with
established program standards, as well as state and federal policy and statutes including HIPAA.
6. Develop an evaluation tool, which identifies the process and outcome indicators of the project.
in the contract as required in the
the attached forms should be sent
MDCH/CMS ATTACHMENT HI Page 34 of 66 07106
7. Ensure delivery of services to all populations, as applicable, including African American,
Arab/Chaldean, Asian and Pacific Islander, Hispanic and Native American.
8. Ensure that programs targeting multicultural populations are culturally competent. Cultural
competency is defined as:
A set of academic and interpersonal skills that allow individuals to increase their understanding
and appreciation of cultural differences and similarities within, among, and between groups. This
requires a willingness and ability to draw on community-based values, traditions, and customs and
to work with knowledgeable persons of and from the community in developing focused
interventions, communications, and other supports.
9. Services are linguistically appropriate to meet the needs of the respective client population.
10. Data collected on clients served will reflect the multicultural racial and ethnic clients served
consistent with the department's rules and statutes as stated in Public Acts 88 and 89.
11. Health Care providers should reflect the racial and ethnic groups served to extent that such
providers could be reasonably recruited and utilized.
12. Agencies rewarded under this RFP are required to attend all grantees meetings.
13. The proposal criteria and the contractor's technical proposal as amended, are made a part of this
agreement by reference.
HEALTHY COMMUNITIES CARDIOVASCULAR
Contractor Requirements:
1. The contractor's program plan will be submitted and on file with the Department.
2. Develop an evaluation process for the project in collaboration with MDCH staff.
3. Submit quarterly progress reports, using the reporting format as required and made available by
the Section.
The quarterly progress reports shall be sent electronically to their program consultant on the
following dates:
Period Covered Report Due Dates
October 1 - December 31, 2006 January 15, 2007
January 1- March 31,2007 April 15, 2007
April 1 June 30, 2007 July 15, 2007
July 1 — September 30, 2007 October 15, 2007
Materials that cannot be emailed should be sent to:
Rochelle Hurst, Manager
Cardiovascular Health, Nutrition and Physical Activity Section
Michigan Department of Community Health
P.O. Box 30195
Lansing, MI 48909
4. Attend Required Training.
5. The Contractor shall collaborate with the program consultant to schedule site visits.
6. To provide policy and environmental changes to support physical activity, nutrition and tobacco
free life-styles.
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HIV/STD PARTNER COUNSELING AND REFERRAL SERVICES
PROGRAM SPECIAL REQUIREMENTS
(FOR HIV POSITIVE TEST NOTIFICATION, PARTNER COUNSELING AND REFERRAL SERVICES
AND SYPHILIS INVESTIGATION
(CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT)
Contractor Requirements
1. Pursuant to a protocol established by MDCH, provide positive test notification, HIV partner
counseling and referral services, victim notification arid recalcitrant and syphilis investigation for
the following local health departments: Central Michigan District Health Department, Barry Eaton
District Health Department, Ottawa Health Department, Ionia County Health Department,
Livingston County Health Department, Mid Michigan District Health Department, Shiawasee
County Health Department, Lapeer County Health Department, St. Clair County Health
Department, Sanilac County Health Department, Huron County Health Department, Tuscola
County Health Department, Bay County Health Department, Midland County Health Department,
District Health Department # 2, District Health Department # 4, District Health Department #10,
Leelanau-Benzie District Health Department, Grand Traverse County Health Department,
Northwest Michigan District Health Department, Chippewa County Health Department, Luce-
Mackinac-Alger-Schoolcraft District Health Department, Delta-Menominee District Health
Department, Marquette County Health Department, Dickinson-Iron District Health Department, and
Western Upper Peninsula District Health Department.
2. Provide these services fifty-two weeks a year.
3. Conduct program activities 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. Provide services supported under this agreement 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 Mucosal Transudate Technology.
Michigan Department of Community Health. March 1997.
D. Strategies to Improve Client Failure to Return for HIV Test Results. Michigan Department
of Community Health. July 2002.
E. Partner Notification Guidelines. Michigan Department of Community Health. January 2002.
F. HIV Partner Counseling and Referral Service Guidelines. US Centers for Disease Control
and Prevention. December 1998.
G. Michigan Local Public Health Accreditation Standards.
H. CDC STD Program Operation Guidelines and CDC STD Treatment Guidelines, latest
versions.
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.
MDCH/CMS ATTACHMENT III Page 36 of 66 07/06
6. Conduct quality assurance of activities supported under this agreement. Quality assurance
activities are to be guided by written policies and procedures. Policies and procedures associated
with evaluation of staff providing services supported under this agreement 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 Health,
Wellness and Disease Control.
8. Participate in technical assistance, training and/or skills-enhancement opportunities as
recommended or required by the Division of Health Wellness and Disease Control. It is understood
that the Division will provide travel support associated with participation in training and skills-
enhancement opportunities.
9. Participate in program evaluation activities conducted by or required by the Division of Health,
Wellness and Disease Control.
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 HIV test and HIV partner counseling and referral services data to the Division of Health,
Wellness and Disease Control via the HIV Event System. The time line and procedures for
submitting these data are to conform to guidelines issued by the Division of Health, Wellness and
Disease Control. Complete and submit currently accepted syphilis case management forms, as
required by the Outstate STD Program Manager.
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.
IMMUNIZATION ACTION PLAN SPECIAL REQUIREMENTS
Contractor Requirements
1. Service Delivery: Offer immunization services to the public.
A. Collaborate with public and private sector organizations to promote adult immunization
activities in the county:
B. Inform providers that Hepatitis B, pneumococcal, and influenza vaccine and their
accompanying administrative costs are Medicare covered benefits.
C. Inform provider that routine adult vaccines should be billed to Medicaid.
D. Provide and implement strategies for addressing the immunization rates of special adult
populations (i.e., college students, educators, health care workers, detention centers,
homeless populations, and child care employees).
E. Develop mechanisms to improve immunization rates.
F. Ensure convenient accessible clinic hours
G. Coordinate immunization services, including WIC
H. Develop methods to target local pocket of need areas.
2. Adhere to all federal and state appropriation laws pertaining to use of programmatic funds.
3. Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993, section 1928
Part IV — Immunizations and the 2003 Vaccines for Children Operations Manual and documents
that are updated throughout the year pertaining to the Vaccines For Children (VFC) Program.
MDCH/CMS ATTACHMENT III Page 37 of 66
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4. Ensure that federally procured vaccine is administered to eligible children only and properly
documented per VFC guidelines.
A. The VFC 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 provided in the jurisdiction are administered only to eligible
clients. This program allows for the immunization of select populations who are
underinsured and not served at a FQHC, RHC, or a public health immunization clinic
affiliated with a FQHC as defined by current state program requirements.
C. Ensure that all providers receiving vaccine from the state screen children for VFC eligibility.
D. Fraud or abuse of federally procured vaccine should be monitored and reported.
5. Adhere to all Federal and Michigan Laws pertaining to immunization administration and reporting
including reporting to the MCIR.
6. Monitor any provider receiving federally procured vaccine at least once every 3 years, and
preferable at least once every 2 years, as a VFC site visit
7. Ensure attendance at two (2) Immunization Action Plan (IAP) meetings each year.
8. Submit original FSR's to MDCH on a quarterly basis.
9. Develop, implement, and submit program IAP Reports to immunization field representative or other
designated point of contact in accordance with the following dates:
Period Covered Date Due
10/01/2006— 03/31/2006 April 15, 2007
04/01/2007 — 09/30/2007 October 15, 2007
10. Develop an IAP Plan for 2007 using a template provided by the Department, due to the
Immunization Field Representative or other designated point of contact by December 31, 2006.
11. 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.
12. 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.
E. Collaborate with local birthing hospitals to ensure birth dose of Hepatitis B is given.
13. Surveillance of vaccine preventable disease (VPD) activities:
MDCH/CMS ATTACHMENT III Page 38 of 66
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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.
Department Requirements
1. The department will receive and review IAP reports and the annual IAP plan, and share this
information with the local health departments.
2. Provide technical assistance in establishing and operating immunization action plans.
3. Provide technical assistance in MCIR activities through regional coordinators.
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.
6. Each LHD will have an annual VFC site visit by the Department.
7. Develop pre-formatted tools including training for new initiatives and IAP reports / plan.
IMMUNIZATION ASSESSMENT FEEDBACK INCENTIVE EXCHANGE (AFIX) 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. Conduct an Assessment Feedback Incentive Exchange (AFIX) with 75% of the maximum number
of VFC site visits for each Contractor. There will be a 25% minimum number of AFIX site visits set
for each Contractor.
2. Combined VFC/AFIX site visits will be conducted using registry based assessment and tools
developed by the Department.
3. Data from the Department regarding the number of AFIX site visits will be used to reconcile the
request from the Comprehensive FSR (DCH-0412). The corresponding reimbursement must be
noted as a funding source in requirements, refer to the guidance provided by the Department in
correspondence to the Immunization Action Plan (IAP) and Immunization Coordinator.
Department Requirements
1. The Department will provide payment based on the fixed unit rate reimbursement mechanism upon
completion and submission of the Comprehensive FSR (DCH-0412).
2. The Department will develop pre-formatted tools.3. The Department will provide support to the
Contractors.
3. The Department will provide training at IAP meetings and through field representatives.
MDCH/CMS ATTACHMENT Page 39 of 66
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IMMUNIZATION — FIELD SERVICE REPRESENTATIVES SPECIAL REQUIREMENTS
(DISTRICT HEALTH DEPARTMENT #10, KALAMAZOO COUNTY HEALTH & COMMUNITY
SERVICES, MARQUETTE COUNTY HEALTH DEPARTMENT, SAGINAW COUNTY HEALTH
DEPARTMENT, AND ST. CLAIR COUNTY HEALTH DEPARTMENT)
Contractor Requirements (Except Kalamazoo)
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,
understanding that their full time is to be devoted for immunization related activities.
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 high speed
intemet capabilities, a printer, a cellular telephone and a use of vehicle or reimbursement
mechanism for transportation unless otherwise arranged.
3. Ensure the Immunization Field Representative will be 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 by the Department 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 and other professional immunization
related conferences, attendance at the MDCH Immunization staff meetings and trainings, and
accreditation visits made in other areas of the state.
Contractor Requirements — Kalamazoo Only
Provide adequate office space, telephone connections, and high-speed Internet access. Also provide
access to fax and photocopiers.
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 responsibilities and definition of Immunization Field Service
Representative responsibilities.
3. Support or solicit the Immunization Field Service Representative input into policy-making
decisions.
IMMUNIZATION — NURSE EDUCATION REIMBURSEMENT SPECIAL REQUIREMENTS
Budget and Agreement Requirements
The rate of reimbursement is $150 per educational session per day to the Contractor, upon completion
and submission of INE Provider Contact and Report Forms. Reimbursement will be based on a first
come-first served basis.
Contractor Requirements
1. Ensure that all Immunization Nurse Educators are trained as required by the Department,
2. Ensure that the INE Provider Contact and Report Form is complete and submitted to
MDCH/Immunization Program within 5 days after the presentation.
MDCH/CMS ATTACHMENT III Page 40 of 66
07/06
Department Requirements
1. The Department will provide payment annually based upon the fixed unit rate reimbursement
mechanism upon completion and submission of the INE Provider Contact and Report Forms.
2. The Department will provide two (2) sessions per calendar year for Contractor Immunization Nurse
Educators.
IMMUNIZATION VACCINE FOR 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.
1.
The federal requirement is to visit each recipient of state-supplied and federally funded vaccine at
least once every three years. More frequent visits may be necessitated for corrective actions,
vaccine deliveries, fraud investigations, or other special events as they arise. 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.
For the Detroit Health and Wellness Department, 100% of all VFC providers will be visited annually
through the Provider Service Representative (PSR) contract, with no reimbursement due to thQ
special circumstances of this contract.
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 and the CDC. 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 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 (IAP) , Immunization Coordinators, or
through health officers.
Department Requirements
1. The Department will provide payment annually based upon the fixed unit rate reimbursement
mechanism upon completion and submission of the questionnaires.
2. The Department will develop pre-formatted tools
3. The Department will provide support to the Contractors.
4. The Department will provide training to IAP meetings and through field representatives.
MDCH/CMS rITACHMENT III Page 41 of 66 07/06
INFANT MORTALITY SUPPORT COALITION
(BERRIEN COUNTY HEALTH DEPARTMENT, DETROIT DEPARTMENT OF HEALTH AND
WELLNESS PROMOTION, GENESEE COUNTY HEALTH DEPARTMENT, INGHAM COUNTY
HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTH & COMMUNITY SERVICES,
KENT COUNTY HEALTH DEPARTMENT, MACOMB COUNTY HEALTH DEPARTMENT,
OAKLAND COUNTY HEALTH DIVISION, SAGINAW COUNTY HEALTH DEPARTMENT,
WASHTENAW COUNTY HEALTH DEPARTMENT, WAYNE COUNTY HEALTH
DEPARTMENT)
Contractor Requirements
1. Continue to develop local community coalition activities to address African American infant
mortality disparity according to Michigan's Infant Mortality Initiative — Infant Mortality
Coalitions (Revised March 28, 2006).
2. Send a representative to the State Coalition Network meetings.
3. Carry out the local coalition workplan as developed.
4. Build upon and maintain target population community collaboration and support.
5. Submit all required reports in accordance with the MDCH reporting requirements.
Reporting Requirements
1. The contractor shall adhere to the Michigan's Infant Mortality Initiative Coalitions program reporting
requirements in Infant Mortality Coalitions (Revised March 28, 2006).
2. Make any membership changes available for review by providing access to MDCH consultant or
authorized contractor.
3. Reports and information shall be submitted to:
Infant Mortality Initiative Coalition
Division of Family and Community Health
Michigan Department of Community Health
P.O. Box 30195
Lansing, Michigan 48909
Or via e-mail to:
LauberC@michigan.gov
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.
MDCH/CMS
07/06
ATTACHMENT III Page 42 of 66
Department Requirements
The Department will provide funding, at the fixed rate of $50 per woman served, for each woman that
expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of
obtaining an abortion and is provided the services noted in item 1 above. The number of services, rate per
service and total amount due must be noted as a funding source, under the element where the staff
providing the services are funded, on the Comprehensive FSR.
LABORATORY SERVICES SPECIAL REQUIREMENTS
(DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION,
KALAMAZOO COUNTY HEALTH AND COMMUNITY SERVICES ,KENT COUNTY, AND SAGINAW
COUNTY HEALTH DEPARTMENTS)
Contractor Requirements
1. Contractor Specific Requirements - All Contractors
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.
Provide secure facilities to store reagents, quality control organisms and
patient isolates.
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.
5. Assure reliability of PCR equipment provided by the Department by maintaining
yearly maintenance contract, and providing user-required maintenance.
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 Bureau
of Laboratories (BOL) Laboratory Information Management Systems (LIMS) 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 LMIS training activities.
Training and purchase of modules for LMIS C other than those module(s)/customization(s)
provided by MDCH will be the responsibility of the Contractor.
g.
MDCH/CMS riTAC:iMENT III Page 43 of 66
07/06
The Contractor is responsible for module(s)/customization(s) 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 module(s)/customization(s) purchased by a Contractor will be restricted to the
Contractor purchasing the module(s)/customization(s).
- Use of module(s)/customization(s) purchased by one Contractor can be negotiated
(formulas for payment will be based upon the percentage of total specimens entered into
the module(s)/customization(s)).
Module(s)/customization(s) purchased by any Contractor will become available to any
participating Contractor at no cost after five years. However, each Contractor using the
module(s)/customization(s) will share in the maintenance fees.
D. Provide laboratory support (examination of food specimens) to investigate up to 12
foodborne disease outbreaks. Laboratory support includes providing test reports and food
samples to the Bureau of Laboratories. Specimens will 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 Promotion Only
A. Meet established standards of performance and objectives in the following areas:
1. Perform testing for detection of foodborne disease outbreaks as specified in items
1.D and 1.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.
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.
6. Maintain sufficient reagents and supplies to test 50 specimens for Norovirus in
outbreak investigations pre-approved by MDCH Bureau of Epidemiology only.
MDCH/CMS ATTACHMENT III Page 44 of 66
rains
7. Renew yearly a Memorandum of Understanding (MOU) with MDCH BOL for
Laboratory Response Network (LRN) testing.
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, 2007 if more than 9,500 commercial
nucleic acid amplification specimens for chlamydia/gonorrhea will be performed.
3. Contractor Requirements — Kalamazoo County Health & Community Services. Kent and
Saginaw County Health Departments Only
A. Administration of the Michigan Regional Laboratory System.
1. Administer the regional laboratories as specified:
a. Kalamazoo County Health & Community Services will administer Region 3
in the Michigan Regional Laboratory System.
b. Kent County Health Department will administer Region 4 in the Michigan
Regional Laboratory System.
c. Saginaw County Health Department will administer Region 2 in the
Michigan Regional 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.
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.
g. 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.
a. Meet established standards of performance and objectives in the following
areas:
1. Maintain sufficient reagents and supplies to test 50 specimens for
Norovirus in outbreak investigations pre-approved by MDCH
Bureau of Epidemiology only.
MDCH/CMS ATTACHMENT lit Page 45 of 66
07/06
2. Renew yearly a Memorandum of Understanding (MOU) with MDCH
BOL for Laboratory response Network (LRN) testing.
4. Contractor Requirements - Kalamazoo County Health& Community Services 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
foodborne disease outbreaks as specified in items 1.D and 1.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 15,2007 if the health department performs
more nucleic acid amplification specimens than specified:
C. Kalamazoo County Health & Community Services performs more than 14,000 nucleic acid
amplifications prior to May 15, 2007.
D. Saginaw County Health Department performs more than 12,000 nucleic acid amplifications
prior to May 15, 2007.
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.
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.
ATTACHMENT III Page 46 of 66 MDCH/CMS
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 15,2007, if more than 18,000 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 foodborne 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 LIMS, support for LMIS hardware (UNIX server)
and software, provide one computer, user training for LMIS module(s)/customization(s)
utilized for testing performed under contract, advanced training for LMIS liaisons for test
master and Contractor specific data base support, and support for network
communications between the Contractor and the LMIS server.
The Department will maintain the sole contract with LMIS vendor. Payment for additional
module(s)/customization(s) and maintenance fees for those modules will be paid for by the
Contractor(s) through MDCH.
Tape backups and maintenance of all module(s)/customization(s) 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 software 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 for food and stool specimen examination related to
foodbome disease outbreaks.
2. Department Requirements — Detroit Department of Health and Wellness Promotion 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.
MDCH/CMS ATTACHMENT III Page 47 of 66 07/06
3. De •artment Re uirements for Kalamazoo Coun Health & Communi I
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.
B. 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.
9. 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.
4. Notify Agency of funding changes for state supported testing 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 Health & Community Services and Saginaw
County Health Department 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 Departmentonly
A. Purchase and arrange for shipment of test kits and reagents from manufacturer as
outlined in items 1.A, 1.D. and 1.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.
arvices. nen
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LABORATORY SERVICES SPECIAL REQUIREMENTS
(OAKLAND COUNTY HEALTH DIVISION AND
NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY)
Contractor Specific Requirements - Oakland and Northwest Michigan
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 using LMIS 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 LMIS training activities. Training and
purchase of module(s)/customization(s) for LMIS other than those modules provided by MDCH will
be the responsibility of the Contractor.
The Contractor is responsible for module(s)/customization(s) 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 module(s)/customization(s) purchased by a Contractor can be negotiated (formulas for
payment will be based upon the percentage of total specimens entered into the
module(s)/customization (s)).
Models purchased by any Contractor will become available to any participating Contractor at no
cost after five years. However, each Contractor using the module(s)/customization(s) will share in
the maintenance fees.
Department Requirements — for both Oakland and Northwest Michigan
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 LMIS, support for LMIS hardware (UNIX server) and
software, support and maintenance for one computer, user training for LMIS
module(s)/customization(s) utilized for testing performed under the contract, advanced training for
MDCH/CMS ATTACHMENT III Page 49 of 66
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LMIS liaisons for test master and Contractor specific data base support, and support for network
communications between the Contractor and the LMIS 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 — Oakland County Health Department only
6. Renew yearly a Memorandum of Understanding (MOU) with MDCH BOL for Laboratory Response
Network (LRN) testing.
Department Requirements — for both Oakland and Northwest Michigan
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.
LABORATORY SERIVCES — STARHS and VARHS
(KENT COUNTY HEALTH DEPARTMENT AND
DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION)
Contractor Requirements
Provide specimen tracking, packaging and shipping of Serologic Testing Algorithm for Determining Recent
HIV Seroconversion (STARHS) and Variant and Atypical Resistant HIV Surveillance (VARHS) specimens
as indicated in the study design.
Department Requirements
Support specimen tracking, packaging and shipping of VARHS and STARHS through funds for personnel
and supplies. Provide instructions, training and study design. Perform VARHS testing in the Department's
Lansing Laboratory.
LEAD SAFE HOME 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 Safe Home Program (LSHP) requirements are divided into the
following categories: 1) Education and Outreach; 2) Identification of Candidate Housing Units; 3) Lead
Hazard Control Activities; 4) Follow-up Activities; and 5) Post Remediation Client Surveys and Data
Collection. These procedures are to be adhered to and should not be interpreted to be inclusive of all
present and future program requirements.
1. Education and Outreach
It is expected that each county will provide a minimum of 10 local presentations on lead poisoning
paint issues per year.
A. Develop new partnerships with other affiliated housing and non-profit agencies in the
jurisdiction.
MDCH/CMS ATTACHMENT III Page 50 of 66
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B. Assist LSHP 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 and distribute the application for the Michigan State
Housing Development Authority's (MSHDA) Property Improvement Loan Program (P1P) 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.
County will forward loan applications for interested applicants to MDCH LSHP. County
should strive to submit between 5 and 10 applications to MDCH LSHP.
I. Subgrantees will be required to work with community-based organizations in their target
areas.
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 LSHP 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. All applicants will be required to come into LHHS for prioritization and assignment to
counties for abatement. There will be no holding of applications by the subgrantees.
LHHS staff will determine and provide which units will be addressed and in which order.
H. Subgrantees will be required to actively search for and identify homes in their target
communities through any means necessary (i.e., agency presentations, events, etc).
I. EBL investigations are not a HUD-funded priority and therefore should be performed by
non-HUD funded staff, except in those cases where the health and well-being of the child
would be compromised by delaying the investigation.
J. There will be a decrease in the number of inspections/risk assessments required to be
completed by the subgrantees. In prior grants, we indicated a higher number of
inspections/risk assessments had to be completed. We are attempting to bring the ratio of
inspection/risk assessments completed to number of units abated closer to a 1.1 ratio.
MDCH/CMS ATTACHMENT III Page 51 of 66
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K. Subgrantees will be required to attempt to blend funds on every project. Leveraged funds
may consist of MSHDA PIP loan dollars, CDBG dollars, homeowner/RPO private funds,
etc. It will be mandatory that subgrantees seek leveraged dollars on projects as part of the
standardization process.
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 LSHP 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 on-site supervision
of lead abatement contractors that are new to 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 specifications and in compliance with LSHP work standards.
Documentation of oversight hours is required by LSHP.
G. All processes involved in the Lead Safe Home Program will be standardized, including
project specifications, forms processing/procedures and the method by which each
subgrantee is dealing with the abatement contractors.
H. LHHS will perform continuous Quality Assurance/Quality Control (QA/QC) on all forms and
processes related to the Lead Safe Home Program through "lessons learned" and as
problems may arise.
4. Follow-up Activities
A. Conduct a visual inspection and obtain clearance dust wipe samples of all work areas
according to LSHP 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 LSHP 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 LSHP within 30 days of completion of work.
D. Conduct a 6-month follow-up which includes a visual and dust wipes of all work areas.
Address any contractor warranty issues. Completed form must be submitted to LSHP
within 30 days of completion.
E. Conduct a 14-month visual certification to address contractorwarranty issues. Completed
form must be submitted to LSHP within 30 days of completion.
F. Perform proper maintenance on the XRF unit.
5. Post-Remediation Client Surveys and Data Collection
A. Assist LSHP in monitoring the quality and cost effectiveness of lead hazard control
projects.
MDCH/CMS ATTACHMENT III Page 52 of 66 one
B. Distribute to each participant the Client Satisfaction Survey at the completion of each unit.
C. Conduct ongoing data collection and quarterly reporting to LSHP.
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 to appoint a full-time equivalent individual to provide
all program requirements as stated in this contract. The contractor will provide a quarterly report in
accordance with format and instructions from LSHP. 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
LSHP prior to sub-grantee meetings by the 10 91 of the following month.
The contractor will provide to LSHP 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.
As part of a regionalization strategy, subgrantees will be required to work out-of-county on up to 30% of
cases. Additional dollars will be included in the budget to reimburse for this travel. The target areas have
been divided up as follows:
Ingham County
Ingham County, more specifically city of Lansing
Jackson County, more specifically city of Jackson
Genesee County
Genesee County, more specifically city of Flint
Oakland County, more specifically city of Pontiac
Muskegon County
Muskegon County, more specifically city of Muskegon
Berrien County, more specifically city of Benton Harbor
CLEARCorps, Detroit
City of Detroit, Highland Park, Hamtramck
Statewide Field Consultant
Calhoun County, more specifically city of Battle Creek
Kalamazoo County, more specifically city of Kalamazoo
Out of Target County areas with leveraged funds
Other EBL units on an ''as needed" basis
1. LHHS Compliance Officers will review a defined percentage of Inspections/Risk Assessments
completed by each subgrantee to ensure all are following proper protocol.
2. LHHS will pay for 1.0 FTE or the equivalent for HUD grant activities ONLY.
3. Subgrantee (field staff) should work on HUD grant objectives ONLY.
4. Each subgrantee will be evaluated on quarterly performance using a similar method of what HUD
uses (i.e., Green, Yellow, Red rankings). LHHS staff will develop a protocol to evaluate progress by
each subgantee, each quarter. LHHS will determine the percentage/score to be achieved for each
ranking and the procedure by which a subgrantee will be dropped for poor performance (i.e., How
many yellow rankings before dropping? How many red rankings before dropping?). Subgrantees
will be evaluated on the number of inspections/risk assessments completed, number of units
abated and amount of education/outreach performed (least important).
MDCH/CMS ATTACHMENT III Page 53 of 66
07/06
5. Subgrantee quarterly site visits will be conducted by LHHS staff.
6. Subgrantees (field staff) will be required to attend subgrantee meetings every other month.
7. Subgrantees will be required to follow all lead regulations/laws.
8. For any subcontracts for field coordination activities (i.e., inspection/risk assessments, specification
writing) used by the subgrantees, the subgrantee will be responsible for making sure the
subcontractor follows the above procedures. Performance monitoring, evaluation and training of
the field coordination subcontractor are the subgrantee's responsibility to ensure all procedures
listed above are being followed.
9. Quarterly and monthly reports must be submitted on time.
Reference Documents
The following reference documents are essential to performing the stated requirements in this contract:
LSHP quarterly report guidance
HUD policy and procedure field guide
HUD 2000 Grant Proposal
Lead Abatement Act and corresponding rules
XRF Performance Characteristics Sheets
Lead Safe Home Project Procession and accompanying MDCH form.
LOCAL MATERNAL AND CHILD HEALTH (MCH) PROGRAM_SPECIALREOUIRENIENTS
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 fundin$1
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
Health Program, 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 MC H funds used to provide health care services
(except Family Planning) to non-pregnant women should be budgeted under Primary Care. If funds are to
ATTACHMENT III Page 54 of 66 MDCH/CMS
117/11A
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 as Medicaid or Plan
First 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.
LOCAL PUBLIC HEALTH OPERATIONS (LPHO) SPECIAL REQUIREMENTS
Budget and Agreement Requirements
1. State funding for LPHO shall support and the agency shall provide for all of the following required
services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act
No. 336, of 1998 Section 909.
Drinking Water Supply* Immunization
Food Service Sanitation On-Site Sewage Treatment Management*
Infectious/Communicable Disease Control Sexually Transmitted Disease
Hearing Vision
State funding for LPHO can support administrative cost for the eight required services including
allowable indirect cost, or an agency's cost allocation plan. (*Services funded under a separate
agreement with the Michigan Department of Environmental Quality.)
2. LPHO funding can also be used to fund other core health functions including: Community Health
Assessment & Improvement, Public Policy Development, Health Services Administration, Quality
Assurance, Creating & Maintaining a Competent Work Force and Local Public Health
Accreditation. These services could be budgeted separately as part of the Administrative Budget
element.
3. Net allowable expenditures are the authorized actual/allowable expenditures (total costs less
specified exclusions). Available funding is also limited by state appropriations.
4. First and second party fees earned in each required service program may be used only in that
required service program.
5. State LPHO funding is subject to local maintenance of effort compliance, in that full distribution of
state LPHO funds shall only be made to agencies with total local general fund public health
services spending in FY 06/07 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 06/07 the FY 92/93 Local Maintenance
of Effort Level must be met.
6. A final statewide cost settlement will be performed to assure that all available LPHO funds are fully
distributed and applied for required services.
Contractor Requirements
1. Assure the availability and accessibility of services for the following basic health services:
Prenatal Care; Immunizations; Communicable Disease Control; STD 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
MDCH/CMS ATTACHMENT III Page 55 of 66
117 incr.
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 Requirements — Food Service Sanitation
Budget and Agreement Requirements
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."
3. 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 (F1-229) 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).
4. Bill the local health department for state fees upon notification by the local health department that
the license has been approved and issued.
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 st 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.
MOCH/CMS ATTACHMENT III Page 56 of 56
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 the 1 st 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
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 tri-annual reports and other required program documentation to Tobacco Program
Consultant on a timely basis.
6. Attend Department regional and statewide coalition coordinator training.
7. Submit a copy of each quarterly Financial Status Report (FSR), at the time original FSR is
submitted to Accounting to program consultant at the following address:
Michigan Department of Community Health
Tobacco Section
109 W. Michigan Avenue, 81h Floor
PO Box 30195
Lansing, MI 48909
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.
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
MDCHICMS ATTACHMENT Ill Page 57 of 66
07,96
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, 2006, funding is only authorized up to $48,241 for FY 07 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. Record 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 13, 2007, April 14, 2007 and July 14, 2007. The year-end report,
which includes both the last quarter and an annual summary, is due November 15, 2007.
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:
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.
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Ill 111C
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 CARE IMPROVEMENT REGISTRY SPECIAL REQUIREMENTS
Contractor Requirements
1. Michigan Care Improvement Registry (MCIR) responsibilities:
A. Ensure that all immunizations administered to persons 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 immunization 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.
MICHIGAN CARE IMPROVEMENT REGISTRY (MCIR)
REGIONAL SPECIAL REQUIREMENTS
(PUBLIC HEALTH DELTA AND MENOMINEE COUNTIES, DISTRICT HEALTH DEPARTMENT #10,
GENESEE COUNTY HEALTH DEPARTMENT, KALAMAZOO COUNTY HEALTH & COMMUNITY
SERVICES, 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 data quality and data entry support staff for scan center services.
3. 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 Care Improvement 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 Department
approved procedures.
3. Monitor and develop strategies to increase private provider enrollment and participation in the
MCIR. Develop strategies to encourage all providers to fully participate with the MCIR, (such as
sites of excellence awards).
4. Process all user/usage agreements, according to MDCH approved procedures, to create user
accounts.
MDCH/CMS ATTACHMENT Ill Page 59 of 66
07,06
5. Implement and update marketing plans in support of increased provider and parent acceptance
and use of the MCIR.
6. Keep regional users updated on MCIR status and system changes.
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 MCIR users.
9. Develop a mechanism to assure persons who have died within the region are appropriately flagged
in the MCIR.
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 a yearly 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 MCIR,
16. Maintain a policy/procedure manual, approved by the regional advisory group and MDCH.
17. Process and file all "opt out" forms according to the Department approved procedures.
18. Attend regular MCIR regional contractor/coordinator meetings.
19. Perform quality assurance checks on the MCIR data for the region as prescribed by the
Department.
20. Assist local health departments and private providers with methodologies to "clean up" their
data.
21. Provide assistance to the Department on User Acceptance Testing (UAT) enhancements.
Contractor Performance/Progress Report Requirements
1. 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)
2. 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.
3. 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:
Bob Swanson, MPH
Michigan Department of Community Health
Immunization Division
MDCH/CMS ATTACHMENT III Page 60 of 66
P.O. Box 30195
Lansing, MI 48909
Phone: (517)335-8159
The contract manager shall evaluate the reports submitted
completeness and adequacy.
The Contractor shall permit the Department or its designee
the project as determined by the contract manager.
Department Requirements
1. Provide support and technical assistance to Regional staff.
2. Provide initial training and support to regional coordinator.
as described above for their
to visit and to make an evaluation of
NURSE FAMILY PARTNERSHIP (NFP) PROJECT
(DETROIT DEPARTMENT OF HEALTH AND WELLNESS PROMOTION, BERRIEN AND KENT
COUNTY HEALTH DEPARTMENTS AND OAKLAND COUNTY HEALTH DIVISION)
1. Adhere to the Nurse Family Partnership, Inc., (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 Promotion, 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 Grand
Rapids, Michigan or CENSUS TRACTS 126, 127 and 128 of the Community of Kentwood,
Michigan at the initiation of services,
D. For Oakland County Health Division, 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 Promotion.
C. Grand Rapids and CENSUS TRACTS 126, 127, and 128 of the Community of Kentwood,
Michigan for Kent County Health Department.
D. Pontiac, Michigan for Oakland County Health Division.
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.
6. Subject to match requirement (hard or in-kind) of two dollars and fifty cents for each ten dollars for
MDCH agreement funding.
7. Provide MDCH consultant or authorized contractor program access.
8. Build upon and maintain diverse community and target population collaboration and support.
ATTACHMENT Page 61 of 66 MDCH/CN1S
n7 17
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 Requirements
1. The contractor shall adhere to the NFP, Inc., 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:
Sandra Altenritter at altenritters@michigan.gov (Please put "Nurse Family Partnership
Reports FY 07" in the subject line.)
PRIMARY CARE DENTAL SPECIAL PROJECT
Contractor Requirements
1. Carry out the intent of the Funding Announcement in accordance with the CPBC Minimum
Program Requirements for the Primary Care Dental element.
2. Provide preventive and remedial dental services to persons not eligible for any other programs
and with incomes under the 200% of the Federal Poverty Level.
3. Provide the services without supplanting existing funding or patients.
4. Develop or show collaboration of strong prevention focus for a primary dental care school-
based/school-linked program.
Reporting Requirements
1. 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 patient so comparisons can be made between the disease
MDCH/CMS ATTACHMENT III Page 62 of 66
patterns of the various population groups. The monthly forms will be submitted with the
Billing Worksheet and FSR. The data will be compiled and analyzed by the Department.
C. Report on prevention focus for school-linked, school-based sealant programs that includes
participating schools and services provided in schools; and if such a program is
undeveloped, efforts made to initiate a school-linked, school-based oral health program.
Reports due: February 15, 2007 (Periods Oct. 2006 — Jan 2007) and June 30, 2007.
2. Submit reports to:
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 U.P. District Health Department have a
staffing reimbursement method.
Department Requirements
1. Provide administrative direction and technical assistance.
2. Reimbursement for services provided to target population as stipulated in the Funding
Announcement.
3. Provide master copies of the billing and MOD forms.
4. Evaluate the reports submitted as described above for their completeness and accuracy.
SIDS 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.
MDCH/CMS A TTA GWENT III Page 63 of 66 n7trP
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 CDC Core Curriculum on Tuberculosis 2004 as: "a
health care worker or another designated person watches the TB patient swallow each dose of the
prescribed drugs." The 2003 American Thoracic Society (ATS) document Treatment of Tuberculosis
regards DOT as "the preferred core management strategy for all patients with tuberculosis". Multi-drug
resistant TB (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/week (excluding holidays)
for daily regimens, and 2 or 3 days/week for intermittent regimens.
Contract Specific Requirements
1. 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 therapy.
4. Achieve a minimum of 60% of TB cases enrolled annually in DOT (October 1 to September 30).
5. Achieve >95% completion rate for treatment of all TB cases. The determination of whether or not
treatment has been completed is based on the total number of doses taken, not solely on the
duration of therapy. Consult the 2003 ATS document Treatment of Tuberculosis for guidance in
both the number of doses needed and also in regards to length of treatment following any
interruptions in therapy.
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(F)(1)].
3. Maintain an inventory of all equipment purchased with WIC program funds and maintain such
inventory at each WIC clinic location.
MDCH/CMS ATTACHMENT III Page 64 of 66
04,0••
4. Assure each Contractor employee authorized for or requesting access to the automated WIC
system complete and sign a security agreement (Form MIS-477) 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.
WIC- BREAST-FEEDING PEER COUNSELOR
(BERRIEN COUNTY HEALTH DEPARTMENT)
Contractor Requirements
Department will provide:
1. Contract with Berrien County Health Department for the WIC-based breastfeeding Peer
Counselor.
2. Contracted Lactation consultant's time and her travel expenses.
Reporting Requirements
Monthly financial report to include current month and year-to-date expenditures.
Monthly progress reports will include peer counselor training, orientation and activities. May use MSUE's
reporting system to capture data. Data will reflect:
1. Client numbers served
2. Referrals made and received
3. Client category such as pregnant and/or breasffeeding
4. Initiation and duration rates;
5. Services provided; and
6. Other data as negotiated between the Department's WIC Program and the Berrien County WIC
Coordinator.
WIC- ELECTRONIC BENEFIT TRANSFER (EBT) SPECIAL REQUIREMENTS
(JACKSON COUNTY HEALTH DEPARTMENT)
Contractor Requirements
Funding is provided to continue the support of contractual staff responsible for assisting with and
coordinating the implementation and operation of the WIC EBT pilot project at the local health department,
including:
Assisting clinic staff in the resolution of EBT card issuance, benefit generation, and benefit
redemption issues.
1. Assisting in completing the evaluation of the EBT project.
2. Coordinating local agency activities, including site changes and local agency staff training, in
preparation of the transition to the new EBT processor.
3. Participating in design sessions and document reviews in preparation for the transition to the
new EBT processor.
4. Coordinating training activities for local agency staff and participants related to any changes
implemented by the new EBT processor.
MDCH/CMS ATTACHMENT III Page 65 of 66
07106
WIC — USDA INFRASTRUCTURE GRANT
Budget and Agreement Requirements
Local Health Departments receiving the USDA Infrastructure Grant funds are required to budget funds
as a separate element. Expenditures and funds must be tracked separately and reported accordingly
on the Financial Status Report (FSR) form.
Contractor Requirements
Submit a work plan that contains measurable objectives and timelines associated with the USDA funded
project.
Reporting Requirements
1. Progress reports should be submitted by April 7, 2007 and October 7, 2007.
2. Progress reports must include the amount of funding spent year-to-date as well as account for
obligated dollars.
3. Progress reports must report on the status of the project based upon the project's goals and
objectives.
WELL-INTEGRATED SCREENING AND EVALUATION FOR WOMEN ACROSS THE NATION
(WISEWOMAN) PROJECT SPECIAL REQUIREMENTS
Contractor Requirements
WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) is a program
designed to screen women for cardiovascular disease risk factors, counsel them about lifestyle changes to
reduce risk factors, and refer them for medical treatment of hypertension and/or hyperlipidemia. This
program will be based within Michigan's Breast and Cervical Cancer Control Program.
For specific WISEWOMAN Program requirements, refer to the most current WISEWOMAN Program
Policies and Procedures Manual.
MDCH/CMS ATTACHMENT III Page 66 of 66
Oakland CountyHealth Department FY 2006-2007 CPBC
AGREEMENT
MDCH Funding Allocations/Reimbursement Mechanisms Matrix
Attachment IV
Total (c) State (d) State Funded Minimum
MDCH Funding Reimbursement Method Performance Target Perform. Funded Target Performance Percent Vendor / Sub-
Program Element/Funding Source (a) Source Amount 00 Output Measurement Expect Perform. Number (e) recipient (f) ,
Pm gram for Local MCH to be determined based on plan approval Local MCH (3) After Program approval, applicable Local MCH funding will be incorporated under the program elements selected in the plan, along with
$332,964 approved output performance measures, via amendment
AIDS/HIV Prevention Categorical Reg. Aline. $497,900 Staffing (6),(16) N/A N/A N/A N/A N/A ISubrecipient
Bioterrorism Emergency Preparedness
Bioterrorism Reg. Alloc. $443,859 Staffing (6) N/A NIA N/A N/A N/A Suhrecipient
Cities Readiness Initiatives Reg. Alloc. $268,234 Staffing (6) N/A N/A N/A N/A N/A Subreopent
Pandemic Flu Supplemental Reg. Alloc. TBD Staffing (6),(18) N/A N/A N/A N/A N/A Subrecipient
Regional EPI Workspace Reg. Alloc. $10,000 Staffing (6) N/A N/A N/A N/A N/A Subreopect
CSHCS Case Mgt/Care Coordination Calc. Amt. Various Fixed Unit Rate (1),(7) N/A N/A N/A N/A N/A vendor
CSHCS Outreach & Advocacy Reg. Alloc. $187,500 Staffing (6) N/A N/A N/A NIA N/A Vendor
Childhood Load Poisoning Prevention Reg. Alloc. $50,000 Staffing (6) N/A N/A N/A N/A N/A Subreepent
' Immunizations
Assessment Feedback Incentive Exchange Calc. Amt. $50/each Fixed Unit Rate (2),(7) N/A N/A WA NIA N/A Vendor
Immunization Action Plan Reg. Alloc. $509,390 Staffing (6) N/A N/A N/A N/A N/A Subreciplent
Nurse Education Cale. Amt. $150/each Fixed Unit Rate (2),(7) N/A N/A N/A N/A N/A Vendor
Vaccine Replacement/Handling Reg. Alloc. $120,253 Staffing (6) NJA N/A N/A N/A N/A Sobrecirnent
VFC Provider Site Visits Cale. Amt. $200/each Fixed Unit Rate (2),(7) N/A N/A N/A N/A N/A , Vendor
Infant Mortality Coalition Support Reg. Alloc. $130,000 Staffing (6) N/A N/A N/A NIA N/A Vendor
-
Informed Consent Cale. Anil. $50/each Fixed Unit Rate (2),(7) N/A N/A N/A N/A N/A Vendor
Laboratory Services
Bioterrorism Lab Reg. Alloc. $133,484 Staffing (6) N/A N/A N/A N/A N/A Subrecipent
Local Public Health Operations
MDCH Reg. Alloc. $2,666,254 I PHO (3),(4) N/A N/A N/A N/A N/A N/A
MDA Reg. Alloc. $853,593 Performance % of Food Service N/A 75% N/A N/A
Licensees receivmg
required inspections
Nurse Family Partnership Reg. Alloc. $324,155 Staffing (6),(14) N/A N/A N/A N/A NIA Vendor
, Sexually Transmitted Disease (STD) Control Reg. Alice. $109,696 Performance # Persons Examined or 90% .Vendor
investigated
SIDS Calc. Amt. $85 each Fixed Unit Rate(2),(11) N/A N/A N/A N/A N/A :N/A
MDCH/CMS
6/06 Page 1
TOTAL MDCH FUNDING $8,316,949
Oakland CountyHealth Department FY 2006-2007 CPBC
AGREEMENT
MDCH Funding Allocations/Reimbursement Mechanisms Matrix
Attachment IV
Total (c) State (d) State Funded Minimum
MDCH Funding Reimbursement Method Performance Target Perform. Funded Target performance Percent Vendor i Sub-
Program Element/Funding Source (a) Source Amount (b) Output Measurement Expect. Perform. Number (e) recipient (1)
TB Control (DOT) Reg. Alloc. $49,724 Performance Number of persons who * 90% . Vendor
have been enrolled in
DOT and who have
completed treatment for
active tuberculosis
WIC
Resident Services Reg. Alloc. $1,585,777 Performance (8) #Average Monthly N/A 97% ' subrecApient
Participation
Special Project Reg. Alloc. $44,166 Staffing (6) N/A N/A N/A N/A N/A Subrecipent
*SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT
MDCH/CMS
6/06 Page 2
FY 06/07 Attachment IV Footnotes
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 methods.
(c) Negotiated starting from the average of the past two complete years' actual number where available.
(d) 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).
(e) Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. •
(f) Refer to master comprehensive agreement and budget instructions package for further explanation regarding these designations.
(1) CSHCS Care Coordination
1. Case Management
A. Maximum of six (6) services per year
B. Reimbursement - $201.58 per service provided face-to-face in the home setting.
2. CARE COORDINATION
A. LEVEL I PLAN OF CARE
1. Annual Plan of Care in the home or home-like setting that requires the Care Coordinator
to travel to a non-LHD site $150
2. Annual Plan of Care over the telephone $100
B. LEVEL II CARE COORDINATION
1. Level II Care Coordination is reimbursed at $30.00 per unit
2. A maximum of 10 units per beneficiary per eligibility year will be reimbursed.
(2) Reimbursement Chart for Fixed Rates
AIDS/HIV Prevention
Non-Categorical
Assessment Feedback
Incentive Exchange
(AFIX)
Immunization Nurse
Education
Immunization VFC
Provider Site Visits
Informed Consent
$8.50 per blood draw for non-categorical health departments. Limited annually to $2,000.
$50 per site visit, not to exceed the maximum set for each individual contractor.
$150 per session, upon completion and submission of Provider Contracts and Report Forms. Reimbursement can . • only be made for one in-service module session per physician clinic site per year.
$200 per site visit, not to exceed the maximum set for each individual Contractor.
$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.
FY 06/07 Attachment IV Footnotes
Laboratory Services - $2.00 for each specimen for diagnosis of gonorrhea and chlamydia infections using a nucleic acid amplification assay.
STD & AIDS
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.
(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.
(6) State funding is first source (after fees and other earmarked sources).
(7) Fixed unit rate subject to actual costs.
(8) The 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 for coordination.
(10) Fixed unit rate limited to contract amount.
(11) Up to six (6) 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 $2.50 for each $10 of MDCH agreement.
(15) Western UP District Health Department's and Northwest Community Health Department's reimbursement mechanisms are staffing; all others
are subject to a fixed unit rate funding mechanism.
(16) Categorical funded Health Departments include: Allegan County Health Department, Berrien County Health Department, Calhoun County
Health Department, Detroit Department of Health and Wellness Promotion, Genesee County Health Department, Ingham County Health
Department, Jackson County Health Department, Kalamazoo County Health Department, Kent County Health Department, Macomb County
Health Department, Muskegon County Health Department, Oakland County Health Department, Saginaw County Health Department, Van
Buren/Cass District Health Department, Washtenaw County Health Department and Wayne County Health Department.
(17) Non-categorically funded Health Departments will be reimbursed at $8.50 per HIV test conducted up to a maximum of $2,000 annually.
(18) Funding must be expended by August 30, 2007
NOTE: Some footnotes may not apply to this agency.
• • 3
FISCAL NOTE106200 October 19, 2006
BY: FINANCE COMMITTEE, CHUCK MOSS, CHAIRPERSON
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION -
2006/2007 COMPREHENSIVE PLANNING, BUDGETING AND CONTRACTING (CPBC)
AGREEMENT ACCEPTANCE
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XIT-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 $8,316,949 for the period October 1, 2006, through
September 30, 2007. This award reflects a 3.05 ($261,603)
decrease from the Fiscal Year 2005/2006 amended funding
allocation of $8,578,552.
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 $ 497,900
Bioterror Planning 443,859
Cities Readiness Initiative 268,234
EPI Planner Workplace 10,000
Childhood Lead 50,000
Immunization Action Plan 509,390
CSHCS Outreach and Advocacy 187,500
Infant Mortality Coalition Support 130,000
Maternal and Infant Support 312,872
Child Health Conference 20,092
TB Control 49,724
BT Lab Program 133,484
Vaccine Replacement/Handling 120,253
Nurse Family Partnership 324,155
WIC 1,629,943
$4,687,406
$8_,a16,949
4. The Fiscal Year 2007 Adopted Budget will be amended after
finalization of the CPBC funding structure.
FINANCE COMMITTEE
(1,1/-76T-(ir
FINANCE COMMITTEE
Motion carried unanimously on a roll call vote with Rogers absent.
.1)
Resolution #06200 October 19, 2006
Ruth Johnson, County Clerk
4. I.
I
Moved by Palmer supported by Coleman the resolutions (with fiscal notes attached) on the Consent Agenda,
be adopted.
AYES: Coleman, Coulter, Crawford, Douglas, Gershenson, Gregory, Jamian, KowaII, Long, Melton,
Middleton, Molnar, Moss, Nash, Palmer, Rogers, Scott, Suarez, Wilson, Woodward, Zack,
Bullard. (22)
NAY: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the Consent Agenda,
were adopted.
elow i.11•0
Mit 1111 RIM ISM
/0/2-ob
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 October 19, 2006,
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 19th day of October, 2006. _