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HomeMy WebLinkAboutResolutions - 2007.06.14 - 28443MISCELLANEOUS RESOLUTION #07141 June 14, 2007 BY: General Government Committee, Christine Long, Chairperson IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION — 2007 MARCH OF DIMES CHAPTER COMMUNITY GRANT AWARD FOR THE TRANSPORTATION OF PREGNANT WOMEN - GRANT ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the lack of transportation has been documented as a primary barrier to accessing prenatal care; and WHEREAS the Health Division has been awarded $15,000 by the March of Dimes Michigan Chapter under its Transportation for Pregnant Women Project; and WHEREAS grant funds will be utilized to purchase approximately 150 round-trip transports to transport non-Medicaid pregnant women in Oakland County to their prenatal care visits; and WHEREAS no county match or additional positions are required; and WHEREAS existing staff will be utilized to administer this program; and WHEREAS this contract has been approved through the County Executive's contract review process; and WHEREAS the acceptance of this contract does not obligate the County to any future commitment. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves the 2007 March OF Dimes Chapter Community Grant Award for the Transportation of Pregnant Women Agreement in the amount of $15,000 and that the Board Chairperson, on behalf of the County of Oakland, is authorized to execute said agreement as attached. BE IT FURTHER RESOLVED that the future level of service 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. Chairperson, on behalf of the General Government Committee, I move adoption of the foregoing resolution. GENERAL GOVERNMENT COMMITTEE GENERAL GOVERNMENT COMMITTEE VOTE: Motion carried on a roll call vote with KowaII absent. Page 1 of 2 Tom Fockler From: Diane Creguer [creguerd@oakgov.com ] Sent: Monday, May 14, 2007 9:34 AM To: 'Fockler, Tom' Subject: FW: GRANT SIGN OFF - Health Division 2007 Transportation Grant for Pregnant Women - March of Dimes Attachments: Final Agreement with revisions 5 1 07.doc Sorry about that!! Diane M. Creguer Grant Administration 248.975.9634 GRANT REVIEW SIGN OFF - Human Services/Health Division GRANT NAME: 2007 Transportation Grant for Pregnant Women FUNDING AGENCY: Michigan Chapter March of Dimes DEPARTMENT CONTACT PERSON: George Miller STATUS: Agreement Acceptance DATE: May 3, 2007 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 (1/16/2007) Department of Human Resources: Approved by HR. — Nancy Scarlet (1/18/2007) Risk Management and Safety: Approved with modifications By Risk Management - Andrea Plotkowski (1/19/2007) Corporation Counsel: Approved with modifications By Corporation Counsel — John Ross (5/3/2007) 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) 5/14/2007 Page 2 of 2 http://www.cms.hlis.gov/HIPAAGenInfo/Downloads/HIPAAlawdetail.pdf Please see the attached Grant Agreement as revised by Corporation Counsel. Diane M. Creguer Grant Administration 248.975.9634 5/14/2007 Contact Person: Gail Martin Phone #: 248-359-1554 Contact Person: Jean Ulmer Phone #: 248-858-1409 MARCH OF DIMES FOUNDATION CHAPTER GRANT AGREEMENT Grantor: March of Dimes Michigan Chapter Address: 27600 Northwestern Highway Suite 150 Southfield, MI 48034 Grantee: Oakland County Health Division Address: 1200 North Telegraph Pontiac, MI 48341 Grant Award: $15,000 Grant Period: 1/1/07 to 12/31/07 Project Name and General Description: Transportation for Pregnant Women project to assist them in obtaining pre/postnatal appointments, parenting/childbirth classes, WIC and Well-Baby Care. Congratulations on your Grant Award! Below are listed specific guidelines which must be adhered to by all March of Dimes grantees. The award of grant funds for your project (the "Project") is contingent upon your agreement to comply with the grant guidelines provided below: 1. The Grantee must submit a press release announcing the receipt and purpose of the Grant Award to the March of Dimes Chapter (the "Chapter") for Chapter review and approval, and may be requested to attend a photo session for presentation of the Grant Award. The Chapter's communications staff will assist with the development of a suitable press release and will make recommendations for its distribution. 2. The March of Dimes may request the Grantee or Project representatives to participate as speakers at March of Dimes events, such as fundraisers, educational conferences, press conferences, WalkAmerica promotions, volunteer leadership meetings, etc. Participation is not mandatory. 3. Grantee will provide Grantor with a minimum of two (2) written progress and expenditure reports summarizing the Project's progress and expenses, and evaluating its overall success. Grantor reserves the right to request additional reports as appropriate. 4. Grantee will receive 50% of its Grant on or before April 15, 2007 and the other 50% of its Grant after the Chapter's receipt and approval of the Grantee's 6-month progress report. Grantee agrees to use the Grant Award for the Project described in its proposal unless prior written approval is received from the Chapter's Program Service Committee. This Grant Agreement is subject to the availability of funding, and accordingly may be terminated or modified in the event funding is discontinued or reduced. The March of Dimes reserves the right to review or audit applicable charges to the Project. The March of Dimes reserves the right to require Grantee to refund the Grant Award in the event Grantee improperly expends this Grant or otherwise fails to fulfill mutually agreed upon Project objectives or promises made hereunder. This provision shall survive the term of this Grant Agreement. 5. Grantee agrees to provide Grantor with reasonable levels of cooperation in connection with the Project. The March of Dimes may make site visits to the Grantee. The Grantee will be contacted in advance in order to schedule visits. 6. NOT APPLICABLE — NO WORKS TO BE DEVELOPED BY GRANTEE Grantees developing public or professional education products or other materials (the "Work(s)") with support from this Grant must submit copies of the Work(s) to the Chapter for review and approval prior to their final production and distribution. 7. NOT APPLICABLE — NO WORKS TO BE DEVELOPED BY GRANTEE Any and all Work(s) developed by the Grantee with March of Dimes funds must be imprinted with the March of Dimes name and logo consistent with March of Dimes graphic standards, and a credit line which states "Funded by a Community Grant from the March of Dimes." Any use of the March of Dimes logo, name, event or program names, or any of its other trademarks or service marks, requires the prior written approval of the March of Dimes. Additionally, any and all Work(s), consisting of medical, or educational materials, developed hereunder will be imprinted with a disclaimer which will advise the user as follows: "This material is for information purposes only and does not constitute medical advice. The opinions expressed in this material are those of the author(s) and do not necessarily reflect the views of the March of Dimes." Effective 1/02; Revised 1/03, 10/03 March of Dimes Grantee Agreement, page 2 8. NOT APPLICABLE — NO WORKS TO BE DEVELOPED BY GRANTEE All rights, title, and interest in any and all public or professional education products or other materials (the "Work(s)") created with support from this Grant shall be owned by the Grantee. Grantee hereby grants to the March of Dimes a royalty free irrevocable world-wide license in perpetuity to reproduce, publish or otherwise use and authorize others to use any and all Work(s) developed hereunder. Any such publication(s) by Grantor will credit Grantee for its contribution to same. Grantee agrees to indemnify and hold the March of Dimes harmless from any claims, actions, damages, penalties, or costs (including reasonable attorneys' fees) that may arise in connection with the Work(s), including without limitation infringement and any other intellectual property based claims. This paragraph shall survive the term of this Grant Agreement 9. Notwithstanding anything to the contrary contained under this Grant Agreement, Grantor shall be free to exercise publication rights and privileges in connection with professional or academic papers or other writings it may develop in connection with the Work(s), Project activities, findings and data relative to the Grant. Any such publication(s) will credit Grantee for its contribution to same. This paragraph shall survive the term of this Grant. 10. Grantee shall not assign this Grant Agreement or subcontract work in connection with the Project, except as outlined in the grant proposal, without the prior written approval of the March of Dimes. Grantee agrees that any and all subcontract agreements it may enter into in connection with the Project will obligate the subcontractor to comply with the terms of this Grant Agreement and Grantee's grant proposal for the Project. 11. Grantee agrees to refrain from giving directive advice concerning abortion, as part of a March of Dimes funded Project. 12. Grantee warrants that it shall require all contracted transportation carriers to acquire and maintain insurance coverage in such amounts as may be customarily obtained by a party engaged in transportation carrier activities. Additionally, Grantee warrants that it shall comply with all applicable federal, state and local laws and regulations, and pay all applicable license fees and taxes which may become due by reason of its own activities. As applicable, each party hereto agrees to abide by the Health Insurance Portability and Accountability Act of 1996 and its Privacy Rules as codified under 45 C.F.R. Parts 160 and 164 (collectively, the "HIPAA Regs"); and as appropriate, comply with any and all other laws regulating patient privacy and other patient rights. The parties will provide one another with reasonable levels of cooperation in connection with compliance with said regulations. 13. Except as otherwise provided for in this Grant Agreement, all liability, loss, or damage as a result of claims, demands, costs, or judgments arising out of the activities to be carried out pursuant to the obligation of the Grantee under this Grant Agreement will be the responsibility of the Grantee and not the responsibility of the Grantor, if the liability, loss or damage is caused by or arises out of the actions or failure to act on the part of the Grantee, its employees, officers, or elected officials. Nothing herein shall be construed as a waiver of any governmental immunity enjoyed by the Grantee, its agencies, employees, officers, elected officials or Oakland County, as provided by statute or modified by court decisions. Contractors retained by Grantee for performance of transportation carrier responsibilities in connection with the Project will be required to indemnify the March of Dimes for their own negligent acts and omissions, however under no circumstances will Grantee be required to indemnify Grantor. 14. In addition to rights of termination provided under Paragraph 4, above, this Grant Agreement may be terminated by Grantor in the event Grantee improperly expends funds provided hereunder or otherwise fails to fulfill mutually agreed upon Project objectives or promises; or in the event of adverse changes in Grantee's business circumstances, capacity, fiscal stability, or such instance of the falsification of any Grant related applications, forms or other documentation. In event of termination, Grantee will promptly and fully return to Grantor the amount equal to any and all improperly expended funds, as well as, any unexpended funds provided hereunder. 15. This Grant Agreement represents the entire understanding between the parties and may be modified only by a writing executed by both Grantor and Grantee. 16. Except as provided for the benefit of the Grantor and Grantee, this Grant Agreement does not and is not intended to create any obligation, duty, promise, contractual right or benefit, right to be indemnified, right to subrogation to the Grantor's or Grantee's rights in this Grant Agreement, and/or any other right in favor of any READ AND AGREED-TOT---------- Grantor: i -0 • Dimes Found_ati ' • MMIIn‘ I I I I II I I I I I I I I I I I I I I 41 IL./ Grantee (Organization): By: Signature Dated: —5: Ple9se Print N o e and Title , 2007 Dated: Please Print Name and Title , 2007 March of Dimes Grantee Agreement, page 2 other person or entity. Federal I.D. No.: March of Dimes. Saving babies, lager her March of Dimes Chapter Community Grants Program PROGRESS REPORT FORMAT Please complete a progress report for your March of Dimes chapter grant, including each of the following sections. This report should cover the period January 1, 2007 —June 30, 2007. 1. Report on progress toward meeting each of the project objectives as listed in the original grant proposal or the most recently approved revision. 2. Detail any barriers which have prevented you from meeting your objectives and what steps you have taken to address these challenges. 3. Have you identified any need to modify the program from its original design since the last report? If so, please detail if you are requesting for approval any revisions to project objectives and/or budget at this time. 4. What, in your opinion, have been the major successes resulting from this project? 5. Summarize results of any program evaluation efforts. 6. Complete a budget report showing project expenditures from January 1, 2007- June 30, 2007. Please make sure that expenditures are shown in comparison to current year budget figures as listed in the original grant proposal budget or most recently approved revision, and that the budget sheet is signed. 7. Attach any documents that provide additional information relevant to sections one, four or five. Please check to make sure that your report includes all required sections and attachments. Progress reports are due Friday, July 13, 2007 and should be mailed to the attention of : Gail Martin, MSN, RN State Director of Program Services March of Dimes Michigan Chapter 27600 Northwestern Highway Suite 150 Southfield, MI 48034 APPLICATION Total Budget EXPENDED (Progress Rpts Only) 6 _lmarch ofimes. . Pity; babies, moth or• March of Dimes Chapter Community Grants Program BUDGET FORM Check One: [ ] Application [ X] Progress Report Grant Period From: - Jan.1, 07-June30, 07 Project Title: BUDGET (see application guidelines for an explanation of allowable/not allowable expenses) A. Salaries (include name, position, and FTE) Sub-total A B. Expendable Supplies Sub-total B C. Equipment Sub-total C D. Other Expenses/Fees Sub-total D TOTAL COSTS (Sub-total A+B+C+D) Indirect Costs 10% (only for proposals $25,000 or over) TOTAL AMOUNT REQUESTED mm/dd/yy Signature - Executive Director Date mm/dd/yy Signature - Director of Operations Date Please Check Budget Totals Form W-9 Request for Taxpayer Give form to the (Rev. January 2003) Identification Number and Certification requester. Do not Department of the Treasury .send to the IRS. Internal Revenue Service csi Name CU cr) Cu a Business name, if different from above 0 0. a) ,c;‘, 0 --) Individual/ Exempt from backup Check appropriate box: .__1 Sole proprietor Corporation Partnership E Other ,i)- withholding 8 2 .a. t-,.., Address (number. street, and apt. or suite no.) Requester s name and address (optional) I: S 2- o F City, state, and ZIP code 5 CU a in cu List account number(s) here (optional) cu til Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Social security number 1 ir 1 1- 1 1i Of Employer identification number I I IL I I- I I I 1 Rift U Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien). - Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See the instructions on page 4.) Signature of U.S. person 10. Sign Here Date 1 Purpose of Form A person who is required to file an information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, Or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. Note: If a requester gives you a form other than Form W-9. to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Foreign person. If you are a foreign person, use the appropriate Form W-8 (see Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the recipient has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that • contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Cat. No. 10231X Form W-9 (Rev 1-2003) FISCAL NOTE (MISC. #07141) June 14, 2007 BY: FINANCE COMMITTEE, MIKE ROGERS, CHAIRPERSON IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2007 MARCH OF DIMES CHAPTER COMMUNITY GRANT AWARD FOR THE TRANSPORTATION OF PREGNANT WOMEN - GRANT ACCEPTANCE TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced resolution and finds: 1. The County of Oakland, Department of Health and Human Services/Health Division has been awarded $15,000 from March of Dimes Michigan Chapter under its Transportation for Pregnant Women Project. Grant Funds will be utilized to purchase approximately 150 round-trip transports to transport non-Medicaid pregnant women in Oakland County to their prenatal care visits. 2. No County match or additional positions are required and existing staff will be utilized to administer this program. 3. The Fiscal Year 2007 budget should be amended as specified below to reflect the latest award. FY2007 HUMAN SERVICE REVENUE FUND 20221 1060291-133200-650104 Contributions EXPENSES 1060291-133200-731997 Transp. Of Clients $15,000 $15,000 $ -0- FINANCE COMMITTEE FINANCE COMMITTEE Motion carried unanimously on a roll call vote. Resolution #07141 June 14, 2007 Moved by Rogers supported by Potts the resolutions (with fiscal notes attached) on the amended Consent Agenda, be adopted. AYES: Burns, Coulter, Crawford, Douglas, Gershenson, Gingell, Gosselin, Gregory, Greimel, Hatchett, Jacobsen, KowaII, Long, Middleton, Nash, Potts, Rogers, Scott, Spector, Suarez, Woodward, Zack, Bullard. (23) NAYS: None. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent Agenda, were adopted. e -;tare ii:, Ruth,-..z. hs:n, County Clerk I HEREBY APPROVE THE FOIEGOING RESOLUTIM 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 June 14, 2007, 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 14th day of June, 2007.