HomeMy WebLinkAboutResolutions - 2020.10.21 - 33771shall be provided to the State no later than February 1 st of the year following the
calendar year for which the data has been collected.
Provide training for staff involved in the Program as necessary to maintain
knowledge of current regulations and internal policies and procedures and to keep
staff informed of technological improvements and advancements in Systems.
Establish and maintain an enforcement process that is utilized to resolve violations
of the Local Entity and/or State's rules and regulations.
• Maintain complaint forms and a filing system containing results of complaint
investigations and documentation of final resolution. Investigate and respond to all
complaints related to onsite wastewater in a timely manner.
Drinking Water:
The Grantee shall perform the following services including but not limited to:
• Perform water well permitting activities, pre -drilling site reviews, random
construction inspections, and water supply system inspections for code compliance
purposes with qualified individuals classified as sanitarians or equivalent.
• Assign one individual to be responsible for quarterly reporting of the data and to
coordinate communication with the assigned State staff. Reports shall be submitted
no later than fifteen (15) days following the end of the quarter on forms provided by
the State. The report form EQP2057 (07/2019) is available on the EGLE website.
All quarterly reports are submitted directly to the EGLE address noted on the form.
• Perform Minimum Program Requirements (MPRs) activities and associated
performance indicators. These are available on the EGLE website. Guidance
regarding the MPRs and indicators is available in the "Local Health Department
Guidance Manual for the Private and Type III Drinking Water Supply Systems."
The guidance manual is available online at Michioan.00v/WaterWellConstruction.
PROJECT TITLE: Hearing ELPHS / Vision ELPHS
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Hearing and Vision Programs screen over 1 million preschool and school -age
children each year. Screening services are conducted in schools, Head Start, and
preschool centers by local health department (LHD) vision technicians. Children who fail
their vision screening are referred to a licensed eye doctor for an exam and
treatment. Follow-up is conducted by the LHD to confirm that the child gets the care that
they need. Children who do not pass their hearing screening are referred to their primary
care physician or Ear, Nose, and Throat physician for diagnosis, treatment, and
recommendations.
Reporting Requirements (if different than agreement language):
Upon initiation of the FY21 contract, grantees must submit a School Based Hearing and
Vision Screening Work Plan to MDHHS-Hearino-and-VisionCa�.michiaan.gov. The work
plan must include:
Outcome Objectives -a goal of program improvement (%) for screening services
and follow-up
The 6 pre -populated Activities as well as a minimum of 2 additional Activities,
with corresponding comments describing how the activity was/is/will be
accomplished by the school -based Hearing Screening Program.
The 6 pre -populated Activities as well as a minimum of 2 additional Activities,
with corresponding comments describing how the activity was/is/will be
accomplished by the school -based Vision Screening Program.
Work plans must be approved by the MDHHS Hearing & Vision Coordinator for their
respective program.
All activities, as specified in the initial approved work plan, shall be implemented and a
final report submitted by the grantee to MDHHS. The reports are due 30 days after the
year end, and include the following timeframes:
Initial Work Plan is due August 1, 2020.
Final year-end report, covering the reporting period of April 1-September 30, is
due October 30'n
MDHHS will provide specific instructions and a template for reporting on the
work plan objectives and activities.
• Changes to the work plan throughout the year can occur with prior approval
from the MDHHS Hearing and Vision State Coordinators.
MDHHS staff shall evaluate the reports for their completeness and
accuracy.
Any additional requirements (if applicable):
Grantees must adhere to established Minimum Program Requirements for School -Based
Hearing & Vision Services as outlined in the Michigan Local Public Health Accreditation
Program 2018 MPR Indicator Guide.
PROJECT: Food Service Sanitation (FOOD ELPHS)
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
State funding for ELPHS shall support and the Grantee shall provide for all 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:
• Infectious/Communicable Disease Control
• Sexually Transmitted Disease
• Immunization
• On -Site Wastewater Treatment Management
• Drinking Water Supply
• Food Service Sanitation
• Hearing
• Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee's cost allocation plan.
ELPHS 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
may be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
First- and second -party fees earned in each required service program may be
used only in that required service program.
Reporting Requirements (if different than contract language)
All final amendment ELPHS funding shift request memos need to be submitted no later
than May 111. Please send the memo to Laura de la Rambelje
(De)aRambeljeL@michigan.gov) and copy Carissa Reece (ReeceCna michiaan.00v)
Food Service Establishment Licensina
• Provide updates to MDARD on the 19t and 15th of each month, as necessary to:
o Provide a list of food service establishments approved for licensure/license
issued.
o Provide a list of food service establishment licenses that have not been
approved for licensure and are considered voided or deleted.
o Return the actual licenses to MDARD that are to be voided or deleted.
o Return renewal license applications and licenses that require
correction. Mark the corrections on the renewal application.
Temoorary Food Establishment Licensinq
• Provide updates to MDARD on the 1 st and 15th of each month, as necessary, to
provide:
o A copy of each temporary food establishment license issued.
o A list of lost or voided licenses by license number.
Any additional requirements (if applicable)
Food Service Establishment Licensina
• Accept responsibility for all licenses specified in the "Record of Licenses
Received."
• Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Temporary Food Establishment Licensinq
Upon receipt, sign and return the "Record of Licenses Received" to MDARD.
Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Make every effort to issue temporary food establishment licenses in numerical order.
Michigan Department of Agriculture and Rural Development (MDARD) Agrees to:
Food Service Establishment Licensinq
• Furnish pre-printed food service establishment license applications and pre-
printed licenses to the Grantee for each licensing year (May 1 through April 30)
using previous year active license data.
• Provide a count of all licenses sent to the Grantee titled 'Record of Licenses
Received."
• Reprint any licenses requiring correction and send corrected copies to the
Grantee.
• Bill the local health department for state fees upon notification by Grantee that
the license has been approved and issued.
Temporary Food Service Establishment Licensina
• Furnish blank temporary food service license application forms (forms FI-231, FI-
231A) and blank Combined License/Inspection forms (FI-229) upon request from
the local health department.
o Furnish a "Record of Licenses Received" with each order of Combined
Licenses/Inspection forms.
o Periodically reconcile temporary food service establishment licenses
sent to the Grantee with the licenses that have been issued (copy
returned to MDARD).
c Bill the local health department for state fees upon notification by the
Grantee that the license has been approved and issued.
PROJECT: MDHHS Essential Local Public Health Services (ELPHS)
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
State funding for ELPHS shall support and the Grantee 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:
• Infectious/Communicable Disease Control
• Sexually Transmitted Disease
• Immunization
• EGLE Drinking Water and Onsite Wastewater Management
• Food Service Sanitation
• Hearing
• Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee's cost allocation plan.
• ELPHS 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
may be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
• First and second party fees earned in each required service program may be
used only in that required service program.
State ELPHS funding is subject to local maintenance of effort compliance.
Distribution of state ELPHS funds shall only be made to agencies with total local
general fund public health services spending in FY 20/19 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 19/20, the FY 92/93 Local Maintenance of Effort Level
must be met.
Reporting Requirements (if different than contract language)
• Local maintenance of effort reports are due:
• Projected Current Fiscal Year— October 30
• Prior Fiscal Year Actual — March 31
A final statewide cost settlement will be performed to assure that all available
ELPHS funds are fully distributed and applied for required services.
All final amendment ELPHS funding shift request memos need to be submitted
no later than May 1st. Please send the memo to Laura de la Rambelje
(DelaRambelieL(a)michioan.00v) and copy Carissa Reece
(Reece C(c)michigan.gov)
Any additional requirements (if applicable)
Assure the availability and accessibility of services for the following basic health
services: Prenatal Care; Immunizations; Communicable Disease Control;
Sexually Transmitted Disease (STD) Control; Tuberculosis Control;
Health/Medical Annex of Emergency Preparedness Plan.
Fully comply with the Minimum Program Requirements for each of the required
services.
Grantee 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. Grantees designated as "not accredited" may
have their Department allocations reduced for Departmental costs incurred in the
assurance of service delivery. The accreditation process is based upon the
Minimum Program Standards and scheduled on a three-year cycle. The
Minimum Program Standards include the majority of the required Department
reviews. Some additional reviews, as mandated by the funding agency, may not
be included in the Program Standards and may need to be scheduled at other
times.
PROJECT: Emerging Threats — Hepatitis C
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Funds are provided to grantees to increase local capacity to make improvements in
hepatitis C virus (HCV) case follow-up, linkage to care, and testing. Progress will be
tracked by monitoring case completion rates within the MDSS, monitoring of HCV linkage
to care logs, and evaluating HCV testing volumes submitted by grantees through
STARLIMS.
Reporting Requirements (if different than contract language)
Quarterly report cards/progress reports on HCV case completeness will be
complied by MDHHS and sent to grantees.
Grantees will keep a log of client interactions to track progress related to client
linkage to care. Please email a running summary, on a quarterly basis, to
MDHHS-Hepatitis(d),michician.aov. .
Grantees will participate on semi -routine group conference calls and/or 1:1
technical assistance check in calls to discuss best practices and identify barriers.
Grantees will collect and submit specimens to the MDHHS Bureau of Laboratories
for HCV testing through their public health clinics.
Any additional requirements (if applicable)
Grantees should document best practices or protocols for HCV case investigation
and follow-up
• Grantees should document pathways to link patients to medical care
Grantees may collaborate with the State Viral Hepatitis Unit for assistance
Grantees can submit HCV specimens to the MDHHS Bureau of Laboratories at no
cost to them or the client
PROJECT TITLE: Family Planning Program
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Michigan Family Planning Program assists individuals and couples in planning and
spacing births, preventing unintended pregnancy, and seeking preventive health
screenings. On -site clinical services are delivered through a statewide network of local
health departments, hospital -based health systems, and federally qualified health centers.
The program's strong educational and counseling components help reduce health risks
and promote healthy behaviors. Family Planning prioritizes serving low-income men and
women, teens, and uninsured or underinsured individuals. The Michigan Family Planning
Program serves as a safety net with providers who have been a reliable and trusted source
of care, and in many cases the only regular source of health care for individuals. Referrals
to other health, behavorial, and social services are provided to clients, as needed.
Services are charged based on ability to pay. No one is denied services because of
inability to pay. Insurance is accepted, including Medicaid.
Reporting Requirements (if different than agreement language):
Each grantee shall submit the required reporting on the following dates:
Report
Time Period
Due Date to
Department
ISubmit To
Work Plan
October 1 —
September 17
Mandy Luft
September 30
luftal(a)michioan.gov
Needs Assessment &
October 1 —
September 17
+ Mandy Luft
Health Care Plan
September 30
I lufta1(a)michioan.gov
FPAR Mid -Year Report
January 1 —
Jul16
y
Mandy Luft
June 30
luftal(a.michiaan.ciov
FPAR Year -End Report
January 1 —
January 15
Mandy Luft
December 31
lufta1(&michioan.00v
Medicaid Cost -Based
October 1 —
EGrAMS with Final
Reimbursement
Sep30
p
November 30
Financial Status
Trackinq Form
Report
Each grantee shall indicate the following project outputs:
Target Total Performance
Measure Expectation
Unduplicated
Number of
Clinic Users
State Funded Minimum
Performance Expected
Percent Number
95%
Any additional requirements (if applicable):
1. Each grantee must serve a minimum of 95% of proposed Title X users to
access its total amount of allocated funds. Semi-annual Family Planning
Annual Report (FPAR) data will be used to determine total Title X users
served.
2. Each grantee will be required to adhere to Federal Statue and Regulations
for Title X Family Planning Programs, including legislative mandates,
executive orders, and grant administration regulations.
3. Each grantee will be required to adhere to the current Michigan Title X
Family Planning Program Standards and Guidelines Manual.
4. Each grantee will provide MDHHS a minimum of 30 days advance notice of
any clinic site changes, including additions, closures, or changes to street
address. Service site changes can be sent to each grantee's agency
consultant.
5. Each grantee will be required to participate in program planning and
evaluation, including the completion of an Annual Plan that consists of a
needs assessment, health care plan, and work plan as detailed in the
current Standards and Guidelines Manual.
6. Each grantee will provide family planning clients with a broad range of
acceptable and effective family planning methods and services, including
fertility awareness -based methods, basic infertility services, and services to
minors.
7. Each grantee will provide family planning services on a voluntary basis,
without coercion to accept services or any particular method of family
planning, and without making acceptance of services a prerequisite to
eligibility for any other service or assistance in another program.
8. Each grantee will provide confidential family planning and related
preventive health services to minors and will not require written consent of
parents or guardians for the provision of services to minors.
9. Each grantee will encourage family involvement in the decision of minors to
seek family planning services and must provide counseling to minors on
how to resist efforts to coerce the minor into engaging in sexual activities.
10. Each grantee will comply with Michigan's Child Protection Law (Act 238 of
1975) and will be required to notify or report child abuse and neglect as
defined by the law. Confidentiality cannot be invoked to circumvent
requirements for mandated reporting.
11. Each grantee will provide family planning services in a manner which
protects the dignity of the individual.
12. Each grantee will provide family planning services without regard to religion,
race, color, height, weight, national origin, sex, number of pregnancies,
marital status, age, sexual orientation, gender identification or expression,
partisan considerations, or a disability or genetic information.
13. Each grantee will train all Title X staff on the unique social practices,
customs, and beliefs of the under -served populations within their service
area(s) at least every two years to reduce staff bias and ensure equitable
service provision.
14. Each grantee will not provide abortion as a method of family planning and
will have written policy that no Title X funds are used to provide abortion as
a method of family planning. Pregnant women will receive nondirective
counseling and medically necessary care as outlined in the current
Standards and Guidelines.
15. Each grantee will ensure that low-income clients :000% of poverty are
given priority to receive family planning services.
16. Each grantee will have a sliding fee schedule, based on current Federal
Poverty Guidelines, to determine a client's ability to pay for family planning
services.
17. Each grantee will have a schedule of fees designed to recover the
reasonable cost of providing services to clients whose income exceeds
250% of poverty.
18. Each grantee where there is legal obligation or authorization for third -party
reimbursement, including public or private sources, all reasonable efforts
must be made to obtain third -party payment without application of any
discounts. Where the cost of services is to be reimbursed under title XIX,
XX, or XXI of the Social Security Act, a written agreement with the title
agency is required.
19, Each grantee will convene a Family Planning Advisory Council that will
serve as their governing board, which will be broadly comprised of the
population served and will meet at least once a year.
20. Each grantee will convene an Information and Education Committee
comprised of five to nine members who are broadly representative of the
population served or community that meets at least once a year to review
and approve all informational and educational materials prior to distribution.
21. Each grantee will provide for informational and educational programs
designed to: achieve community understanding of the objectives of the
program; inform the community of the availability of services; and promote
continued participation in the project by person to whom family planning
services may be beneficial.
22. Each grantee will provide, to the extent feasible, an opportunity for
participation in the development, implementation, and evaluation of the
project by persons broadly representative of all significant elements of the
population to be served, and by others in the community knowledgeable
about the community's needs for family planning services.
23. Each grantee will provide for orientation and in-service training for all
project personnel.
24. Each grantee will provide services without the imposition of any durational
residency requirement or requirement that the patient be referred by a
physician.
25. Each grantee will provide that family planning medical services will be
performed under the direction of a physician with special training or
experience in family planning.
26. Each grantee will provide that all services purchased for project participants
will be authorized by the project director or his/her designee on the project
staff.
27. Each grantee will have written clinical protocols that are in accordance with
nationally recognized standards of care that are reviewed and signed
annually by the medical director overseeing Family Planning.
28. Each grantee will have a quality assurance system in place for ongoing
evaluation of family planning services, including a tracking system for
clients in need of follow-up or continued care, quarterly medical audits to
determine conformity with agency protocols, quarterly chart audits/record
monitoring to determine the accuracy of medical records, and a process to
implement corrective actions for deficiencies.
29. Each grantee will have a current list of social services agencies and
medical referral resources that is reviewed and updated annually.
30. Each grantee will address clients' social determinants of health to the extent
feasible through the coordination and use of referral arrangements with
other providers of health care services, local health and welfare
departments, hospitals, voluntary agencies, and health services projects
supported by other federal programs.
31. Each grantee will offer education on HIV and AIDS, risk reduction
information, and either on -site testing or provide a referral for this service.
32. Each grantee will offer client -centered counseling services on -site or by
referral and ensure the information is medically accurate, balanced,
provided in a non -judgmental manner, and is non -coercive.
33. Each grantee will have a separate budget for Title X funds and maintain a
financial management system that meets the standards specified in 45 CFR
Part 74 or Part 92, as applicable.
34. Each grantee assures that Title X funds will be expended solely for the
purpose of delivering Title X Family Planning Services in accordance with
an approved plan & budget, regulations, terms & conditions, and applicable
cost principles prescribed in 45 CFR Part 74 or Part 92, as applicable.
35. Each grantee assures that if family planning services are provided by
contract or other similar arrangements with actual providers of services,
services will be provided in accordance with a plan, which establishes rates
and method of payment for medical care. These payments must be made
under agreements with a schedule of rates and payments procedures
maintained by each grantee. Grantees must be prepared to substantiate
these rates are reasonable and necessary.
36. Each grantee will comply with the Office of Population Affairs (OPA) FPAR
requirements, as well as MDHHS required FPAR elements, for the
purposes of monitoring and reporting performance.
37. Each grantee will have a data collection system in place to assure accurate
FPAR reporting, and will be responsible for updating their system, as
needed, to be in compliance with OPA and MDHHS FPAR reporting
standards.
38. Each grantee will use FPAR to identify program disparities and to the extent
feasible, will use program promotion, community outreach, or other
community -based strategies to address identified disparities (e.g., disparity
in men vs. women served or disparity in low-income clients vs. full -fee
clients served).
39. Each grantee will comply with the MDHHS Medicaid Cost -Based
Reimbursement (MCBR) reporting requirements and attach the MCBR
Tracking Form to their final financial status report. The MCBR Tracking
Form must be completed in its entirety and include Family Planning MCBR
and Other Medicaid MCBR financial information for all programs.
40.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),
41. Pursuant to Public Act (PA) 360 (2002) Section 333.1091, grantees qualify
as priority family planning providers who do not engage in any activities
outlined in PA 360 (2002) Section 333.1091.
42. Grantee funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Case Abstraction
Start Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
Qualified individuals will perform medical record case abstraction for Fetal Infant
Mortality Review to include the following:
• Review of medical records involved in fetal and infant death to include, but not
limited to hospital records, prenatal records, emergency and medical examiner's
records.
• Interact with other agencies and service providers involved in infant's death
(Child Protective Services, local health department, law enforcement).
• Develop de -identified case summaries from the above abstracted information, as
well as the FIMR interview, using Michigan FIMR Network tools and guidelines.
• Attend the review team meetings to facilitate the presentation of the cases and
develop recommendations.
• Enter cases into the National Fatality Review Case Reporting System (FIMR
database) at the National Center for Fatality Review and Prevention.
Reporting Requirements (if different than agreement language):
Quarterly progress reports following the template supplied by the State coordinator.
Quarterly reports are due the 15'h of the month following the end of the quarter and are
submitted to Audra Brummel, State coordinator, via email at brummelatd)michioan.00v.
Reporting Time Period
Due Date
1s' Quarter
October 1 — December 31
January 15
2nd Quarter
January 1 — March 31
April 15
3rd Quarter
April 1 — June 30
July 15
4'h Quarter
July 1 — September 30
October 15
Any additional requirements (if applicable):
Each completed case abstraction will be compensated at $270.00 per case.
FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
Maximum Program Reimbursement:
Grantee
Berrien County Health Department
Calhoun County Public Health Department
Detroit Health Department
Genesee County Health Department
Ingham County Health Department
Jackson County Health Department
Kalamazoo County Health and Community
Services Department
Kent County Health Department
Macomb County Health Department
Public Health Muskegon County
Oakland County Department of Health and
Human Services/Health Division
Saginaw County Health Department
Maximum Reimbursement Amount
$ 4,050
$ 3,240
$ 2,700
$ 4,115
$ 3,240
$ 3,240
$ 6,480
$ 9,450
$ 4,050
$ 2,700
$ 6,480
$ 4,860
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Interviews
Start Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
Conduct Fetal Infant Mortality Review (FIMR) interviews with the intent of informing the
FIMR case abstraction process and informing the infant mortality reduction efforts both
locally and statewide.
Reporting Requirements (if different than agreement language):
Mid -year progress report and final report using the FIMR interviews template provided
by the State coordinator, which will address what was learned about preventability at the
individual, clinical care, health system, community, and policy level are due April 15 and
a final report due October 15 by submission to Audra Brummel, State coordinator, via
email at brummela an.michiaan.00v.
Any additional requirements (if applicable):
• Each completed FIMR interview will be compensated at $125.00 per interview. A
maximum of 6 visits are reimbursable per fetal/infant death up to the contract
allocation.
• FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
Maximum Program Reimbursement:
I Grantee
Berrien County Health Department
Calhoun County Public Health Department
Detroit Health Department
Inqham County Health Department
I Jackson County Health Department
Kalamazoo County Health and Community
Services Department
I Kent County Health Department
Macomb County Health Department
I Public Health Muskeqon County
Oakland County Department of Health and
Human Services/Health Division
I Maximum Reimbursement Amount
1 $ 1,875
$ 1,500
$ 6, 750
1 $ 2,500
$ 1,250
$ 2,250
$ 1,250
$ 1,500
$ 625
$ 2,000
PROJECT: Gonococcal Isolate Surveillance Project
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
• To monitor trends in antimicrobial susceptibilities in N. gonorrhoeae.
• To characterize patients with gonorrhea (GC), particularly those infected with N.
gonorrhoeae that are not susceptible to recommended antimicrobials.
• To phenotypically characterize antimicrobial -resistant isolates to describe the
diversity of antimicrobial resistance in N. gonorrhoeae.
• To monitor trends in sexually transmitted N. Meningitidis
Reporting Requirements (if different than contract language)
Report Period Due Date(s)
On a quarterly basis, extract
from EMR, and submit to
MDHHS, the number of
culture specimens collected
and number of presumptive Quarterly January 15, April 15,
y
positive GC and suspected July 15, October 15
N.Men specimens
forwarded to CDC and their
designated laboratories for
further testing.
How to Submit Report
Written report submitted
to
kenti3(a)michiaan.aov;
cc:
petersona7@michigan.
gov
On a quarterly basis, for
clients with GC positive
isolates, or suspected N.
Men, submit demographic
and behavioral data to
MDHHS utilizing the CDC
required format.
Quarterly January 15, April 15,
July 15, October 15
Any additional requirements (if applicable)
Written report submitted
to
kenti3a-michioan.00v;
cc:
petersona7@michigan.
gov
• For each male STD clinic patient suspected of having GC (symptoms, known
partner etc.), collect a urogenital sample using a Modified Thayer Martin (MTM)
plate.
• For male and female STD clinic patient suspected of having oral GC (symptoms,
known partner etc.), collect a pharyngeal sample using a Modified Thayer Martin
(MTM) plate.
• For each male STD clinic patient who reports same sex partners, collect sample
using a MTM plate from extragenital sites of exposure (rectal, pharyngeal),
regardless of symptoms.
• For clients with positive isolates, submit specimen to CDC assigned Regional
Laboratory for further testing; and associated demographic and behavioral data to
the CDC and MDHHS at agreed intervals.
PROJECT: Harm Reduction Support Services
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within their jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on monthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices
Any additional requirements (if applicable)
• MDHHS or other contracted partners are available to provide technical assistance
to grantees
• Funds may not be used to buy sterile needles or syringes
• Grantees must establish relationships to link clients to care for substance use
disorder treatment
• Grantees must be able to provide clients with naloxone
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
PROJECT: Harm Reduction
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within heir jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on monthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices
Any additional requirements (if applicable)
• MDHHS or other contracted partners are available to provide technical assistance
to grantees
• Funds may not be used to buy sterile needles or syringes
• Grantees must establish relationships to link clients to care for substance use
disorder treatment
• Grantees must be able to provide clients with naloxone
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
PROJECT TITLE: HIV and STD Testing and Prevention
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The City of Detroit bares a disproportionate burden of reported sexually transmitted
diseases, including HIV. As a complement to public health clinical services, the Detroit
Health Department provides community level education and awareness building, along
with targeted screening activities to ensure additional access to service for early case
detection and link to care.
Reporting Requirements (if different than agreement language):
How to
Report Period Due Date(s) Submit
Report
Activity Report Quarterly 30 days after the end of STD Section
the quarter
Any additional requirements (if applicable):
• In partnership with MDHHS, provide technical assistance and capacity building to
ensure the Public Health STD Clinic adheres to MDHHS and CDC screening,
diagnostic and treatment recommendations and guidelines
• Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
o Ensure timely entry of client encounter information into EvaluationWeb
(EvalWeb)
• Conduct community awareness building activities to increase STD and HIV
knowledge, including points of access for service.
• By September 30, distribute MDHHS determined allocation worth of condoms,
tube, dental dams, and display equipment/materials.
By September 30, develop and begin distribution of HIV Prevention
advertising/marketing materials.
PROJECT TITLE: HIV Data to Care
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Data to Care (D2C) is a Centers for Disease Control (CDC) program specifically focused
on people living with HIV (PLWH) that are not engaged in care. D2C employs an
intensive individualized outreach program which works to eliminate barriers
(transportation, insurance, access/knowledge of access to medical care, stigma -related
mental health issues, etc.) to accessing care through a combination of referrals and
linkage to existing Early Intervention Services (EIS) providers, Ryan White Service
providers and other community services. D2C is an essential program that facilitates
access to HIV treatment.
Reporting Requirements:
• The Department will update Not in Care (NIC) client list progress monthly. The
Grantee shall maintain up to date information in CAREWare (CW) in preparation
for evaluation:
Report
Period Due Date(s)
How to Submit Report
NIC client level data and
Monthly 10rh of the
Enter into CAREWare
services provided list
following month
All Funded agencies:
Quarterly January 30, 2021
Email report to MDHHS-
Complete quarterly
April 30, 2021
HIVSTDooerations(cDmichi
workplan progress reports
July 30, 2021
gan.gov
December 15,
2021
The Grantee shall permit the Division of HIV/STD Programs (DHSP) or its
designee to conduct site visits and to formulate an evaluation of the project.
Any additional requirements:
Publication Rights
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, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
• The percentage of the total costs of the program or project that will be financed
with Federal money.
• The dollar amount of Federal funds for the project or program.
Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Grant Program Operation
• If Grantee is receiving NIC list via secure transfer (e.g. DCH file transfer):
o Grantees must enter NIC lists into CW.
o Grantees must maintain password protected NIC lists on secure server
locations and not in any portable storage devices.
o Grantees must store NIC lists on shared servers and not on desktops or
personal computers.
o Grantees must transmit updated surveillance data to MDHHS in pre -
approved secure manners (e.g. DCH file transfer),
o If NIC lists or partial lists are sent via US Mail, list size must not exceed 10
individuals in a given mailing and words indicating HIV infection must not be
contained in the sent documents.
• If Grantee is receiving NIC list via direct CW import, grantee must complete
necessary fields in CW for transfer back to Surveillance.
Grantees must not email NIC lists or individual health information contained on
NIC lists either internally or externally.
The Grantee must adhere to security measures when working with client
information and must:
o Not email individual health information either internally or externally.
o Keep all printed materials in locked storage cabinets in locked rooms.
Provide written documentation of annual Security and Confidentiality
training for all staff regarding the Health Insurance Portability Accountability
Act (HIPAA), the Health Information Technology for Economic and Clinical
Health (HITECH), and the Michigan Public Health Code.
o Maintain the standards of CDC's Data Security and Confidentiality
Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and
Tuberculosis Programs
https://www. cdc. aov/nch hsto/o roa ram intea ra tion/docs/pcs id atasecu ritva u id
elines.pdf.
• Grantees will document all data sharing agreements and share a copy with the
Department. The data sharing agreements may be emailed to MDHHS-
HIVSTDoperations(Wmichiaan.aov.
• Grantees must provide written documentation of annual Security and
Confidentiality training for all staff that have access to NIC lists.
• Grantees will maintain the standards of CDC's Data Security and Confidentiality
Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and
Tuberculosis Programs,
https://www.cdc.aov/nchhstp/proaramintearation/docs/pcsidatasecuritvauidelines.o
df
• The Grantee will participate in the DHSP needs assessment and planning
activities, as requested.
o The Grantee will participate in regular Grantee meetings which may be
face-to-face, teleconferences, webinars, etc. The Grantee is highly
encouraged to participate in other training offerings and information -sharing
opportunities provided by the DHSP.
o The Grantee will use CW to report program activities, the Grantee must
include the following language in all Client Consent and Release of
Information forms used for services in this agreement: "I also understand
that some limited information in the electronic data may be shared with
other agencies if they also provide me with services and are part of the
same care and data network. [AGENCY] is mandated to collect certain
personal information that is entered and saved in a database system called
CAREWare. CW records are maintained in an encrypted and secure
statewide database. The CW database program allows for certain medical
and support service information to be shared among providers involved with
your care, this includes but is not limited to medical visits, lab results,
medications, case management, transportation, substance abuse, and
mental health counseling.
o In CW, the Grantee will complete the collection of all required data variables
and clean-up any missing data or service activities by the 10th day after the
end of each calendar month.
o The Grantee must consult and adhere to the Policy Clarification Notice
(PCN) #16-02 established by Health Resources and Services
Administration (HRSA). PCN #16-02 describes the core medical and
support services that HRSA considers allowable uses of Ryan White grant
funds and the individuals eligible to receive those services. A copy of the
revised PCN 16-02 is available at this link.
o An expanded list of "unallowable" grant costs is available in the PCN 16-02.
o HRSA RWHAP funds may not be used to make cash payments to
intended clients of HRSA RWHAP-funded services. This prohibition
includes cash incentives and cash intended as payment for HRSA RWHAP
core medical and support services. Where a direct provision of the service
is not possible or effective, store gift cards, vouchers, coupons, or tickets
that can be exchanged for a specific service or commodity (e.g., food or
transportation) must be used.
o HRSA RWHAP recipients are advised to administer voucher and store gift
card programs in a manner which assures that vouchers and store gift
cards cannot be exchanged for cash or used for anything other than the
allowable goods or services and that systems are in place to account for
disbursed vouchers and store gift cards
HRSA Unallowable Costs:
• Off -premise social or recreational activities (movies, vacations, gym
memberships, parties, retreats)
• Medical Marijuana
• Purchase or improve land or permanently improve buildings
• Direct cash payments or cash reimbursements to clients
• Clinical Trials: Funds may not be used to support the costs of operating clinical
trials of investigational agents or treatments (to include administrative
management or medical monitoring of patients)
• Clothing: Purchase of clothing
• Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
• Funerals: Funeral, burial, cremation or related expenses
• Household Appliances
• Mortgages: Payment of private mortgages
• Needle Exchange: Syringe exchange programs, Materials, designed to
promote or encourage, directly, intravenous drug use or sexual activity,
whether homosexual or heterosexual
• International travel
• The purchase or improvement of land
• The purchase, construction, or permanent improvement of any building or other
facility
• Pets: Pet food or products
• Taxes: Paying local or state personal property taxes (for residential property,
private automobiles, or any other personal property against which taxes may be
levied)
• Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a
privately -owned vehicle or any additional costs associated with a privately -
owned vehicle, such as a lease, loan payments, insurance, license or
registration fees
• Water Filtration: Installation of permanent systems of filtration of all water
entering a private residence (If water filtration/ purification systems are
provided, the community has water purity issues)
• It is unallowable to divert program income (income generated from charges/
fees and copays from Medicare, Medicaid, other third -party payers collected to
cover RW services provided) toward general agency costs or to use it for
general purposes
• Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
• Non -occupational Post -Exposure Prophylaxis (nPEP)
General -use prepaid cards are considered "cash equivalent' and are therefore
unallowable. Such cards generally bear the logo of a payment network, such as
Visa, MasterCard, or American Express, and are accepted by any merchant
that accepts those credit or debit cards as payment. Gift cards that are
cobranded with the logo of a payment network and the logo of a merchant or
affiliated group of merchants are general -use prepaid cards, not store gift
cards, and therefore are unallowable.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot
be exchanged for cash or used for anything other than the allowable goods or
services, and that systems are in place to account for disbursed vouchers and
store qift cards.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the
grant period, program, fiscal records, including documentation to support program
activities and expenditures, under the terms of this agreement, for clients residing
in the State of Michigan.
The Grantee will maintain client files, charts, and electronic records from last date
of service plus seven (7) years. For minors, Grantee will maintain client files and
records from last date of service and until minor reaches the age of 18, whichever
is longer, plus seven (7) years.
Software Compliance
The Grantee and its subcontractors are required to use the HRSA-supported software
CW to enter client and service data into the centrally managed database on a secure
server. The Grantee must:
• Enter all Ryan White services delivered to HIV -infected and affected clients.
• Enter all data by the 10th of the following month.
• Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
The Grantee must 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:
• Regular back-up of client records with back-up files stored in a secure location.
• Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
• Use of virus protection software to guard against computer viruses.
• Provide annual training to staff on security and confidentiality of client level
data and sharing of electronic data files according to MDHHS policies
concerning Sharing and Secured Electronic Data.
New staff needing access to CAREWare are required to email the CAREWare user
request form to MDHHS-CAREWareSupport@michigan.gov. The Grantee shall notify
MDHHS within 30 days CAREWare users who are separated from the agency for
deactivation.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, in the event
of any of the following:
• Any formal grievance initiated by a client and subsequent resolution of that
grievance.
Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee 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 Grantee or subcontractor employees.
• Any staff vacancies funded for this project that exceed 30 days.
This information may be sent via US Mail to the DHSP in Lansing, MI.
Technical Assistance
The Department will provide technical assistance (TA), as requested, on the
implementation of the Ryan White program. This may include issues related to:
CAREWare, Quality Management, Programs, Budget/Fiscal, Grants and Contracts,
ADAP, or other activities related to carrying out Ryan White activities. To request TA,
please send an email to MDHHS-HIVSTDooerations ..michioan.00v or complete this
form located on the DHSP website httos://www.michiaan.aov/mdhhs/0,5885,7-339-
71550 2955 2982---,00.html
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
• Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan
White HIV/AIDS Treatment Extension Act.
The Grantee should have procedures to protect the confidentiality and security of
client information.
PROJECT TITLE: HIV Prevention
Start Date: 10/112020
End Date: 9/30/2021
Project Synopsis:
The purpose of this project is to provide comprehensive HIV prevention services to all
priority populations and People Living with HIV (PLWH) in order to improve overall health
and well-being and reduce the incidence of new HIV infections.
Grantees will provide HIV Counseling, Testing, and Referral (CTR) and, if applicable,
Partner Services (PS), and Syringe Service Programs (SSP) within their jurisdiction,
pursuant to applicable federal and state laws; and policies and program standards
issued by the Division of HIV & STD Programs (DHSP). See "Applicable Laws, Rules,
Regulations, Policies, Procedures, and Manuals."
Reporting Requirements:
Report
Period
Due Date(s)
How to
Submit Report
Quality Control Reports
Monthly
10rh of the
Department
following month
Staff
Daily Client Logs
Monthly
101h of the
Department
following month
Staff
Reactive Results
As
Within 24 hours
EvalWeb
needed
of test
Non -Reactive Results
As
Within 7 days of
EvalWeb
needed
test
Linkage to Care and Partner
Services Interview (e.g. client
attended a medical care
As
Within 30 days of
EvalWeb,
appointment within 30 days of
diagnosis, and was interviewed by
needed
service
PSWeb
Partner Services within 30 days of
diagnosis)
Condom Distribution Data
Quarterly
10'h of the
following month
CTR Supplies
Disposition on Partners of HIV
Ongoing
Within 30 days of
PSWeb
Cases, if applicable
service
HIV Testing Competencies
Annually
Reviewed during
Department
site visits
Staff
SSP Data Report, if applicable
Quarterly
10rh of the
SUP
following month
• The Grantee will clean-up missing data by the 10th day after the end of each
calendar month.
• The Quality Control and Daily Client Logs may be sent to the Contract Manager
via:
Email - ctrsuDDlies(@michioan.00v
Fax - (517) 241-5922
Mailed - HIV Prevention Unit, Attn: CTR Coordinator, 109 W. Michigan
Ave., 10th Floor, Lansing, MI 48913
The Contract Manager shall evaluate the reports submitted as described in
Attachment III, Item D. for their completeness and accuracy.
Publication Rights
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
funds, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
• The percentage of the total costs of the program or project that will be financed
with Federal funds.
• The dollar amount of Federal funds for the project or program.
Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Grant Program Operation
• The Grantee will participate in DHSP needs assessment and planning activities,
as requested.
• The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, etc. The Grantee is highly encouraged to
participate in other training offerings and information -sharing opportunities
provided by DHSP.
Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
o Have policies and procedures to ensure time and effort reporting.
o Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
o Denote accurately the percent of effort to the project. The percent of effort
may vary from month to month, and the effort recorded for funds must
match the percentage claimed on the FSR for the same period.
o Submit a budget modification to DHSP in instances where the percentage
of effort of contract staff changes (FTE changes) during the contract period.
o The Grantee will receive a condom and lubrication allowance. The Grantee
must:
o Distribute condoms and lubrication
o Place orders for condoms/lubrication by emailing ctrsupplies@michigan.gov
If conducting HIV testing using rapid HIV testing, the Grantee will comply with
guidelines and standards issued by DHSP and:
o Conduct quality assurance activities guided by written protocol and
procedures. Protocols and procedures, as updated and revised Quality
assurance activities are to be responsive to: Quality Assurance for Rapid
HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals."
o Ensure provision of Clinical Laboratory Improvement Amendments (CL1A)
certificate.
o Report discordant test results to DHSP.
o Ensure that staff performing counseling and/or testing with rapid test
technologies has successfully completed rapid test counselor certification
course or Information Based Training (as applicable), test device training,
and annual proficiency testing.
o Ensure that all staff and site supervisors have successfully completed
appropriate laboratory quality assurance training, blood borne pathogens
training and rapid test device training and reviewed annually.
o Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
If conducting PS, the Grantee will comply with guidelines and standards issued by
the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures,
and Manuals." The Grantee must:
c Provide Confidential PS follow-up to infected clients and their at -risk
partners to ensure disease management and education is offered to reduce
transmission.
o Effectively link infected clients and/or at -risk partners to HIV care and other
support services.
o Work with Early Intervention Specialist to ensure infected clients are
retained in HIV care.
o Procure TLO or a TLO-like search engine.
If conducting SSP, the grantee will develop programs using MDHHS guidance
documents and will address issues such as identification and registration of
clients, exchange protocols, education, and trainings for staff, and referrals.
o Grantees will participate on monthly or quarterly conference calls to discuss
best practices and identify barriers.
o The Grantee shall permit DHSP or its designee to visit and to make an
evaluation of the project as determined by DHSP.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State of
Michigan.
Software Compliance
The Grantee and its subcontractors are required to use Evaluation Web (EvalWeb) to
enter HIV client and service data into the centrally managed database on a secure
server.
The Grantee and its subcontractors are required to use Partner Services Web (PSWeb)
to enter Partner Services interview and linkage to care data, where appropriate.
Mandatory Disclosures
• The Grantee will provide immediate notification to DHSP, in writing, including but
not limited to the following events:
o Any formal grievance initiated by a client and subsequent resolution of that
grievance.
Any event occurring or notice received by the Grantee or subcontractor,
that reasonably suggests that the Grantee 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 Grantee or
subcontractor employees.
o Any staff vacancies funded for this project that exceed 30 days.
o All notifications should be made to DHSP by MDHHS-
HIVSTDooerationsCc).michioan.00v.
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
PROJECT TITLE: HIV Care Ryan White Part B
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary
medical care, essential support services, and medications for low-income people living
with HIV who are uninsured and underserved. The program provides funding to provide
care and treatment services to people living with HIV to improve health outcomes and
reduce HIV transmission among hard -to -reach populations.
Reporting Requirements:
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) How to Submit
Report
All Agencies: Ryan White Monthly 10th of the Enter into CAREWare
services delivered to HIV- following month (CW)
infected and affected clients
All Ryan White federally
Annual
Generally,
Submission to HRSA
funded agencies: Ryan White
Grantee
through Electronic
Services Report (RSR)
submission will
Handbook (EHB)
open in early
February and
close early
March.
All Ryan White federally
Annual
December 31,
Email report to
funded agencies providing at
2020
MDHHS-
least one core medical
HIVSTDoperations(a).
service: Quality Management
michioan.00v
Plan
All Ryan White federally
10/1/20 —
As completed
Email report to
funded agencies: Complete
9/30/21
over contract year
MDHHS-
and submit at least one Plan-
HIVSTDoaerations(a)
Do -Study -Act worksheets to
michioan.00v
document progress of QI project
All Funded agencies: Quarterly January 30, 2021 Submit in EGrAMS
Complete quarterly workpian April 30, 2021 Email report to
progress reports July 30, 2021 MDHHS-
December 15, HIVSTDooerationsna
2021 michigan.gov
Report Period Due Date(s) How to Submit
Report
All Ryan White federally Quarterly January 30, 2021 Attached to quarterly
funded agencies: FY21 actual April 30, 2021 FSR
expenditures by service July 30, 2021
category, program income, and December 15,
administrative costs through the 2021
RW Reporting Tool
All Ryan White federally Annually December 31, Uploaded to EGrAMS
funded agencies: RW Form 2020 Portal Agency Profile
2100 and RW Form 2300
To complete the Ryan White Services Report (RSR), a Health Resources and Services
Administration (HRSA) required annual data report, the Grantee must assure that all CW
data is complete, cleaned, and entered into an online form via the HRSA EHB. RSR
submission requirements include:
The RSR shall have no more than 5% missing data variables.
Exact dates for the Grantee submission will be provided by the Department
each reporting year.
The Department validates the data within the Grantee's RSR submission
before receipt by HRSA.
Reports and information shall be submitted to the Division of HIV/STD Programs (DHSP)
Please refer to the table in Section D for where to submit reports and information.
The DHSP shall evaluate the reports submitted for their completeness and accuracy.
The Grantee shall permit the DHSP or its designee to conduct site visits and to formulate
an evaluation of the project.
Any additional requirements:
Publication Rights
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, the Grantee 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 that will be financed
with Federal money.
2. The dollar amount of Federal funds for the project or program.
3. Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Fees
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act and bill for services that are billable.
Grant Program Operation
• The Grantee will participate in the Department needs assessment and planning
activities, as requested.
The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged
to participate in other training offerings and information -sharing opportunities
provided by the Department.
The Grantee is responsible for ensuring that staff retain minimum educational
requirements for staff positions and are proficient in Ryan White -funded service
delivery in their respective roles within the organization. Ensure that Ryan White
funded staff receive MDHHS required case management training within one (1)
year of hire.
• Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
1. Have policies and procedures to ensure time and effort reporting.
2. Assure the staff member clearly identifies the percentage of time
devoted to contract activities in accordance with the approved
budget.
3. Denote accurately the percent of effort to the project. The percent of
effort may vary from month to month, and the effort recorded for
Ryan White funds must match the percentage claimed on the Ryan
White FSR for the same period.
4. Submit a budget modification to the Department in instances where
the percentage of effort of contract staff changes (FTE changes)
during the contract period.
The Grantee must include the following language in all Client Consent and Release of
Information forms used for services in this agreement:
"Consent for the collection and sharing of client information to
providers for persons living with HIV under the Ryan White Program
provided through (grantee name) is mandated to collect certain
personal information that is entered and saved in a federal data
system called CAREWare. CAREWare records are maintained in an
encrypted and secure statewide database. I understand that some
limited information in the electronic data may be shared with other
agencies if they also provide me with services and are part of the
same care and data network for the purpose of informing and
coordinating my treatment and benefits that I receive under this
Program. The CAREWare database program allows for certain
medical and support service information to be shared among
providers involved with my care, this includes but is not limited to
health information, medical visits, lab results, medications, case
management, transportation, Housing Opportunities for Persons with
AIDS (HOPWA) program, substance abuse, and mental health
counseling. I acknowledge that if I fail to show for scheduled medical
appointments, I may be contacted by an authorized representative of
(grantee name) in order to re-engage and link me back to care."
The Grantee must adhere to security measures when working with client information
and must:
1. Not email individual health information either internally or externally.
2. Keep all printed materials in locked storage cabinets in locked rooms.
3. Provide written documentation of annual Security and Confidentiality training
for all staff regarding the Health Insurance Portability Accountability Act
(HIPAA), the Health Information Technology for Economic and Clinical Health
(HITECH), and the Michigan Public Health Code.
4. Maintain the standards of CDC's Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs
httos://www.cdc.00v/nchhstr)/Drociramintearation/does/Dcsidatasecuritvouidelin
es.Ddf.
The Grantee will complete the collection of all required data variables and clean-up
any missing data or service activities by the 10th day after the end of each calendar
month.
Subrecipient quality management program should:
1. Include: leadership support, dedicated staff time for QM activities,
participation of staff from various disciplines, ongoing review of
performance measure data and assessment of consumer satisfaction.
2. Include consumer engagement which includes, but is not limited to, agency -
level consumer advisory board, participation on quality management
committee, focus groups and consumer satisfaction surveys.
3. Include conduction of at least one quality improvement (Ql) project
throughout the year, using the Plan -Do -Study -Act (PDSA) method to
document progress. This QI project must be aimed at improving client care,
client satisfaction, or health outcomes.
If the Grantee is federally funded for Ryan White services (one of which is a core
medical service), the Grantee will develop and/or revise a Quality Management Plan
(QMP) annually, to be kept on file at agency. QM Plans must contain these eleven
components:
1. Quality statement
2. Quality infrastructure
3. Annual quality goals
4. Capacity building
5. Performance measurement
6. Quality improvement
7. Engagement of stakeholders
8. Procedures for updating the QM plan
9. Communication
10. Evaluation
11. Work Plan
The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02
established by Health Resources and Services Administration (HRSA). PCN #16-02
describes the core medical and support services that HRSA considers allowable uses of
Ryan White grant funds and the individuals eligible to receive those services. A copy of
the revised PCN 16-02 is available at this link.
f An expanded list of "unallowable" grant costs is available in the PCN 16-02.
• HRSA RWHAP funds may not be used to make cash payments to intended
clients of HRSA RWHAP-funded services. This prohibition includes cash
incentives and cash intended as payment for HRSA RWHAP core medical
and support services. Where a direct provision of the service is not possible
or effective, store gift cards, vouchers, coupons, or tickets that can be
exchanged for a specific service or commodity (e.g., food or transportation)
must be used.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot
be exchanged for cash or used for anything other than the allowable goods or
services and that systems are in place to account for disbursed vouchers and
store gift cards
HRSA Unallowable Costs:
• Off -premise social or recreational activities (movies, vacations, gym memberships,
parties, retreats)
• Medical Marijuana
• Purchase or improve land or permanently improve buildings
• Direct cash payments or cash reimbursements to clients
• Clinical Trials: Funds may not be used to support the costs of operating clinical trials
of investigational agents or treatments (to include administrative management or
medical monitoring of patients)
• Clothing: Purchase of clothing
• Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
• Funerals: Funeral, burial, cremation or related expenses
• Household Appliances
• Mortgages: Payment of private mortgages
• Needle Exchange: Syringe exchange programs, Materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether homosexual or
heterosexual
• International travel
• The purchase or improvement of land
• The purchase, construction, or permanent improvement of any building or other
facility
• Pets: Pet food or products
• Taxes: Paying local or state personal property taxes (for residential property, private
automobiles, or any other personal property against which taxes may be levied)
• Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -
owned vehicle or any additional costs associated with a privately -owned vehicle,
such as a lease, loan payments, insurance, license or registration fees
• Water Filtration: Installation of permanent systems of filtration of all water entering a
private residence (If water filtration/ purification systems are provided, the
community has water purity issues)
• It is unallowable to divert program income (income generated from charges/ fees
and copays from Medicare, Medicaid, other third -party payers collected to cover RW
services provided) toward general agency costs or to use it for general purposes
• Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
• Non -occupational Post -Exposure Prophylaxis (nPEP)
General -use prepaid cards are considered "cash equivalent' and are
therefore unallowable. Such cards generally bear the loqo of a payment
network, such as Visa, MasterCard, or American Express, and are accepted
by any merchant that accepts those credit or debit cards as payment. Gift
cards that are cobranded with the logo of a payment network and the logo of
a merchant or affiliated group of merchants are general -use prepaid cards,
not store gift cards, and therefore are unallowable.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot be
exchanged for cash or used for anything other than the allowable goods or services,
and that systems are in place to account for disbursed vouchers and store gift cards.
Record Maintenance/Retention
• The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State
of Michigan.
• The Grantee will maintain client files and charts from last date of service plus seven
(7) years. For minors, Grantee will maintain client files and records from last date of
service and until minor reaches the age of 18, whichever is longer, plus seven (7)
years.
Software Compliance
The Grantee and its subcontractors are required to use the HRSA-supported software
CW to enter client and service data into the centrally managed database on a secure
server. The Grantee must:
1. Enter all Ryan White services delivered to HIV -infected and affected clients.
2. Enter all data by the 10th of the following month.
Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
The Grantee must 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:
1. Regular back-up of client records with back-up files stored in a secure location.
2. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
3. Use of virus protection software to guard against computer viruses.
Provide annual training to staff on security and confidentiality of client level data and
sharing of electronic data files according to MDHHS policies concerning sharing and
Secured Electronic Data.
New staff needing access to CAREWare are required to email the CAREWare user
request form to MDHHS-CAREWareSupport@michigan.gov. The Grantee shall notify
MDHHS within 30 days CAREWare users who are separated from the agency for
deactivation.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, in the event
of any of the following:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee 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 Grantee or subcontractor
employees.
3. Any staff vacancies funded for this project that exceed 30 days.
This information maybe sent via US Mail to the DHSP in Lansing, MI.
DEPARTMENT REQUIREMENTS
Technical Assistance
The DSHP will provide technical assistance (TA), as requested, on the implementation of
the Ryan White program. This may include issues related to: CAREWare, Quality
Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or
other activities related to carrying out Ryan White activities. To request TA, please send
an email to MDHHS-HIVSTDooerations(abmichioan.gov or complete this form located on
the DHSP website httas://www.michiaan.aov/mdhhs/0.5885.7-339-71550 2955 2982---
,00.html
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act.
PROJECT: IMMUNIZATION VFC/QI SITE VISITS
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
The format of the site visit will be based on the completed site visit questionnaires, the
CDC -PEAR and CDC-IQIP database systems reviewed at the most recent Fall IAP
meeting, web -training with MDHHS VFC and QI coordinators, in -person training with
Field Reps and the site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the appropriate
database as required by CDC (PEAR and QI database system) within 10 days of the site
visit by the individual who conducted the site visit. VFC site visit documentation must be
entered online within PEAR during the time of the site visit.
Reporting Requirements (if different than contract language)
• All reimbursement requests should be submitted on the quarterly Comprehensive
Financial Status Report (FSR),
o The submission should include, as an attachment, detail all the visits
during the quarter using the current spreadsheet information provided by
the Department.
The rate of reimbursement is $150 for a VFC Enrollment, AVP Only visit, or VFC
Only visit, $100 for a VFC Unscheduled Storage and Handling Visit, $350 for a
Combined VFC/QI site visit or Birthing Hospital visit, and $200 for a QI Only visit.
A VFC Enrollment visit is required for all new VFC enrolled provider sites.
Unannounced Storage and Handling Visits are not required but when performed,
must occur in conjunction with Immunization Nurse Education Sessions required
for VFC Providers that experience a loss exceeding a VFC dollar amount of
$1500. These visits can only be completed if eligible according to current CDC
requirements (e.g., visits cannot be performed for providers who have any visit
that is either in "In Progress" or "Submitted" status). Notify MDHHS VFC staff for
approval prior to performing these visits. MDHHS VFC will monitor the number of
Unannounced Storage and Handling visits performed and, if necessary, may limit
the allowable number of those that can be performed.
• All LHD staff involved with any site visits must complete the Department site visit
training webinar, presented by the Department VFC and QI Coordinator, prior to
conducting any site visits. Annual VFC and QI visit guidance and review materials
will be provided to each LHD at the (AP Meetings and consult will be conducted by
the Department Immunization Field Representative for each Grantee.
• Data from the CDC PEAR and CDC IQIP databases regarding the number and
type of site visits will be used to reconcile the agency request for reimbursement.
For additional detail on the program requirements, refer to the Resource Guide for
Vaccine for Children Providers and the current Department site visit guidance
documents, as well as other current guidance provided by the
Department/Immunization Program in correspondence to Immunization Action
Plan (IAP), Immunization Coordinators, or through health officers.
Any additional requirements (if applicable)
Every VFC visit performed for a QI-eligible provider must receive a QI visit within
the same site visit cycle. This may be performed as either a Combined VFC-QI
visit or separate VFC Only and QI Only visit, according to current MDHHS
guidelines. A QI visit can only be conducted within a cycle in which a VFC visit has
also been conducted for the same provider.
Local health departments must complete an in -person VFC or VFC/QI site visit for
every VFC provider at minimum, every 24-months, using the date of their previous
visit as a starting point. Site visits will vary in time an average of 1 hour for QI and
2 hours for VFC Compliance and must not exceed the two-year time frame.
Annual visits are encouraged but must not be conducted sooner than 11 months
from the previous site visit date.
Combined VFC/QI site visits will be conducted using MCIR QI reports and QI tools
developed by the Department. All VFC and QI follow-up activities and outstanding
issues must be completed within CDC guidelines.
Detroit Department of Health and Wellness Promotion Immunization Program is
required to complete visits annually to 100% of the VFC providers in accordance
with the SEMHA Quality Assurance Specialist (QAS) contractual obligations,
including the completed site visit questionnaires and the CDC -PEAR and the
CDC-IQIP database systems reviewed at the most recent Fall IAP meeting, web -
training with MDHHS VFC and QI coordinators, in -person training with Field Reps
and the current site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the
appropriate database as required by CDC (PEAR and QI database system) within
10 days of the site visit by the individual who conducted the site visit. VFC site visit
documentation must be entered online within PEAR during the time of the site
visit.
PROJECT: IMMUNIZATION ACTION PLAN
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Offer immunization services to the public.
• Collaborate with public and private sector organizations to promote childhood,
adolescent and adult immunization activities in the county including but not limited
to recall activities.
• Educate providers about vaccines covered by Medicare and
Medicaid.
• Provide and implement strategies for addressing the immunization rates of
special populations (i.e., college students, educators, health care workers, long
term care centers, detention centers, homeless, tribal and migrant and childcare
employees).
• Develop mechanisms to improve jurisdictional and LHD immunization rates for
children, adolescents and adults.
• Ensure clinic hours are convenient and accessible to the community, operating
both walk-in and scheduled appointment hours.
• Coordinate immunization services, including WIC, Family Planning, and STD,
developing plans or memorandums of understanding.
• Collaboratively work with regional MCIR staff to ensure providers are using
MCIR appropriately.
• Develop strategies to identify and target local pocket of need
areas.
Reporting Requirements (if different than contract language)
• IAP Reports are submitted electronically in accordance with due dates set by the
Department.
• IAP Plan will be submitted electronically using a template provided by the
Department, in accordance with due dates set by the Department.
• Utilize VAERS to report all adverse vaccine reactions
• Ensure that all reportable diseases are reported to the Department in the time
specified in the public health code and appropriate case investigation is
completed.
• By April 1, of each year provide one copy of the VFC provider with an online re -
enrollment form which includes a profile for each provider who receives vaccine
from the state. These documents must be submitted electronically in MCIR no
later than April 1.
Any additional requirements (if applicable)
• Adhere to federal and state appropriation laws pertaining to use of programmatic
funds. See Immunization Allowable Expenditures in Attachment I for appropriate
use of Federal Funds.
• Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993,
section 1928 Part IV — Immunizations and the most current CDC Vaccines for
Children Operations Manual, Michigan Resource Book for VFC Providers, and
documents that are updated throughout the year pertaining to the Vaccines for
Children (VFC) Program.
• Ensure that federally procured vaccine is administered to eligible children only
and is properly documented per VFC guidelines.
o The VFC Program provides VFC vaccine to only eligible children who meet
the following criteria: are Medicaid eligible, 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.
o Ensure state -supplied vaccines provided in the jurisdiction are
administered only to eligible clients as determined by the state. 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.
o Ensure that all providers receiving vaccine from the state screen children
for VFC eligibility for children
• Fraud or abuse of federally procured vaccine must be monitored and reported.
• Adhere to all Federal and Michigan Laws pertaining to immunization administration
and reporting including reporting to the MCIR, VAERS and schools and daycare
reporting
• Coordinate the submission of immunization data from schools and childcare
centers in your jurisdiction and follow-up with programs providing incomplete or
inaccurate data. Assure compliance levels are adequate to protect the public.
• Provide education to the parents of children seeking a non -medical exemption in
your jurisdiction.
• Monitor any provider receiving federally procured vaccine including but not limited to
VFC/QI site visit.
• Ensure on -site attendance of at least 1 LHD immunization program staff to two (2)
Immunization Action Plan (AP) meetings each year.
• Implements Perinatal Hepatitis B program activities to prevent the spread of
Hepatitis B Virus (HBV) from mother to newborn.
o Verify pregnancy status on all hepatitis B surface antigen (HBsAg)
positive pregnant women of childbearing years (10-60 years of age.)
o Ensure HBsAg positive pregnant women are reported to the Perinatal
Hepatitis B case manager and according to the Public Health Code.
c Coordinate Perinatal Hepatitis B case management activities between
local health department, provider, and Perinatal Hepatitis B Case Manager
to:
• Ensure that all infants, born to women who are HBsAg positive receive hepatitis B
vaccine and hepatitis B immune globulin (HBIG) within 12 hours of life, a complete
hepatitis B vaccine series with post vaccination serology testing and program
support services.
• Ensure that all susceptible household and sexual contacts associated with HBsAg
positive women receive appropriate testing, vaccination, and support services.
• Ensure birthing hospitals are able to offer hepatitis B vaccine to all newborns
prior to hospital discharge by enrolling them in the Universal Hepatitis B
Vaccination Program for Newborns.
• Surveillance of vaccine preventable disease (VPD) activities
o Conduct active surveillance when indicated (i.e. during an outbreak)
and contact hospitals, laboratories, and/or other providers on a
regular basis.
PROJECT: Immunization Action Plan- Pilot
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Project to increase immunization rates within the jurisdiction with a focus on influenza
vaccination.
• Staffing to work with schools on implementing school located vaccination clinics.
• Staff school located vaccination clinics and provide vaccines to eligible students.
• Distribute report cards to providers within the jurisdiction and research methods
to increase immunization rates within the practice.
• Work with MDHHS staff to coordinate immunization services to schools.
Reporting Requirements (if different than contract language)
• On a quarterly basis provide number of clinics held and number of students
vaccinated at school located clinics
• On a quarterly basis report the number of interventions initiated with provider
offices to improve immunization rates
• On a quarterly basis report any other immunization outreach efforts completed
using this funding
Any additional requirements (if applicable)
PROJECT: IMMUNIZATION — FIELD SERVICE REPRESENTATIVES
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
Field Representative Roles and Responsibilities- District #10, NW
Michigan,
This position serves as a liaison, resource person and as a regional expert for local
health jurisdictions regarding all the Department immunization programs and initiatives.
PROGRAM SUPPORT:
• Assist with the regional MCIR activities and act as a regional resource on MCIR
processes and assessment protocols.
• Assist with the local implementation and monitoring of all state programs at the
regional level- including IAP implementation, VFC, IQIP, Accreditation, Perinatal
Hepatitis B, School / Childcare reporting, special projects and the INE program.
• Participate in planning for regional conferences, IAP Coordinator meetings, and
other Department programs and initiatives as needed.
• Assist state, regional and local epidemiologists and communicable disease staff as
needed with VPD surveillance and outbreak control.
PROGRAM QUALITY ASSURANCE:
• Assist in the orientation of new IAP Coordinators.
• Work with local health departments to assess and increase immunization levels for
all age groups, especially identifying and targeting pockets of need.
• Identify evidence -based strategies that support improved coverage levels in the
region, including use of recall, support for the IQIP program, coordination of LHD
services, and provider and LHD staff education.
• Consult with the local health department on the immunization component of the
accreditation process, including preparation for reviews and conducting a walk
through or mock accreditation review.
• Consult with local coalitions and private stakeholders to promote immunizations
and ensure consistent messages are relayed to the public.
• Consult with local health departments on the school and day care assessment
process.
Encourage or provide educational updates and interventions on all immunization
issues with staff at local health departments, healthcare providers, school and
childcare staff and other stakeholders, may also include INE presentation if
applicable.
PROGRAM COMPLIANCE:
• Monitor compliance with policies/legislation at national/state and local levels such as:
o VFC program requirements and vaccine distribution and storage.
o VAERS program
o Public Health Code
o Administrative Rules
o School and childcare legislation and reporting requirements
o MCIR legislation and rules
o Communicable Disease Rules
PROGRAM OVERSIGHT and PROGRAM REVIEW:
• Perform oversight of the following programs with assigned local health
departments.
• Accreditation -Conduct reviews and monitor corrective actions.
• VFC including orientation and observation of LHD staff to annual VFC site visit
process, monitoring of VFC vaccine losses, submission of mandatory reports,
annual LHD VFC site visits and quality assurance review of all provider public
vaccine orders, perform E-VFC site visits to all LHD clinics, and unannounced
VFC storage and handling site visits.
• IQIP—including the required IQIP follow-up with VFC providers, and full
implementation of recommendations.
• Perinatal Hepatitis B-regional birth dose levels and universal vaccine program.
• Review and summarize LHD IAP Annual Plans and Biannual IAP Reports.
• Monitor LHD compliance with Comprehensive agreements and special
requirements relating to the Immunization program.
• Subrecipient monitoring of funds.
District #10, NW Michigan, Marquette and St. Clair Counties
• Employ and oversee 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 regional immunization related activities, including travel time.
• 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 internet capabilities, a printer, a cellular telephone and a
use of vehicle or reimbursement mechanism for transportation unless otherwise
arranged.
• Ensure the Immunization Field Representative will be available to all local health
departments in the assigned regions 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 Grantee.
• Provide for reimbursement for reasonable telephone charges incurred in the
conduct of business by the Immunization Field Representative unless otherwise
arranged.
• Provide reasonable reimbursement for any travel and subsistence expenses
incurred by the Immunization Field Representative necessary to the conduct of the
Immunization Program. Travel could include the annual National Immunization
Conference or other professional immunization related conferences, attendance at
the Department Immunization staff meetings and trainings, and accreditation visits
made in other areas of the state, as determined by the Division of Immunization.
WMTW•, ►r • •
• Provide adequate office space, telephone connections, high-speed internet
access, as well as access to fax and photocopiers.
• Provide feedback to Section Manager as needed, on employee work related
conduct.
PROJECT: IMMUNIZATION MICHIGAN CARE IMPROVEMENT
REGISTRY (MCIR) REGIONAL
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements
• Ensure the quarterly submission of status reports on work plan progress. Reports
are due within 30 days of the end of each quarter:
Report Period
October 1 — December 31
January 1 - March 31
April 1 - June 30
July 1 - September 30
Report Due
January 31
April 30
July 31
October 31
• Final quarterly report shall be an annual report. The annual report will be distributed
to the Department. The report shall include a summary of all the required activities
listed above in the quarterly reports.
• Any other information as specified in the special requirements shall be developed
and submitted by the Grantee as required by the Department.
o Reports and information should be submitted to:
Bea Salada, MCIR Coordinator
Michigan Department of Health & Human Services
Immunization Division
333 South Grand Ave
Lansing, MI 48909
Phone: (517) 284-4889
• The Grantee shall permit the Department or its designee to visit and to evaluate
on an as- needed basis.
Any additional requirements (if applicable)
• The Grantee shall ensure the performance of the following activities on behalf of
the Department to support the MCIR:
• Promote and train providers and Health Care Organizations (HCOs) on all features
of the MCIR Web application.
• Support regional MCIR users by operating the regional help desk in accordance
with Department approved procedures.
• Monitor and develop strategies to increase private provider and HCO enrollment
and participation in the MCIR which includes development of strategies to
encourage all providers to fully participate with the MCIR, (such as sites of
excellence awards).
• Process all user/usage agreements, according to the Department's approved
procedures, to create user accounts.
► Implement and update marketing plans in support of increased provider and
parent acceptance and use of the MCIR.
• Keep regional users updated on MCIR status and system changes.
• Conduct ad hoc reporting and querying on behalf of MCIR users.
• Work with local health departments to establish a mechanism and internal
process to assure persons who have died within their county are appropriately
flagged in the MCIR.
• Maintain a listing of HCO private and public immunization providers. This listing
should be as comprehensive as possible and should include all providers in the
region.
• Conduct regular de -duplication activities to assure that duplicate records are
removed from the MCIR as quickly as possible.
• Process user petitions to change MCIR data according to Department approved
procedures.
• Monitor ongoing immunization data submission for all local health departments
and private providers.
• 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.
• Maintain a policy/procedure manual, approved by the Department.
• Process and file all 'opt out' forms according to the Department approved
procedures.
• Attend regular MCIR regional Grantee/coordinator meeting.
• Conduct Onboarding activities as required for providers submitting immunization
data via HL7 messaging to MCIR.
• Perform quality assurance checks on the MCIR data for the region as
prescribed by the Department.
• Assist local health departments and private providers with
methodologies to "clean up" their data.
• Provide assistance to the Department on User Acceptance Testing
(UAT) when required to verify MCIR system releases of bug fixes
and enhancements.
• Attend all UAT training sessions as required by the Department.
• The Grantee shall provide to the MCIR Regional Coordinator:
a) permanent office space
b) general office supplies
c) a land -based telephone
d) a computer with high speed internet capabilities
e) a printer
f) a cellular telephone
g) use of a vehicle or in the alternative reimbursement mechanism for
transportation unless otherwise arranged
• When sufficient funding is available, provide to the MCIR Regional Coordinator
reimbursement for travel to attend the National Registry related meetings if
approved by the Department. This includes travel related expenses concerning air
fare, lodging, baggage processing, taxi services, etc.
• Consult with the Department on any personnel or performance issues that could
affect the above -mentioned contract requirements.
• Facilitate the Department's attendance in the interview process for hiring of a
MCIR Regional Coordinator / MCIR staff. This process includes consultation
with the Department regarding selection of interview candidates as well as
participation in the hiring determination.
PROJECT: IMMUNIZATION VACCINE QUALITY IMPROVEMENT
ASSURANCE
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
The rate of reimbursement per completed QI follow-up visit is $100 for the 2-month and
6-month check in calls and the 12-month follow-up (either an in -person or phone call
following current Department guidance) after the QI site visit. The $100 is reimbursable
only if all 3 activities occur within the Department guidance.
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
Conduct the 2-month and 6-month QI check -in calls with each VFC provider that
received a QI site visit during the previous or current CDC cycle (using current
Department guidance).
• Conduct the12-month QI follow-up with each VFC provider that received a QI site
visit during the previous or current CDC cycle (using current Department
guidance).
• Complete data entry of each site -visit, 2-month check -in call, 6-month check -in
call and 12-month follow-up in the CDC-IQIP database using current Department
guidance within 10 business days of each QI activity.
PROJECT: IMMUNIZATION —VACCINE QUALITY ASSURANCE
PROGRAM
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
• Follow-up on vaccine losses and replacement for compromised vaccines for
immunization providers within the jurisdiction.
• Monitor and approve all temperature logs, doses administered reports and ending
inventory reports received from participating VFC providers within the jurisdiction.
• Monitor and approve vaccine orders for participating VFC providers within the
jurisdiction.
• Act as the Primary Point of Contact (PPOC) for VFC providers within the
jurisdiction.
• Provide education and intervention on inappropriate use of publicly purchased
vaccine.
• Follow-up on VFC site visit non-compliance issues.
• Assist VFC providers within the jurisdiction on issues related to balancing vaccine
inventories.
• Assist with the redistribution of short dated vaccine for providers within the
jurisdiction.
• Assist with the equitable allocation of vaccines to providers in the jurisdiction
during a vaccine shortage.
PROJECT TITLE: Infant Safe Sleep
Start Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis:
Local health departments will provide educational activities, conduct community outreach
efforts and/or expand community awareness of infant safe sleep.
Reporting Requirements (if different than agreement language):
LHD will attach completed 'Infant Safe Sleep Mini -Grant Work Plan" to the
indirect cost line of the budget for review and approval by the Infant Safe Sleep
program.
2. Prior to the submission of the proposed work plan, LHD will participate in a
meeting (by person or phone) with all mini -grantees facilitated by the Infant Safe
Sleep Program to review current data, discuss infant safe sleep best practices
and answer any questions related to mini -grant requirements.
LHD will attach `Infant Safe Sleep Mini -Grant Work Plan" with reporting column
completed and completed "Infant Safe Sleep Mini -Grant Report Grid" to the
indirect cost line of the 2nd quarter FSR. The reporting period will cover October
1, 2020 - March 31, 2021. The reports are due by April 30, 2021.
4. LHD will participate in a technical assistance call with the Infant Safe Sleep
Program to review progress to date.
5. LHD will attach "Infant Safe Sleep Mini -Grant Work Plan" with reporting column
completed and completed "Infant Safe Sleep Mini -Grant Report Grid" to the
indirect cost line of the final FSR. The reporting period will cover October 1, 2020
- September 30, 2021. The reports are due by December 15, 2021.
Any additional requirements (if applicable):
1. Grantee must provide educational activities, conduct community outreach efforts
and/or expand community awareness of infant safe sleep. These efforts must
adhere to the updated policy statement titled "SIDS and Other Sleep -Related
Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping
Environment' issued by the American Academy of Pediatrics in October 2016.
2. Activities are to be data driven, to the extent possible, and culturally relevant to at -
risk, high -risk families in the community and reflect diversity in terms of race,
ethnicity, language, and socioeconomic status. In addition, activities should support
families and encourage open and nonjudgmental conversations with families about
infant sleep practices.
3. Grantee must participate in and/or coordinate a local advisory team or regional
group (such as the county's Regional Perinatal Quality Collaborative) to coordinate
efforts to promote infant safe sleep and reduce infant deaths related to unsafe
sleep environments.
4. Activities of the grantee must align with the Mother Infant Health and Equity
Improvement Plan to address preventable infant deaths and disparities through
evidence -based infant safe sleep program activities.
Funds may be used for the purchase of demonstration and/or educational items,
however, grantee is encouraged to use department -provided educational materials
when possible. Additionally, a maximum of 15% of the funding may be used for
giveaway items that are directly related to infant safe sleep such as cribs, pack -
and -plays, and/or sleep sacks. A maximum of 15% of the funding may be used for
advertising, including billboards, bus signage and the purchase of radio, TV,
and/or print media.
6. Grantee must adhere to the approved work plan. Deviations to the work plan must
be approved by the Program Coordinator.
Program Coordinator
Colleen Nelson
Washington Square Building
109 Michigan Avenue
3rd floor
P.O. Box 30195
Lansing, Michigan 48909
nelsonc7a.michioan. oov
517-335-1954
PROJECT: Informed Consent
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
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 a pregnancy test with
a determination of the probable gestational stage of a confirmed pregnancy.
Reporting Requirements (if different than contract language)
The numberof 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 FSR
through the MI E-Grants system.
Any additional requirements (if applicable)
The following requirements apply to all Grantees, whether the Grantee operates a Family
Planning Clinic or not:
• When a woman states that she is seeking an abortion and is requesting services
for that purpose the Grantee will provide:
o A pregnancy test with a determination of the probable gestational stage of a
confirmed pregnancy.
Note: The Grantee must destroy the individual "informed consent" files
containing identifying information (Name, Address, etc.) after 30 days.
• 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.
PROJECT: Laboratory Services Bio
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
Provide the Bureau of Laboratories records and reports as required.
Any additional requirements (if applicable)
• The Department will provide notifications and explicit instruction for stop and
start days to Grantee laboratory regarding this contractual arrangement prior to
its implementation.
• The Department will provide access to LIMS, support for LIMS hardware and
software, user training for LIMS utilized for testing performed under contract,
advanced training for LIMS liaisons for test master and Grantee specific data. The
Department will maintain the sole contract with LIMS vendor. Backups and
maintenance of all module(s)/customization(s) will be performed by the
Department staff.
• Analyze data from reports submitted from Grantee. Supply timely feedback of
statistical analysis and other data related to ongoing program activities.
Assist in technical training of personnel and computer software utilization.
• Supply Grantee with a copy of the contracts associated with this program.
• Meet established standards of performance and objectives in the following areas:
Public Health Emergency Preparedness:
• Maintain a current list of contact information for local community hospital
laboratories to facilitate communication.
• Facilitate response with local community hospital laboratories in preparation for and
during public health threats.
• Coordinate and facilitate specimen collection and transport with facilities within
jurisdiction. This may include specimen packaging and shipping and coordination
with the courier service.
• Provide 24/7 contact information to hospital partners and BOL.
• Participate in and provide support for Department PHEP exercises with community
hospital laboratories within jurisdiction.
• The Grantee will designate one staff member as a liaison to the Bureau of
Laboratories. Each Grantee must designate appropriate staff to take part in LIMS
training activities.
• Provide information on specimen submission to local health jurisdictions to assure
that specimens are submitted to the BOL LRN laboratory, or other appropriate LRN
laboratory as determined by the Department.
PROJECT: Local Health Department Sharing
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Local health departments participating in the project will utilize funds to support activities
pertinent to the exploration, preparation, planning, implementing, and improving sharing
of local health department services, programs or personnel.
Reporting Requirements (if different than contract language)
Grantees will receive notification of reports along with reporting templates. Reporting is
twice per year based on reporting dates required by the CDC.
Any additional requirements (if applicable)
Local health departments must submit a continuation workplan and budget for
continuation funding of the project "Local Health Department Collaboration and
Exploration of Shared Approach to Delivery of Services,"
Eligible Activities:
• Meeting activities, including time and travel costs
• Cost of research activities
• Supplies and presentation materials
• Legal fees and other professional services related to the project
• IT cost related to service sharing (grant funds may not be used to reimburse
equipment costs)
PROJECT TITLE: Local Maternal Child Health (LMCH)
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis: Local Maternal Child Health (LMCH)
LMCH funding is made available to local health departments to support the health of
women, children, and families in communities across Michigan. Funding addresses one
or more Title V Maternal and Child Health Block Grant national and state priority areas
and/or a local MCH priority need identified through a needs assessment process. Local
health departments complete an annual LMCH plan, and a year end report. Target
populations are women of childbearing age, infants, and children aged 1-21 years and
their families, with a special focus on those who are low income. The LMCH allocated
funds are to be budgeted as a fundino source in two project categories for FY 21,
LMCH
Local Maternal and Child Health (MCH)
ESCMCH MCH - Children
J OTHERMCHV MCH — All Other
Reporting Requirements (if different than agreement language):
• The LMCH Plan submission and due date will be communicated through a
notification mailing. The department will provide the format for the LMCH Plan.
The LMCH Plan, approved by the department, is to be uploaded with the budget
application into EGrAMS.
• The FY 21 LMCH Year -End Report submission and due date will be
communicated through a notification mailing. The department will provide the
format for the LMCH Year -End Report. The Local MCH Year -End Report,
approved by the department, is to be uploaded in EGrAMS with the final FSR.
Any additional requirements (if applicable):
• Local MCH funding must be used to address the unmet needs of the maternal
child health population and based on data and need(s) identified through the
Local Health Department community health assessment process.
• Activities and programs supported with Local MCH funds must be evidence-
based/informed. Exceptions must be submitted in writing and pre -approved by
MDHHS.
• Local MCH funding cannot be used under the WIC element, except in extreme
circumstances where a waiver is requested in advance of the expenditures and
evidence is provided that the expenditures satisfy all funding requirements.
• Local MCH funds may not be used to supplant available/billable program income
such as Medicaid or Healthy Michigan Plan fees or additional funding under the
Medicaid Cost -Based Reimbursement process.
Local Health Departments should leverage all other funding sources, especially
third -party payers (Medicaid, private insurers) before utilizing LMCH MCH block
grant funds. LMCH funds are to be used for those services that cannot be paid for
through other sources or for gap filling services. Third party fees should be listed
in other funding sources. If no 31d party fees are listed, an explanation must be
noted.
The LMCH program follows the same principle on budget transfers and
adjustments outlined in the comprehensive agreement. The comprehensive
agreement allows for budget transfers and adjustments of $10,000 or 15%,
whichever is greater. However, if the transfer or adjustment is greater than the
$10,000 or 15%, OR there are any changes made to any of the children
performance measures an amended LMCH Work Plan and budget will be
required.
LMCH has adopted Title 2 Code of Federal Regulations 200 Cost principles.
PROJECT TITLE: MATERNAL, INFANT AND EARLY CHILDHOOD HOME
VISITING INITIATIVE LOCAL HOME VISITING LEADERSHIP GROUP
(MIECHVLLG)
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to improvement and coordination of home visiting
programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The LLG shall submit all required reports in accordance with the Department reporting
requirements.
Staffing Changes: Within 10 days of a staffing change, notify the ECIC contractor
via e-mail and incorporate the change(s) into the budget and facesheet during the
next amendment cycle as appropriate. The facesheet identifies the agency
contacts and their assigned permissions related to the tasks they can perform in
E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet
changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30, and October 30).
• Any such other information as specified in the Work Plan shall be
developed and submitted by the Grantee as required by the Contract
Manager.
d. See the MDHHS Home Visiting Guidance Manual for specific CQI reporting
requirements which include monthly data tracking and PDSA cycle updates (due
the 15th of each month) and Story Board and Team Charter submissions.
e. The Contract Manager shall evaluate the reports submitted as described for their
completeness and adequacy.
f. The Grantee shall permit the Department or its designee to visit and make an
evaluation of the project as determined by the Contract Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the Home Visiting mailbox at MDHHS-HVlnitiativee.michigan.gov.
Any additional requirements (if applicable):
Comply with MDHHS Home Visitinq Proqram Requirements:
The Grantee shall operate the program with fidelity to the requirements of the MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual.
The LLG will work with the MDHHS contractors: Early Childhood Investment
Corporation (ECIC) and the Michigan Public Health Institute (MPHI). See the
MDHHS Home Visiting Guidance Manual for details related to working with ECIC
and MPHI.
2. The LLG will continue the following efforts started in previous years:
a. Ensure recruitment and participation of both required and strongly
encouraged LLG representatives.
b. Integrate parent leaders as active members of the LLG. Membership on
the LLG CQI team must include a parent leader. This includes their
attendance at local CQI meetings and the three LLG Grantee meetings.
c. Implement one strategy from the respective community's local Home
Visiting Continuum of Models Project Plan.
d. Participate in the LLG Quality Improvement Learning Collaborative to
identify strategies and activities for the purposes of improving outreach and
enrollment in evidence -based home visiting.
e. Implement the community's Sustainability Plan.
See the MDHHS Home Visiting Guidance Manual for requirements related to LLG
membership/participation, development of CQI strategies, as well as the implementation
of Continuum and Sustainability Plans.
Fundina Reauirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting Unit activities as specified in this
agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising, or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Guidance Manual.
PROJECT TITLE: MATERNAL, INFANT, AND EARLY CHILDHOOD
HOME VISITING INITIATIVE RURAL LOCAL HOME VISITING
LEADERSHIP GROUP (MHVRLH)
and
MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING
INITIATIVE RURAL LOCAL HOME VISITING GROUP 3 (MHVRLH3)
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to improvement and coordination of home visiting
programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The Grantee shall submit the following reports:
a. Staffing Changes: Within 10 days of a staffing change, notify the ECIC contractor
via e-mail and incorporate the change(s) into the budget and facesheet during the
next amendment cycle as appropriate. The facesheet identifies the agency
contacts and their assigned permissions related to the tasks they can perform in
E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet
changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval. See the MDHHS
Home Visiting Guidance Manual for requirements related to Work Plan
development and reporting.
c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30, and October 30).
Any such other information as specified in the Work Plan shall be developed and
submitted by the Grantee as required by the Contract Manager.
d. Seethe MDHHS Home Visiting Guidance Manual for specific CQI reporting
requirements which include monthly data tracking and PDSA cycle updates (due
the 15'h of each month) and Story Board and Team Charter submissions.
e. The Contract Manager shall evaluate the reports submitted as described for their
completeness and adequacy.
f. The Grantee shall permit the Department or its designee to visit and make an
evaluation of the project as determined by the Contract Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the Home Visiting mailbox at MDHHS-HVlnitiativeCa),michiaan.aov.
Any additional requirements (if applicable):
Comply with MDHHS Home Visitina Proaram Requirements:
The Grantee shall operate the program with fidelity to the requirements of the MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual.
The LLG will work with the MDHHS contractors: Early Childhood Investment
Corporation (ECIC) and the Michigan Public Health Institute (MPHI). See the
MDHHS Home Visiting Guidance Manual for details related to working with ECIC
and MPHI.
2. The LLG will continue the following efforts started in previous years:
a. Ensure recruitment and participation of both required and strongly
encouraged LLG representatives.
b. Integrate parent leaders as active members of the LLG. Membership on
the LLG CQI team must include a parent leader. This includes their
attendance at local CQI meetings and the three LLG Grantee meetings.
c. Implement one strategy from the respective community's local Home
Visiting Continuum of Models Project Plan.
d. Participate in the LLG Quality Improvement Learning Collaborative to
identify strategies and activities for the purposes of improving outreach and
enrollment in evidence -based home visiting.
e. Implement the community's Sustainability, Plan.
See the MDHHS Home Visiting Guidance Manual for requirements related to LLG
membership/participation, development of CQI strategies, as well as the implementation
of Continuum and Sustainability Plans.
Fundina Requirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting activities as specified in this agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising, or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Guidance Manual.
PROJECT: Medicaid Outreach
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Medicaid Outreach activities are performed to inform Medicaid beneficiaries or potential
beneficiaries about Medicaid, enroll individuals in Medicaid and improve access and
utilization of Medicaid covered services. All outreach activities must be specific to
Medicaid. Reference bulletin: MSA 18-41
Additional instructions can be found in Attachment I.
Reporting Requirements (if different than contract language)
• Submit quarterly reports no later than 1 month after the end of the quarter. The
exception is the 41 quarter report which is due at the time as the final FSR. If the report
due date falls on a weekend or holiday, the report the next business day.
Quarter Reporting Period
1 sc October 1 — December 31
2nd January 1 — March 31
3r° April 1 — June 30
4'h July 1 — September 30
Due Date
January 31
April 30
July 31
no later than December 15
• Quarterly reports must be attached/uploaded on the Source of Funds/Federal Medicaid
Outreach line on the FSR in EGrAMS.
• Reimbursements occur based on actual expenditures reported on Financial Status
Reports (FSR) using the reporting format and deadlines as required by the Department
through EGrAMS.
Any additional requirements (if applicable)
All claimable outreach activities must be in support of the Medicaid program.
Activities that are part of a direct service are not claimable as Medicaid Outreach.
• Must maintain documentation in support of administrative claims which are
sufficiently detailed to allow determination of whether the activities were necessary
for the proper and efficient administration of the Medicaid State Plan.
• Must maintain a system to appropriately identify the activities and costs in
accordance with federal requirements.
• Must provide quarterly summary reports of Medicaid outreach activities conducted
during the quarter. The following reporting elements must be included in the
quarterly report:
o Name of Health Department
o Name and contact information of the individual completing the report
o Time period the report covers (e.g., FY 21: 1sr quarter, or October -December
2020)
o Types of services provided during the quarter (Note: the types of services
provided do not have to include every single activity the LND conducted during
the quarter. Rather, simply include examples of the types of services provided.
The Grantee can include as much or as little detail as they chose.)
o Number of clients served
o Amount of funds expended during the quarter and total expenditures
o Number of FTEs who provided these activities
Successes/Challenges
This is not a reporting requirement but provides an opportunity for the LHD to
share successes during the quarter (e.g., For the first time, someone from the
school board attended the Infant Mortality Reduction Coalition meeting) or to
describe any challenges encountered during the quarter (e.g., the health advocate
quit and the lactation consultant went on maternity leave, so we are down 2 staff)
PROJECT: MI Health and Wellness 4x4 Plan - Implementation
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
Michigan Health & Wellness fund recipients are working on the implementation of
population -based approaches to prevent obesity through the implementation of healthy
eating and physical activity interventions with an emphasis on decreasing health
disparities. Strategies include: implement existing master/community plans and land use
interventions by connecting sidewalks, paths, bicycle routes, public transit with homes,
early care and education, schools, worksites, parks, or recreation centers; establish new
or improved pedestrian, bicycle, or transit transportation systems that are combined with
new or improved land use or environmental design; implement food service guidelines
(FSG) in worksites and in community settings in multiple venues to increase the
availability of healthy foods.
Reporting Requirements (if different than contract language)
The Contractor will submit quarterly progress report to the project evaluator as prescribed in the
evaluation plan.
Period Covered
October 1 — December 31
January 1 — March 30
April 1 — June 30
July 1 —September 30
Report Due Dates
January 15
April 15
July 15
November 15 (Final)
Any additional requirements (if applicable)
• Develop, submit and implement an approved work plan and budget which will be
maintained on file at MDHHS.
• Develop and implement an evaluation process, as appropriate and approved by
MDHHS staff. A copy of all evaluation reports and data collection must be
provided to the MDHHS consultant.
• Maintain an active coalition that systematically aligns organizational outcomes and
shared decision -making and resources associated with the intervention. Coalition
membership should also be representative of the community it serves.
• Advance strategies to increase access to social determinants of health such as
healthy food, quality housing, access to quality care, quality education, and safe
neighborhoods
• Attend required meetings, including conferences, partner meetings and progress
updates.
• The Contractor shall collaborate with the program consultant to schedule and
participate in site visits (as required).
• Provide interventions and strategies to support physical activity or healthy eating
and include a community wide public awareness campaign that incorporates the
4x4 health messages and recognizes the grant support of MDHHS and the MI
Health and Wellness 4x4 Plan.
• Performance will be measured based on the progress towards meeting work plan
objectives. Activities in your work plan, the expenditures, reports, site visits,
success stories and evaluation outcomes will also be used to assess progress and
level of impact.
• Each Health Department will have a 25% required match.
• Failure to comply with these requirements may result in punitive consequences
including but not limited to reimbursement of activities that were not performed,
denial of future funding and/or other consequences as appropriate.
PROJECT TITLE: MI HOME VISITING INITIATIVE RURAL EXPANSION
GRANT (MHVIRE)
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma -informed care. The program is designed to
promote positive parent -child relationships and healthy attachment. It is a strengths -
based and family -centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must
be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HFA model
consultant via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the
facesheet changes once the agreement is available to be amended.
b. Family Stories: At a minimum, one home visiting experience, as told from the
perspective of a currently enrolled family, due within 30 days of the end of the
fourth quarter (October 30).
c. HFA Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30 and October 30).
All reports and/or information (a-d), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiativea..michiaan.gov.
e. Implementation Monitoring Date and HRSA data collection requirements on the 511
business day of each month.
f. Continuous Quality Improvement reporting for the Learning Collaborative due on
the 15"' of each month from February to September.
g. Continuous quality Improvement reporting for LIA specific projects due by the 15'h
of the next month following the end of the quarter (January 15, April 15, July 15
and October 15).
All reports and/or information (e-g) shall be submitted to the MPHI mailbox as designated
in the MDHHS Guidance Manual.
Any additional requirements (if applicable):
The LIA shall serve the target population approved by the Michigan Department of Health
and Human Services (MDHHS), which supports the findings of their community's Needs
Assessment.
a. The Health Department of NWMI HFA Program (Region 2) will serve the
applicable number of families with children at high risk per section d. below.
b. The Health Department of NWMI HFA Program (Region 3) will serve the
applicable number of families with children at high risk per section d. below.
c. The Luce-Mackinac-Alger-Schoolcraft Health Department HFA Program
(Region 1) will serve the applicable number of families with children at high risk
per section d. below.
d. In general, across all regions, the home visitor -to -family ratio should agree with
the following:
a. 16 families per 1.0 FTE serving one county
b. 15 families per 1.0 FTE serving two counties
c. 14 families per 1.0 FTE serving three or more counties
See the MDHHS Home Visiting Guidance Manual for requirements related to the
development of a Work Plan and the timeframe for reaching full caseloads.
Maintain Fidelitv to the Model
The LIA shall adhere to the Healthy Families America (HFA) Best Practice Standards. In
addition, all Healthy Families America affiliates shall comply with the requirements of the
Central Administration for the Multi -site State System (also known as "The State Office")
housed within the Michigan Public Health Institute. All HFA model required training will be
accessed through the Center as available.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Guidance Manual for requirements related to PA 291.
Staffing
The LIA's HFA home visiting staff will reflect the community served
The LIA will provide documentation to demonstrate due diligence if unable to fully meet
this requirement within 90 days of a MDHHS site visit in which this was a finding.
See the MDHHS Home Visiting Guidance Manual for requirements related to program
staffing.
Comolv with MDHHS Proaram Requirements
The LIA shall operate the program with fidelity to the requirements of the MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual.
Proaram Monitorina. Assessment, Support and Technical Assistance (TA)
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPHI) with regards to program development and monitoring (including annual
site visits), training, support and technical assistance services. See the MDHHS Home
Visiting Guidance Manual for requirements related to program monitoring, assessment,
support and TA.
Professional Development and Trainina
All of the LTA's HFA program staff associated with this funding will participate in
professional development and training activities, as required by both HFA and the
Department. All LIA HFA
program staff must receive HFA-specific training from a Michigan -based approved HFA
training entity.
See the MDHHS Home Visiting Guidance Manual for requirements related to
professional development and training activities.
Supervision
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hour
individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice
Standards. Written policies and procedures shall specify how Reflective Supervision is
included in, or added to, that
time to ensure provision for each home visitor at a minimum of 1.0 hour per month.
Enaaae and Coordinate with Communitv Stakeholders
The LIA shall assure that there is a broad -based community advisory committee that is
providing oversight for HFA.
The LIA shall build upon and maintain diverse community and target population
collaboration and support.
The LIA shall participate in the Local Leadership Group (LLG) (if not the HFA community
advisory committee) or, if none, the Great Start Collaborative.
See the MDHHS Home Visiting Guidance Manual for requirements related to
engagement and coordination with community stakeholders.
Data Collection
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Guidance Manual for
requirements related to data collection.
Continuous Qualitv Improvement (CQI1
The LIA shall participate in all HFA quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all State and local Home Visiting CQI activities as required by
MDHHS. Required activities include, but are not limited to:
a. QI team participating in one Quality Improvement (QI) Learning Collaborative per
fiscal year, with all required training, reporting requirements and deliverables.
b. Conducting and completing two LIA-specific PDSA cycles per fiscal year.
c. With prior approval from the MDHHS Model Consultant, a national, regional, or
other quality improvement project can replace one or both individual LIA QI cycles.
See the MDHHS Home Visiting Guidance Manual for requirements related to CQI.
Work Plan Reouirements
By June 30, 2020, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox
(MDHHS-HVlnitiative(c).michioan.00v) for preapproval. See the MDHHS Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
Promotional Materials
If the LIA wishes to produce any marketing, advertising or educational materials, using
contract funds, they must follow the requirements outlined in the MDHHS Home Visiting
Guidance Manual.
PROJECT TITLE: Michigan Adolescent Pregnancy and Parenting Program
(MI-APPP)
Start Date: 10/1 /2020
End Date: 9/31 /2021
Project Synopsis:
The goal of MI-APPP is to create an integrated system of care, including linkages to
support services, for pregnant and parenting adolescents 15-19 years of age, the fathers,
and their families. MI-APPP grantees implement the Adolescent Family Life Program -
Positive Youth Development (AFLP-PYD; a California model), an evidence -informed case
management curriculum designed to elicit strengths, address various risk behaviors, the
impact of trauma, and provide a connection to health care and community services. In
addition, MI-APPP grantees engage communities through locally driven steering
committees, a comprehensive needs assessment, and creation of support services to
ensure the program is responsive to the needs of pregnant and parenting teens.
MI-APPP aims to:
1. Reduce repeat, unintended pregnancies,
2. Strengthen access to and completion of secondary education,
3. Improve parental and child health outcomes, and
4. Strengthen familial connections between adolescents and their support networks
Reporting Requirements (if different than agreement language):
Report :.'' I'' TImO Period I ' Due Date
October 1- December31, 2020 I January 15, 2021
Program January 1-March 31, 2021 April 15, 2021
Narrative April 1-June 30, 2021 July 15, 2021
July 1-September 30, 2021 October 15, 2021
Evaluation/Data
Submission
Monthly
Any additional requirements (if applicable):
Submit the 7th of
every month
Submit To I
Program
Coordinator
REDcap
• Information provided must be medically accurate, age -appropriate, culturally
relevant, and up to date.
• Pregnancy prevention education must be delivered separate and apart from
any religious education or promotion. MI-APPP funding cannot not be used to
support inherently religious activities including, but not limited to, religious
instruction, worship, prayer, or proselytizing (45 CFR Part 87).
• Family planning drugs and/or devices cannot be prescribed, dispensed, or
otherwise distributed on school property as part of the pregnancy prevention
education funded by MI-APPP as mandated in the Michigan School Code.
• Abortion services, counseling and/or referrals for abortion services cannot be
provided as part of the pregnancy prevention education funded under MI-
APPP.
i Must adhere to the Minimum Program Requirements for MI-APPP.
• MI-APPP funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT TITLE: MATERNAL INFANT CHILDHOOD HOME VISITING
PROGRAM (MIECHVP) HEALTHY FAMILIES AMERICA EXPANSION
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma -informed care. The program is designed to
promote positive parent -child relationships and healthy attachment. It is a strengths -
based and family -centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must
be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HFA model
consultant via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the
facesheet changes once the agreement is available to be amended.
b. Family Stories: At a minimum, one home visiting experience, as told from the
perspective of a currently enrolled family, due within 30 days of the end of the
fourth quarter (October 30).
c. HFA Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30 and October 30).
All reports and/or information (a-d), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiative(cD,michigan.pov.
e. Implementation Monitoring Data and HRSA data collection requirements on the 51h
business day of each month.
f. Continuous Quality Improvement reporting for the Learning Collaborative due on
the 15th of each month from February to September.
g. Continuous Quality Improvement reporting for LIA-specific projects due by the 15th
of the month following the end of the quarter (January 15, April 15, July 15 and
October 15).
All reports and/or information (e-g) shall be submitted to the MPHI mailbox as designated
in the MDHHS Home Visiting Guidance Manual.
Work Plan Requirements:
By June 30, 2020, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox
(MDHHS-HVlnitiative(a)michiaan.nov) for preapproval. See the MDHHS Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
Any additional requirements (if applicable):
Grantee Specific Requirements:
The LIA shall serve the target population approved by the Michigan Department of Health
and Human Services (MDHHS), which supports the findings of their community's Needs
Assessment.
The Kalamazoo County Health and Community Services Dept. HFA program
will serve 48 families with children who are at high risk in the areas of
Comstock Township, City of Kalamazoo -Arcadia, Vine, Eastside
neighborhoods, Richland Township, City of Portage, Texas Township,
Oshtemo and Galesburg.
b. The Wayne County Babies HFA program will serve 32 families who are young
parents, through age 24,
living in the cities of Hamtramck, Highland Park, Redford, Inkster, Taylor,
Romulus, Van Buren Township and Westland.
See the MDHHS Home Visiting Guidance Manual for requirements related to the
development of a Work Plan and the timeframe for reaching full caseloads.
Maintain Fidelity to the Model
The Local Implementing Agency (LIA) shall adhere to the Healthy Families America
(HFA) Best Practice Standards. In addition, all Healthy Families America affiliates shall
comply with the requirements of the Central Administration for the Multi -site State System
(also known as "The State Office") housed within the Michigan Public Health Institute. All
HFA model required training will be accessed through the Central Administration as
available. Contact HFA State Office for details.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Guidance Manual for requirements related to PA 291.
Staffing
The LIA's HFA home visiting staff will reflect the community served.
The LIA will provide documentation to demonstrate due diligence if unable to fully meet
this requirement within 90 days of a MDHHS site visit in which this was a finding.
See the MDHHS Home Visiting Guidance Manual for requirements related to program
staffing.
Complv with MDHHS Program Reauirements
The LIA shall operate the program with fidelity to the requirements of the MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual,
Proaram Monitorina, Assessment, Support and Technical Assistance (TAII:
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPHI) with regards to program development and monitoring (including annual
site visits), training, support and technical assistance services. See the MDHHS Home
Visiting Guidance Manual for requirements related to program monitoring, assessment,
support and TA.
Professional Development and Trainina:
All of the LTA's HFA program staff associated with this funding will participate in
professional development and training activities as required by both HFA and the
Department. All LIA HFA program staff must receive HFA-specific training from a
Michigan -based approved HFA training entity.
See the MDHHS Home Visiting Guidance Manual for requirements related to
professional development and training activities.
Supervision:
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hour
individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice
Standards. Written policies and procedures shall specify how Reflective Supervision is
included in, or added to, that time to ensure provision for each home visitor at a minimum
of 1.0 hour per month.
Enaaae and Coordinate with Communitv Stakeholders:
The LIA shall assure that there is a broad -based community advisory committee that is
providing oversight for HFA.
The LIA shall build upon and maintain diverse community and target population
collaboration and support.
The LIA shall participate in the Local Leadership Group (LLG) (if not the HFA community
advisory committee) or, if none, the Great Start Collaborative.
See the MDHHS Home Visiting Guidance Manual for requirements related to
engagement and coordination with community stakeholders.
Data Collection:
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Guidance Manual for
requirements related to data collection.
Continuous Qualitv Improvement (COD:
The LIA shall participate in all HFA quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all State and local Home Visiting CQI activities as required by
MDHHS. Required activities include, but are not limited to:
a. QI team participating in one Quality Improvement (QI) Learning Collaborative per
fiscal year, with all required training, reporting requirements and deliverables.
b. Conducting and completing two LIA-specific PDSA cycles per fiscal year.
c. With prior approval from the MDHHS Model Consultant, a national, regional, or
other quality improvement project can replace one or both individual LIA QI cycles.
See the MDHHS Home Visiting Guidance Manual for requirements related to CQI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials, using
contract funds, they must follow the requirements outlined in the MDHHS Home Visiting
Guidance Manual.
PROJECT TITLE: NURSE FAMILY PARNERSHIP (NFP) SERVICES
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Nurse Family Partnership (NFP) program offers families one-on-one home visits with
a registered nurse. The model is grounded in human attachment, human ecology, and
self -efficacy theories. Home visitors use model -specific resources to build on a parent's
own interests to attain the model goals.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must
be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the NFP model
consultant via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the
facesheet changes once the agreement is available to be amended.
b. Family Stories: At a minimum, one home visiting experience, as told from the
perspective of a currently enrolled family, due within 30 days of the end of the
fourth quarter (October 30).
c. Medicaid Outreach Report (Berrien, Calhoun, Kalamazoo and Kent only): Due
within 30 days of the end of each quarter.
NFP Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
e. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30 and October 30).
All reports and/or information (a-e), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiativea.michioan.aov. .
f. Implementation Monitoring Data and HRSA data collection requirements on the 5th
business day of each month.
g. Continuous Quality Improvement reporting for the Learning Collaborative due the
15th of each month from February to September.
h. Continuous Quality Improvement reporting for LIA-specific projects due by the 15'h
of the month following the end of the quarter (January 15, April 15, July 15 and
October 15).
All reports and/or information (f-h) shall be submitted to the MPHI mailbox as designated
in the MDHHS Home Visiting Guidance Manual.
Any additional requirements (if applicable):
Maintain Fidelity to the Model:
The LIA shall adhere to the Nurse Family Partnership National Service Office (NSO)
program standards and operate the program with fidelity to the NSO Application Review
Team's approved Implementation Plan.
P.A.291:
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Guidance Manual for requirements related to PA 291.
Comply with MDHHS Program Requirements:
The LIA shall operate the program with fidelity to the requirements of the MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual.
Staffing:
The LIA's NFP home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement,
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Guidance Manual for requirements related to program staffing.
Taraet Population:
Michigan is using NFP as a specialized home visiting service strategy for low income,
first-time mothers whose population group contributes to the community's excess pre -
term births (based on the Kitagawa analysis provided by MDHHS). This specialized
service strategy is a focused way of using limited resources, directing them to the most
at -risk populations. The LIA will conduct outreach activities to the population group
identified in their Kitagawa analysis, in order to enroll families from those outreach efforts.
The MDHHS expects LIAs to maintain a caseload capacity of 25 families per 1.0 FTE.
See the MDHHS Home Visiting Guidance Manual for requirements related to the
development of a Work Plan and timeframe for reaching full caseloads.
Proaram Monitorina. Qualitv Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the NFP NSO, the Department, and the Michigan
Public Health Institute (MPHI) with regards to program monitoring (including annual site
visits), assessment, support and technical assistance services. See the MDHHS Home
Visiting Guidance Manual for requirements related to program monitoring, quality
assessment, support and TA.
Professional Development and Training:
All of the LTA's NFP staff associated with this funding will participate in professional
development and training activities, as required by both NFP and the Department. See
the MDHHS Home Visiting Guidance Manual for requirements related to professional
development and training activities.
Supervision:
The LIA shall adhere to the NFP supervision requirements.
Enaaae and Coordinate with Communitv Stakeholders:
The LIA shall assure that there is a broad -based community advisory committee that is
providing oversight and feedback for NFP.
The LIA shall build upon and maintain diverse community and target population
collaboration and support.
The LIA shall participate in the Local Leadership Group (LLG) (if not the NFP community
advisory body) or, if none, the Great Start Collaborative.
See the MDHHS Home Visiting Guidance Manual for requirements related to
engagement and coordination with community stakeholders.
Data collection:
The LIA shall comply with all NFP and MDHHS data training, collection and entry, and
submission requirements. See the MDHHS Home Visiting Guidance Manual for
requirements related to data collection.
Continuous Qualitv Improvement 1CQII:
The LIA shall participate in all NFP quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all State and local Home Visiting CQI activities, as required by
MDHHS. Required activities include, but are not limited to:
QI team participates in one Quality Improvement (QI) Learning Collaborative per
fiscal year, with all required training, reporting requirements and deliverables.
• Conduct and complete two LIA-specific PDSA cycles per fiscal year.
With prior approval from the MDHHS Model Consultant, a national, regional, or
other quality improvement project can replace one or both individual LIA QI cycles.
See the MDHHS Home Visiting Guidance Manual for requirements related to CQI.
Work Plan Requirements:
The LIA must submit a Work Plan by June 30 2020, to the MDHHS Home Visiting
mailbox at MDHHS-HVlnitiativena michioan.00v. See the MDHHS Guidance Manual for
requirements related to Work Plan development and reporting.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials, using
contract funds, they must follow the requirements outlined in the MDHHS Home Visiting
Guidance Manual.
PROJECT: PHEP COVID-19 Response
Beginning Date: 10/112020
End Date: 9/30/2021
Project Synopsis
The expenses will be used by the local health department to provide resources to
prevent, prepare, and to respond to COVID-19. The expenses will include surge staffing,
activities and various supplies eligible to help with the response coordination. They
expenses will be necessary to carry out surveillance, infection control, communications,
and other preparedness and response activities.
Reporting Requirements (if different than contract language)
Quarterly FSR's- all same as contract language
A monthly spend plan is due on the 15'h of each month.
Any additional requirements (if applicable)
PROJECT: Public Health Emergency Preparedness
9 Month Project
Beginning Date: 10/1/2020
End Date: 6/30/2021
3 Month Project
Beginning Date: 7/1/2021
End Date: 9/30/2021
Project Synopsis
As a Grantee of funding provided through the Centers for Disease Control and
Prevention (CDC) National Bioterrorism Hospital Preparedness Program (HPP) and
Public Health Emergency Preparedness (PHEP) Cooperative Agreement, each Grantee
shall conduct activities to build preparedness and response capacity and capability.
These activities shall be conducted in accordance with the HPP/PHEP Cooperative
Agreement guidance for 2020-2021 plus any and all related guidance from the CDC and
the Department that is issued for the purpose of clarifying or interpreting overall program
requirements.
Reporting Requirements (if different than contract language)
• Recipients are required to submit a 9-month (October 1 to June 30) budget
and a 3-month (July 1 to Sept 30) for both Base PHEP and CRI funding,
including the 10% MATCH for those periods (see below for detail regarding
Match). Submitted to MI)I-IH5-I3F1P-DF.PP-PHUP6( m4lii {,,n uv by May
1, 2020.
Recipients provide the required 10% MATCH for July 1, 2020 through
September 30, 2020 and October 1, 2020 through June 30, 2021.
Recipients are required to submit a letter (on agency letterhead) stating the
source, calculation and narrative description of how the match was
achieved, unless said match is met using local dollars. This was due with
the narrative budget submission to the Division of Emergency
Preparedness and Response-DEPR.
• ALL activities funded through the PHEP cooperative agreement must be
completed between July 1, and June 30, and all BP2 funding must be
obligated by June 30, 2021 and activity completed by the August 15, 2021
FSR submission deadline.
• The final Financial Status for funding period ending June 30 reports MUST
be submitted in the MI E-Grants system for this funding source no later
than August 15, 2021.
Recipients must submit required PHEP program data and reports by the
stated deadlines. This includes, but is not limited to, progress reports,
performance measure data reports, National Incident Management System
(NIMS) compliance reports, updated emergency plans, budget narratives,
Financial Status Reports (FSR), etc. Failure to do so will constitute a
benchmark failure. All deliverables must be submitted by the designated
due date in the Grantee BP2 work plan.
• Recipients must maintain National Incident Management System (NIMS)
compliance as detailed in the LHD work plan and submit annually to the
Department — DEPR per the LHD BP2 work plan.
• Each subrecipient Grantee must retain program -related documentation for
activities and expenditures consistent with Title 2 CFR Part 200; Uniform
Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, to the standards that will pass the scrutiny of audit.
Any additional requirements (if applicable)
All Grantee activities shall be consistent with all approved Budget Period 2 1 (BP2) work
plan(s) and budget(s) on file with the Department through the MI E-Grants system. In
addition to these broad requirements, the Grantee will comply with the following:
One (1) full time equivalent (FTE) emergency preparedness coordinator (EPC), as
a point of contact. In addition to the Grantee health officer, the EPC shall
participate in collaborative capacity building activities of the PHEP Cooperative
Agreement, all required reporting and exercise requirements and in regional
Healthcare Coalition (HCC) initiatives. Anv chances to this staffino model must be
approved by the Public Health Emeroencv Preparedness Prooram Manaoer at the.
Division of Emeroencv Preparedness and Response (517-335-8150).
• Under the PHEP cooperative agreements, Grantee's must continue to partner
with the Regional Healthcare Coalition (HCC) and support HCC initiatives to
ensure that healthcare organizations receive resources to meet medical surge
demands. Working well together during a crisis is facilitated by meeting on a
regular basis. To this end, EPCs, supported by CDC PHEP are required to
participate in and support regional HCC initiatives. In addition, the EPC or
designee is required to attend regional HCC planning or advisory board meetings.
The intent is for LHD's that cross regional boundaries to align with one regional
coalition.
There are a number of special initiatives, projects, and/or supplemental funding
opportunities that are facilitated under this cooperative agreement. For example,
the Cities Readiness Initiative (CRI) performance and evaluation initiatives. Each
Grantee that is designated to participate in any of these types of supplemental
opportunities is required to comply with all CDC and the Department— Division of
Emergency Preparedness and Response (DEPR) guidance, and all
accompanying work plan and budgeting requirements implemented for the
purpose of subrecipient monitoring and accountability. Some or all supplemental
opportunities may require separate recordkeeping of expenditures. If so, this
separate accounting will be identified in separate project budgets in the MI E-
Grants system. These supplemental opportunities may also require additional
reporting and exercise activities.
All budget amendments must be submitted to the Division of Emergency
Preparedness and Response (DEPR) for review prior to submitting them in the MI
E-Grants system. Budget amendments that contain line items deviating more than
15% or $10,000 (whichever is greater) from the original budgeted line item must
be approved by DEPR prior to implementation via email to MUHH`., _HL;TIDEPR
1'I-1E_f'(<r7ir ick id n, 0V
Supplantation is the replacement of non-federal funds with federal funds to
support the same activities. The Public Health Service Act, Title I, Section 319(c)
specifically states, "SUPPLEMENT NOT SUPPLANT. — Funds appropriated under
this section shall be used to supplement - not supplant - other federal, state, and
local public funds provided for activities under this section." This law strictly and
expressly prohibits using cooperative agreement funds to supplant any current
state or local expenditures.
In response to repeated communications from CDC strongly urging states to
ensure all funds are spent each year a threshold has been established to limit the
amount of unspent funds. A maximum of 2% of the Grantee allocation or $3,000
(whichever is greater) of unspent funds is allowable each budget period. Failure to
meet this requirement, or misuse of funds, will affect the amount that is allocated
in subsequent budget periods.
Unallowable Costs
• Recipients may not use funds for research.
• Recipients may not use funds for clinic care except as allowed by law.
• Recipients may use funds only for reasonable program purposes including
personnel, travel, supplies and services.
• Generally, recipients may not use funds to purchase furniture or equipment. Any
such proposed spending must be clearly identified in the budget.
• Reimbursement of pre -award costs generally is not allowed, unless the CDC
provides written approval to the recipient.
• Other than for normal and recognized executive -legislative relationships, no funds
may be used for:
o Publicity or propaganda purposes, for the preparation, distribution, or use of
any material designed to support or defeat the enactment of legislation
before any legislative body.
o The salary or expenses of any grant or contract recipient, or agent acting
for such recipient related to any activity designed to influence the
enactment of legislation, appropriations regulation, administrative action, or
Executive order proposed or pending before any legislative body.
• Lobbying is prohibited
• The direct and primary recipient in a cooperative agreement must perform a
substantial role in carrying out project outcomes and not merely serve as a conduit
for an award to another party or provider who is ineligible.
• Recipients may not use funds to purchase vehicles to be used as means of
transportation for carrying people or goods, e.g., passenger cars or trucks,
electrical or gas -driven motorized carts.
• Payment or reimbursement of backfilling costs for staff is not allowed.
• No clothing may be purchased with these funds.
• Items considered as give away such as first aid kits, flashlights, shirts etc., are not
allowable
• None of the funds awarded to these programs maybe used to pay the salary
of an individual at a rate in excess of Executive Level 11 or $181,500 per year.
• Recipients may not use funds for research.
i Recipients may not use funds for clinical care.
Y Recipients may only expend funds for reasonable program purposes, including
personnel, travel, supplies, and services, such as contractual.
Recipients may not generally use HHS/CDC/ATSDR funding for the purchase of
furniture or equipment. Any such proposed spending must be identified in the
budget.
The direct and primary recipient in a cooperative agreement program must
perform a substantial role in carrying out project objectives and not merely serve
as a conduit for an award to another party or provider who is ineligible.
Other than for normal and recognized executive -legislative relationships, no funds
may be used for: publicity or propaganda purposes, the preparation, distribution,
or use of any material designed to support or defeat the enactment of legislation
before any legislative body the salary or expenses of any grant or contract
recipient, or agent acting for such recipient, related to any activity designed to
influence the enactment of legislation, appropriations, regulation, administrative
action, or Executive order proposed or pending before any legislative body.
• The direct and primary recipient in a cooperative agreement program must
perform a substantial role in carrying out project outcomes and not merely serve
as a conduit for an award to another party or provider who is ineligible.
• Recipients may not use funds for construction or major renovations.
• Recipients may supplement but not supplant existing state or federal funds for
activities described in the budget.
• Payment or reimbursement of backfilling costs for staff is not allowed.
• None of the funds awarded to these programs may be used to pay the salary of an
individual at a rate in excess of Executive Level II or $187,000 per year.
• Recipients may use funds only for reasonable program purposes, including travel,
supplies, and services.
Recipients may purchase basic (non -motorized) trailers with prior approval from
the CDC OGS.
• HPP and PHEP funds may not be used to purchase clothing such as jeans, cargo
pants, polo shirts, jumpsuits, sweatshirts, or T-shirts. Purchase of items that can
be reissued, such as vests, may be allowable.
• HPP and PHEP funds may not be used to purchase or support (feed) animals for
labs, including mice. Any requests for such must receive prior approval of
protocols from the Animal Control Office within CDC and subsequent approval
from the CDC OGS as to the allowable of costs.
• Recipients may not use funds to purchase a house or other living quarter for those
under quarantine.
• HPP and PHEP recipients may (with prior approval) use funds for overtime for
individuals directly associated (listed in personnel costs) with the award.
• PHEP recipients cannot use funds to purchase vehicles to be used as means of
transportation for carrying people or goods, such as passenger cars or trucks and
electrical or gas -driven motorized carts.
• PHEP recipients can (with prior approval) use funds to lease vehicles to be used
as means of transportation for carrying people or goods, e.g., passenger cars or
trucks and electrical or gas -driven motorized carts.
• PHEP recipients can (with prior approval) use funds to purchase material -handling
equipment (MHE) such as industrial or warehouse -use trucks to be used to move
materials, such as forklifts, lift trucks, turret trucks, etc. Vehicles must be of a type
not licensed to travel on public roads.
• PHEP recipients can use funds to purchase caches of medical or non -medical
• Counter measures for use by public health first responders and their families to
ensure the health and safety of the public health workforce.
• PHEP recipients can use funds to support appropriate accreditation activities that
meet the Public Health Accreditation Board's preparedness -related standards.10.
Audit Requirement
A grantee may use its Single Audit to comply with 42 USC 247d — 3a(j)(2) if at least once
every two years the awardee obtains an audit in accordance with the Single Audit Act (31
USC 7501 — 7507) and Title 2 CFR, Part 200 Subpart F; submits that audit to and has the
audit accepted by the Federal Audit Clearinghouse; and ensures that applicable PHEP
CFDA number 93.069 are listed on the Schedule of Expenditures of Federal Awards
(SEFA) contained in that audit.
Administrative preparedness
During BP1S, Recipients must continue to strengthen and test its
administrative preparedness plan, to include written policies, procedures, and/or
protocols that address the following:
o Expedited procedures for receiving emergency funds during a real
incident or exercise
o Expedited processes for reducing the cycle time for contracting and/
or procurement during a real emergency or exercise
o Internal controls related to subrecipient monitoring and any negative
audit findings resulting from suboptimal internal controls;
o Emergency authorities and mechanisms to reduce the cycle time for
hiring and/ or reassignment of staff (workforce surge).
• All administrative preparedness planning activities should be considered in
coordination with healthcare systems, law enforcement, and other relevant
stakeholders as appropriate.
Pandemic and All Hazards Preparedness and Advancing Innovation Act of 2018
• Requires the withholding of amounts from entities that fail to achieve
PHEP benchmarks. The following PHEP benchmarks have been identified by CDC
and MDHHS-DEPR for the Fiscal Year:
Demonstrated adherence to all PHEP aoolication and
reoortino deadlines. Grantees must submit required PHEP program data
and reports by the stated deadlines. This includes, but is not limited to,
progress reports, performance measure data reports, National Incident
Management System (NIMS) compliance reports, updated emergency
plans, budget narratives, Financial Status Reports (FSR), etc. Failure to do
so will constitute a benchmark failure. All deliverables must be submitted
by the designated due date in the LHD BP2-2020 work plan.
o Demonstrated capability to receive, stage, store, distribute,
and dispense medical countermeasures (MCM) I during a public health
emergency, per the BP 2-2020 LHD Work Plan.
o Further guidance related to pandemic preparedness will be
included in the LHD workplan.
Pandemic Influenza Preparedness plans
Further guidance will be included in the Grantee PHEP Work Plan.
Benchmark Failure
Awardees are expected to "substantially meet' the PAHPRA benchmarks. Per the
Cooperative Agreement, failure to do so constitutes a benchmark failure, which carries an
allowable penalty withholding of funds. Failure to meet any one of the two benchmarks
and/or the spending threshold is considered a single benchmark failure. Any awardee (or
sub-awardee) that does not meet a benchmark, and/or the spending threshold will have
an opportunity to correct the deficiency during a probationary period. If the deficiency is
not corrected during this period, the awardee is subject to a 10% withholding of funds the
following budget period. Failure to meet the pandemic influenza plan requirement
constitutes a separate benchmark failure and is also subject to a 10% withholding. The
total potential withholding allowable is 20% the first year. If the deficiency is not
corrected, the allowable penalty withholding increases to 30% in year two and 40% in
year three.
Regional Epidemiology Support:
For those Recipients receiving additional funds to provide workspace for Regional
Epidemiologists, the grantee must provide adequate office space, telephone connections,
and high-speed Internet access. The position must also have access to fax and
photocopiers.
PROJECT TITLE: Regional Perinatal Care System
Start Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
The aim of the Regional Perinatal Quality Collaboratives (RQPCs) is to develop data -
driven innovative strategies and efforts that are tailored to the strengths and challenges
of each region to improve maternal, infant and family outcomes; especially looking at
preterm birth, very low birth weight infants, low birth weight infants, and maternal health.
Furthermore, RPQCs ensure statewide alignment with the strategies and goals outlined
in the Michigan Mother Infant Health and Equity Improvement Plan (MIHEIP) and are
tasked with addressing disparities in birth outcomes and health inequities. Each RPQC
engages cross -sector, diverse stakeholders and implements evidence -based, or
promising practice, interventions utilizing quality improvement methodology.
Reporting Requirements (if different than agreement language):
The Grantee shall submit the following reports on a quarterly basis:
• Report on Aim statement, measures and corresponding outcomes, as identified by
the grantee and MDHHS, through submission of quarterly progress reports
• RPQCs will submit quarterly narrative reports summarizing efforts of member
agency activities, including participation and status of other MDHHS initiatives and
the composition and number of attendees at each Collaborative meeting. This
report will be submitted with the quarterly progress report to the Contract Manager,
Emily Goerge, via email at: GoeraeE(a)michigan.gov. A template for the narrative
report will be provided.
• RPQCs will be required to report on the number of participants with 'active
membership' in their quarterly progress reports. See definitions below for what
qualifies as 'active membership'.
Any such other information as specified above shall be developed and submitted by the
Grantee as required by the Contract Manager.
Any additional requirements (if applicable):
• In alignment with the Regional Perinatal Quality Collaborative's (RPQC) role of
authentically engaging families and convening diverse stakeholders, the
Collaborative must be comprised of a multi -stakeholder and diverse membership;
ensuring to recruit families, faith -based organizations, clinicians, Medicaid Health
Plans, community -based organizations, business partners, and etcetera.
MDHHS stresses the importance of garnering the input and feedback of families
most impacted by adverse birth outcomes. Therefore, continuing in fiscal year
2021, there must be family representation in the RPQC's membership
o Family engagement is essential to the success of the RPQCs and can be
fostered via various avenues, for example: family groups through Great
Start Collaborative and Children Special Health Care Services, community
centers, local churches, focus groups, parent panel and etcetera
RPQCs are expected to convene periodic (with frequency of at least quarterly)
collaborative meetings, inclusive of diverse regional partners, to garner feedback
and discussion, including but not limited to, regional maternal and infant vitality
concerns, review of data, analysis of gaps in care and birth outcomes, quality
improvement efforts, alignment with the Mother Infant Health and Equity
Improvement Plan and etcetera
o The collaborative meetings are to be in addition to any leadership or
steering team meetings that the RPQC may choose to convene as
oversight for the RPQC
Definitions
Active membership is defined as attending a minimum of two (2) Collaborative
meetings, participating in RPQC quality improvement efforts, reporting out on their
respective agency's efforts related to maternal and infant mortality, and etcetera
Family active membership is defined as a family presence at a minimum of 2
Collaborative meetings and/or garnering family input at least twice per fiscal year
o Family and community presence should comprise 10% of the RPQC's
active membership
Membership must include:
• Families
• Clinicians
• Community -based organizations
• Local public health
• Medicaid health plans
• Faith -based organizations
• Business partners
• Others
• To ensure regional stakeholders are aligned with the Mother Infant Health and
Equity Improvement Plan (MIHEIP), RPQCs will need to infuse maternal and infant
Statewide initiatives into their Collaborative (example: MMMS, FIMR, MI AIM,
CDR, etc.)
o Each Collaborative should have dedicated time during meetings for
members to share updates, as well as time for reporting out on
participation in other Statewide initiatives
o Beginning in fiscal year 2021, RPQCs will specifically be required to:
• Invite MI -AIM leads to share region -specific MI -AIM efforts at
two (2) fiscal year 2021 collaborative meetings. A list of MI -
AIM leads in the region can be obtained from your assigned
State consultant
• Know the MI -AIM designation status of the birthing hospitals
in their respective region
• The names and titles of the RPQC leadership, and the Quality Improvement
project team leads, for fiscal year 2021, must be identified on the work plans
submitted to the Contract Manager via email, GoeraeE(a).michiaan.00v
• Selected quality improvement objective(s), and corresponding evidence -based or
promising practices intervention(s), must align with the MIHEIP.
All quality improvement efforts must:
• Be inclusive of addressing health inequities, the social
determinants of health and actively address disparate
outcomes
• Utilize quality improvement methodology
• Be data -driven
• Utilize evidence -based and/or promising practices
interventions that address improving outcomes for mothers,
infants and families
• As the RPQCs are a conduit to the community, the region must provide
representation at MIHEIP-related MDHHS meetings, such as the Mother Infant
Health and Equity Collaborative (MIHEC) meeting and the State Perinatal Quality
Collaborative meetings (i.e., RPQC Leadership meetings)
• In -person attendance is required, unless prior approval
received from State consultant
° For MIHEC meetings, each RPQC should have two
attendees present, with at least one representing the
leadership team
° For the bi-annual State Perinatal Quality Collaborative
meetings, at least two members of the RPQC
leadership team are required to attend
• Each region will be required to report on their efforts,
challenges, successes and etcetera at one of the quarterly
MIHEC meetings
Regional collaborative leadership is expected to work collectively with assigned
State consultant and other members of the MIHEIP team
Budget Allowances
To ensure most of the awarded funding is funneled into the community for quality
improvement efforts:
• Budgets line items for external consultants must be capped at 25% for
contractors/consultants who have been hired as subject matter experts
• Budgets must be capped at 75% for contractors hired to carry out the
quality improvement tasks of the collaborative
PROJECT: SEAL! Michigan Dental Sealant
Beginning Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
SEAL! MI is the School Based Dental Sealant Program, providing oral health prevention
to students in Michigan schools.
Reporting Requirements (if different than contract language)
Quarterly Report Dental Sealant Tracking Form's at the end of each quarter
to the Michigan Department of Health and Human Services Oral Health
Program.
Submit completed copies of the SEAL! MI MDHHS Student Data and Event
Data forms within two weeks of the end of the fiscal year and upon request.
Reports and information shall be submitted to the Contract Manager:
Jill Moore RDH, BSDH, MHA, EdD
School Oral Health Consultant
Division of Child and Family Programs
P.O. Box 30195
Lansing, MI 48909
517-241-1502
MooreJ 14(amichioan.gov
The Contract Manager shall evaluate the reports submitted for their completeness
and adequacy.
The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by Contract Manger.
Any additional requirements (if applicable)
All program staff (paid and unpaid) must attend the annual SEAL! MI
Training via webinar.
At least one person from program must attend the SEAL! MI Annual
Workshop, in person, all day.
All monies collected from insurance billing from dental sealants must be
allocated back into the SEAL! MI program (equipment, staff, supplies,
travel, incentives etc.).
• There must be one EXTRA complete treatment set up available for program
use in the event of equipment failure (including: portable dental unit, curing
light, Isolite other isolation system, patient chair, operator light and operator
chair).
0 Patient privacy screens must be available for use
PROJECT TITLE: Sexually Transmitted Disease (STD) Control
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Sexually Transmitted Diseases (STDs) result in excessive morbidity, mortality, and health
care cost. Women, especially those of child-bearing age, and adolescents are particularly
at risk for negative health outcomes. Local health STD programs ensure prompt reporting
of cases, provide screening and treatment services for Michigan's citizens, and respond to
critical morbidity increases in their jurisdiction.
Reporting Requirements (if different than agreement language):
How to
Report Period Due Date(s) Submit
Report
Email to:
STD 340E Tracking Report Quarterly 10 days after the end MDHHS-
of the quarter HIVSTDoperation
s@michigan.gov
Any additional requirements (if applicable):
Grant Program Operation
1. For medical providers that identify 5% or more of the County's gonorrhea,
chlamydia, and/or syphilis morbidity, the local STD program will contact them at
least annually to review provider screening, reporting, treatment, and partner
management methods.
2. Participate in technical assistance/capacity development, quality assurance, and
program evaluation activities as directed by Division of HIV and STD
Programs/Sexually Transmitted Disease (DHSP/STD).
3. Implement program standards and practices to ensure the delivery of culturally,
linguistically, and developmentally appropriate services. Standards and practices
must address sexual minorities.
4. For gonorrhea and chlamydia cases in the Michigan Disease Surveillance System,
50% shall be completed within 30 days and 60% within 60 days from the date of
specimen collection.
5. For gonorrhea and chlamydia cases, develop plans to respond to issues in quality,
completeness, and timeliness.
Mandatory Disclosures
1. Inform DHSP/STD at least two weeks prior to changes in clinic operation (hours,
scope of service, etc.).
PROJECT TITLE: Sexually Transmitted Disease (STD) Specialty Services
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Sexually Transmitted Diseases (STDs) result in excessive morbidity, mortality, and health
care cost. Women, especially those of child-bearing age, and adolescents are
particularly at risk for negative health outcomes. Local health STD programs ensure
prompt reporting of cases, provide screening and treatment services for Michigan's
citizens, and respond to critical morbidity increases in their jurisdiction. In addition, the
purpose of this project is to provide specialty STD clinical service with a focus on the
LGBTQ+ community.
Reporting Requirements (if different than agreement language):
How to
Report Period Due Date(s) Submit
Report
Quarterly Progress Report Quarterly 30 days after the end Email toof the quarter MDHHS
contract liaison
Any additional requirements (if applicable):
Mandatory Disclosures
Inform DHSP/STD at least two weeks prior to changes in clinic operation (key
staff, hours of operation, scope of service, etc.).
PROJECT: Tuberculosis Control
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Each Grantee as a sub -recipient of the CDC Tuberculosis Elimination Cooperative
Agreement shall conduct activities for the purposes of tuberculosis control and
elimination.
Funds may be used to support personnel, purchase equipment and supplies, and
provide services directly related to core TB control front-line activities, with a
priority emphasis on DOT (Directly Observed Therapy) and electronic DOT, case
management, completion of treatment and contact investigations.
• Funds may also be used to support incentive or enabler offerings to mitigate
barriers for patients to complete treatment.
• Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds to
purchase anti -tuberculosis medications or to pay for inpatient services.
• Examples of appropriate incentive/enabler offerings include retail coupons, public
transit tickets, food, non-alcoholic beverages, or other goods/services that may be
desirable or critical to a particular patient.
For more information and suggested uses of incentive/enabler options, refer to CDC's
Self -Study Module #9, Enhancing Adherence to Tuberculosis Treatment at
http://www. cdc.gov/tb/education/ssmod ules/module9/ss9reading3, htm.
Reporting Requirements (if different than contract language)
DOT Logs are maintained on site and available if needed. All other data must be entered
into MDSS as stipulated in contract specific requirements.
Ensure that confidential public health data is maintained and transmitted to the
Department in compliance with applicable standards defined in the "CDC Data Security
and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted
Diseases, and Tuberculosis Programs"
httr)://www.cdc.aov/nchhsti)/r)rooramintearation/docs/PCSIDataSecuritvGuidelines.pdf
Any additional requirements (if applicable)
• Utilize DOT as the standard of care to achieve at minimum 80% of TB cases enrolled
in DOT or electronic DOT (Jan 1- Dec 31).
• Document in Michigan Disease Surveillance System (MDSS) all changes to
treatment regimen using the Report of Verified Case of Tuberculosis (RVCT)
comments field (pg. 12), and completion of therapy using RVCT Follow -Up 2 (pg.
7).
• Maintain evidence of monthly DOT logs on site (to be made available if
needed). Monthly submission of DOT logs is no longer required.
• Achieve at least 94% completion of treatment within 12 months for eligible TB
cases. The determination of treatment completion is based on the total number of
doses taken, not solely on the duration of therapy. Consult the most current ATS
document Treatment of Tuberculosis for guidance in the number of doses needed
and the length of treatment required following any interruptions in therapy.
• Maintain appropriate documentation on site (to be made available if needed).
Document the appropriate use of expenditures for incentive and enablers for
clients to best meet their needs to complete appropriate therapy.
• Ensure >90% completion of RVCT pages 1 - 6 in MDSS within one month of
diagnosis.
Unallowable Costs per federal guidelines
• Funds cannot be used for procurement of anti -tuberculosis medications.
• Funds cannot be used for research.
• Funds cannot be used for inpatient services
PROJECT: Vector -Borne Disease Surveillance
Beginning Date: 4/1/2021
End Date:9/30/2021
Project Synopsis
This agreement is intended to support the development of vector -borne disease
surveillance and control capacity at the local health department level. Funds may be used
to support a low-cost surveillance system for endemic mosquito and tick species,
endemic vector -borne pathogens, and/or the early detection of invasive vector species or
pathogens at the community level. This information can be utilized by participating local
health departments to notify its citizens of any local transmission risk using education
campaigns, and to potentially work with local municipalities to conduct vector control
activities such as drain management, scrap -tire campaigns, breeding site removal,
landscape modifications, or pesticide application. Requirements for participation in this
program include providing for the placement of a minimum number of mosquito traps
and/or a minimum number of field collections of ticks, identifying ticks and mosquitoes,
and weekly reporting to MDHHS of surveillance results.
Reporting Requirements (if different than contract language)
Quarterly financial status reports (FSR's) will be required for this new project. Due dates
and periods covered are listed below:
Activitv Period: FSR Due:
Jan 1 — March 31 April 15
April 1 —June 30 July 15
July 1 — Sept 30 October 15
The subrecipient shall submit weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe(a-_ michiaan.aov) Kim
Signs (signsk@michigan.gov) at the MDHHS EZID Section.
Any additional requirements (if applicable)
• Mosquito and/or Tick Surveillance
Minimum recommended mosquito and tick surveillance effort according to the
point formula in Table 1 (below) over a period of 16 weeks.
Provide weekly reporting of surveillance results to MDHHS EZID Section (see
contact information below).
• Use surveillance data to notify the public of risks related to vector borne disease in
mosquitoes or ticks in the jurisdiction.
• The total funds allocated for this project to participating local health departments
must be utilized prior to September 30, 2021.
Each local health department as a sub -recipient of the State of Michigan Emerging
Public Health Funds shall conduct activities for the purposes of mosquito and tick
surveillance in their jurisdiction. For mosquito surveillance, funds may be used to
support personnel, to purchase equipment and supplies related to conducting
mosquito surveillance in areas of historically high incidence of WNV, and to
produce and/or distribute educational and other materials related to mosquito -
borne disease prevention and control. For tick surveillance, funds may be used to
support personnel, to purchase equipment and supplies, and to produce and/or
distribute educational and other materials related to tick -borne disease prevention
and control.
Activities can be conducted according to the needs of the local jurisdiction but
must conform to the point allocation formula in the table below. Each activity listed
is awarded 2 points and a local jurisdiction must accumulate at least 64 points
during the funded timeframe (April 1-Sept.30). Mosquito surveillance and tick
surveillance have required minimum efforts totaling 34 points. The remainder of
the required points (30 points) may be accomplished according to the needs of the
local health department. For instance, if mosquitoes are more of a concern in the
jurisdiction, the funded LHD can focus its efforts on mosquito surveillance,
educational activities, etc. If ticks are more of a concern in the jurisdiction, the
funded LHD can focus its efforts on tick surveillance, educational activities, etc.
Table 1. Local Health Department VBD Surveillance Project, Point Allocation Formula
Activity
5 BG-2 mosquito traps placed
for 24-hour period
2 BG-2 mosquito traps placed
for 24 hour period in August
1,000 meter tick drag 000
Educational outreach activity /
event
Press release
Coordination of control efforts
with local municipalities / other
prevention efforts
Points
I Required
Total Points Metric Evaluation
I
Points / Weeks
Method
2
20/10
At least 20 Report to
MosquitoNET
(CDC)
2
214
At least 8 Report to
MosquitoNET
(CDC)
2
4/ 2
At least 4 I Report to MDHHS
2
Report to MDHHS
2 1 ReporttoMDHHS
2 Report to MDHHS
Total Points: Must equal at
least 64
PROJECT: WEST NILE VIRUS COMMUNITY SURVEILLANCE
Beginning Date: 5/1/2021
End Date: 9/30/2021
Project Synopsis
This agreement is intended to support the development of a low-cost surveillance
system for the early detection of West Nile virus in mosquitoes at the community level,
for the purpose of educating the public and healthcare providers and preventing
outbreaks. This information can be utilized by participating local health departments to
notify its citizens and healthcare providers of any local transmission risk using education
campaigns, press -releases and other means, and to potentially work with local
municipalities to conduct mosquito population mitigation activities such as drain
management, scrap -tire campaigns, breeding site removal, larviciding, and adulticiding.
Requirements for participation in this program include providing for the placement of a
minimum number of mosquito traps, operating for at least two "trap nights" per week,
identifying mosquitoes, and weekly reporting to the Department of surveillance results.
Reporting Requirements (if different than contract language)
The Grantee shall submit weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe@michigan.gov),
and Kim Signs (signsk@michigan.gov) at the MDHHS EZID Section.
Any additional requirements (if applicable)
Each Grantee as a sub -recipient of the Centers for Disease Control and Prevention
(CDC) Epidemiology and Laboratory Capacity Cooperative Agreement shall conduct
activities for the purposes of West Nile virus (WNV) surveillance among mosquito
populations in their jurisdiction. Funds may be used to support personnel and travel, to
purchase equipment and supplies related to conducting mosquito surveillance in areas
of historically high incidence of WNV, and to produce and/or distribute educational and
other materials related to West Nile virus prevention and control.
Mosquito Surveillance:
Minimum recommended mosquito traps for this project is 5 traps utilized per
county, operating 2 nights per week for a total of 10 "trap nights" per week for
approximately 16 weeks.
• Provide weekly reporting of surveillance results to the Department EZID Section
(see contact information below).
Use surveillance data to notify the public and healthcare providers of any risk
related to West Nile Virus in mosquitoes in the jurisdiction.
• The total funds allocated for this project to participating local health departments
must be utilized prior to September 30.
The Department's Emerging & Zoonotic Infectious Diseases (EZID) Section will provide
the Grantee with the following support:
• Training for staff associated with the project (Spring 2021)
• Trapping equipment necessary to collect mosquitoes (traps, batteries, chargers)
• VecTOR test kits for the rapid, field detection of West Nile Virus
• Entomologic and epidemiologic support to guide trapping efforts
PROJECT TITLE: WISEWOMAN
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
WISEWOMAN (Well -Integrated Screening and Evaluation for Women Across the Nation)
is a program designed to screen women for chronic disease risk factors, counsel them
about lifestyle changes to reduce risk factors, and refer them for medical treatment of
hypertension, hyperlipidemia, and/or diabetes mellitus.
Reporting Requirements (if different than agreement language):
Any additional requirements (if applicable):
A statewide database called MBCIS is maintained by MDHHS and the Cancer Prevention
and Control Section (CPCS). Instructions for contractor use of MBCIS are provided in
manuals for programs that contribute data to this database. The CPCS will exchange
relevant program reports with appropriate contractors through a secure file transfer
system, as noted in the same program manuals.
For specific WISEWOMAN Program requirements, refer to the most current
WISEWOMAN Program Policies and Procedures Manual.
WISEWOMAN Entrepreneurial Gardening Program North Region Coordinator
Project Synopsis:
The Entrepreneurial Gardening Program North Region Coordinator will coordinate the
Entrepreneurial Gardening Program in the Northern Lower Peninsula WISEWOMAN
Counties, train participants in gardening skills and garden design, assist in the purchase
of garden materials and supplies based on appropriated project budget, and coordinate
trainings that strengthen participants understanding of sales and marketing skills at area
farm markets for greatest impact.
Reporting Requirements (if different than agreement language):
The Entrepreneurial Gardening Program North Region Coordinator will provide updates
on monthly Gardening Coordinator Conference Calls.
Any additional requirements (if applicable):
The WISEWOMAN Entrepreneurial Gardening Program North Region Coordinator funds
will not be subject to the caseload performance requirement. Therefore, these funds will
not be included in the settlement that may be required if screening levels do not meet the
caseload performance requirement.
WISEWOMAN Entrepreneurial Gardening Program
Project Synopsis:
The WISEWOMAN Entrepreneurial Gardening Program will work with current
entrepreneurial gardeners to plan for the coming year and will recruit new participants
into the program. The program will train participants in gardening skills and garden
design, assist in the purchase of garden materials and supplies based on appropriated
project budget, and coordinate trainings that strengthen participants understanding of
sales and marking skills at area farm markets for greatest impact.
Reporting Requirements (if different than agreement language):
The local Gardening Coordinator will provide updates on monthly Gardening Coordinator
Conference Calls.
Any additional requirements (if applicable):
The WISEWOMAN Entrepreneurial Gardening Project will be subject to a 100%
performance requirement. The Department will only reimburse for clients enrolled and
participating in the Gardening Project. Any unused funds will be returned to the
Department.
PROJECT: Women Infant Children (WIC)
WIC Breastfeeding
WIC Migrant
WIC Resident
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
A Financial Status Report (FSR) must be submitted to the Department on a
quarterly basis by deadlines as defined by MDHHS Expenditure Operations.
Grantees shall (when requested) annually report expenditures on a supplemental
form, if needed and required, to be provided by the Department and attached to the
final Financial Status Report (FSR) which is due on November 30 after the end of the
fiscal year through the MI E-Grants system.
• As part of the Breastfeeding Peer Counseling Grant, the Grantee must submit
quarterly progress reports to the State Breastfeeding Peer Counselor
Coordinator (or designee) by the 15rh of the month following end of quarter.
• Funds allocated for the Breastfeeding Peer Counseling Program are exempt
from the WIC Nutrition Education and Breastfeeding Time Study.
Additional Requirements
• The Grantee is required to comply with all applicable WIC federal regulations,
policy and guidance.
The Grantee is required to comply with all State WIC Policies.
• The Grantee is required to complete the NE and BF Time Study as instructed by the
MDHHS WIC Program. Breastfeeding Peer Counseling grant, if supported with
funds allocated through the WIC funding formula, must report as time study data.
• The Grantee must follow the allowable expense guidelines provided by USDA
FNS for the Peer Counselor Grant.
The primary purpose of these funds is to provide breastfeeding support services
through peer counseling to WIC participants. The Grantee must follow the
staffing requirements as set forth in the Loving Support Model and through
signed allocation letter for the Breastfeeding Peer Counseling Grant.
• Comply with the requirements of the WIC program as prescribed in the
Code of Federal Regulations (7 CFR, Part 246) including the following special
provisions from Part 246.6 (f)(1)(2):
(f) Outreach/Certification In Hospitals. The State agency shall ensure that
each local agency operating the program within a hospital and/or that has
a cooperative arrangement with a hospital:
(1) Advises potentially eligible individuals that receive inpatient or
outpatient prenatal, maternity, or postpartum services, or that accompany
a child under the age of 5 who receives well -child services, of the
availability of program services; and
(2) To the extent feasible, provides an opportunity for individuals who may
be eligible to be certified within the hospital for participation in the WIC
Program. [246.6(F)(1)].
The Grantee 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.
• The Grantee is required to operate the Project FRESH Program within the
guidelines as laid out in the "WIC Project FRESH Local Agency Guidebook"
The Grantee is required to abide by the Dissemination License Agreement
between Michigan State University and Michigan Department of Health and
Human Services for "Mothers in Motion." Any use of these licensed materials in
the provision of program related services is subject to the terms and conditions
outlined in the licensure agreement, which is included in Addendum 1, as
reference.
WIC Resident Services/Migrant/Breastfeeding Peer Counseling Grant Training and
Education Requirements:
The Grantee is required to comply with MI -WIC Policy 1.07L Staff Training Plan as
detailed for applicable staff as it pertains to all State WIC training opportunities.
3PP7Li 11 ',..
Dissemination License Agreement for"Mothers in Motion"
Between
Michigan State University
And
Michigan Departmentof Health and Human Services
This License Agreement ("Agreement" J, effective asof October 16, 2015 ("Effective Date'), is made by and
between Michigan State University, having offices at 325 E. Grand River, Suite 350, East Lansing, MI
48823 ("Licensor") and State of Michigan Department of Health and Human Services Women, Infants
and Children, having offices at 320 S. Walnut, Lansing, MI 48913 ("Licensee") (individually a "Party" and
collectively, the'Parties").
WHEREAS, Licensor has created the "Mothers in Motion" materials (herein, "Physical Materials"), MSU
reference number TEC2015-0036 utilizing funds from a grant from the National Institutes of Health (NIH),
grant number 1 RI8-DK083934-01A2 ("Grant').
WHEREAS, Licensor istheownerofcertain rights, title and interest in the Physical Materials and has the
right to grant licenses thereunder.
WHEREAS, Licensee wishes to license the Physical Materials for dissemination purposes and Licensor, in
orderto meet its obligations underthe NIH grant, desires to grant such license to Licensee on the terms
and conditions herein.
WHEREAS, Licensee wishes to obtain this Agreement in orderto carry outthe intent of their master
agreement between Licensee and Licensor with an effective date of FY 2015-2016.
NOW THEREFORE, the parties agree as follows:
I. Definitions.
a.'PhysicalMaterials" shall mean all physical items listed in Schedule A.
b. 'Sublicenseable Materials" shall mean one electronic copy of the Physical Materials.
c. 'Materials Modification Guide" shall mean the specifications outlined in Schedule B.
d.'Derivative Works" means all works developed by Licensee or Sublicensee which would be
characterized as derivative works of the Physical Materials and/or Sublicenseable Materials under the
United States Copyright Act of 1976, or subsequent revisions thereof, specifically including, but not limited
to, translations, abridgments, condensations, recastings, transformations, or adaptations thereof, or works
consisting of editorial revisions, annotations, elaborations, or other modifications thereof. The term
"Derivative Work" shall not include those derivative works which are developed by Licensor.
e. "Sublicense" means an agreement which maytake the form of, but is not limited to, a sublicense
agreement, memorandum of understanding, or special provisions added as an amendment to an existing
agreement between Licensee and a Sublicensee in which Licensee grants or otherwise transfers any of
the rights licensed to Licensee hereunder or other rights thatarerelevantto usingthe Sublicenseable
Materials.
AGR2015-01 146 1
TEC2015-0036
f. "Sublicensee" means any entity to which a Sublicense is granted.
1. Grant of License
1.1 Subject to the terms and conditions of this Agreement, to the extent that Licensee's rights to
Physical Materials as a result of Licensor's grant of rights to the Federal Government in accordance
with the terms and conditions of the Grant are insufficient for Licensee's activities hereunder,
Licensor hereby grants to Licensee a nonexclusive, nontransferable, worldwide, license to use,
perform, reproduce, publically display and create Derivative Works (as outlined in the Physical
Materials Modification Guide) of the Physical Materials. Notwithstanding the foregoing, Licensee
may only distribute the Physical Materials within Licensee managed locations within the state of
Michigan. Licensee is not permitted to sell or receive consideration for any of the Physical Materials
or reproductions of the Physical Materials.
1.2. Licensor grants Licensee the right to grant Sublicenses of its rights under Section 1.1 of
the Sublicensable Materials to Sublicensee for the sole purpose of placing the content contained
in the Sublicenseable Materials on a website that is controlled by Sublicensee and that is
access limited, password protected. Any Sublicense shall be in accordance with Article 3 below.
Sublicensee may be granted the right to create Derivative Works of the Sublicenseable Materials
limited to that which is described in the Materials Modification Guide and only to ensure that the
Sublicenseable Materials meet - technical specifications necessary to place the content contained
in the Sublicenseable Materials on Sublicensee's controlled website. Notwithstanding the
foregoing, Sublicensee may create split-up lessons (meaning placing the content of a full-length
lesson into multiple videos) of the full-length lessons contained in the DVD portion of the
Sublicenseable Materials only in order to conform to the technical format of Sublicensee's
website platform; the content, however, shall not be modified. Sublicensee is not permitted to
sell or receive consideration for the Sublicenseable Materials in any format. Any content created
solely by Sublicensee that supports the implementation of the Sublicensable Materials shall be
owned by Sublicensee. If Derivative Work is created by Sublicensee, Sublicensee shall own their
creative contribution to the Derivative Work and Licensor retain all copyright rights to the original
Sublicensable Materials contained in such Derivative Work. Licensee and Sublicensee may address
ownership of Sublicensee's creative contribution to Derivative Works in the Sublicense
agreement.
1.3 In such incidences where, for financial reasons, Licensee is not able to reproduce the
label displayed on the original master copy of the DVD portion of the Physical Materials,
Licensee must ensure that the entire content of the DVD portion of the Physical Materials are
reproduced in its entirety so that the inclusion of the copyright notice, Licensor owned logos
(including wordmark), grant number information, title of each lesson, and acknowledgements are
maintained.
1.4 Except as provided in Section 1.2 and 1.3, Licensee will refrain, and shall require
Sublicensees to refrain, from using the name of the Licensor in publicity or advertising without
the prior written
approval of Licensor. Notwithstanding the foregoing, Licensee may, without- prior approval from
Licensor, use Licensor's name in a manner that is (a) informational in nature (i.e. describes
the existence, scope and/or nature of the relationship of the Parties and/or the fact that the
Physical Materials were developed by Licensor), (b) does not suggest Licensor's endorsement of
Licensee or its goods or services, (c) does not create the appearance that the source of the
communication is Licensor or any party other than Licensee, and (d) otherwise consistent with the
terms of the Agreement.
AG R2015-01 146 2
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Except as described in Section 1.2 and 1.3 and this Section 1.4, the use of the name of the Licensor
does not extend to any trademark, logo, or other name or unit of Licensor.
1.5 Licensor shall provide Physical Materials to Licensee by October 31, 2015, Licensor assumes
no responsibility for distributing Physical Materials to the state of Michigan Licensee locations.
2. Licensor's Rights
2.1 Notwithstanding the rights granted in Article I hereof, Licensee acknowledges that all right,
title and interest in the Physical Materials, including any copyright applicable thereto, shall
remain the property of Licensor and/or the third party rights holders. With the exception of the
portion contributed by Licensee or Sublicensee in a Derivative Work of the Physical Materials,
Licensee or Sublicensee shall have no right, title or interest in the Physical Materials, including any
copyright applicable thereto, except as expressly setforth in this Agreement.
2.2 Any rights not granted hereunder are reserved by Licensor and/or the third party rights holders.
2.3 As of Licensor's present knowledge, MSU Extension (which is a unit within Licensor) is the
copyright holder of the pizza recipe included in the Physical Materials. If Licensor is notified that
a third party is the copyright holder to the pizza recipe, Licensor will in good faith attempt to secure
the copyright rights from the third party rights holder in order for Licensor, Licensee and
Sublicensee to maintain using the Physical Materials as described in the Agreement herein. In the
event Licensor is unable to secure such rights, Licensor will use reasonable efforts to identify a
replacement for such third party material.
3. Sublicense
3.1 (a) Any Sublicense entered into hereunder (i) shall contain terms no less protective of
Licensor's rights than those set forth in this Agreement, (ii) shall not be in conflict with this
Agreement, and (iii) shall identify Licensor as an intended third party beneficiary of the Sublicense.
Licensee shall provide Licensor with a complete electronic or paper copy of each Sublicense within
thirty (30) days after execution of the Sublicense. Licensee shall provide Licensor with a copy of
each report received by Licensee pertinent to any data produced by Sublicensee that would pertain
to the report due under Section 4. Licensee shall be fully responsible to Licensor for any breach of
the terms of this Agreement by a Sublicensee. Licensee and Sublicensee may address ownership of
Sublicensee's creative contribution to Derivative Works in the Sublicense agreement.
(b) Upon termination of this Agreement for any reason, all Sublicenses shall terminate. If
a Sublicensee was in compliance with the terms of its Sublicense in effect on the date of
termination, Licensor may grant such Sublicensee that so requests, a license with terms and use _
rights as are acceptable to Licensor. In no event shall Licensor have any obligations of any
nature whatsoever with respect to (i) any past, current or future obligations that Licensee may have
had, or may in the future have, for the payment of any amounts owing to any Sublicensee,
(ii) any past obligations whatsoever, and (iii) any future obligations to any Sublicensee beyond
those set forth in the new license between Licensor and such Sublicensee.
AG R2015-01 146 3
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4. Consideration
Inconsideration of the rights granted herein, Licensee will provide to Licensor two effectiveness and
utilization data reports based on the use of the Physical Materials. One data report shall include:
a) number of clients who access the Physical Materials lessons; h) number of times specific lessons
are completed; c) number of unique users; d) client perceptions for useful ness and helpfulness of
lessons; and e) client beliefs in relation to ability to make changes based on lesson completion and
shall be due to Licensor two years from the Effective Date and one data report containing the
same data as described above shall be due thirty (30) days after the end of the five (5) year term.
The reports shall be sent to Mci-Wei.Chang@.ht.msu.edu and msulagrr@msu.edu.
5. Diligence
Licensee shall use its reasonable efforts to disseminate the Physical Materials in a fashion that
Licensee determines aliens with its mission in order to provide public benefit.
6. Term and Termination
6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five
(5) years unless earlier terminated in accordance with paragraph 6.2 hereof.
6.2. In the event that either Party believes that the other has materially breached any obligation
under this Agreement, such Party shall so notify the breaching Party in writing. The breaching
Party shall have thirty (30) days from the receipt of notice to cure the a Ileged breach and to notify
the non -breaching Party in writing that said cure has been affected. Ifthe breach is not cured
within said period, the non- breaching Party shall have the right to terminate the Agreement without
further notice.
1.3 Effect of Termination.
6.3.1 Upon termination, Licensee shall cease using, distributing and displaying the Physical
Materials, and shall confirm in writing to Licensor that the Physical Materials have either been
returned to Licensor or have been destroyed (in Licensor's sole discretion). All Sublicenses shall
terminate upon termination of this Agreement pursuant to Section 3(b).
6.3.2 Upon termination, the following provisions shall survive and remain in effect; 2.1; 4; 6.3; 8.
7. Representations and Warranties
7.1 Licensor and third parties hereby represent that it has. full right, power and authority to enter
into this Agreement and to provide the license of rights granted under this Agreement.
7.2 LICENSOR, INCLUDING ITS TRUSTEES, OFFICERS AND EMPLOYEES, MAKES NO
REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL
MATERIALS AND SUBLICENSEABLE MATERIALS AND HEREBY DISCLAIMS ALL
REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT
LIMITATION, ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR
PURPOSE OR NONINFRINGEMENT. LICENSEE ASSUMES THE ENTIRE RISK
AGR2015-01 146 4
TEC1015-0036
AND RESPONSIBILITY FOR THE SAFETY, EFFICACY, PERFORMANCE, DESIGN,
MARKETABILITY AND QUALITY OF THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS.
WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE PARTIES, INCLUDING THEIR
OFFICERS AND EMPLOYEES, ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND
SUBLICENSEABLE MATERIALS AND DERIVATIVE WORKS ARE PROVIDED "AS IS";(B) NEITHER THE
PHYSICAL MATERIALS NOR SUBLICENSEABLE MATERIALS MAY BE FUNCTIONAL ON EVERY
MACHINE OR IN EVERY ENVIRONMENT; AND (C) THE PHYSICAL MATERIALS AND SUBLICENSEABLE
MATERIALS ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT IS ERROR -FREE OR THAT
LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS.
8. Limitation of Liability
8.1 Each Party acknowledges and represents that it will be responsible for any claim for
personal injury or property damage asserted by a third party and arising out of or related to its acts or
omissions in the performance of its obligations hereunder to the extent that a court of competent
jurisdiction determines such Party to be at fault or otherwise legally responsible for such claim.
8.2 In no event shall either Party be liable to the other Party or to any third party, whether
under theory of contract, tort or otherwise, for any indirect, incidental, punitive, consequential, or
special damages, whether foreseeable or not and whether such Party is advised of the
possibility of such damages.
9. Assignment and Transfer
Neither Party may assign, directly or indirectly, all or part of its rights or delegate its obligations under
this Agreement without the prior written consent of the other Party.
10. Dispute Resolution
10.1 In the event of any dispute or controversy arising out of or relating to this Agreement or
the subject matter hereof, the Parties shall use their best efforts to resolve the dispute as soon as
possible. The Parties shall, without delay, continue to perform their respective obligations under this
Agreement which are not affected by the dispute.
10.2 This Agreement and any disputes arising out of or relating to this Agreement shall be governed
by and construed in accordance with the laws of the State of Michigan without regard to the conflicts of
law provisions thereof. In any action to enforce this Agreement, the prevailing Party will be entitled to
recover reasonable costs and attorneys' fees.
11. Force Majeure
Neither Party shall be liable for damages or subject to injunctive or other relief, or have the right to
terminate this Agreement, for any delay or default in performance hereunder if such delay or default is
caused by conditions beyond its control including, but not limited to, Acts of God or force majeure,
government restrictions (including the denial or cancellation of any necessary license), wars,
insurrections and/or any other cause beyond the reasonable control of the Party whose performance
is affected.
AGR2015-01 146
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12. Entire Agreement
This Agreement constitutes the entire agreement of the Parties and supersedes all prior communications,
understandings and agreements relating to the subject matter hereof, whether orator written.
1A Amendment
No modification or claimed waiver of any provision of this Agreement shall be valid except by written
amendment signed by authorized representatives of Licensor and Licensee.
14 Severability
If any provision of this Agreement is determined to be invalid or unenforceable under applicable law, it
shall not affect the validity or enforceability of the remainder of the terms of this Agreement, and
without further action by the Parties hereto, such provision shall be reformed to the minimum extent
necessary to make such provision valid and enforceable.
15 Waiver
Waiver of any provision herein .shall not be deemed a waiver of any other provision herein, nor shall
waiver of any breach of this Agreement be construed as a continuing waiver of other breaches of the
same or other provisions of this Agreement.
16. Notices
All notices given pursuant to this Agreement shall be in writing and may be hand delivered, or shall be
deemed received within three (3) days after mailing if sent by registered or certified mail, return receipt
requested. Ifany notice is sent by facsimile, confi rmation copies must be sentby mail or hand delivery to
the specified address. Either party may from time -to -time change its notice address by written notice to
the other Party.
If to Licensor:
Licensing Notices:
MSU Technologies
Attention: Agreement Coordinator AGR2015-01146
325 E. Grand RiverSuite350
City Center Building
East Lansing, MI48823
517-884.1605
msutagr@.msu.edu
AGR201 5-01 146
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If to Licensee:
Michigan Department of Health and
Attn: Kristen Hanulcik
Manager, Consultation and Nutrition
320S. Walnut, LewisCass Bldg., 6th
Lansing, MI 48913
517-335-8545
hanulcikk@michigan.gov
17. Article Headings
N.
Human Services, WIC Division
Services Unit
Floor
The Parties have carefully considered this Agreement and have determined that ambiguities, if any, shall not
be construed or enforced against the drafter. Furthermore, the headings of Articles have been inserted
for convenience of reference only and shall not control or affect the meaning or construction of any of the
agreements, terms, covenants or conditions of this Agreement i n any manner.
18 Relationship of Parties
Licensor and Licensee each acknowledge and agree that the other is an independent contractor in the
performance of each and every part of this Agreement and is solely responsible for all of its employees and
students and such Party's labor costs and expenses arising in connection therewith. The Parties are not
partners, joint venturers or otherwise affiliated, and neither has any right or authority to make any statements,
representations or commitments of any kind, or to take any action, which shall be binding on the other Party,
without the priorwritten consent of such other Party.
(remainder of page intentionally left blank)
AG R2015-01 146
TEC201 5-0036
IN WITNESS WHEREOF, the Parties have executed this Agreement by their respective, duly
authorized representative as of the date first above written.
LICENSOR: Michigan State University
Sianature on file Date: 10/15/15
By: Dr. Richard W. Chylla
Executive Director, MSU Technologies
LICENSEE: Stateof Michigan Department of Health and Human Services Women; Infants&
Children
Sianature on file
By: Kim Stephen Date: 10/16/15
Bureau of Purchasing
Michigan Department of Health and Human Services stephenk@michigan.gov
517-241-1196
Sianature on file
By: Stan Bien, Director Date: 10/16/15
WIC Division
Michigan Department of Health and Human Services
320S. Walnut, Lewis Cass Bldg., 6th Floor
Lansing, M148913 biens@michigan.gov
517-335-8448
AGRZO 15-Ql 146 8
TEC2QI 5-0036
Schedule A
Physical Materials
I. Client Materials
A. Mothersin Motion intervention materials
1.260 sets packaged in Mothers in Motion bag. One set includes:
a. I Mothers in Motion DVD set (I set is comprised of 3 DVDs)
b. I looped DVD of Mothers in Motion Overview and Introduction
c. Folder containing Mothers in Motion worksheets (e.g.,"Goaland Plans"and
"Where Do I Go from Here?" worksheets, and stress log) and
reference/guidance sheet detailing contents of each Mothers in Motion lesson
(Total of 11 lessons)
d. 1 CD containing PDF formatted documents of Mothers in Motion worksheets to
accommodate additional printing needs.
2. All Mothers in Motion intervention materials listed above will also be saved on 2
external drives provided by WIC.
II. Staff Materials
A. "Rethinking How We Listen and Respond in WIC" Videos/DVDs
I. 260 "Rethinking How We Listen and Respond in WIC" DVDs [included in Mothers
In Motion bag described above (I DVD per bag)]
2. "Rethinking How We Listen and Respond in WIC" contents saved in video format
on 2 external drives provided by WIC
**All Items listed above will be saved on total of 4 external drives, provided by WIC**
AG R2015-01146 9
TEC2015-0036
Schedule B
Materials Modification Guide
I. Client Materials'
A. Mothers In Motion DVD
I. The following Items are NOT permitted to be altered on DVDs
a. DVD content
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK,1RI8-DK083934-01A2)
iii. All lesson module and intervention content [exception: food label reading if
contents become outdated]
iv. Acknowledgement section
v. Copyrightnotice
b. Label on Disks*
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK,1RI8-DK083934-01A2)
iii. Title of each lesson
iv. Copyright notice
2. Items that may be reproduced
a. Mothers in Motion DVDs
b. CD contains all Mothers in Motion worksheets
B. Mothers In Motion Worksheets
I. The following items are NOT permitted to be altered on worksheets
a. Grant number(NIH-NIDDK, IR18-DK083934-01A2)
b. Mothers In Motion logo
c. Title of each lesson
d. Copyright notice
2. The following items are permitted to be altered on Worksheets
A. Contents in the worksheets
3. Items that may be reproduced
a. All worksheets
b. Reference/guidance sheet detailing contents of each Mothers In Motion lesson
II. Staff Materials '
A. "Rethinking How We Listen and Respond in WIC" Videos/DVD I. Items that are NOT
permitted to be altered on DVD
a. DVD content
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2)
iii. Acknowledgement section
iv. Video/DVD Contents
v. Copyright notice
b. Label on Disks*
i. MSU and Mothers in Motion logo
ii. Grant number (NI H-NIDDK, 1RI8-DK083934-01A2)
iii. Title of each lesson
iv. Copyright notice
AG R2015-01 146 10
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*WIC is allowed to duplicate DVDs without label org rant number on the disks, if necessary, 1 Sublicensee
may create contentthat supports the implementation of the content contained in the
Mothers in Motion DVDs, Mothers in Motion Worksheets and "Rethinking How We Listen and Respond in
WIC"Videos/DVD. Any content created solely by Sublicensee shall be owned in accordance with Section
1.2 and Section 3.1(a). Implementation of the content contained in the Mothers in Motion DVDs, Mothers in
Motion Worksheets and'Rethinking How We Listen and Respond in WIC" Videos/DVD shall be in
accordancewith Section 1.2.
AGR2015-01 146 11
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A nnCAlnt INI'
P1()IAP1--g91-M
Dissemination Licensa Agreement for "Communicate to Motivate„
Among
Michigan Stale University,
Ohio State tunovalion Foundation
Aad
Michigan Department of Health and Human Services
This License Agreement C"Agreemerd!% effective as of lonuary 1, 2017 ("Eftl+Mive Date), is made by
aid among Michigan State University, having offices at 325 E. Grand River, Suite 350, i9nA Lansing,
MI 48823 C MSU"), Ohio State Innovation Foundation, having offices at 1524 N. High Sitcet,
Columbus, O1i 43201 ("OS1F") (together "Lieeme) and State of Michigan Department of Health No
Human Services Women, Infants end Chlidren, having offices at 320 S. Walnut, Lansing, Nil 48913
("Licensee") (individually a "Patty" and calieaffvaly, the "parties" .
WHFW.AS, Licensor has intellectual property rights In the "Communicate to Motivate"'matedals
(hnrchn, "Physical Materlah"), M'SU reference number'1'RC2016-0178, OSU reference nurnberT2017-
132, developed alillxing Reeds from a grant from the National institutes ofHcalth (NIR), grant number
RIB-M-083934-01(40tunt").
WHEREAS, Licensor is the owner of certain rigius, title and Interest In the Physicel Malodalsand has
the sight to grant licenses thereunder.
WHEREAS, Ucemsse wishes to hearse the Physical Materials for diasemination purposes and Licensor
desires to grant such license to Licensee on the terms and conditions hefein.
NOW 114EREFORE, the Parties agree as follows:
L Definitions.
a. "Physical Materia1s"'shall mean all physical items listed in Schedule A.
b. "Sublicensable MaterieV shall mean one elcctronlo copy Of Ike Physical Matstials,
c, "Materials Modification Uulde" shall moan the apool0caWauaouUfned In Schedule H.
d, "Derlvative, Works"" means all works developed by Licensee or Sublicensee which would be
chamolcrixed as derivative works of the Physical Malerials wWGr Subliconsable Materials under
the United States Copyright Act of 1976,or subsequent revisions lhorcoC specifically including,
but not atoned to, translations, abridgments, condensations, rcessflngs, transformations, or
adaptations thereof, or works consisting of editorial revisions, annotations, elaborations, or other
modifications thereof. The term "Derivative Work" shall not include those derivative works
which ate developed byLicemar.
e, "Subliecnso"` mesns an agreement which may take the form of, but is not limited to, a
sublicense agreement, memorandum ofunderatanding, or special provisions added as an
a mchnont to an existing ogrcamoot between Licensee and a Sablhxnseo in which lacansec
grants or otherwise i nmsfhrs any of the rights licensed to Licenses hereunder or othersighis that
are relevant to using Ile Sublicensable Matcrlals.
E "Subllcensee" means any entity to which a Sublicense Is gtemed.
1. Cram of License
1.1 Subject to the terms and conditions of lids Agmentenl. to the extent that Liconsec's rights to
physical Materials as a result of Licensor's grant of rights to the Federal Government to ntcardwe, with
Ott terms and conditions of the Grant arc Insufficient for Liconme's activities hereunder, Licensor
hereby grants to Lioomaea a nonexclusive, nontransferable, worldwide, license to use, perform,
repmduae, publically display the Physical Materials. Lleensee is granted the limited right to create
Derivative Walks of the Physical Materals, specifically Licenneo shall have the right to create
Derivative Works which are (a) companion guidance handouts to the Physical Mmiedals for edueallonal
use by Instructors In the course of employing Physioal Materials, (b) materials for promotion of the
availability of educational opportunities omploying the Physical Materials, and (c) instruments for
collecting evaluations and feedback from course participants. Notwithstanding the foregoing, Mcensm
may only distribute the Physical Materials within Liceosce-managed locations within the state of
Michigan. Licensee is not permitted to sell or receive consideration for any of the Physical Matedals or
reproductions oftho Physical Mnleriais.
1.2. Licensor granis Licensee the right to grant Sublicenses of its rights under Section 1.1 of the
Sublletnsable Materials to Subliconwo for the sole purpose of placing am content containad in the
Subitcensablo Materials (including the videos) an a w6sito that is controlled by Sublicuraee mid that is
access 11roited, password protecled. Any Sublicense shall be In eeoordonce with Article 3 below.
sublicense I$ not permitted to sell or receive consideration for the Sublicensable Materials In any
format Any content created solely by Subliccrtscc that supports the implementallon of the SuMicerisebie
Materials shall be owned by Sublicensae.
1.1 In such incldencos where, for tnanaled reasons, Lieenses la not able to reproduce the Intel
displayed on the original moster copy of the DVD portion of the Physical Matedals, Licensee raust
ensurndhat the entire content of the DVD portion orate Physical Materials are reproduced In Its entirety
so that the inclusion of the copyright notice, grant number information, title of each lesson, and
Otnowledgements aramalmalned.
1.4 Licensee will refrain, and shall require Sublicomsces to rofrtdn, ham using, the name of the
Licensor or Tile Ohio Stale University ("DStf'") lit publicity or advertising without the prior written
approval of Licensor.
1.5 Uiceisor shall provide Phyaleel Materials to Licensee by May 1, 2017. Licensor assumes no
responsibility for distributing Physical Materials to Iha state of Michigan Licensee locations.
2. Llcaasor`o Rights
2A Notwithstanding the tights granted in Article I hereof, Licensee eeknowledgce (hot all right, ark
and interest in the Pityshcat Materials, Including any copyright applicable thereto, shall remain the
propatty of Licensor. Licensee or Sublicensee shall have no right, title or Interest In the Physical
Materials, Including any copyright applicable thereto, except as expressly Bet forth in this Agreement.
2.2 Any rights not granted hereunder at reserved by Licensor.
31 Sublicense
3,1 (a) Any Sublicense entered into hereunder (1) shall contain terms no less protective of
Licensor's rights than those setfbrih in this Agreement, (if)shall not he in conflict with this
AgltNO-0e453 2 OSUA2a17-1172
7Ec2aWo lit
Agreement, and (lit) shall identify Licensor as an intended third party beneficiary of the
Sabllconse, LlcenseeshallprovideLicensorwithaoomplateeleatoardearpapercopyofeach
Subliense within thirty (30) days after execution of the Sublicense. Licensee shall provide
Licensor with it copy of each report received by Licensee pertinent to any data praluced by
Sublieentee that would parts]a to the report due under Sation 4. Licensee shall be fully
responsible to Licensor for any breach of the lorms of this Agreement by a Sublieensee,
(b) Upon termination of this Agreement for any reason, all Sublicenses shall ternddnate, If a
Sublicertsee was in compliance with the terms of Its Sublicense in effect on rho date of
terrninetion, Licensor may grant such Subllcansee that so requests, a license with terms and use
rights as arc acceptable to Licensor. In no event shall Licensor have any obligations of any
natum whalwever with respect to (i) any post, current or Nature obligations that Licensee may
have had, or may irk the future have, for the payment of any amounts owing to any Subficensce,
(ii) any past obligations whatsoever„ and (lit) any future obligations to any Sublicensce beyond
those set faith is the new license between Licensor and such Sublicensce.
d. Consideration
In consideration of the rights gnashed herein, Licensee will provide to Licensor two effectiveness and
utilzationdata reports based on the use ofthc Physical Materials. One data report shall include: a)
number of clients who access the Physical Materials Iossons; b) number of dmosapeollic lessons arc
completed; c)nuntberof unique uscts; d) client petaapliaos for useffrhtess and helpiittnem ofiasaoms;
and o) client beliefs in relation to ability to make changes based on lesson completion and shall be due to
Licensor two yours from the Effective Gate and one data report containing the some dale as described
above shall be due thirty (30) days after the and of the five (5) year term, Such data reports shall
segregata the information provided in a•e by CPA (dietitians and nurses) orbruwifsedingpact
counselors. The reports situp he sent to ehang1572@osu,edo, tnrvovation@nitu.edu and
msutegr@mau,edu.
S. IHllgeuso
Licensee shall use its reasonable efforts to dissemiante the Physical Materials in it fashion Chet Licensee
detennittes aligns with its mission in order to provide public benefit.
6, Tatum and Termination
6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five (5)
yam unless culler tersttlnated in accordance with paragraph 62 hereof. This Agreement may be
rimcwod at extended by written amendment signed by authorized representatives of Licensor and
Licensee in mccordence with Article 13.
6.2. in the event that a Party believes that another party Intl materially breached any obligation under
this Agreement, such Party shall so notli'y the breaching Party in waiting, The buaaehing Party shell have
thirty (34) days from the reeaipt of notice to auto the alleged breach end to nollry the non-breachlog
Party in visiting that amid othra has been affected. If the breach is tint cured within said period, this nun -
breaching Party shell have the right totettntnate the Agreement without further notice.
63 Effeci of Termination.
A092037•00413 3I 05U A2e17-1172
TEM01151o178
6.3.1 Upon larmination, Licensee shall erase using, distributing and displaying the Physical Materials,
and shall confirm in Writing to Licensor that the Physical Materials have either been returned to Licensor
or have been destroyed (in Limsor'ssole discretion), All Subliccoses shall terminate upon termination
of this Agreement purmsat to Section 3(b).
0.2 Upon Wntinatlan, the following provisions shalt survive and remain In effect, 21; 4; 6.3; Ii»
7. Representations and Warraotles
7.1 Licensor represents that to the knowledge of The Ohio State University's and MSU's technology
transfer offices that it has full right, power and authority to enter into this Agreement and to provide the
licanse of rights 1panied under this Agreement.
7.2 LICENSOR AND OSU, INCLUDING THEIR CREATORS, TRUSTEES, OFFICERS,
EMPLOYEES, AGENTS OR AFFILIATED ENTERPRISES WAKE NO REPRESENTATIONS OR
WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL MATERIALS AND
SUBLICENSABLE MATERIALS AND HEREBY DISCLAIM ALL REPRESENTATIONS AND
WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY
WARRANTIES OF MERCHANTA91LITY OR FITNESS FOR A PARTICULAR PURPOSE,
NONINFRINOEMBNT, SAFETY, EFFICACY, APPROVAOIL1TY BY REGULATORY
AUTHORITIES, TIME AND COST OF DEVELOPMENT, OR PATENTABILITY, LICENSEE
ASSUMES THE ENTIRE RISK AND RESPONSIBILITY FOR THE SAFETY, EFFICACY,
PERFORMANCE, DESIC+N, MARXETARILITY AND QUALITY OF THE PHYSICAL
MATERIALS AND SUBLICENSABLE MATERIALS. WITHOUT LIMITING THE OENERALITY
OF THE FOREGOING, THE PARTIES, iNCLUDINO THEIR OFFICERS AND EMPLOYEES,
ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND SUBLICENSABLE
MATERIALS ARE PROVIDED "AS IS'; (B) NEITHER THE PHYSICAL MATERIALS NOR
SUBLICENSABLE MATERIALS MAY OR FUNCTIONAL ON EVERY MACHINE OR IN EVERY
ENVIRONMENT; AND (C) THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS
ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT 18 ERROR -FREE OR THAT
LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS.
& Llmitalion of Liability
B.1 Each Party acknowledges end represents that It will be responsible for any clydm for personal
injury or property dmnsge asserted by a third party and arising out of or rotated to Its acts or omissions
in the perfomumce of itsobligations hereunder to the extent Chet it court of eornpetent jurisdiction
determinas such Party to be at fault or otherwise legally responsible for such ofiden. Nothing in this
Agreement shall be deemed or treated as any waiver of any Potty's sovereign Immunity or Immunity
granted by statule or cesa law, if applicable,
82 In no event shall a Party be liable to another Party or to any third party, Whether under theory of
contract, tort or otherwise, ror any Indirect, incid4ntai, punitive, consequantal, or special damages,
whether foreseeable or not and whether such party Is advised of the possibility of such damages.
9. Assigamant and Transfer^
No Polity may assign, directly or Indirectly, all or part of its rights or delegate let obligations larder 05
Agreement Without the prior written consent of the other Parties.
A010017-00453 4 03UA2017-1177
TEC2016.0179
10. lilsputto Resolution
10.1 In the event of any dispute or controversy arising out of or relating to this Agreement or the
subject matter hereof, The Parties shall use their best efforts to resolve the dispute as soon os possible.
The P+st m shall, without delay, continue In perform their respeolivc obllgallova under Ibis Agreement
which art not aMowd by the disputt.
11, Force Majaure
Na Party shall be liable foe damages or subject to Inlunetive or other relief, or have the right to terminate
ibis Agreemam, for any delay or default in performance hereunder if such May or default is caused by
conditions beyond Its control Including, but not limited to. Acts of God or farce majeure, government
restrictions (including the denial or cancellation of any neeassary licertse), wars, insurrections andlor any
other cause beyond the reasonable control of the Party whose peftmanoe Is att'ected.
12. Entire Agrecwartt
This Agreement cowlitutes the entire agreement of the Portios and sapersedes all prior communications,
understandings and agreements relating to the subject matter hereof, whether oral or written.
11, Amendment
No modification or claimed weiver of any provision of this Agreement shall be valid except by written
amendment sigrrad byautherixed ropms,rtalives aflieeosor and Licensee.
14. Savarability
If any provision of this Agreement is determined to be invalid or unenfercembte under applicable law, it
shall not affect the validity or enforceability or the remainder or the tetras or this Agreement, and
without further action by the Parties hereto, such provision shall be refonnred to the minimuan extent
accessary to snake such provision valid and enforoeabie.
I& Waiver
Waiver of any provision heroin shall not be deemed a waiver of any, other provision herein, nor shall
waiver of any breach of this Agreement bit construed as a continuing waiver of other breaches of Ito
same or other provisions of this Agreement,
2b. Notices
All notleca given pursuant to this Agreement shall be in writing and may be Rend delivered, or $bell be
deemed received within three (3) days aiier malting if sent by registered or certified mail, return recelpt
regaasted. if any notice is sent by rhesimlle, confirmation copies must be sent by mail or hand delivery
to the specified address. Either party may from t1me4o-time change its notice address by written notice
to the other Pasty,
AOR" P-00453 $ OSU A2017-1112
TEC2016-0I Ta
If go Licensor:
MSU Technologies
Atteotion: Agreement Coordinator A6'R2017-00453
325 E. Grand River Suite 354
City Center Building
East Lansing, MI488'23
51 T-884-16t15
a nStatMgaOsn_Stt,M11
Ohio State Innovation Foundalion
1524 M High Street
Columbus, 014 43201
614-292-1315
If to Licensee:
Michigan Department of Heallh and Human Scrvlecs, WIC Divislon
Atto1 Kristen Hanulalk
Manager, Consullatlon and Tlulrition Services Unit
320 S. Walnut, Lewis Cass Bldg„ 6a' Floor
Lansing, MI 48913
517-335-8545
hanuicik L@michlgan.gov
M Artlele Ideadings
The Parties We carefUlly considered this Agreement and bavcdctermined thatambiguilies, irony, shall
not be construed or enrorced against the drafter. 'Furthermore, the headings of Articles have been
Inserted for convenience of reference only and shall not control or affcet the rocaning or construction of
any of line agreements, terms, covenants or conditions of This Atercement In wy muster.
18. Relallonship of Parlles
Liccosor and Lltensee each «clowNvledge and agree that the other is on Independent contractor in the
perfomwce of cash and every part orthis Agreement and is solely responsible for all of its employees
and students and such P'arty's labor costs and a xpcnses arising in connection therewith, The Parties are
not partners, joint venturers or otherwise affiliated, and nelther has any right or authority to rroake any
stalemcras, representations orcarr miimentsofany kind, or to take any nation, whieh shall be bindingon
the other Party, Without the prior written WFINT11 of such enter Party.
A(ALV17.0003 OSU A3017-1172
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IN WITf' ESS 4VE-3E}➢ES31.e, the 3'nrilvq Jaw, cm:oiCii t$t s,n.I;raemcw by a3ralr te:-lo-eel.dva, duly
maticn&u.l re€trescnim[ns as or itic data first at:ovr: w !III,un.
LICE+•N'S0Itt
t'.'iiahl3;o11 State Uldvo"'ity
➢.7r� Richaid C,f}']le .
F%crutive f.)I'r"Itir, msu'FChnwtopuls
Chia State trnnwatian I'Du.itdall;m p
1y: _ rt Dale:21d—f�f C •1T
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LICRNSEEr Starent'twtsc➢titrumMpntnte,tti,fJtuult€titn.€➢3omonScrviccslVonit! rt,€tbftnts&
Chil�frcn r
1'.
,Jeanetrs Henslr'r, L)h-At.tor
Grants Divsslort, Bureau of P'wchasing
SAM" Mcri, Diraetor
y1Plf 33ivasir,:t
Pvt icis'tl;iva 1)c3tttrtn7cn l +e C Hcnl ih Sad 3 [4un ert S rr✓i ecs
RZC➢ 5.'Mulnul, f.rwis f,'n:;ti Bhtg., 6111 Floor
I etghig, hr3 090
hi cr slct nM is h3�,� n •I;uv
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fill R IO 17.00453 i QSU A2017-1' 173
ITC20 t d• tit u
Schedule A
Physleal Materials
A, Communicate to Motivate videos up to 10sels In DVD format
IS lessons: 12 video lessons, raminderand general tip lesson, introduction and preview
B. Rethinking what we think andrespmndinW11Cvideo
C. Tip Shoats— 650 copies (color print, laminated and coil)
D. CDs That contain the follmvting materials related to Communicate to Motivate saved In PDF (up
to 10capie*
a. Tip Sheets;
It, Power point slides of A 12 lessons, reminder and goncrnl tip lesson;
c, St ummy of key points in each video lesson;
d. Instruclions for use of the videos.
E. ICKa nal hard drives (2) thal contain the following mmeriaist
a. Cr nmenisate to aidoiivate videos; 15 video lessons;
h, Rethtmkingwhat wethink ondrespondinWIC video;
e, Tip Shoats In PDF;
d. Pouter point slldos orail 12 lessons, mmmminder and general tip lesson In PDF;
e, Sunmmy of key points In each video lesson In PDFI
f. Instructions for use of the videos In PDF.
AOR201740453 $ OSU A7017-1112
TWMI64170
sew"le B
Materials Medifiaaiian Guide
aceµl as prowlded in Seel%n 1.1, nmdifieallanofPhyslexd Moilodals is not permittO&
MBR29174M3 9 OSUA2017-1172
T 1"179
ackage for Furth
er exPlanation of
F`( 202012021 budget 'Instructions P fund
ent definitions here available. in9
FOO-NOTES-, for elem Program and ber W total State
ramework ram ents
ent and p actual num Of the stem will be made d
Budget F reem lete years the ratio ustments
I.E., fixed unit
(a) Refer to Plan an comprehensive a9 methods* o comp , column by i ad'} based
master ent m ast tW ectatiori calculation erformance
(b) Refer to relmbursem e of the P EXP prior to
of these from the averag er{ptmance bins ) ursement not p column.
17
applicability starting the"Total P " H pand MpxH reimb n by „percent these
S the ardin9
(c) NegOtiatedb multiplying errditures DC and „ colum lanat1On re9
(d) Calculated Y to "Total EXP local funds erforrnance
(DC" 0410e cIne 24quiprnent funded y Target P ackage for further exP
b
Funded Element et instructions P
unallowab ,State and budg
rate, staSfing) ing the agreement
(e) Calculated by r GO
i Y rehensive
Refer to master omp
designations.
CS Care Coordination ear
face -face in the home setting-
0) 1- CS Ma Maria
O es nt(6) se 58 Pe
Provided
Gass Coordinator
A' burseme the Care Co
B Reim that requires
2 ,P,V,e COORpINAT10N e or hOme_like setting
N OF CARE home
$150
P. LEVEL i pLA are in the $100
I Plan ofOc I -Hp site telephone
1. Annua Over the Pe
unit ursed.
to travel to n of Care TION 30.
2 Annual Plan COORpINA
ursed at $ ib10y year will be reim
reimb ti
B. LEVEL 11 GAare Coordinafio er beneficiary Per e g artment
of 15 units P orical health dep
2 A maxim m cate9
d Rates draw for non
Chart for Fixe 0 per blood t° 711
Reimbursement $11.0 P 2 000 nse prior
(2) Categorical annuall I t° $i annual lice after 711,
Non Cate9 $264 071app
$132.041aPPl. annual licef�ense',
AlpS1HN prevention l_ tem ora
Q,i17 531a
°viginal Notes FY 2021
$261.20/appl. renewal prior to 12/1;
$396.11/appl. renewal after 1211;
$26.40duplicate license
CSHCS-Medicaid Elevated Blood Lead Case
$201.58 per home visit, for up to 6 home visits
Management
FDA Tobacco Retailer (A&L) Inspections -
$325.20 per inspection
Oakland only
Fetal Infant Mortality Review (FIMR) Case
$270.00 per case, not to exceed the maximum set for each Grantee
Abstractions
Immunization Assessment Feedback Incentive
$100 per personal visit or $50 for a phone call (with information mailed
Exchange (AFIX) Follow-up
afterward) to the provider office, not to exceed the maximum set for
each individual contractor.
Immunization Nurse Education
$200 per session except Vaccines Across the Lifespan, which is to be
reimbursed at $250 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.
Immunization VFC (only) Provider Site Visits
$150 per site visit, not to exceed the maximum set for each individual
Grantee
Immunization VFC/AFIX Combined Provider Site $350 per site visit, not to exceed the maximum set for each individual
Visits Grantee
Informed Consent $50 per woman served, for each woman that expressly states that she
is seeking a pregnancy test or confirmation of a pregnancy for the
purpose of obtaining an abortion and is provided the services.
Laboratory Services & STD See contract language for gonorrhea and chlamydia testing reimbursement performance
requirements, AIDS
SIDS (FIMR Interviews) $125 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.
Original Notes FY 2021
(4) Funding Source (not a single element). Hearing and Vision are single elements.
(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 MDHHS.
(9) Subject to a match requirement (hard or in -kind) of $1 for each $3 of MDHHS agreement funding for Coordination.
(10) Fixed rate limited to contract amount.
(11) Up to six (6) visits per family.
(12) Non -categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum
of $2,000 annually.
(13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Semi-
annual FPAR data will be used to determine
total Title X users.
(14) Public Health Emergency Preparedness (PHEP) funding BP1 must be expended by June 30 and is subject to a 10%
match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement
Guidance. LHDs must submit a nine -month budget and a quarterly Financial Status Report (FSR) column for this
program element.
(15) Public Health Emergency Preparedness (PHEP) funding for October 1—June 30, and July 1—September 30, is
subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative
Agreement Guidance. LHDs must submit a three-month budget and a quarterly Financial Status Report (FSR)
column for this program element.
(16) Project meets the Research and Development criteria as defined by Title 2 CFR, Section 200.87.
(17) Not Applicable
(18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements.
NOTE: Some footnotes may not apply to this agency.
Original Notes FY 2021
FOOTNOTESFY 2020/2021
(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 starling 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 MDHHS reimbursement not performance based (I.E., fixed unit
rate, staffing).
(a) 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
CARE COORDINATION
A. LEVEL 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 11 Care Coordination is reimbursed at $30.00 per unit
2 A maximum of 15 units per beneficiary per eligibility year will be reimbursed.
(2) Reimbursement Chart for Fixed Rates
AIDS/HIV Prevention Non- Categorical
Body Art
Original Notes FY 2021
$11.00 per blood draw for non -categorical health departments Limited
annually to $2,000
$264.07/appl annual license prior to 7/1;
$132.04/appl. annual license after 7/1,
$117.53/appl temporary license;
Version: Comprehensive
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
FY 20/21 AGREEMENT ADDENDUM A
This addendum adds the following section to Part I and Renumbers existing 11
Special Certification to 12 and existing 12 Signature Section to 13:
Part I
11. Aareement 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, baror 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.
This addendum modifies the following sections of Part II, General Provisions:
Part II
Res Pons i bil ities-Contractor
J. Software Compliance. This section will be deleted in its entirety and
replaced with the following language:
Version: Comprehensive
The Michigan Department of Health and Human Services and the
County of Oakland will work together to identify and overcome
potential data incompatibility problems.
III. Assurances
A. Compliance with Applicable Laws. This first sentence of this
paragraph will be stricken in its entirety and replace with the following
language:
The Contractor will comply with applicable Federal and State laws,
and lawfully enacted administrative rules or regulations, in carrying out
the terms of this agreement.
Health Insurance Portability and Accountabilitv Act. The
provisions in this section shall be deleted in their entirety and replaced
with the following language:
Contractor agrees that it will comply with the Health Insurance
Portability and Accountability Act of 1996, and the lawfully enacted
and applicable Regulations promulgated there under.
IX. Liability. Paragraph A. will be deleted in its entirety and replaced with the
following language.
A. Except as otherwise provided by law neither Party shall be
obligated to the other, or indemnify the other for any third party
claims, demands, costs, or judgments arising out of activities to be
carried out pursuant to the obligations of either party under this
Contract, nothing herein shall be construed as a waiver of any
governmental immunity for either party or its agencies, or officers
and employees as provided by statute or modified by court
decisions.
CSHCS-Medicaid Elevated Blood Lead Case
Management
FDA Tobacco Retailer (A&L) Inspections -
Oakland only
Fetal Infant Mortality Review (FIMR) Case
Abstractions
Immunization Assessment Feedback Incentive
Exchange (AFIX) Follow-up
Immunization Nurse Education
Immunization VFC (only) Provider Site Visits
$261.20/appl. renewal prior to 12/1;
$396 11/appl. renewal after 12/1;
$26 40duplicate license
$201.58 per home visit, for up to 6 home visits
$325.20 per inspection
$270 00 per case, not to exceed the maximum set for each Grantee
$100 per personal visit or $50 for a phone call (with information mailed
afterward) to the provider office, not to exceed the maximum set for
each individual contractor
$200 per session except Vaccines Across the Lifespan, which is to be
reimbursed at $250 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
$150 per site visit, not to exceed the maximum set for each individual
Grantee
Immunization VFC/AFIX Combined Provider Site $350 per site visit, not to exceed the maximum set for each individual
Visits
Grantee
Informed Consent
$50 per woman served, for each woman that expressly states that she
is seeking a pregnancy test or confirmation of a pregnancy for the
purpose of obtaining an abortion and is provided the services.
Laboratory Services & STD See contract
language for gonorrhea and chlamydia testing reimbursement performance
requirements, AIDS
SIDS (FIMR Interviews)
$125 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
Ouginal Notes FY 2021
(4) Funding Source (not a single element). Hearing and Vision are single elements.
(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 MDHHS.
(9) Subject to a match requirement (hard or in -kind) of $1 for each $3 of MDHHS agreement funding for Coordination
(10) Fixed rate limited to contract amount.
(11) Up to six (6) visits per family.
(12) Non -categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum
of $2,000 annually.
(13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Semi-
annual FPAR data will be used to determine
total Title X users
(14) Public Health Emergency Preparedness (PREP) funding BP must be expended by June 30 and is subject to a 10%
match requirement as specified in the Public Health Emergency Preparedness (PREP) Cooperative Agreement
Guidance LHDs must submit a nine -month budget and a quarterly Financial Status Report (FSR) column for this
program element
(15) Public Health Emergency Preparedness (PHEP) funding for October 1—June 30, and July 1—September 30, Is
subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative
Agreement Guidance. LHDs must submit a three-month budget and a quarterly Financial Status Report (FSR)
column for this program element.
(16) Project meets the Research and Development criteria as defined by Title 2 CFR, Section 200.87
(17) Not Applicable
(18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements.
NOTE: Some footnotes may not apply to this agency.
Original Notes FY 2021
FY215pecial Revenue Grant Positions to Continue
Dept. #
FY21 Budgeted Class
FT/PT
Filled As
Pos.#
1060284
00674 Auxiliary Health Worker
FTE
1060230,
00252, Public Health Nurse 111
FTE
1060284
00866,Office Assstant ll
FTE
Wention Specialist -PTNE
1060M.
00906 Public Health Nurse 111
FTE
10602M
00912, Public Health Nutritionist 111
FTE
3060284
00958,Offce Supervisor l
FTE
106D284
01328 Auxiliary Health Worker
FIE
106D235,
01752 Auxiliary Health Worker
FTE
Auxiliary Health Worker-PTNE
1050284
01865,Public Health Nutrition Supervisor
FTE
1060218
02070 Health Program Coordinator
FTE
1060284
02074 Public Health Nutritionist If
FTE
1060234
02436 Vaccine Supply Coordinator
FTE
10602M
02509 N ountion Technioa n - WIC
FTE
1060284
03073, Office Supervisor ll
FTE
1060201
03094 Health Program Coordinator
FIE
1060230,
03107 Public Health Nurse III
FTE
1060230,
03183 Public Health Nurse III
FTE
1060230.
03427 Public Health Nurse III
FTE
1060291
04736, Health Program Coordinator
FTE
10602M
04M Auxiliary Health Worker
FTE
10602M
04A3 Auxiliary Health Worker
FTE
106D292
05128 Student
PTNE
105DZ92
05129 C)i Assstant ll
FTE
1060292
05130, Supervisor PH Nursing
FTE
1060292
05131 Public Health Nurse II
PTNE
1060292
05163,Public Health Nurse III
FTE
Public Health Nurse 11-PTNE
ID60284
05204 Office Assistant II
FTE
1D60284
05205 Auxiliary Health Worker
FTE
1060284
05233,Public Health Nutntiomrt 11
FTE
1060284
05234 Public Health Nutritionist I
FTE
Nutrition Technician - WIC - FTE
1060284
05235,Public Health Nutritionist l
FTE
Nutrition Technician -WIC -FTE
1060201
05246,Ofrice Leader
FTE
Public Health Educator ll -PTNE
1060291
05401. Public Health Nutritionist 11
FTE
1060292
05526 Office Assistant I
FTE
Office Assistant I -PTNE
1060284
05693. Public Health Nutritionist ll
FTE
1060294
06099, Public Health Nurse 111
FTE
1060294
06100 Public Health Nurse 111
FTE
Auxilia ry Health Worker -FTE
1060294
06426 Health Program Coordinator
FTE
1060294
06538 Office Assistant 11
FTE
1060201
06142 Public Health Nurse III
FTE
Public Health Educator 11-FTE
1060292
06824 Auxiliary Health Worker
FTE
Office Assistant ll -FTE
1060291
07346, Public Health Nutritionist ll
FTE
Public Health Nutritionist 111-PTNE
1060291
07360 Public Health Nutritionist 111
71
Public Health Educator ll -FTE
1060284
07381. Public Health Nutritionist 111
FTE
1060284
07382 Nutrition Technician -WIC
FTE
10602M
07384 Auxiliary Health Worker
FIE
1060219
02413 Public Health Nurse III
FTE
1060218
07414 Office Leader
FTE
1060219
07415,Office Assistant 11
FTE
1060201
07416 Pubhc Health Educator111
FTE
1060294
07557 Public Health Nurse III
FTE
Public Health Nurse II -PTNE
1060234
07559 Vaccine Supply Coordinator
FTE
Grant
WIC
MCH-Maternal & Infant Support -Enabling Women, NFP
WIC Breastfeeding
Nurse -Family Partnership
WIC Breastfeedm& WIC
WIC
WIC
TB Control
WIC
IAP
WIC
Vaccine quality Assurance
WIC
WIC
Nurse -Family Partnership
Nurse -Family Partnership
Nurse -Family Partnership
Nurse -Family Partnership
Nurse -Family Partnership, MCH-Public Health Functions & Infrastructures
WIC
WIC
Childen's special Health Care Services
Children's Special Health Care Services
Children's Special Health Care Services
Children's Special Health Care Services
Children's Special Health Care Services
WIC Breastfeeding
WIC
WIC
WIC
WIC
Cities Readiness Initiative
MCH-Maternal & Infant Support -Enabling Women
Children's Special Health Care Services
WIC
Data to care
HIV PEP Uric
HIV Prevention
HIV Prevention
Cities Readiness Initiative, PHEP
Children's Special Health Care Services
MCH-Maternal & Infant Support -Enabling Women, WIC Breastmeding
WIC
WIC
WIC
WIC
AP
IAP
IAP
Cities Readiness Initiative, PREP
HIV Prevention
Vaccine Quality Assurance, IAP
10602841
07562
Nutrition Technician - WIC
FIFE
10602
Auxiliary Health Worker
PTE
1060234
0]565
Public Health Nurse III
ETE
1060234
0]814
Public Health Nurse III
FTE
1060292
07839
Auxiliary Health Worker
PTNE
1060294
09668
Pubhc Health Nurse 111
FTE
1060201
09999
PH Emerg Preparedness Specialist
FE
10602841
115791Iactatkrr
Specialist
FIFE
10602841
1244111actation
Specialist
PTNE
1060292[
U442
Office Assistant l
PTNE
1060294
12443
Clinical Health Specialist
PTNE
1060241[
12095lPublic
Health Educator 11
PTNE
I
Auxiliary Health Worker- PTNE
Auxiliary Health Worker- PTNE
WIC
WIC
Here C
Hop C
Children's Special Health Care Services
HIV Prevention
Cities Readiness Initiative, PHEP
WIC Breastfeeding
WIC Breastfeeding
Children's Special Health Care Services
HIV PrEP Clinic
Health & Wellness 4x4 Plan
Resolution #20459
October21, 2020
Moved by Long seconded by Quarles the resolutions on the amended Consent Agenda be adopted.
AYES: Gingell, Hoffman, Jackson, Kochenderfer, Kowall, Kuhn, Long, Luebs, Markham,
McGillivray, Miller, Nelson, Powell, Quarles, Spisz, Taub, Weipert, Woodward, Zack,
Gershenson. (20)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions on the amended Consent Agenda were adopted.
CHIEF p • ` , nto 17ESOLU7I01
Ty
AC -nine AEA COUNTY EXECUTIVE
PURSUANT TO MCL 45.559A (7)
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, 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 21,
2020, 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 Circuit Court at Pontiac,
Michigan this 21s' day of October, 2020.
Lisa Brown, Oakland County