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HomeMy WebLinkAboutResolutions - 2020.12.07 - 33964MISCELLANEOUS RESOLUTION #20640 December 7, 2020 BY: Commissioner Penny Luebs, Chairperson, Health, Safety and Human Services Committee IN RE: HEALTH AND HUMAN SERVICES/HEALTH DIVISION — AMENDMENT #1 TO THE FISCAL YEAR 2021 LOCAL HEALTH DEPARTMENT (COMPREHENSIVE) AGREEMENT To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Oakland County Health Division has received Amendment #1 to the Fiscal Year (FY) 2021 Local Health Department (Comprehensive) Agreement (formerly the Comprehensive Planning, Budgeting, and Contracting Agreement - CPBC) from the Michigan Department of Health and Human Services (MDHHS); and WHEREAS the original agreement totaling $15,769,498 was adopted by the Board of Commissioners on October 21, 2020, via Miscellaneous Resolution #20459; and WHEREAS Amendment #1 increases the funding to $17,535,535, an increase of $1,766,037; and WHEREAS Amendment #1 provides funding for COVID-19 contact tracing and case investigation, Influenza vaccination, COVID-19 non -congregate sheltering, and regional laboratory COVID response; and WHEREAS the Health Division is requesting to create two (2) Part -Time Non -Eligible (PTNE) Special Revenue (SR) 1,000 hours per year Medical Technologist positions within the Laboratory Unit (#1060212); and WHEREAS the grant agreement has completed the Grant Review Process in accordance with Miscellaneous Resolution #19006. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the FY 2021 Local Health Department (Comprehensive) Agreement Amendment #1 in the amount of $1,766,037. BE IT FURTHER RESOLVED to create two (2) Part -Time Non -Eligible (PTNE) Special Revenue (SR) 1,000 hours per year Medical Technologist positions within the Laboratory Unit (#1060212). BE IT FURTHER RESOLVED that the future commitment and continuation of the Special Revenue positions is contingent upon the level of funding associated with the agreement. BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to execute the grant agreement and to approve the grant extensions or changes, within fifteen percent (15%) of the original award, which are consistent with the original agreement as approved. BE IT FURTHER RESOLVED that the FY 2021 Special Revenue budgets are amended as follows: COVID 19 FUND #28630 FY 2021 GR0000001029 Bud Ref: 2021 Analysis: GLB Activity GLB Revenues 1060201-133095-610313 Federal Operating Grants 33,113 Total Revenues 33 1 Exoenditures 1060201-133095-731458 Professional Services 33,113 Total Expenditures 3 113 COVID 19 FUND #28630 GR0000001030 Bud Ref: 2021 Analysis: GLB Activity GLB Revenues 1060201-133095-610313 Federal Operating Grants $381,080 Total Revenues 381 8 Exoenditures 1060201-133095-731458 Professional Services $300,000 1060201-133095-750294 Material and Supplies 81,080 Total Expenditures �381 080Q$ ELC ENHANCED DETECTION FUND 428631 GR0000001031 Bud Ref2021 Analysis: GLB Activity GLB Revenues 1060201-133095-615571 State Operating Grants $256,210 Total Revenues 25 2 Expenditures 1060201-133095-702010 1060201-133095-722740 1060201-133095-760160 1060201-133095-730926 Salaries Regular Fringe Benefits Furniture and Fixtures Indirect Costs Total Expenditures COVID 19 FUND #28630 GR0000000977 Bud Ref: 2021 Analysis: GLB Activity GLB Revenues 1060201-133095-610313 Expenditures 1060201-133095-702010 1060201-133095-722740 1060201-133095-730982 1060201-133095-731458 1060201-133095-774636 1060201-133095-778675 Federal Operating Grants Total Revenues Salaries Regular Fringe Benefits Interpretation Fees Professional Services Info Tech Operations Telephone Communications Total Expenditures $ 54,344 2,858 193,623 5,385 256 2 $1,095,634 $1, 095,634 $495,000 173,889 15,693 321,052 30,000 60,000 $1 095 634 Chairperson, on behalf of the Health, Safety and Human Services Committee, I move the adoption of the foregoing resolution. A I P Commissione Penny Luebs, District #16 Chairperson, ealth, Safety and Human Services Committee HEALTH, SAFETY AND HUMAN SERVICES COMMITTEE VOTE: Motion carried on a roll call vote with Kochenderfer absent. GRANT REVIEW SIGN -OFF — Health & Human Services / Health Division GRANT NAME: FY 2021 Local Health Department (Comprehensive) Agreement FUNDING AGENCY: Michigan Department of Health & Human Services DEPARTMENT CONTACT: Stacey Smith / (248) 451-2151 STATUS: Grant Amendment #1 (Greater than or Equal to 15% Variance from Current Award) DATE: 11 / 12/20 Please be advised the captioned grant materials have completed internal grant review. Below are the returned comments. The Board of Commissioners' liaison committee resolution and grant amendment package (which should include this sign -off and the grant amendment with related documentation) may be requested to be placed on the agenda(s) of the appropriate Board of Commissioners' committee(s) for grant amendment by Board resolution. DEPARTMENT REVIEW Management and Budget: Approved by M & B. The draft resolution needs to be updated to include the necessary budget amendment. Also, the fringe benefit rate noted on the HR write up needs to be corrected to 5.26% (not 5.66%). —Lynn Sonkiss (11/10/20) Human Resources: HR Approved — Requires HR Action — Creates Positions —Lori Taylor (11/05/20) Risk Management: Approved by Risk Management. —Robert Erlenbeck (11/05/20) Corporation Counsel: Approved by Corporation Counsel (no legal issues with Amendment #1). — Sharon Kessler (11/06/20) 11/04/2020 Contract #: 20210269-00 Amendment Number: 1 to the Between Michigan Department of Health and Human Services and County of Oakland hereinafter referred to as the "Local Governing Entity" on Behalf of Health Department Oakland County Department of Health and Human Services/ Health Division AMENDMENT PURPOSE AND JUSTIFICATION 1. The purpose of this amendment is to: 1. Add/revise information in Attachment I - Annual Budget Instructions; 2. Add/revise information in Attachment III - Program Specific Assurance and Requirements; and 3. Incorporate Attachment IV- Funding/Reimbursement Matrix as revised for the Essential Local Public Health Service (ELPHS) and categorical budget details, output measures and performance criteria. 4. Increase the Department's agreement amount from $15,769,498 to $17,535,535, as shown on the Attachment B budget pages. 2. Amendment Revisions: The following are the additions/revisions to Attachment I and III A) The following projects include additions/revisions as highlighted in Attachment I - Annual Budget Instructions: No Change B) The following projects include additions/revisions as highlighted in Attachment III - Program Specific Assurance and Requirements: 1. Body Art Fixed Fee 2. CRF LHD Homeless Match noon 1,—nnmennon D— In(1n 11/04/2020 3. Hearing and Vision ELPHS 4. Emerging Threats Hepatitis C 5. Family Planning 6. HIV Ryan White Part B MAI - New 7. Local Maternal Child Health (MCH) 8. SOS Evaluation - New Following are adjustments to funding levels of the Local Health Department agreement as reflected in Attachment IV: Budget line item changes are reflected in the attached budgets for the following elements: Project Title Current Amended New Project —Amnnnio� Amount moun COVID-19 Influenza Vaccination Supplemental 0 381,080 381,080 CRF LHD Homeless Match 0 33,113 33,113 CRF Local Health Department Contact Tracing 405,000 1,095,634 1,500,634 ELC COVID-19 Enhancing Detection 0 256,210 256,210 Total Comprehensive Funding 405,000 1,766,037 2,171,037 Performance Level Adjustments N/A Budget category Adjustments It is understood and agreed that all other conditions of the original agreement remains the same. 1 ......, u....uF n.......1......A nn01 I-.- N/nA/MOO Dane 1 of 4o 11/04/2020 3. Signing this amendment The individual or officer sigining this amendment certifies by his or her signature that he or she is authorized to sign this amedment on behalf of the reponsible governing board official or agency. Signature Section For Oakland County Department of Health and Human Services/ Health Division David T. Woodward County Commissioner Name (please print) Title For the Michigan Department of Health and Human Services Christine H. Sanches Christine H. Sanches, Director Bureau of Purchasing 11/04/2020 Date 1 n...J unNa nnnn.......... OnOn nn.n 11 R.A nnOn Dane. z ni 1 n 11/04/2020 Attachments Attachment I - Instructions for the Annual Budget Attachment III - Program Specific Assurances and Requirements I —, u.... u., llnnn 1-1 antra 1-,-. 111n111 on Dane n of in Program ElemenUFunding Source (a) Adolescent STD Screening Body Art Fixed Fee Children's Special Hlth Care Services (CSHCS) Care Coordination Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy Contract# Date 11/04/2020 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2021 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division MDHHS Fed/St Funding Reimbursement Performance Total (c) State (d) State Funded Minimum Contractor / Source Amount Method Target Perform Funded Subrecepient (b) Output Expect Target Performance Percent (f) Measurement Perform Number (a) Reg. Alloc. F 73,000 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement - Calc. Amt. 250.00/Numb Fixed Unit Rate (2) N/A N/A N/A N/A N/A Recepient ers Calc. Amt. 150.00Nario Fixed Unit Rate (1), N/A N/A N/A N/A N/A Subrecepient us (7) Reg. Alloc. F 147,203 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement Reg. Alloc COVID-19 Influenza Vaccination Reg. Alloc Supplemental CRF Immunizations COVID Reg. Alloc Response CRF LHD Homeless Match Reg. Alloc CRF Local Health Department Reg. Alloc Contact Tracing CRF Local Health Department Reg. Alloc Lab CRF Local Health Department Reg. Alloc Testing CSHCS Medicaid Elevated Blood Calc. Amt. Lead Case Mgmt EGLE Drinking Water and Onsite Reg. Alloc Wastewater Management ELC COVID-19 Contact Tracing Reg. Alloc Testing Coordination ELC COVID-19 Enhancing Reg. Alloc Detection ELC COVID-19 Infection Reg. Alloc Prevention S 147,202 F 381,080 Actual Cost N/A Reimbursement F 401,714 Actual Cost N/A Reimbursement F 33,113 Actual Cost N/A Reimbursement F 1,500,634 Actual Cost N/A Reimbursement F 285,714 Actual Cost N/A Reimbursement F 150,007 Actual Cost N/A Reimbursement 201.58Nario Fixed Unit Rate (2) N/A us S 985,042 ELPHS (3), (6) N/A F 2,755,800 Actual Cost N/A Reimbursement S 256,210 Actual Cost N/A Reimbursement F 337,500 Actual Cost N/A Reimbursement N/A WA N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Recepient N/A N/A N/A N/A Subrecepient N/A N/A N/A N/A Recepient N/A N/A N/A N/A Subrecepient Local Health Department - 2021, Date: 11/04/2020 Page: 5 of 14 Contract # Date: 11/04/2020 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2021 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source MDHHS Fed/St Funding Reimbursement Performance Total (c) Perform State (d) Funded State Funded Minimum Contractor Subrecepient (a) Source Amount Method (b) Target Output Expect Target Performance Percent (f) Measurement Perform Numbr_r (a) Emerging Threats - Hepatitis C Reg. Alloc. S 76,221 Actual Cost N/A - N/A N/A N/A N/A Recepient Reimbursement Fetal Infant Mortality Review Calc. Amt. 270.00/Vario Fixed Unit Rate (2) N/A N/A N/A N/A N/A Subrecepient (FIMR) Case Abstraction us - -- FIMR Interviews Calc. Amt. 85.00/Numbe Fixed Unit Rate (2), N/A N/A N/A N/A N/A Subrecepient rs (11) Food ELPHS Reg. Alloc. S 1,176,612 ELPHS (3), (4) N/A N/A N/A N/A N/A Recepient Gonococcal Isolate Surveillance Reg. Alloc. F 15,750 Actual Cost N/A N/A N/A N/A N/A Subrecepient Project Reimbursement Reg. Alloc. S 47,250 Hearing ELPHS Reg. Alloc. L 253,969 ELPHS (3), (6) N/A N/A N/A N/A N/A Recepient HIV Data to Care Reg. Alloc. P 128,000 Actual Cost - N/A N/A N/A N/A N/A Recepient Reimbursement HIV PrEP Clinic Reg. Alloc. F 118,800 Actual Cost N/A N/A N/A N/A N/A Subrecepient - - Reimbursement Reg. Alloc. S 1,200 HIV Prevention Reg. Alloc. F 130,789 Actual Cost N/A N/A N/A N/A N/A Subrecepient _ Reimbursement Reg. Alloc. P 4,522 Reg. Alloc. S 316,934 Immunization Action Plan (IAP) Reg. Alloc. F 501,895 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement Immunization Fixed Fees Calc. Amt. 300.00/Numb Fixed Unit Rate (2), N/A N/A N/A N/A N/A Subrecepient ers (7) Immunization Vaccine Quality Reg. Alloc. S 105,347 Actual Cost N/A N/A N/A N/A N/A Recepient Assurance Reimbursement Infant Safe Sleep Reg. Alloc. F 2,250 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement Reg. Alloc. S 20,250 Laboratory Services Bio Reg. Alloc. F 15,000 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement Local Health Department - 2021, Date: 11/04/2020 Page: 6 of 14 Contract # Date: 1110412020 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2021 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source MDHHS Fed/St Funding Reimbursement Performance Total (c) State (d) State Funded Minimum Contractor / (a) Source Amount Method (b) Target Output Perform Expect Funded Target Performance Subrecepient Percent (f) Measurement Perform Number(e) MCH -All Other Local MCH S 321,457 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement MDHHS-Essential Local Public Reg. Alloc. S 2,557,216 ELPHS (3),(6) N/A N/A N/A N/A N/A Recepient Health Services (ELPHS) MI Health and Wellness 4x4 Plan Reg. Alloc. S 73,084 Actual Cost N/A N/A N/A N/A N/A Subrecepient - Implementation Reimbursement Nurse Family Partnership Reg. Alloy F 385,524 Actual Cost - N/A=-- N/A N/A N/A N/A Subrecepient Services Reimbursement Reg. Alloc. S 257,016 Public Health Emergency Reg. Alloc. F 222,088 Actual Cost N/A N/A N/A N/A N/A Subrecepient Preparedness (PHEP) 10/1 - 6/30 Reimbursement Public Health Emergency Reg. Alloc. F 151,699 Actual Cost N/A N/A N/A N/A N/A Subrecepient Preparedness (PHEP) CRI 10/1 - Reimbursement 6/30 Sexually Transmitted Disease Reg. Alloc. F 34,121 Actual Cost N/A N/A N/A N/A N/A Subrecepient (STD) Control Reimbursement Reg. Alloy S 36,144 - Tuberculosis (TB) Control Reg. Alloc. F 20,141 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement Vector -Borne Surveillance & Reg. Alloc. S 9,000 Actual Cost N/A N/A N/A N/A N/A Recepient Prevention Reimbursement Vision ELPHS Reg. Alloc. L 253,968 ELPHS (3), (6) N/A N/A N/A N/A N/A Reoepient West Nile Virus Community Reg. Alloc. F 10,000 Actual Cost N/A N/A N/A N/A N/A Subrecepient Surveillance Reimbursement WIC Breastfeeding Reg. Alloc. F 219,199 Actual Cost N/A N/A N/A N/A N/A Subrecepient Reimbursement WIC Resident Services Reg. Alloc. F 2,615,870 Performance (8) # Average N/A N/A 97 0 Subrecepient Monthly Participation TOTAL MDHHS FUNDING 17,535,535 'SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Local Health Department - 2021, Date 11/04/2020 Page. 7 of 14 NUMPN sERvIGEs PN� t . 202 IF kA Nea h DePafv T sWX01I s! NeaxkR ONts{on NP��MEN an seN��e Sta`ne", MNeattb and NUm P{o`m Fta, Of name Expel Pi Oakland GoUnfi! chme"ll "— tes A a . d'oePaert2�2{ �� {�IOh12020 lv, 2oa{ Hea conttaa# Sato, IA10412020 ?age. 8�{�4 Contract # Date: 1110412020 Project Budgets 1 Program Budget Summary PROGRAM/PROJECT DATEPREPARED Local Health Department -2021 /CRF Local Health 11/412020 Department Contact Tracina CONTRACTOR NAME BUDGET PERIOD Oakland County Department of Health and Human Services/ From: 10/1/2020 To: 12/30/2020 Health Division MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # 1200 N. Telegraph Rd. r Original iV,, Amendment 1 34 East CITY STATE ZIP CODE FEDERAL ID NUMBER Pontiac MI 48341-0432 38-6004876 , 1 Category I Total I Amount DIRECT EXPENSES Program Expenses 1� 1 Salary & Wages 130,000.00 130,000.00 I 2 Fringe Benefits 46,052.00 46,052.00 1� 3 Cap. Exp. for Equip & Fac. 0.00 0.00 11 4 Contractual 0.00 0.0011 5 Supplies and Materials 0.00 0.00 11 6 Travel 0.00 0.0011 7 Communication 15,000,00 15,000.0011 8 County -City Central Services 0.00 0.00 I 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.) 213,948.00 213,948.00 1 Total Program Expenses 405,000.00 405,000.00 I TOTAL DIRECT EXPENSES 405,000.00 406,000.00 1 INDIRECT EXPENSES 1 Indirect Costs 1� 1 Indirect Costs I 0.00 0.00 11 2 Cost Allocation Plan / Other 0.00 0.00 I Total Indirect Costs 0.00 0.00 1 TOTAL INDIRECT EXPENSES 0.00 0.00 1I` TOTAL EXPENDITURES 405,000.00 405,000.00 I n.,m ++rnnionon D­ o M 1 A Contract# Date: 1110412020 2 Program Budget - Source of Funds SOURCE OF FUNDS Category I Total I Amount I Cash I Inkind 1 Source of Funds Fees and Collections - 1 at and 2nd 0.00 0.00 0.00 0.00 Party Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 11 Federal or State (Non MDHHS) 0.00 0.00 0.00 0.00 I Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 1 Required Match - Local 0.00 0.00 0.00 0.00 I Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0:00 0.00 0.00 0.00 � Other Non-ELPHS 0.00 0.00 0.00 0.001 MDHHS Non Comprehensive 0.00 0.00 0.00 0.001 MDHHS Comprehensive 405,000.00 405,000.00 0.00 0.00 MCH Funding 0.00 0.00 I 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 I 0.00 0.00 MDHHS Fixed Unit Rate 1� Totals I 405,000.00I 405,000.00I 0.00 0.001 i -I - 1n11 n=le a Unn noon Dana 1 r) of 1 d Contract# Date. 11/04/2020 3 Program Budget - Cost Detail ILIneItem I Qtyl DIRECT EXPENSES Program Expenses 1 Salary & Wages Various I 1.00OOI 2 Fringe Benefits All Composite Rate 0.0000 Notes: FICA UNEMPLOY RETIREMENT HOSPITAL LIFE INSURANCE VISION DENTAL WORKERS COMP SHORT/LONG TERM DISABILITY 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication - Telephone Communicatin I 0.00001 8 County -City Central Services I9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Professional Services 0.0000 Notes : Staffing Services IT Operations 0.0000 (Total for All Others (ADP, Con. Employees, Misc.) ITotalProgramExpenses (TOTAL DIRECT EXPENSES (INDIRECT EXPENSES Indirect Costs Rate UnitsluOM 130000.000I 0.0001 FTE 35.425 130000.000 0.000I 0.000I 0.000 0.000 0.000 0.000 Total I I I I 130,000.00I I 46,052.00 15,000.00 178,948.00 35,000.001 213,948.001 405,000.001 405,000.001 1 1 I n i Nodu nerool # - onol ne,n. 1UMhn9n D.— 11 of 1d Contract # Date: 11/04/2020 Line Item I Qtyl Rate l UnitsIUOM I Total' 1 Indirect Costs J 2 Cost Allocation Plan / Other 'Total Indirect Costs I 0.00 +TOTAL INDIRECT EXPENSES 0.00 ITOTAL EXPENDITURES + 405,000.00 ... _.1..,__-__. ,,,..,. — - D—. 10 ni I Contract# Date: 11/04/2020 Summary of Budget PROGRAM / PROJECT DATE PREPARES Local Health Department- 2021 / Local Health Department- 11/4/2020 2021 CONTRACTOR NAME BUDGET PERIOD Oakland County Department of Health and Human Services/ From : 10/1/2020 Health Division To : 9/30/2021 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT 1200 N. Telegraph Rd. 34 East i Original rAmendment CITY STATE ZIP CODE FEDERAL ID NUMBER Pontiac MI 48341-0432 38-6004876 Category I Total I DIRECT EXPENSES Program Expenses 11 Salary & Wages 12 Fringe Benefits 13 Cap. Exp. for Equip & Fac. 14 Contractual 15 Supplies and Materials 16 Travel 17 Communication 18 County -City Central Services 19 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Total Program Expenses TOTAL DIRECT EXPENSES INDIRECT EXPENSES (Indirect Costs I1 Indirect Costs 12 Cost Allocation Plan / Other 1Total Indirect Costs ITOTAL INDIRECT EXPENSES ITOTAL EXPENDITURES SOURCE OF FUNDS Category 1 Fees and Collections - 1st and 2nd Total 4,424,519.00 20,201,874.00 10,157,404.00 125,606.00 2,118,056.00 2,099,771.00 344,359.00 439,400.00 in 11 1,209,714.00 3,819,540.00 40,515,724.00 40,515,724.00 1,363,701.00 4,335,159.00 5,698,860.00 5,698,860.00 AMENDMENT# 1 46,214,584.00 Amount Cash 0.00 4,424,519.00 Amount 20,201,874.00 10,157,404.00 125,606.00 1 2,118,056.00 2,099,771.00 1 344,359.00 1 439,400.00 1 0.00 11 1,209,714.00 I 3,819,540.00 1 40,515,724.00 40,515,724.00 1 1,363,701.00 11 4,335,159.00 1I 5,698,860.00 I 5,698,860.00 1 46,214,584.00 i Inkind NOR i. 1 Llnnl,A llnn..dmeN n11 l -'-I101 lm� Dane"11 of 1A Contract# Date: 11/04/2020 Party 12 Fees and Collections - 3rd Party 241,000.00 0.00 241,000.00 0.001 13 Federal or State (Non MDHHS) 2,258,791.00 0.00 2,258,791.00 0.001 14 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.001 15 Federally Provided Vaccines 1,444,452.00 0.00 1,444,452.00 0.001 16 Federal Medicaid Outreach 1,158,403.00 1,158,403.00 000 0.001 17 Required Match- Local 1,214,053.00 0.00 1,214,053.00 0,001 18 Local Non-ELPHS 0.00 0.00 0.00 0.00 19 Local Non-ELPHS 0.00 0.00 0.00 0.00 I10 Local Non-ELPHS 0.00 0.00 0.00 0.00 I11 Other Non-ELPHS 0.00 0.00 0.00 0.00 112 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 113 MDHHS Comprehensive 15,448,041.00 15,448,041.00 0.00 0.00 114 MCH Funding 321,457.00 321,457.00 0.00 0.00 115 Local Funds - Other 19,371,816.00 0.00 19,371,816.00 0.00 116 Inkind Match 0.00 0.00 0.00 0.001 117 MDHHS Fixed Unit Rate 332,052.00 332,052.00 0.00 0.001 TOTAL 46,214,584.00 17,259,953.00 28,954,631.00 0.001 I -, LJo.aliA I --- A-, 1/ 1� 11e 111I1A /7I1'1I1 D- IA of I ATTACHMENT MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Local Health Department Agreement October 1, 2020- September 30, 2021 Fiscal Year 2021 INSTRUCTIONS FOR THE ANNUALBUDGET INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES TABLE OF CONTENTS Page I. INTRODUCTION............................................................................................................2 II. MINIMUM BUDGETING REQUIREMENTS...................................................................2 III. REIMBURSEMENT CHART............................................................................................3 IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES...............................................................................................................4 V. FORM PREPARATION - GENERAL...............................................................................4 VI. FORM PREPARATION - EXPENDITURE CATEGORIES..............................................4 VII. FORM PREPARATION - SOURCE OF FUNDS..............................................................7 VIII. SPECIAL BUDGET INSTRUCTIONS A. Public Health Emergency Preparedness(PHEP)...................................................10 B. WIC.........................................................................................................................10 C. Family Planning.....................................................................................................12 D. Breast and Cervical Cancer...................................................................................13 E. CSHCS Outreach and Advocacy...........................................................................15 F. Program Budget Detail- Cost Detail Schedule Preparation.....................................16 G. Medicaid Outreach Activities Reimbursement Procedures.....................................20 H. Michigan Colorectal Cancer -Screening Program...................................................25 I. Immunization 317 and VFC Allowable Expenditures..............................................26 i INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH SERVICES INTRODUCTION The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs' funding and Essential Local Public Health Services (ELPHS) (formerly known as the local public health operation's funding) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. MINIMUM BUDGETING REQUIREMENTS A. Cost Principles - Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. B. Federal Block Grant Funds - Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (other than minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. C. Expenditure and Fundina Source Breakdown - For purposes of development, analysis and negotiation activities must be budgeted at the individual expenditure and funding source category level on the Annual Budget for Local Health Services. D. SDecial Budget Requirements for Certain Categorical Proaram Elements - The Annual Budget for Local Health Services is completed in the MI E-Grants System through the application budget to include details for all program elements (excluding Administration and Grantee Support). E. Local MCH - Local MCH funds can be used 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. Priority areas are developed into Local MCH Work Plans which are described in the Annual Local MCH Plan. These funds are to be budgeted as a fundina source in two project categories. The Local MCH projects need to be budgeted separately. Please note only two LMCH project titles can be used: • MCH — Children • MCH — All Other These funding sources cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of expenditures, and evidence is provided that the expenditures satisfy all funding requirements. Local health departments are encouraged to select only one to two performance measures and delve deeper into the strategies in an effort to "move the needle." III. REIMBURSEMENT CHART A. Proaram Element/Fundina Source The Program Element/Funding Source column has been moved to Attachment III and provides the listing of all currently funded MDHHS programs that are included in the Comprehensive Local Health Department Agreement. B. Tvoe of Prolect The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Research and development (R&D) means all research activities, both basic and applied, and all development activities that are performed by non -Federal entities. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. C. Reimbursement Chart The Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures for each program/element having a performance reimbursement option. In addition, the chart also provides the subrecipient, contractor, or recipient designations, as in prior years: IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES As in past years, no additional accounting system detail is being required beyond local uniform accounting procedures prescribed by the Michigan Department of Treasury, Local Financial Management System requirements, documentation requirements of categorical program funding sources and any local requirements. Some agencies may already have separate cost centers in their accounting system to directly identify costs and related funding of required services, but such breakdowns are not essential to being able to meet minimum reporting requirements if proper allocation procedures are used and adequate documentation is maintained. All allocations must have clearly measurable bases that directly apply to the amounts being allocated, must be documented with work papers that will provide an adequate audit trail and must result in a representative reporting of costs and funding for affected programs. More specific guidance can be found in Title 2 CFR, Part 200 Appendix V State/Local Government and Indian Tribe -Wide Central Service Cost Allocation Plans and the brochure published by the Department of Health and Human Services entitled "A Guide for State, Local and Indian Tribal Governments: Cost Principles and Procedures for Developing Cost Allocation Plans and Indirect Cost Rates for Agreements with the Federal Government. V. FORM PREPARATION - GENERAL The MI E-Grants System on-line application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Grantee. The system is designed to accommodate any number of local program elements including those unique to a particular local Grantee. Applications, including budget forms, are completed for all program elements, regardless of the reimbursement mechanism, including Agency administration(s) fee for service program elements, categorical program elements, performance - based program elements and Medicaid Outreach associated program elements. Budget entry is required for each major expenditure and source of fund categories for which costs/funds are identified. VI. FORM PREPARATION - EXPENDITURE CATEGORIES Budaeted expenditures are to be entered for each program element, project or group of services by applicable major category. A. Salaries and Waaes- This category includes the compensation budgeted for all permanent and part-time employees on the payroll of the Grantee and assigned directly to the program. This does not include contractual services, professional fees or personnel hired on a private contract basis. Consulting services, vendor services, professional fees or personnel hired on a private contracting basis should be included in "Other Expenses." Contracts with secondary recipient organizations such as cooperating service delivery institutions or delegate agencies should be included in Contractual (Sub -contract) Expenses. B. Frinae Benefits - This category is to include, for at least the specified elements, all Grantee costs for social security, retirement, insurance and other similar benefits for all permanent and part-time employees assigned to the specified elements. C. Cap Exv for Enuip & Fac - This category includes expenditures for budgeted stationary and movable equipment used in carrying out the objectives of each program element, project or service group. The cost of a single unit or piece of equipment includes necessary accessories, installation costs, freight and other applicable expenses associated with the purchase of the equipment. Only budgeted equipment items costing $5,000 or more may be reported under this category. Small equipment items costing less than $5,000 are properly classified as Supplies and Materials or Other Expenses. This category also includes capital outlay for purchase or renovation of facilities. D. Contractual (Subcontracts/Subrecivient► - Use for expenditures applicable to written contracts or agreements with secondary recipient organizations such as cooperating service delivery institutions or delegate agencies. Payments to individuals for consulting or contractual services, or for vendor services are to be included under Other Expenses. Specify subcontractor(s) address, amount by subcontractor and total of all subcontractors. E. SUDolieS and Materials - Use for all consumable items and materials including equipment - type items costing less than $5,000 each. This includes office, printing, janitorial, postage and educational supplies; medical supplies; contraceptives and vaccines; tape and gauze; prescriptions and other appropriate drugs and chemicals. Federal Provided Vaccine Value should be reported and identified on in Other Cost Distributions category. Do not combine with supplies. F. Travel - Travel costs of permanent and part-time employees assigned to each program element. This includes costs of mileage, per diem, lodging, meals, registration fees and other approved travel costs incurred by the employee. Travel of private, non -employee consultants should be reported under Other Expenses. G. Communication Costs - These are costs for telephone, Internet, telegraph, data lines, websites, fax, email, etc., when related directly to the operation of the program element. H. County/City Central Services -These are costs associated with central support activities of the local governing unit allocated to the local health department in accordance with Title 2 CFR, part 200. I. Space Costs - These are costs of building space necessary for the operation of the program. J. All Others (Line 111 - These are costs for all other items purchased exclusively for the operation of the program element and not appropriately included in any of the other categories including items such as repairs, janitorial services, consultant services, vendor services, equipment rental, insurance, Automated Data Processing (ADP) systems, etc. K. Total Direct Expenditures — The MI E-Grants System sums the direct expenditures budgeted for each program element, project or service grouping and records in the Total Direct Expenditure line of the Budget Summary. L. Indirect Cost— These cost categories are used to distribute costs of general administrative operations that have not been directly charged to individual subrecipient programs. The Indirect Cost expenditures distribute administrative overhead costs to each program element, project or service grouping. Two separate local rates may apply to the agreement period (i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter part. Indirect costs are not allowed on programs elements designated as vendor relationship An indirect rate proposal and related supporting documentation must be retained for audit in accordance with records retention requirements. In addition, these documents are reviewed as part of the Single Audit, subrecipient monitoring visit, or other State of Michigan reviews. Following is further clarification regarding indirect rate and/or cost allocation approval requirements to distribute administrative overhead costs, in accordance with Title 2 CFR Part 200 (formerly Circular A-87 2 CFR Part 225, Appendix E), for Local Health Departments budgeting indirect costs: 1. Local Health Departments receiving more than $35 million in direct Federal awards are required to have an approved indirect cost rate from a Federal Cognizant Agency. If your Local Health Department has received an approved indirect rate from a Federal Cognizant agency, attach the Federal approval letter to your MI E-Grants Grantee Profile. Local Health Departments receiving $35 million or less in direct Federal awards are required to prepare indirect cost rate proposals in accordance with Title 2 CFR and maintain the documentation on file subject to review. 3. Local Health Departments that received approved indirect cost rates from another State of Michigan Department should attach their State approval letter to their MI E-Grants Grantee Profile. 4. Local Health Departments with cost allocation plans should reflect these allocations in the Other Cost Distributions budget category. See Section M. Other Cost Distribution for budgeting guidance. 5. As a Subrecipient of federal funds from MDHHS, a Local Health Department that has never received a negotiated indirect cost rate, your Local Health Department may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) based on Title 2 CFR part 200 requirements. MTDC includes all direct salaries and wages, fringe benefits, supplies and materials, travel, services, and contractual expenses up to the first $25,000 of each contract. MTDC excludes all equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs, and portions subcontractual/subaward expenses in excess of $25,000 per contract. Attach a current copy of the letter stating the applicable indirect costs rate or calculation information justifying the de minimis rate calculation to you MI E-Grants Grantee profile. Detail on how the indirect costs was calculated must be shown on the Budaet Detail Schedule. The amount of Indirect Cost should be allocated to all appropriate program elements with the total equivalent amount reflected as a credit or minus in the Administration projects. M. Other Cost Distributions — Use to distribute various contributing activity costs to appropriate program areas based upon activity counts, time study supporting data or other reasonable and equitable means. An example of Other Cost Distributions is nursing supervision. The distribution process permits costs reflected in a single program element to be subsequently distributed, perhaps only in part, to other programs or projects as appropriate. If an allocation is made, the charges must be reflected in the appropriate program element and the offsetting credit reflected in the program element being distributed. There must be a documented, well-defined rationale and audittrail for anv cost distribution or allocation based upon Title 2 CFR. Part 200 Cost Principles Local Health Departments using the cost distribution or cost allocation must develop the plan in accordance with the requirements described in Title 2 CFR, Part 200. Local Health Departments should maintain supporting documentation for audit in accordance with record retention requirements. The plan should include a Certification of Cost Allocation plan in accordance with Title 2 CFR, Part 200 Appendix V. The cost allocation plan documentation is not required to be submitted unless specifically requested. Cost associated with the Essential Local Public Health Services (ELPHS), Maternal and Child Health (MCH) Block Grant and Fixed Fee may be budgeted in the associated program element and distributed to the associated projects. Federal Provided Vaccine Value should be reported on a separate line and clearly identified N. Total Direct & Admin. Expenditures — The MI E-Grants System sums the indirect expenditures program element and records in the Total Indirect Expenditure line of the Budget Summary. O. Total Expenditures —The MI E-Grants System sums the direct and indirect expenditures and records in the Total Expenditure line of the Budget Summary. VII. FORM PREPARATION - SOURCE OF FUNDS Source of Funds are to be entered for each program element, project or group of services by applicable major category as follows: A. Fees & Collections - Fees 15' & 2nd Partv- 15t party funds projected to be received from private payers, including patients, source users and any member of the general population receiving services. 2nd party funds received from organizations, private or public, who might reimburse services for a group or under a special plan. iii. Any Other Collections B. Fees & Collections - 31d Partv — 3rd Party Fees - Funds projected to be received from private insurance, Medicaid, Medicare or other applicable titles of the Social Security Act directly related to the cost of providing patient care or other services (e.g., includes Early Periodic Screening, Detection and Treatment [EPSDT] Screening, Family Planning.) C. Federal/State Fundina (Non-MDHHS) - Funds received directly from the federal government and from any state Contractor other than MDHHS, such as the Department of Natural Resources and Environment (MDNRE). This line should also be used to exclude state aid funds such as those provided through the Michigan Department of Treasury under P.A. 264 of 1987 (cigarette tax). D. Federal Cost Based Reimbursement — Funds received for Federal Cost Based Reimbursement which should be budgeted in the program in which they were earned. E. Federally Provided Vaccines — The projected value of federally provided vaccine. F. Federal Medicaid Outreach — (Please note: to be used onlyfor Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership Medicaid Outreach program elements.) Funds projected to be received from the federal government for allowable Medicaid Outreach activities. This amount represents the anticipated 50% federal administrative match of local contributions. G. Reauired Match - Local — Funds projected to be local contribution for programs that have a match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) H. Local Non-ELPHS - Local funds budgeted for the following expenditures: 1. Expenditures for services not designated as required and allowable for ELPHS funding (e.g., medical examiner and inpatient maternity services); expenditures determined notto be reasonable; and, expenditures in excess of the maximum state share of funds available. 2. Any losses arising from uncollectible accounts and other related claims. Under -recovery of reimbursable expenditures from, or failure to bill, available funding sources that would otherwise result in exclusions from ELPHS funding, if recovered. However, no exclusion is required where the local jurisdiction has made and documented a decision to have local funds underwrite: a. The cost of uncollectible accounts or bad debts incurred in support of providing required or allowable health services. An example of this condition would be for services provided to indigents who are billed as a matter of procedure with little chance for receipt of payment. b. Potential recoveries or under -recoveries from other sources for the principal purpose of providing required and allowable health services at free or reduced cost to the public served by the Grantee. An example would be keeping fees for services at a reduced level for the benefit of the people served by the Grantee while recognizing that to do so limits recovery from third parties for the same types of services. 3. Contributions to a contingency reserve or any similar provisions for unforeseen events. 4. Charitable contributions and donations. 5. Salaries and other incidental expenditures of the chief executive of a political subdivision (i.e., county executive and mayor). 6. Legislative expenditures, such as, salaries and other incidental expenditures of local governing bodies (i.e., county commissioners and city councils). Do not enter board of health expenses. 7. Expenditures for amusements, social activities and other incidental expenditures related to, such as, meals, beverages, lodging, rentals, transportation and gratuities. 8. Fines, penalties and interest on borrowings. 9. Capital Expenditures- Local capital outlayfor purchase of facilities and equipment (assets) are excluded from ELPHS funding. I. Other Non- ELPHS - Funds budgeted from sources other than state, federal and local appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local substance abuse coordinating grantee, local area on aging grantees). J. MDHHS - NON -COMPREHENSIVE - Funds budgeted for services provided under separate MDHHS agreements. Examples include funding provided directly by the Community Services for Substance Abuse for community grants, etc. K. MDHHS - COMPREHENSIVE - This section includes all funding projected to be due under the Comprehensive Agreement from categorical programs and needs to equal the allocation. L. ELPHS - MDHHS Hearina — This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Hearing program and has to equal the MDHHS ELPHS Hearing allocation. Additional ELPHS to be budgeted for the Hearing Program must be entered into ELPHS — MDHHS Other. Hearing allocations may only be spent on the Hearing Program. M. ELPHS - MDHHS Vision — This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Vision program and has to equal the ELPHS MDHHS Vision allocation. Additional ELPHS to be budgeted for the Vision Program must be entered into ELPHS — MDHHS Other. Vision allocations may only be spent on the Vision Program. N. ELPHS — MDHHS Other — This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Other program for eligible program elements. Please note: The MI E-Grants System validates the ELPHS MDHHS Other budgeted funds across the applicable program elements to assure the agreement does exceed the ELPHS — MDHHS Other allocation. O. ELPHS — Food - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS Food program and has to equal the ELPHS Food allocation. P. ELPHS — Drinkina Water - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS Drinking Water program and has to equal the ELPHS Drinking Water allocation. Q. ELPHS — On -site Sewage - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS On -site Sewage program and has to equal the ELPHS On -site Sewage allocation. R. MCH Fundina - This section includes all funding projected to be due under Comprehensive Agreement specific to the MCH eligible program elements. Please note: The MI E-Grants System validates the MCH budgeted funds across applicable program elements to assure the agreement does exceed the MCH allocation. S. Local Funds - Other - Enter all local support in the appropriate element, project or service group column. This may include local property tax, and other local revenues (does not include fees). T. Inkind Match — Enter Local Support from donated time or services. U. MDHHS Fixed Unit Rate — Select the type of fee -for -services from the lookup to correspond with the program element. Vill. SPECIAL BUDGET INSTRUCTIONS Certain elements are supported by federal or other categorical program funds for which special budgeting requirements are placed upon grantees and subgrantees. These include: Element Federal or Other Fundina Contractor Public Health Emergency U.S. Department of Health & Human Services, Centers for Preparedness Disease Control WIC U.S. Department of Agriculture, Food & Nutrition Service Family Planning U.S. Department of Health & Human Services, Public Health Service Breast and Cervical U.S. Department of Health & Human Services, Centers for Cancer Disease Control CSHCS Outreach & Michigan Department of Health & Human Services Advocacy Medicaid Outreach Centers for Medicare and Medicaid Services Activities In general, subgrantee budgets must provide sufficient budget detail to support grantee budget requests and be in a format consistent with grantor Contractor requirements. Certain types of costs must receive approval of the federal grantor Contractor and/or the grantee prior to being incurred. A. Public Health Emeraencv Preparedness (PHEP) Special Budaet Reauirements Local Health Departments will receive the initial FY 20/21 allocation of the CDC Public Health Emergency Preparedness (PREP) funds in nine equal prepayments for the period October 1, 2020 through June 30, 2021. LHDs must submit a nine -month budget and a quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE Local Health Department program elements: 1. Public Health Emergency Preparedness (PHEP) (October 1 —June 30) 2. Public Health Emergency Preparedness (PHEP)— Cities of Readiness (October 1 — June 30) 3. Laboratory Services - Bioterrorism (October 1 — September 30) B. WIC Special Budaet Reauirements 1. Cost/Fundina Cateaories -The following local budget breakdowns are required to fulfill WIC grant application budget requirements each fiscal year: Salaries & Fringe Benefits 10 2. Automated Management Systems Space Utilization Costs Equipment Supplies Communications & Travel All Other Direct Costs Indirect Costs All Funding Sources by Type The WIC cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget form in the MI E-Grants System. General instructions for these forms are contained at the end of this section. Agencies receiving WIC -USDA Infrastructure grants must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. Agencies receiving WIC -USDA Breastfeeding Peer Counselor funds must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. And comply with special reporting requirements. Costs Allowable Only With Prior Anoroval - The following costs are allowable only with prior review/approval of the Michigan Department of Health & Human Services as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR Part 246, and USDA -WIC Administrative Cost Handbook 3/86). Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Automated Information Svstems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental -purchase agreement or other method of acquisition. B. Capital Expenditures of $2.500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C. Manaaement Studies - performed by agencies or departments other than the local Grantee or those performed by outside consultants under contract with the local Grantee. D. Accountina and Auditina Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Grantee level. I F. Trainina and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out -of -service training over extended periods of time. G. Buildina Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H. Non-Frinae Insurance and Indemnification Costs All charges to WIC must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. C. Family Plannina Special Budaet Requirements Cost/Fundina Cateaories - The following local budget breakdowns are required to fulfill Family Planning grant application budget requirements each fiscal year: Salaries & Wages Fringe Benefits Travel Equipment Supplies Contractual Construction All Other Direct Costs Indirect Costs All Funding Sources by Type The Family Planning cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget in the MI E-Grants System. General instructions for these forms are contained at the end of this section. 2. Costs Allowable Oniv With Prior Approval - The following costs are allowable only with prior review/approval of MDHHS. Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Alterations and Renovations - to change the interior arrangements or other physical characteristics of existing facilities or installed equipment, to the extent that such changes cost more than $1,000 each. B. Audiovisual Materials and Activities - acquired, produced, presented, or disseminated to the general public. C. Consultant Contracts for General SUpnort Services - including equipment and supplies, that will cost in excess of $25,000 or 10% of the total direct cost budget (whichever is greater). D. Equipment - including general purpose and special equipment (e.g., air conditioning) costing $5,000 or more per unit. E. Insurance - contributions to a reserve for a self-insurance program. 12 F. Public Information Service Costs — for the cost of providing public information services. G. Publication and Printina Costs - for the cost of publications. H. Capital Expenditures -for land or buildings. Indemnification Aaainst Third Parties Costs -insurance against potential liabilities. J. Mass Severance Pav - involving grant -supported personnel. K. Oraanization/Reoraanization Costs - allocable to the program. L. Overtime Premium - involving grant -supported personnel. M. Patient Care Costs — re -budgeting out of or reduction in patient care costs (considered a change in scope). N. Professional Services - in connection with Patent/Copyright Infringement Litigation. O. Trailers or Modular Units —for costs of trailers and modular units. P. Transfers Between Construction and Non -construction -for approved construction funds. Q. Transfers Between Indirect and Direct Costs - for amounts awarded for indirect costs to absorb increases in direct costs. R. Transfers for Substantive Proarammatic Work -to a third party, by contracting, or any other means used for the actual performance of substantive programmatic work. All charges to Family Planning must be necessary, reasonable, allowable, and allocable, for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule and 2 CFR, Part 215 (OMB Circular A-110) D. Breast and Cervical Cancer Control Coordination Proqram Special Budget Reauirements 1. The Breast and Cervical Cancer Control Navigation Program (BCCCNP) budget is to be developed in the following way: BCCCNP Coordination should be used to budget costs associated with coordination of the program in assuring implementation of all minimum program requirements and policies and procedures. Only coordination expenses will be reimbursed through the Comprehensive Agreement. All Direct Service claims, including MTA Navigation Services and Navigation -Only Services, must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing Direct Service claims to the MDHHS Cancer Prevention and Control Section. No Direct Services or MTA Navigation or Navigation -Only Service expenses will be reimbursed through the Comprehensive Agreement. 13 The Coordination amount $200 per woman based on a target caseload established by MDHHS. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS. For specific billing requirements refer to the most recent BCCCNP Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and Other Program Instructions for the BCCCNP issued in August of each fiscal year. The above referenced documents are available at www.michiaancancer.ora/BCCCNP. 2. The Well -Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) budget is to be developed in the following way: WISEWOMAN Coordination and Screening should be used to budget costs associated with coordination of the program and delivery of the initial screening and risk reduction counseling to WISEWOMAN participants. This includes administration and interpretation of health risk instrument, WISEWOMAN screening services (height, weight, body mass index, 2 blood pressure readings, total cholesterol, HDL cholesterol, and glucose or AlC), and delivery of risk reduction counseling. All Direct Service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreements with the LCA will be responsible for billing Direct Service claims to the MDHHS Cancer Prevention and Control Section. This includes follow-up fasting lipid panel, fasting glucose, Al c, and one diagnostic exam. No Direct Services expenses will be reimbursed through the Comprehensive Agreement. The Coordination and Screening amount is $200 per woman based on a target caseload established by MDHHS. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 95% caseload performance requirement for this project. For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and other Program instructions for the WISEWOMAN Program issued in August of each fiscal year. The above referenced documents are available at www.michigan.gov/cancer. 14 E. Children's Special Health Care Services (CSHCS) Outreach and Advocacv - The program element, titled CSHCS Outreach and Advocacy should be used to budget costs associated with this program. I. Proaram Budaet - Online Detail Budaet Application Entry, Complete the appropriate budget forms contained within the MI E-Grants System for each program element. An example of this form is attached (see Attachment 1 for reference). Salary and Waaes - a. Position Description - Select from the expenditure row look -up all position titles or job descriptions required to staff the program. If the position is missing from the list, please use Other and type in the position in the drop -down field provided. b. Positions Required - Enter the number of positions required for the program corresponding to the specific position title or description. This entry may be expressed as a decimal (e.g., Full -Time Equivalent — FTE) when necessary. If other than a full-time position is budgeted, it is necessary to have a basis in terms of time reports to support time charged to the program. c. Amount— The MI E-Grants System calculates the salary for the position required and records it on the Budget Detail. Enter this amount in the Amount column. d. Total Salary —The MI E-Grants System totals the amount of all positions required and records it on the Budget Summary. e. Notes - Enter any explanatory information that is necessary for the position description. Include an explanation of the computation of Total Salary in those instances when the computation is not straightforward (i.e., if the employee is limited term and/or does not receive fringe benefits). 2. Fringe Benefits — Select from the expenditure row look -up applicable fringe benefits for staff working in this program. Enter the percentage for each. The MI E-Grants system updates the total amount for salary and wages in the unit field and calculates the fringe benefit amount. If the "Composite Rate" fringe benefit item is selected from the expenditure row look up, record the applicable fringe benefit items (i.e. FICA, Life insurance, etc.) in the "Notes" tab. 3. Eauinment- Enter a description of the equipment being purchased (including number of units and the unit value), the total by type of equipment and total of all equipment purchases. 4. Contractual - Specify subcontractor(s)/subrecipient(s) working on this program, including the subcontractor's/subrecipient's address, amount by subcontractor/subrecipient and total of all subcontractor(s)/subred pie nt(s). Multiple small subcontracts can be grouped (e.g., various worksite subcontracts). 5. Supplies and Materials - Enter amount by category. A description is required if the budget category exceeds 10% of total expenditures. 6. Travel - Enter amount by category. A description is required if the budget category exceeds 10% of total expenditures. 7. Communication - Enter amount by category. A description is required if the 15 budget category exceeds 10% of total expenditures. 8. County -City Central Services - Enter amount by category and total for all categories. 9. Space Costs - Enter amount by category and total for all categories. 10. Other Expenses - Enter amount by category and total for all categories. A description is required if the budget category exceeds 10% of total expenditures. 11. Indirect Cost Calculation - Enter the base(s), rate(s) and amount(s). 12. Other Cost Distributions - Enter a description of the cost, percent distributed to this program and the amount distributed. 13. Total Exp. - MI E-grants totals the amount of all positions required and records it on the Budget Summary. F. Program Budget -Cost Detail Schedule Preparation B1 Attachment 131-Proaram Budaet Summary Agency ABC Health Department Program Comprehensive Agreement -FY 20 XX ApplicationFamily Planning Serticee SAMPLE 6how 00cumenla cenrficnhons Budget I Miscellmoons Index I xCioae �FecesheeIr uvalidate 6i XFOF .CppY hshow Tree (�(t} Budget Summary l OIRECTEXPENSES Program Expenses Salary E Wages 9341900I, 83,419 Ocd - - 000', 000 121 Forms Benefits 34202001 34,20200j OOo'l' 000 (91 Cap Exp for ENmp&Far 1 I, lZ Contractual , 19 1 Supplies and tdetenels 23,27500 23275001, 00011 0001' Treeel 3,34000 3340,OOI, 00011 1 0001 Commumcatlnu 7262 Oni, 1,2620011 Dog 1 00011 County City Central Sererres I I 1 1 1� Spare Casts 10,131001i 10, 13100' 000, 0001I M All Others tAOP Con Employees AS, 1 3,69400p 1 3,0940D 0001 0001, 0 Total Program EFPense6 1 165F230D, 1 165.5230011, 0001 1 0001 _- TOTALOIRECTEXPENSES 165,12300l 1 16552300'I cool, 1 0Poll INDIRECT EXPENSES Indirect costs 1 ltdimct ucMs 29,40500 29,405001 000 0.00 51 Other Costs UrstnOubons 1,E85.9D, '�, 1,685001 000 000'ii 0 Total Indirect Costa 31,0 31,03000 _ 0.001 0001, TOTAL INDIRECT EXPEN SES 1 3 1,090 0011 1 31,090001 o001 0001, TOTAL EXPENDITURES 1 196,613 OU1 1 196,613001 0001 it 09011 - 16 Source of Funds A9enq ABC Health Oepadmenl -- ---- Program Comprehensive Agreement -FV 20aR or Phcalium Family Hawing Services BAMPLE Snmz Documents FSCesheal CertlfCaYoni I Bptl9 1 1.115CBIIane0u5 Ind. % CIOSe O SaSv lllli p0 IN;,IN=3 POF Qi'-COpY J_Show hm I11 (11 Source of funs _ ENOITURE ---- -- TOTALE%P1 9 __-- -- - 001 1966113 -- Cool D00.' --- -- 00, 196fi13 t1' In I source of rruds ( Fees and Co116cilon5-1 at ..it 2nd Parry Cool osol; 000' 000 h1 Fe es and Collec0ovs-3rd Parry 000 66,00000'i 0.001 66,000.00 21 Federal of State Blon MOCH) 000 00011 0.00 0001 d >' Federal Cos) Based ftelmbursement 000 19,000OOI, 0.00� t9,00J 001 C"3 Pedelally Provided Vadtmea 1 000' Om'il 0001 Cod Ifetleral fdedlcald Oulreac0 a or 000 0.00 OOOI Q (Required Match - Local gOJ _ Cool, 00U" 00011 Local PlomEIPHS COD' cool, I aDO, 000 Local l lon-ELPHS BOB _ 000I 0.001 0,00', 'Other (ion-ELPHS 000d 000I 000 0001 Ly LIDCH (don Oelnprehera). 0.00I 000i 0ooI JOo d % IJDOH Compmhenelue 56,e13001 DOD 1 000 66,01300. Q ,ELPHS —MOCH Hearing --- 000III 000 000 O,m ELPHS—HOCH Vision 000'1I 000 000, OOO,i d _ ELPHS—MDCH Other l 000' l 000, OOOy 000 d ELPHS—Food 000 000 000 0.00 L^j ELPHS—Ddnidng Waist 000 aon Coot 0001, [j ;ELPHS —On-Rile Sewage 0.00 O.00 O00 OCC Gi MCH Fundm9 - 0.00 0Oo' 000; 0,0 V Local Fundd Other Boo, ', 44,00000' 000'1l dp.60000, 0 __ 1lnklnd ldatch 000 0.00 00011 000, 'h1DCN fINOd UlI1l R0IB O 000, 000,, 0,001,; uoa q _1 17 B2 Attachment B2-Proaram Budaet Cost Detail Aged, ABC Health Department PPP11callo0 Family Pladdrig5srvlees SAMPLE Facesneet Certifications Budget I M111sce0ane o0 e Program Comprehensive Agreement -FY 20M Index C Sa� ♦D Savet 93BIItle1¢ F 9pDF NCopy BudgetBefaA Category. Program Expenses - salary&'Wages Type 'Expenditure Cseadicuum Seq. 1 Sue Type. Direct InstructionsSelerttreposlion Cesar,moa 4Jenntylhequannyas"l leeuber the rate a i average cost per RE x Clx-o );Shaw Tree faJ(a) IJarrapve: i3 ❑�Y,Y Practitioner iuu _ ___IIIII1 1�90 �00 tjurss ❑-!Public H..M Nurse W �s III'II10 J6 3432�IFT 6F699100F 180 000 W'�I�WYWJ11�11`�' C. rato, 019 910000 ,290001 17,29000 000 000 L,J -- - 3 000 '.7 ❑ 110360 20,925901 2092 AO 000 000 Q1 ❑ _ - - - _ IQ, 1091 28)22401I'M I❑ 29,13500, 29,13500'Boo'L�] OLSarel IO save 1Lj Va lldate¢� a�J� DF Va CopY kShow Trer. (I)il) Budget Detail Category' Program Expenses - Cap Ern of EqulpdFac Type IEYpendlture Classiflcatwo Rb'.. 1 Sub Type Dlfer4 Ifarfaw Q j InSINCIIOna I Epeficeent ntle...E astM1e ai'refeslnAle Mem vaNernsce AAA pr, O'e"tle+We(will ltle olmor dor One year Cmts seOuppies ar thefame, ere, ! ,eppOcaele eepensessucenain¢IeIlefloncpsls manlenancp teas, tilt XemamsOnAlasslM1an S[AOO spoultl 4e enlsreq mlp Me suppBas enU nielenals line. ❑ EI 1 L!J O SnVa aver' IIf Va lltlate WpDF Copy r ShoW Taee (41 (1) Budget Need Dalegory !program Expenses - Con¢adual Vie; ''Expenditure IassNcaOon Sub Type read Nanalive Instructions. jCpOtmelUel lelxl9M ¢econda/RapknlolAem±a10na Onb Pion,arx,bectelect lntglmalbn C¢nsuXapts anti supFOILnA se!'+Ice supc¢nlrnds sM1OUH Le Cutl9alE1 unLertbS ¢Ih....pen¢e the C saes Osavei 60 V.IWata F NPpOF Copy Ip Shaw Tres Budget Breton Category - muscled Expenses-9upples and Maleals Type: Expdlle I� ClasslOcaM1OP Seq 11 Level NUne Item 6Catagem Sub Type Direct ilarratwe @9 1p51lllClOns. 'Wnna Mef :a%!eaa lhart 55,p00 Li p Ponetur ❑ Y 11 Postage -- - - OSavrry OSaveC [:I Validate�yq PDF Copy Budget Betpll - - -_ .- --- - -- Category' Program Expenses -Travel Classigcahon earl 1 Level 0Llne Item 11Category jnslNrOons ❑ r 'Condolences 10000' 100.001 000 coo )'.7 70000 10000I 000', coo CJ L Show Tree ��I (�) Type Expenditure SO Type Dlred ined.tive L:j 3,00000 3.00000: 000 a00, 1'J B 34000, 340.00, 000 000', L°,1 Is e sere wave+ Cc,I vaudate n..�l PDF E�cpnr Budget Detail Category I Program Expense" -Communication Type Eependlfum Classecation Seq. 11 Level. Yi Une Item C` Category Sub Type: 101pect IIIetILlftOns ❑ T' :,other I phones and IT Imes eser. 16sara : I d V.Ild.al U ISPPDF by Copr _Budget Detail_ Category. Program lopenses- County-Clry Central Services Classigcatlon Seq,. :1 Level. I:>Urlltem ()Category Inebudlens: . _.._...... ....... Q 7,262001— 7,2620 Type 6pendlWre Sub Tlpe, Chad ❑ ❑ �I e sore I esava, Luyalldarau a .• PPUF Lkbcapy Budget Detail Calegary Program Expenses Space Costs Type' Expenditure Classlgaailon Seq 1 Level: !)Linellem()Category Sub Type 'Dived ❑ Y 'Rent J' 6,923001 T IClher --- - - Willllles esara esara 5' f�Vabdele� I'I'„ „ �PUF I�Cppy Budget DelsA Category: Program Expenses- All Others IMP, Can Employees, Mlsc 2,608 00, 2.608 001 Type FJpa0tlIWI6 Bub Type Direct ' 300001 aoo oD' no an I :nn nn' El Fiscal Year Rate 81 25000,:117621,0 29,405,001 ❑ BI EPEE] e save e5mn> Ed Validate II�cnpy Budget Detail Category unload Costs- Other USIS DISVIbullons Type Expendllura Clasafhahon Seq. 3 Sub Type. malted Instructions El Plursagadmole butlon El le show Tree ii)ii) PlarratbeM cashl w1upw Bolas —-li:shaw beet IS) 1) llenabve C7 1 P5 `' UtshPwTraaIshrlw Tr (I) (I) I] Idarralive 000 00o tfd 000 00o t'?] t' show heal I r) i ry ila rah''. �- 0.00, D 00 12 O.00i n nn� n nn iy=1 Y show Tree) tlartative' 0 0.00 0,0o B) ICJ II+ Show Tr—al(5ii1} I_larrallve Ill 1.66500,1 1,60500; 000, 000, C.J 10. i J 19 G. Medicaid Outreach Activities Reimbursement Procedures Medicaid Outreach Activities that are funded by local dollars and meet federal requirements are eligible for reimbursement at a 50% federal administrative match rate. Local Health Departments must maintain proper documentation of the activities performed and those activities must conform with the activities outlined in MSA Bulletin 05-29. Medicaid Outreach Activities funding is a subrecipient relationship. Budget Preparation A. Medicaid Outreach Activities Complete the MI E-Grants application and budget forms for the application Medicaid Outreach Activities that occur during the fiscal year: 10/1-09/30. Reimbursable activities included in the budget must conform to the requirements as specified in the MSA Bulletin 05- 29. Complete the MI E-Grants application and budget forms for this program. 1. Expenditure Cateoory Tab Enter the expenditures budgeted for the fiscal year: 10/01-09/30. Expenses budgeted for each of the listed expenditure categories are allowable and must be specific to the Medicaid program as described in MSA Bulletin 05-29. Outreach activities must not be part of direct service. Expenditures must be reflected in the cost allocation plan. 2. Source of Funds Tab Budget the amount expected from the federal government for allowable Medicaid Outreach Activities. Federal Medicaid Outreach represents the anticipated 50% federal administrative match of local contributions. Budget the local contribution. Required Match - Local represents the 50% matching local contribution for Medicaid Outreach activities. These two amounts must match 3. Sources of Local Funds TVDeS Local Health Departments may utilize their county appropriation, any earned income, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the Health Department as a source for matching funds. Other state and/or federal grant awards for Medicaid Outreach must be recorded on the appropriate line as indicated in the Comprehensive Budget Instructions - Attachment I. B. Nurse -Family Partnership Outreach (applicable only for Berrien, Calhoun, Ingham, Kalamazoo, Kent, Oakland, and Saginaw) z0 Complete the MI E-Grants application and budget forms for the application titled Nurse -Family Partnership Medicaid Outreach for the timeframe: 10101-09/30. Complete the MI E-Grants application and budget forms for this program. Expenditures related to Nurse -Family Partnership Medicaid Outreach should be reflected under one program element and adhere to Section Vill, Special Budget Instructions section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1-09/30. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD Nurse -Family Partnership program has been applied. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution in Required Match — Local. Federal Medicaid Outreach and Required Match — Local must equal each other. Additional local contribution related to service provision for non - Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds — Other. 3. Sources of Local Fund TvDes Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non- federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the Health Department as a source for matching funds. CSHCS Medicaid Outreach Complete the MI E-Grants application and budget forms for the application titled CSHCS Medicaid Outreach for the timeframe: 10/01-09/30. Expenditures related to CSHCS Medicaid Outreach should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1- 09/30. 1. Federal Medicaid Outreach 21 Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD CSHCS program has been applied. A table containing each health jurisdiction Medicaid Participation Rate is located in the MI E-Grants site. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Reauired Match - Local Represents the 50% match of local contributions. Budget the local match contribution. Federal Medicaid Outreach and Required Match — Local must equal each other. Additional local contribution that is not eligible for the 50% federal match should be reported on the Local Funds — Other line. 3. Sources of Local Fund Tvues Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the health department as a source for matching funds to be used at the discretion of the health department as a source for matching funds. 4. Comprehensive CSHCS Outreach and Advocacv and Case Manaaement/Care Coordination Funds Should be reported in a separate program element. D. Indirect Costs There are three (3) options for indirect costs. They are: 1. an approved federal or state indirect rate 2. a 10% de minimis rate; or 3. a cost allocation/distribution plan Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go to VI. Form Preparation, L. Indirect Cost, on page 5 of this document. E. Cost Allocation Certification The Cost Allocation Certification remains on file with the Department until there is a change in the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS-Medicaid- Outreach), the local health department must: 1) submit a copy of the revised cost allocation plan with the budget request; and 2) complete a revised cost allocation methodology certification. Both documents are to be attached to a Detailed Budget line in EGrAMS. 22 II. Financial Status Report (FSR) — LHDs seeking 50% federal administrative match must request reimbursement by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through MI E-Grants. A. Quarteriv and Final FSR LHDs must reflect the actual Medicaid Outreach expenses incurred on the quarterly and final FSR. Actual expenses incurred must be specific to Medicaid Outreach as defined by the MSA Bulletin 05-29 and not part of a direct service. All expenses should be supported by an approved methodology and appropriate support documentation. Federal Medicaid Outreach Should be used to request the 50% federal administrative match for Medicaid Outreach. Reauired Match - Local Should be used to report the local match for Medicaid Outreach, both the federal and local amounts must match. 3. Source of Funds Cateqory Other source of funds that are non -reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds — Other). Total Source of Funds must equal Total Expenditures. B. Nurse-Familv Partnership Medicaid Outreach — Quarteriv and Final FSRs, For Quarters 1-3, LHDs must reflect the actual Medicaid Outreach expenses incurred in a separate program element titled Medicaid Outreach. Actual expenses incurred for each of the listed expenditure categories are allowable but must be specific to Medicaid Outreach as defined by MSA Bulletin 05-29 and not part of a direct service. Expenses should be supported by a time study or other federally approved methodology. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Reauired Match - Local �3 Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match, Both lines should equal. Additional local contribution related to service provision for non -Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Cateaory Other source of funds that are non -reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds — Other). C. CSHCS Medicaid Outreach — Final FSR CSHCS Medicaid Outreach billing may occur before the final FSR through the MI E-Grants system after Comprehensive Agreement CSHCS Outreach and Advocacy funds have been fully expended. Local contributions eligible for the Medicaid Outreach match should be cost distributed to the CSHCS Medicaid Outreach program element from the CSHCS Outreach and Advocacy program element and reported as indicated below. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Reauired Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match, Additional local contribution that is not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Cateaory Other source of funds that are non -reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I. 4. Comprehensive CSHCS Outreach and Advocacv and Care Coordination Should be billed as separate program element. III. Comprehensive Local Health Department Agreement Obliaation Renort — filed in September. 24 The Obligation report is used to estimate the payable amount due to Local Health Departments from MDHHS for each program element. A. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach Activities to be earned from Medicaid Outreach on the Federal Medicaid Outreach row. B. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach activities to be earned from CSHSC — Medicaid Outreach. This should reflect the local contribution multiplied by the Medicaid enrollment participation rate x 50% federal match rate. C. In the Estimate Column, enter the maximum projected federal administrative match earnings for allowable Medicaid Outreach activities to be earned from Nurse Family Partnership Outreach. This should reflect the local contribution multiplied by the Medicaid enrollment participation rate x 50% federal match rate. Note: CSHCS Outreach and Advocacy and CSHCS Care Coordination activities funded through the Comprehensive Agreement are recorded as separate program element. H. Michigan Colorectal Cancer Screening Program — The Michigan Colorectal Cancer Early Detection program (MCRCEDP) budget is to be developed in the following ways: This budget is intended to cover all staffing and coordination for the program. All allowable expenses will be reimbursed through the Local Health Department Agreement. All direct service claims must be billed through the MDHHS Cancer Prevention and Control Section. The LHD and/or direct service providers with contracts or letters of agreement with the LHD will be responsible for billing. The staffing, coordination and direct service total amount is $255 per woman or man based on a target caseload established by MDHHS. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 90% performance requirement for this program. The performance target output measure is the number of women and men that complete a screening test for colorectal cancer. For specific program requirements, including current direct service reimbursement rates and other documentation refer to the most current MCRCEDP manual. 25 Object Class CategorylP.xpenses i I NTC-cnly site visits aFIX-only site visits Comb-med (A.FLX R VFC site visits) Perinatal hospital record reviews Allowable with 3I" operations funds ✓ i I, Equipment* Iax mnbines for vaccire orlcrine Vaccine sw-rage equipment for WC vaccine Copy machines `Eguiptnerr: an curie?e of tculgible rionp-Tent able personproperty hra -h g ria ful life q f more than one year and of acquisition rose of $5.000 or mare per unit. lfoost is 'below this threshaid aarount• item+rriav be inciudedin supplies. Supplies Vaccine administration supplies (including, but not limited -,n_ nasal phanmgealswabs,sr.ingesfor cmer!�cncy vaccination cl'mics) ©fficc supplies -computers, genera] office {pens, paler, paper clips. e:c.p, ink cartridges,. calculators Personal computers t Laptops i Tables °ink Books, Rew Books. Yellow Books j i E'rirters I J J Allowable 1,Allowable, Allowable Allowable j Allowablewitb, i. Allowable with WCwith 1 EC with with PanVFC Distribution 1 gifii PPJU operation :ordering "tfcam nu funds i fonds i,' feuds sfunds I funds funds i (IVlfereapplicable) / ✓ ✓ I j I I I i J � J � ✓ fur J II- I ✓ ✓ J J J I , j i ✓ i i ✓ t i J J ; ✓ ./ J J ✓ � J � ✓ i ✓ J r J '16.1M 16 ' rtiot I —The Basics p MOM 1-017 Object Class Ca"orcfi�:apeases k . AHowable AUowxhle Allowable A_ ilowable ' Allowable- Allowable with Mowable . I witb 317 operations witb NT C operation witls VFC f with VFG`AFLX ! with Pan - - VFC Distributing with PPHF ordering { Fill funds funds funds funds' sfunds funds funds: _ (xkcrenpp cahte) i Laboratory supplies {influenza cuhures .{ and PClts. cultmes and moietular, lab ✓ m..dia serotypin I Dwital data logger wan valid certif•.care ✓ � � f 9r C2[ilip IrPOC t '&ll �ai101 'C SIflRj :xport Vaccine slapping stipplies (sxomyt ✓ / cctrtainars,-ice tracks, bubble wap, etc.) I Contractual I i Start"local tonfmnres exacmes I, (conference Sate, materials pr:rSair g' hotel ! ✓ ✓ ✓ � ✓ accommodations expeR_es.sprakcrfees) I Food cost �s a;a.' al;av�a,51e. j I Reginnal;Lors1 n:sctint;s i ✓ ! ,/ d ✓ � ✓ Ciercr I C0:V` ctual ser`'iCCS (e-,g_ IAPs, kwa heath deparmenos, con.rcaiz[ ✓ i stall, advisory eommiftee media. ✓ ✓ ✓ x' provider trainings) CSA Coutraepjal se:-4ices (CI) C ✓ ✓ j (Xaer US cuntracmal s;rctiKnents s (SL`p^yDlr. enhSRccn em. upgrares) V ✓ eaa-e�rus ,� Financial .As"istanee (rA) :ton -CDC Contract vaccines _ requested in funding 117 vac. int fumA must b. apriicaCoD f�GtATISi under 317 FA'accines % 16`2016 Section I-11e Basacs p.'_'3 IPOM 2017 Dbjeet Class Category(Espenm i Ailowable Allowable Allowable with 317 with VFC ` with VFC aerations operation .ordering { fonds stands i 'funds - Indirect I Miscellaneous I Accounting services - - ✓ ✓ Advertising (_ca-trictcd tc recruitment of staff or trainees, procurement of goods ✓ ✓ and services, disposal of scrrp or s�arphas materials) Audit Fees ✓ ✓ _ BRFSS Survey ✓ CommIme mettings ('.00m rtrtal, etlaiprrcut rcn:a',etO ✓ ✓ %cmztutucadcn (etecmanicr'cotnptuer transmittal, messenger, postage, local and ' ✓ � ✓ long distance telephone) I Consumer information ac5ritics ✓ ✓ Gensurter i provider hoard participation (travel reimbursement) ✓ I Data precessint= ✓ ✓ L aboraton services (ests conduc-ed for immunization program) i ✓ Local service delivery aclivities j ✓ Maintenance operatics -repairs _- ✓ Malpracticc insmnce fbr volunteers I ✓ Membershins: subsuri-Lon5 ✓ NIS Ov.Isamplusg ✓ Paec:S'Ccll Phones ✓ ✓ Printing of vace-ine acco;tntahii:ty forms ✓ ✓ 9116;2016 Allowable j Mlowable t Allowablewith Altowable i with, with Pan 11-PC DisWbution wifh PPHF VTCIAFIX F Flu foods (I - funds funds hinds {wTiereuppTi€alilej € I , + I J i ✓ I I ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ I ✓ I I i I f i I f ✓ Section 1—Thc Basics p14 ffhreet Class CategoryTxvenses Allowable Allowable Allowable Allowable Allowable ; Ailowable with ; Allowable. With 317 with NIFC with 4TC. with with Pan WC:Distributiou with PPHF operations operation 1 ordering VF'CIAJwik Flu funds funds funds ' funds s funds ! funds - `. funds ; (where upplicahle) i i Professional service casts direr: i!v rslated to immunization. activities (::suited term I ✓ ✓ I s'.affl, Attome4• Genera Office services PLb1ic relation; ✓ j , - Publica8oninrintingcosts (11 ocher irranunizatlon related Publication and r / I ✓ r � printing expenses} Rent (mgstires explanation ofivhy hes; i costs are not irtc'udetl in the indirect cast I ✓ rate agreement or cost allocation plan) ' Sh ppin_g fa: materials (other `Im ✓ 'VaGGit:e} Sofhvarelicense;Renew�als(ORACLE ✓ etc.) Stipend RremEursemerts J To1I-fine phone lints for vac—,inc I E t~rderrs i raining costs ® Statmide, staff. ✓ i providers Tramlations (transfaTing materials) ✓ t, Vehicle lease (re tricted to awardees wb ! policies &..at prohibit local travel ✓ I reintbumment) VFf ertirollmmtmated als ✓ VFC pn)vider feedback sttrt ey, j VIs canter-neady Copies � ✓ W162MI6 Section I —The Basics p,_d TOM 01- Ton -Allowable Expenses with Federal Immunization Funds Expense P•iOT allowable with fuderal B itamlmiration funds Flonoa•ariao ✓ Adverti.sin[y casts (e,t;., r. tfn r rrrr uad', +ir..I+f r s, c+a"Pr NYy, naafi yt , ✓ Pyliem rerhWa,,.gi{re} snas�'nirsJ _, Alu-,hr 1 is 1rew'aral c_fi - . ✓ (loildkigparchaases, c« mtruction, capital improvements ✓ ---- - — Land pull -chase's — ✓ - -- Legisladvedlobbyiny activities Bondiap Depivehation on tvw char..pL%-- Heserivch ✓ k'untEraisinK ,•" lnturest on loans 8or cite €;cLlaisitiotr allll.lor lnodornizalion of ✓ naa ex19tirig IniildliIIg Clinical etaro liY�/!FilRlDil+tPilcT(PO1+91?iv`lR.YA'�I Hntcrtainment ✓ Payment of had debt +� _k)cy cleaning Vehicle Purchase ✓ Pcomotional and/or Incentive �'taEsri iIs (e,g., IIfJ (t!(es, rlirdi+i ( rfnri' ✓ L'frl)l1JJGIl+[1P'L+((lit'iiel)!5'.vfeh aspwns, 1J+PI .1J4IdjA). r/Iflt'4l'.Y(•fifll Ct]', fU!{§CII !f1, rorrkl�+nrcrebu�sl Purchase of l uod r'lnaleas ,rsm t vJ`rerlr+i!'rr! lrm�rl ,r.•rr rliern rusts) ✓ t Ath" msti,ioli w; +.vhiob naa:+t be lalicaa inlo accowit w'bale ♦vrltila'g' Il1G IMILlbet:' • Funds may be s cO only Liar activities and lic"onno costs, ihtat are directly i-0111tc(l to the ImniLmization and Vn Vela'% for C•_hildmi C.oripei-ative Agreement. Funding nequests licit d+reoly related to ili'ummizution activities are mit•:.ide the scope of AN coopel'ative agreement pi-ograna and will taut be I'ainded. lflr. iawvaard costs will not 110 reiilllna-seLL W 1612016 Section I—'I'ho Ila.sics 11.26 L ON4 2017 30 ATTACHMENT III MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES LOCAL HEALTH DEPARTMENT AGREEMENT October 1, 2020 — September 30, 2021 Fiscal Year 2021 PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Grantee and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on -site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Many program specific assurances and other requirements are defined within the referenced documents including Minimum Program Requirements established for the following program elements as of October 1, 2006: 1. Breast and Cervical Cancer Control 2. Clinical Laboratory 3. CSHCS 4. EGLE Drinking Water and Onsite Wastewater Management 5. Family Planning 6. Food ELPHS 7. Hearing ELPHS 8. HIV/STD Prevention Treatment 9. MDHHS Essential Local Public Health Services (ELPHS) 10. Michigan Care Improvement Registry 11. Vision ELPHS 12. WIC For Fiscal Year 2021, special requirements are applicable for the remaining program elements listed in the attached pages. Attachment IV Reimbursement Chart Program Element: The Program Element indicates currently funded Department programs that are included in the Comprehensive Local Health Department Agreement. Reimbursement Methods The Reimbursement Methods specifies the type of method used for each of the program element/funding sources. Funding under the Comprehensive Local Health Department Agreement can generally be grouped under four (4) different methods of reimbursement. These methods are defined as follows: Performance Reimbursement A reimbursement method by which local agencies are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of state funds prior to any utilization of local funds. Performance targets are negotiated startina from the last year's negotiated target and the most recent year's actual numbers except for programs in which caseload targets are directly tied to funding formulas/annual allocations. Other considerations in setting performance targets include changes in state allocations from past years, local fiscal and programmatic factors requiring adjustment of caseloads, etc. Once total performance targets are negotiated, a minimum state funded performance target percentage is applied (typically 90% unless otherwise specified). If local Grantee actual performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation for cost reimbursement will be reduced equivalent to actual performance in relation to the minimum performance. Fixed Unit Rate Reimbursement A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. ELPHS A reimbursement method by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required Essential Local Public Health Services (ELPHS), as noted in the current Appropriations Act. Grant Reimbursement A reimbursement method by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total state allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable and a source before any local funding requirements unless a special local match condition exists. Performance Level If Applicable The Performance Level column specifies the minimum state funded performance target percentage for all program elements/funding sources utilizing the performance reimbursement method (see above). If the program elements/funding source utilizes a reimbursement method other than performance or if a target is not specified, N/A (not available) appears in the space provided. Performance Target Output Measures Performance Target Output Measure column specifies the output indicator that is applicable for the program elements/ funding source utilizing the performance reimbursement method. Output measures are based upon counts of services delivered. Relationship Designation The Subrecipient, Contractor, or Recipient Designation column identifies the type of relationship that exists between the Department and grantee on a program -by -program basis. Federal awards expended as a subrecipient are subject to audit or other requirements of Title 2 Code of Federal Regulations (CFR). Payments made to or received as a Contractor are not considered Federal awards and are, therefore, not subject to such requirements. Subrecipient A subrecipient is a non -Federal entity that expends Federal awards received from a pass -through entity to carry out a Federal program, but does not include an individual that is a beneficiary of such a program; or is a recipient of other Federal awards directly from a Federal Awarding agency. Therefore, a pass -through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. Subrecipient characteristics include: • Determines who is eligible to receive what Federal assistance; • Has its performance measured in relation to whether the objectives of a Federal program were met; • Has responsibility for programmatic decision making; • Is responsibility for adherence to applicable Federal program requirements specified in the Federal award; and • In accordance with its agreements uses the Federal funds to carry out a program for a public purpose specified in authorizing status as opposed to providing goods or services for the benefit of the pass -through entity. Contractor A Contractor is for the purpose of obtaining goods and services for the non -Federal entity's own user and creates a procurement relationship with the Grantee. Contractor characteristics include: • Provides the goods and services within normal business operations; • Provides similar goods or services to many different purchasers; 0 Normally operates in a competitive environment; Provides goods or services that are ancillary to the operation of the Federal program; and Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. In determining whether an agreement between a pass -through entity and another non - Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass -through entity must use I udgment in classifying each agreement as a subaward or a procurement contract. Recipient A Recipient is for grant agreement with no federal funding. Amendment Schedule FY 2021 Amendment #1 - New Projects Only Amendment #2 Amendment #3 Amendment Request Due Date August 19, 2020 October 22, 2020 February 17, 2021 Anticipated Consolidation Date October 20, 2020 December 15, 2020 April 20, 2021 Amendment #4 June 10, 2021 July 23, 2021 New Project Start/Effective Date November 1, 2020 January 1, 2021 May 1, 2021 August 1, 2021 lent Laura de la Rambelje Laura de la Rambelje Robert Swanson Marty Soehnlen Laura de la Rambelje Robert Swanson Jessica Altenbernt Laura de la Rambelje Marty Soehnlen Laura de la Rambelje Michelle Twichell Kelly Gram Jennifer Gray / Hope Bartlett Dana DeBruyn Marty Soehnlen Joseph Coyle Steve Utter Aurea Booncharoen Nicholas Drzal Nicholas Drzal Adam Christenson Amy Peterson Joseph Coyle Joseph Coyle (517) 284-9002 DelaRambeljeL@mich (517) 284-9002 DelaRambeljeL@mich (517) 335-8934 Swansonr@Michigan.( (517) 335-8064 soehnlenm@michigan (517) 284-9002 DelaRambeljeL@mich (517) 335-8934 Swansonr@Michigan.( 517-284-8016 AltenberntJ@michigar (517) 284-9002 DelaRambeljeL@mich (517) 335-8064 soehnlenm@michigan (517) 284-9002 DelaRambeljeL@mich (517) 284-0053 twichellm@michigan.g (517) 335-8630 Gramk2@michigan.go (517) 281-3483 / (517) 284-9610 grayj@michigan.gov / (517) 930-6463 debruynd@michigan.g (517) 335-8064 soehnlenm@michigan (517) 284-4915 coylej@michigan.gov (517) 241-0114 utters@michigan.gov (517) 335-9750 booncharoena@michil (517) 241-5380 drzaln@michigan.gov (517) 241-5380 drzaln@michigan.gov (517) 284-5706 christensona@michigC- (313)456-4425 PetersonA7@michigar (517) 284-4915 coylej@michigan.gov (517) 284-4915 coylej@michigan.gov Laura de la Rambelje (517) 284-9002 DelaRambeljeL@mich Shannon Sharp (517) 335-9653 sharpsl @michigan.go Shatoria Townsend (517) 373-6486 TownsendS2@michig< Laura de la Rambelje (517) 284-9002 DelaRambeljeL@mich Trudy Esch / Robin Orsborn (517)241-3593 / (517) 335-8976 MDHHS-Maternal-Chili 3cal Home Visiting Grp Charisse Sanders (517) 241-1676 sandersc2@michigan. Kcal Home Visiting Grp3 Charisse Sanders (517) 241-1676 sandersc2@michigan. Kcal Home Visiting Grp Charisse Sanders (517) 241-1676 sandersc2@michigan. Laura de la Rambelje (517) 284-9002 DelaRambeljeL@mich Robin Orsborn (517) 335-8976 orsbornr@michigan.gc Hillary Brandon (517) 335-5928 brandonh@michigan.c Charisse Sanders (517) 241-1676 sand ersc2@michigan. Scott Bell (517) 335-9300 bells1 @michigan.gov Robin Roberts (517) 335-1178 robertsr6@michigan.g, Charisse Sanders (517) 241-1676 sandersc2@michigan. Charisse Sanders (517) 241-1676 sandersc2@michigan. Charisse Sanders (517) 241-1676 sandersc2@michigan. Scott Bell (517) 335-9300 bellsl@michigan.gov i/30 Tera Poag (517) 335-9018 PoagT1 @michigan.go )/1 - 6/30 Tera Poag (517) 335-9018 PoagT1 @michigan.go Dawn Shanafelt (517) 335-4945 ShanafeltD@michigan Christine Farrell (517) 335-8388 farrellc@michigan.gov Thomas Dunn (517) 373-3725 dunnt2@michigan.gov Matthew Buck (517) 284-2960 BuckM@michigan.gov PROJECT TITLE: Adolescent Sexually Transmitted Disease (STD) Screening Start Date: 10/1/2020 End Date: 9/30/2021 Project Synopsis: Adolescents and young adults account for approximately half of reported cases of gonorrhea and chlamydia. The Oakland County Adolescent STD Project provides targeted screening activities in venues with access to this vulnerable populations to ensure early diagnosis and treatment. Reporting Requirements (if different than agreement language): • Quarterly Report of screening and treatment activity should be submitted no later than 15 days after the end of the quarter. • Report should be emailed to the MDHHS contract liaison Any additional requirements (if applicable): Grant Program Operation Project Summary: Individuals 15-24 years of age will be screened for chlamydia and gonorrhea at the following Oakland County sites: 1. Oakland County Main Jail 2. Oakland County Work Release 3. Oakland County Community Sites where Priority Population Gathers Utilizing the identified project sites: • Test at least 100 adolescents and young adults per month, using NAAT tests for gonorrhea and chlamydia. • Collect race, gender, age, test result, and treatment date for all tests. Refer clients for further health evaluation if indicated. Provide client centered risk reduction plan, promoting abstinence. • Treat all positives on site if possible. • Contact positive clients that are released prior to treatment with treatment options in community. • Promote self -notification of partners. • Analyze and forward screening and treatment data to the Department quarterly: April 15, July 15, October 15, and January 15. • Develop one annual slide set highlighting year end data by demographic variable including trend data. • Continue to promote awareness of prevalence of STDs within adolescent and young adult populations. • Participate in quarterly Michigan Infertility Prevention Project meetings; providing quarterly screening project data. PROJECT: Asthma Demonstration Beginning Date: 10/1/2020 End Date: 9/30/2021 Project Synopsis: Provide evidence -based asthma management education to families and providers in an attempt to decrease hospitalizations and emergency room utilization for individuals with asthma. Reporting Requirements (if different than contract language) Progress report updates are required twice per year per CDC reporting requirements. Any additional requirements (if applicable) PROJECT: Body Art Fixed Fee Beginning Date: 10/1/2020 End Date: 9/30/2021 Project Synopsis This agreement is intended to establish a payment schedule to the Grantee, following notification of a completed inspection and recommendation for issuance of license. The intent is to help offset costs related to the licensing of a body art facility, when fees are collected from the respective Grantee's jurisdiction in accordance with Section 13101-13111 of the Public Health Code, Public Act 149 of 2007, which was updated on December22, 2010 and is now Public Act 375, Reporting Requirements (if different than contract language) The Department will reimburse the Grantee on a quarterly basis according to the following criteria: 1. Initial annual license for a Body Art Facility prior to July 1 • $275,22 (50% of state fee) 2. Initial annual license for a Body Art Facility after to July 1 • $137,61 (50% of state fee) 3. Issue a temporary license) for a Body Art Facility • $123.84 (75% of state fee) 4. License renewal prior to December 1 • $275,22 (50% of state fee) 5. License renewal after to December 1 • $412.83 (50% of state fee + 50% late fee penalty) 6. Duplicate license • $27.51 Payment will be made for those body art facilities that have applied and paid in full to the Department, following notification of a completed inspection and recommendation for issuance of license. Please note that the fees in the list above are based on FY2021 reimbursement rates and are subject to change with the Consumer Price Index. Any additional requirements (if applicable) The Grantee is authorized to enforce PA 375 and conduct an inspection of all body art facilities under its jurisdiction, investigate complaints, and enforce licensing regulations and requirements. The Grantee must complete a Body Art Facility Inspection Report [DCH-1468 (07-09)], as provided by the Department, or other report form approved by the Department that meets, at minimum, all standards of the state inspection report. Only body art facilities that have applied for licensure should be inspected. All body art facilities must be inspected annually. Licenses will only be released from the Department following notification of a completed inspection and upon recommendation by the Grantee. Completed inspection reports should be signed by the facility owner and recommendation for licensure should be forwarded to the Department within two to four weeks following the inspection. Reports should be entered via the online interface or can be sent to: HIV/STD and Body Art Section Division of Communicable Diseases 333 S. Grand Ave, 3 l Floor Lansing, Michigan 48933 PROJECT: CHILD AND ADOLESCENT HEALTH CENTER (CAHC) PROGRAM EXPANSION Beginning Date: 10/1/2020 End Date: 9/30/20201 Project Synopsis A major role of the CAHC program is to provide a safe and caring place for children and adolescents to receive needed medical care and support, learn positive health behaviors, and prevent diseases, resulting in healthy youth who are ready and able to learn and become educated, productive adults. CAHCs assist eligible children and adolescents with enrollment in Medicaid and provide access to Medicaid preventive services. Reporting Requirements (if different than contract language) A. The Grantee shall submit the following reports on the following dates: • Annual Work Plan: Due upon submission of FY initial application • Quarterly Program Data Report: Due 30 days after the end of the reported quarter • Quarterly Work Plan Report: Due 30 days after the end of the reported quarter • Annual Program Narrative: Due 30 days after the end of the grant period B. Any such other information as specified in the Statement of Work, shall be developed and submitted by the Grantee as required by the Contract Manager. C. Reports and information shall be submitted to the Contract Manager as follows: • Annual Work Plan: via e-mail to Kim Kovalchick at kovalchickk@michigan.gov Quarterly Program Data Report: via the Child and Adolescent Health Center Clinical Reporting Tool located at httos://cahc.knack.com/clinical-renortine- tool#home/ • Quarterly Work Plan Report: via e-mail to Kim Kovalchick at kovalchickk@michigan.gov • Annual Program Narrative: via e-mail to Kim Kovalchick at kovalchickk@michigan.gov D. The Contract Manager shall evaluate the reports submitted for their completeness and adequacy. E. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager Any additional requirements (if applicable) Funding Eligibility To be eligible for funding, all applicants must provide signed assurance that referrals for abortion services or assistance in obtaining an abortion will not be provided as part of the services (MCL §388.1766). For programs providing services on school property, signed assurance is required that family planning drugs and/or devices will not be prescribed, dispensed or otherwise distributed on school property as mandated in the Michigan School Code (MCL §380.1507). Applicants must assure compliance with all federal and state laws and regulations prohibiting discrimination and with all requirements and regulations of MDE and MDHHS. Target Populations to be Served Proposals should focus on the delivery of health services to ages 5-21 years at school -based sites, and 10-21 years at school -linked sites, in geographic areas where it can be documented that health care services that are accessible and acceptable to children and adolescents require enhancement or do not currently exist. The children (birth and up) of the adolescent target population may also be served where appropriate. Funding may be used to provide clinical services to students receiving special education services up to 26 years of age. Technology Successful applicants are required to have an accessible electronic mail account (email) to facilitate ongoing communication. All successful applicants will be added to a CAHC program list serve, which is the primary vehicle for communication from the State. Successful applicants must have the necessary technology and equipment to support billing and reimbursement from third party payers. Refer to Reference A, Minimum Program Requirements which describes the billing and reimbursement requirements for all grantees. Training At least one staff member is required to attend a yearly Michigan Department of Health and Human Services CAHC Annual Meeting in the fall, as announced by the MDHHS team. Unallowable Expenses The following costs are not allowed with this funding: • The purchase or improvement of land • Fundraising activities • Political education or lobbying, including membership costs for advocacy or lobbying organizations • Indirect costs The following restrictions are in effect for this funding: • Funds may not be used to refer a student for an abortion or assist a student in obtaining an abortion (MCL §388.1766). • Funds may not be used to prescribe, dispense or otherwise distribute a family planning drug or device in a public school or on public school property (MCL §380.1507). • Funding may not be used to serve the adult population (ages 22 years and older), with the exception of students up to 26 years of age who are receiving special education services. • Funds may not be used to supplant or replace an existing program supported with another source of funds or for ongoing or usual activities of any organization involved in the project. Minimum Program Requirements The Minimum Program Requirements document that follows is considered to be part of Attachment III. PROJECT: Childhood Lead Poisoning and Prevention Beginning Date: 10/1/2020 End Date: 9/30/2021 Project Synopsis MDHHS CLPPP's mission is "to prevent childhood lead poisoning across the state through surveillance, outreach and health services". This grant provides local health departments the opportunity to prevent and address lead poisoning within their community, with support of CLPPP. The overall goal of the grant is to increase testing for children under the age of 6, specifically capillary to venous testing rates within the grantees focus area. Grantees could achieve this goal through: 1) Educating providers about testing, risk factors, this can include: • Distribution of toolkits f Promotion of an online training module for health care providers Hosting provider forums/trainings 2) Educating parents about testing, cleaning, risk factors, this can include: Establishing a protocol for following up with families to get a venous confirmatory test after an elevated capillary test. 3) Outreach to at -risk populations, this can include: f Non -Medicaid children — providing nursing case management home visits • Foreign adoptees, refugees, migrants, immigrants, and foster children Targeted communities (Adrian, Dearborn, Detroit, Flint, Grand Rapids, Hamtramck, Highland Park, Jackson, Lansing, Leoni Township, Muskegon, Muskegon Heights) Reporting Requirements (if different than contract language) Provide a workplan with a detailed overview of how your LHD plans to increase capillary to venous rates within the grantee focus area, and explanation of target audience/locations Submit quarterly reports CLPPP support will include: o LHD report cards o Nursing and Public Health Consultant technical assistance as requested o miclppp.org website with educational materials re: testing, cleaning o Online training module for health care providers Any additional requirements (if applicable) Attend quarterly call/in-person meetings Ensure all communication materials that are developed and distributed by the grantee are approved by CLPPP if MDHHS funds are used. Grantees Focus Areas: • Bay County Health Department — Region 5 • Detroit Health Department — City of Detroit • District Health Department #10 — Regions 2/3 • Genesee County Health Department —City of Flint • Ingham County Health Department — Region 7 w/ additional focus on City of Lansing • Jackson County Health Department — Region 9 w/ additional focus on City of Jackson and Leoni Township • Kalamazoo County Health and Community Services Department — Region 8 w/ additional focus on City of Kalamazoo • Kent County Health Department Region 4 w/ additional focus on City of Grand Rapids • Lenawee County Health Department — Adrian • Muskegon County Health Department — Muskegon and Muskegon Heights • Wayne County Department of Health, Veterans, and Community Wellness — Region 10 w/ additional focus on Hamtramck, Dearborn, Highland Park • Public Health, Delta & Menominee Counties — Region 1 • St. Clair County Health Department — Region 6 PROJECT: COVID-19 Response Beginning Date: 10/1/2020 End Date: 09/30/2021 Project Synopsis: This project allows the Local Health Departments to respond to the COVID response in their community. Response may include testing, outreach, community education, tracing contacts, and data collection. Funding is intended to support staff time and supplies associated with COVID-19 response in the LHD jurisdiction. Reporting Requirements (if different than contract language) Any additional requirements (if applicable) PROJECT: CRF Detroit Testing Beginning Date: October 1, 2020 End Date: December 30, 2020 PROGRAM SPECIFIC REQUIREMENTS Proaram Description and Purpose For COVID-19 funding from the Coronavirus Relief Fund for LHD-supported COVID Testing. The primary purpose for this project is to support staff time and supplies for LHD-supported COVID community testing events for the city of Detroit. Uniform CRF Eliaibility The funding being used for this project is Federal Coronavirus Relief Fund (CRF). As a result, additional provisions apply and are included in this Attachment. The information contained in this Attachment supersedes the General Provisions of the Agreement, as related to all activities undertaken with CRF funding Payments from the Coronavirus Relief Fund may only be used to cover expenditures that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19); 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government; 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Usage of these funds must comply with the federal requirements of the Coronavirus Relief Fund. This project is eligible for CRF funds because CRF funds are intended to be used for community testing events. For a cost to be considered to have been incurred, performance or delivery must occur during the covered period but payment of funds need not be made during that time (though it is generally expected that this will take place within 90 days of a cost being incurred). Administrative Costs • Administrative costs are allowed with this program to the extent that the expenditure can be directly associated to the administration of the program. • R&D costs are not allowed with this program. Eliaible CRF expenditures under this program Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase. Allowable expenses include staffing, communications, supplies to support indoor/outdoor public COVID testing events. Nonexclusive examples of ineligible CRF expenditures • Fund payments may not be used for government revenue replacement, including the provision of assistance to meet tax obligations or unpaid utility fees. • Funds may not be used to fill shortfalls in government revenue to cover expenditures that would not otherwise qualify • Damages covered by insurance. • Payroll or benefits expenses for employees whose work duties are not substantially dedicated to mitigating or responding to the COVID-19 public health emergency. • Reimbursement to donors for donated items or services. • Workforce bonuses other than hazard pay or overtime. • Severance pay. • Legal settlements. Period of Performance October 1, 2020 — December 30, 2020 Program Contact Information Laura de la Rambelje, delarambeliel(o-),michiaan.govwith the MDHHS Office of Local Health Services Section II. Standard Provisions: Proqram Requirements Funds were awarded to the State of Michigan as Federal Financial Assistance from the U.S. Department of Treasury. The funds were awarded under the Social Security Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act') signed into law March 27, 2020 httos://home.treasurv.gov/policv- issues/cares/state-and-local-qovernments as the Coronavirus Relief Fund. The State of Michigan was awarded $3.08 billion dollars under the Coronavirus Relief Fund. CFDA #: 21.019 FAIN #: SLT0040 Coronavirus Relief Funds are considered federal financial assistance and have been assigned a Catalog of Federal Domestic Assistance (CFDA) or Assistance Listing Number of 21.019. Fund payments are considered to be federal financial assistance subject to the Single Audit Act (31 U.S.C. Sections 7501 — 7507) and the related provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Section 200.330 — 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements. Under the Single Audit Act, subrecipients will need to report expenditures under this program using the CFDA number 21.019. Each eligible applicant must register with the Federal System for Award Management (SAM) by September 30, 2020. The SAM website is: httos://www.sam.00v/SAM. Use of Funds: The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover expenses that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19) and 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government. 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Coronavirus Relief Funds expended under this Agreement may only be used for expenses incurred between March 1, 2020, and September 30, 2020, unless the Department notifies the Grantee in writing of a change in the end date of this Agreement. OMB Uniform Guidance for Non-federal Agencies Receiving These Funds The U.S. Department of Treasury has indicated in the Coronavirus Relief Fund Frequency Asked Questions that are accessible at U.S. Department of Treasury Coronavirus Relief Fund FAQ, located at httDS://home.treasurv.aov/system/files/136/ Coronavirus-Relief-Fund-Freauently-Asked-Questions.odf, that the provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Sections 200.330 through 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements are applicable to all CRF subawards at this time. However, guidance is evolving, and jurisdictions will be required to comply with additional guidance as it is published. Effective internal controls must be established and maintained (2 CFR Section 200.303). All reimbursements requested under this program should be accounted for with supporting documentation. Eligible applicants should maintain documentation evidencing that the funds were expended in accordance with federal, state, and local regulations. In accordance with federal Uniform Guidance, funds received under this program shall be included on the eligible applicant's Schedule of Expenditures of Federal Awards (SEFA) and included within the scope of the eligible applicant's Single Audit. The following is a summary of Uniform Guidance provisions that have been identified as significant. Applicants must review the eCFR Uniform Guidance at httos://www. ecfr.aovfca i-bin/text-idx?Sl D=6214841 a79953f26c5c23Od72d6b7Oa 1 &tnl=/ ecfrbrowselTitle02l2cfr200 main 02.to1 for complete requirements. 2 CFR 200.303 Internal Controls The non -Federal entity must: 1. Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non -Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the federal award. 2. Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. 3. Evaluate and monitor the non -Federal entity's compliance with statutes, regulations, and the terms and conditions of Federal awards. 4. Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings. 5. Take reasonable measures to safeguard protected personally identifiable information. 2 CFR 200.330 — 200.332 Subrecioient Monitorina and Manaaement 2 CFR 200.330 Subrecioient and contractor determinations The non -Federal entity may concurrently receive Federal awards as a recipient, a subrecipient, and a contractor, depending on the substance of its agreements with Federal awarding agencies and pass -through entities. Therefore, a pass - through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. The Federal awarding agency may supply and require recipients to comply with additional guidance to support these determinations provided such guidance does not conflict with this section. (a) Subrecipients. A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. See §200.92 Subaward. Characteristics which support the classification of the non -Federal entity as a subrecipient include when the non -Federal entity: (1) Determines who is eligible to receive what Federal assistance; (2) Has its performance measured in relation to whether objectives of a Federal program were met; (3) Has responsibility for programmatic decision making; (4) Is responsible for adherence to applicable Federal program requirements specified in the Federal award; and (5) In accordance with its agreement, uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass -through entity. (b) Contractors. A contract is for the purpose of obtaining goods and services for the non -Federal entity's own use and creates a procurement relationship with the contractor. See §200.22 Contract. Characteristics indicative of a procurement relationship between the non -Federal entity and a contractor are when the contractor: (1) Provides the goods and services within normal business operations; (2) Provides similar goods or services to many different purchasers; (3) Normally operates in a competitive environment; (4) Provides goods or services that are ancillary to the operation of the Federal program; and (5) Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. (c) Use of judgment in making determination. In determining whether an agreement between a pass -through entity and another non -Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass - through entity must use judgment in classifying each agreement as a subaward or a procurement contract. [78 FIR 78608, Dec. 26, 2013, as amended at 80 FIR 54409, Sept. 10, 2015] 2 CFR 200.331 Requirements for pass -through entities, All pass -through entities must: (a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass -through entity must provide the best information available to describe the Federal award and subaward. Required information includes: (1) Federal Award Identification. (i) Subrecipient name (which must match the name associated with its unique entity identifier); (ii) Subrecipient's unique entity identifier; (iii) Federal Award Identification Number (FAIN); (iv) Federal Award Date (see §200.39 Federal award date) of award to the recipient by the Federal agency; (v) Subaward Period of Performance Start and End Date; (vi) Amount of Federal Funds Obligated by this action by the pass -through entity to the subrecipient; (vii) Total Amount of Federal Funds Obligated to the subrecipient by the pass -through entity including the current obligation; (viii) Total Amount of the Federal Award committed to the subrecipient by the pass -through entity; (ix) Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA); (x) Name of Federal awarding agency, pass -through entity, and contact information for awarding official of the Pass -through entity; (xi) CFDA Number and Name; the pass -through entity must identify the dollar amount made available under each Federal award and the CFDA number at time of disbursement; (xii) Identification of whether the award is R&D; and (xiii) Indirect cost rate for the Federal award (including if the de minimis rate is charged per §200.414 Indirect (F&A) costs). (2) All requirements imposed by the pass -through entity on the subrecipient so that the Federal award is used in accordance with Federal statutes, regulations and the terms and conditions of the Federal award; (3) Any additional requirements that the pass -through entity imposes on the subrecipient in order for the pass -through entity to meet its own responsibility to the Federal awarding agency including identification of any required financial and performance reports; (4) An approved federally recognized indirect cost rate negotiated between the subrecipient and the Federal Government or, if no such rate exists, either a rate negotiated between the pass -through entity and the subrecipient (in compliance with this part), or a de minimis indirect cost rate as defined in §200.414 Indirect (F&A) costs, paragraph (f); (5) A requirement that the subrecipient permit the pass -through entity and auditors to have access to the subrecipient's records and financial statements as necessary for the pass -through entity to meet the requirements of this part; and (6) Appropriate terms and conditions concerning closeout of the subaward. (b) Evaluate each subrecipient's risk of noncompliance with Federal statutes, regulations, and the terms and conditions of the subaward for purposes of determining the appropriate subrecipient monitoring described in paragraphs (d) and (e) of this section, which may include consideration of such factors as: (1) The subrecipient's prior experience with the same or similar subawards; (2) The results of previous audits including whether or not the subrecipient receives a Single Audit in accordance with Subpart F— Audit Requirements of this part, and the extent to which the same or similar subaward has been audited as a major program; (3) Whether the subrecipient has new personnel or new or substantially changed systems; and (4) The extent and results of Federal awarding agency monitoring (e.g., if the subrecipient also receives Federal awards directly from a Federal awarding agency). (c) Consider imposing specific subaward conditions upon a subrecipient if appropriate as described in §200.207 Specific conditions. (d) Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward; and that subaward performance goals are achieved. Pass -through entity monitoring of the subrecipient must include: (1) Reviewing financial and performance reports required by the pass - through entity. (2) Following -up and ensuring that the subrecipient takes timely and appropriate action on all deficiencies pertaining to the Federal award provided to the subrecipient from the pass -through entity detected through audits, on -site reviews, and other means. (3) Issuing a management decision for audit findings pertaining to the Federal award provided to the subrecipient from the pass -through entity as required by §200.521 Management decision. (e) Depending upon the pass -through entity's assessment of risk posed by the subrecipient (as described in paragraph (b) of this section), the following monitoring tools may be useful for the pass -through entity to ensure proper accountability and compliance with program requirements and achievement of performance goals: (1) Providing subrecipients with training and technical assistance on program -related matters; and (2) Performing on -site reviews of the subrecipient's program operations; (3) Arranging for agreed -upon -procedures engagements as described in §200,425 Audit services. (f) Verify that every subrecipient is audited as required by Subpart F—Audit Requirements of this part when it is expected that the subrecipient's Federal awards expended during the respective fiscal year equaled or exceeded the threshold set forth in §200.501 Audit requirements. (g) Consider whether the results of the subrecipient's audits, on -site reviews, or other monitoring indicate conditions that necessitate adjustments to the pass -through entity's own records. (h) Consider taking enforcement action against noncompliant subrecipients as described in §200.338 Remedies for noncompliance of this part and in program regulations. [78 FR 78608, Dec. 26, 2013, as amended at 79 FR 75885, Dec. 19, 2014; 80 FR 54409, Sept. 10, 20151 2 CFR 200.332 Fixed amount subawards With prior written approval from the Federal awarding agency, a pass -through entity may provide subawards based on fixed amounts up to the Simplified Acquisition Threshold, provided that the subawards meet the requirements for fixed amount awards in §200.201 Use of grant agreements (including fixed amount awards), cooperative agreements, and contracts. 2 CFR 200.501 — Audit Reauirements (a) Audit required. A non-federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in Federal awards must have a single or program - specific audit conducted for that year in accordance with the provisions of this part. 2 CFR 200.508 — Auditee Responsibilities The auditee must: 1. Procure or otherwise arrange for the audit, if required. 2. Prepare appropriate financial statements, including the schedule of expenditures of Federal awards. 3. Promptly follow up and take corrective action on the audit findings. 4. Provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit. Reoavment for ineliaible CRF expenditures or under soendina Any funds received under the authorizing legislation for this program expended by the eligible applicant in a manner that does not adhere to the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136 or Uniform Guidance 2 CFR 200, as applicable, shall be returned to the state. If it is determined that an eligible applicant receiving funds under this act expends any funds under this act for a purpose that is not consistent with the requirements of the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136, or Uniform Guidance 2 CFR 200, the state budget director is authorized to withhold payment of state funds, in part or in whole, payable from any state appropriation. All subawards are subject to future audits and eligible applicants must allow the State of Michigan, any of its duly authorized representatives and/or State of Michigan's Office of the Auditor General access to the eligible applicant's records and financial statements to ensure compliance with Federal statutes, regulations and the terms and conditions of the grant award. CRF Record Retention Reauirements Recipients of Coronavirus Relief Fund payments shall maintain and make available to the U.S. Department of Treasury, Office of Inspector General, upon request, all documents and financial records sufficient to establish compliance with subsection 601(d) of the Social Security Act as amended, (42 U.S.C. 801(d)). Records shall be maintained for a period of five (5) years after final payment is made using Coronavirus Relief Fund monies. These record retention requirements are applicable to prime recipients and their grantees and subgrant recipients, contractors, and other levels of government that received transfers of Coronavirus Relief Fund payments from prime recipients. Records to support compliance with subsection 601(d) may include, but are not limited to, copies of the following: 1. general ledger and subsidiary ledgers used to account for (a) the receipt of Coronavirus Relief Fund payments and (b) the disbursements from such payments to meet eligible expenses related to the public health emergency due to COVID-19; 2. budget records for 2019 and 2020; 3. payroll, time records, human resource records to support costs incurred for payroll expenses related to addressing the public health emergency due to COVID-19; 4. receipts of purchases made related to addressing the public health emergency due to COVID-19; 5. contracts and subcontracts entered into using Coronavirus Relief Fund payments and all documents related to such contracts; 6. grant agreements and grant subaward agreements entered into using Coronavirus Relief Fund payments and all documents related to such awards; 7. all documentation of reports, audits, and other monitoring of contractors, including subcontractors, and grant recipients and subrecipients; 8. all documentation supporting the performance outcomes of contracts, subcontracts, grant awards, and grant recipient subawards; 9. all internal and external email/electronic communications related to use of Coronavirus Relief Fund payments; and 10. all investigative files and inquiry reports involving Coronavirus Relief Fund payments. Reoortina Requirements: Additional information will be communicated to you at a future date as the subrecipient or contractor. State agencies may identify and develop additional reporting requirements that is specific for their program. Statewide Reportina Requirements The State Budget Director will report on the status of these funds to the Senate and House appropriations committees and the Senate and House fiscal agencies periodically until all funds are exhausted. U.S. Treasury reporting requirements are evolving and additional reporting guidance will be issued with more detail but the elements described below are the minimum reporting expectations. Federal Reporting Requirements The United States Treasury Office of Inspector General has engaged GrantSolutions, a grant and program management Federal shared service provider under the U.S. Department of Health and Human Services, to develop a customized and user-friendly reporting solution to capture the use of Coronavirus Relief Fund payments. In this regard, the GrantSolutions portal will be prepopulated with prime recipient data to include the Coronavirus Relief Fund payment amount, date, recipient Dun & Bradstreet unique identification number (DUNS number), and contact information. It is the responsibility of the prime recipients to report on uses of Coronavirus Relief Fund payments. Accordingly, each prime recipient shall report Coronavirus Disease 2019 (COVID-19) related costs incurred quarterly. The State of Michigan is currently working on a template (financial status report) that will need to be completed by grantees to assist the State with the required reporting. The following delineates the reporting requirements for the State of Michigan as the prime recipient to provide context regarding the type of information that may be collected through the reporting template. Projects List all projects the prime recipient plans to complete with Coronavirus Relief payments. For each project, the prime recipient will be to enter the project name, identification number (created by the prime recipient), description, and status of completion. Once a project is entered into the GrantSolutions portal, the prime recipient will be able to report on the project's obligations and expenditures. Expenditure Categories Once expenditures are entered against obligations, the prime recipient will need to select the specific expenditure category from the available options from a dropdown menu: a. Administrative Expenses b. Budgeted Personnel and Services Diverted to a Substantially Different Use c. COVID-19 Testing and Contact Tracing d. Economic Support (Other than Small Business, Housing, and Food Assistance) e. Expenses Associated with the Issuance of Tax Anticipation Notes f. Facilitating Distance Learning g. Food Programs h. Housing Support i. Improve Telework Capabilities of Public Employees j. Medical Expenses k. Nursing Home Assistance I. Payroll for Public Health and Safety Employees m. Personal Protective Equipment n. Public Health Expenses o. Small Business Assistance p. Unemployment Benefits q. Workers' Compensation r. Items Not Listed Above - to include other eligible expenses that are not captured in the available expenditure categories Each prime recipient shall also provide detailed obligation and expenditure information for any contracts and grants awarded, loans issued, transfers made to other government entities, and direct payments made by the prime recipient that are greater than or equal to $50,000 as follows. Contracts Greater Than or Equal to $50,000 a. Contractor identifying and demographic information (e.g. DUNS number and location) b. Contract number c. Contract date, type, amount, and description d. Primary place of contract performance e. Related project name(s) f. Period of performance start date g. Period of performance end date h. Quarterly obligation amount i. Quarterly expenditure amount j. Expenditure categories (listed above) Grants Greater Than or Eaual to $50,000 a. Grantee identifying and demographic information (e.g. DUNS number and location) b. Award number c. Award date, amount, and description d. Award payment method (reimbursable or lump sum payment(s)) e. Related project name(s) f. Period of performance start date g. Period of performance end date h. Primary place of performance i. Quarterly obligation amount j. Quarterly expenditure amount k. Expenditure categories (listed above) Loans Greater Than or Eaual to $50,000 a. Borrower identifying and demographic information (e.g. DUNS number and location) b. Loan number c. Loan amount, date (date when loan signed by prime recipient and borrower), d. and description e. Loan expiration date (date when loan expected to be paid in full) f. Purpose of loan g. Primary place of performance h. Related project(s) i. Quarterly obligation amount j. Quarterly payments on outstanding loans k. Recipient plans for reuse of Coronavirus Relief Fund loan repayments 1. Loan/expenditure categories Transfers to Other Government Entities Greater Than or Eaual to $50.000 a. Transferee/government unit identifying and demographic information (e.g. DUNS number and location) b. Transfer date, amount, and description c. Related project(s) d. Quarterly obligation amount e. Quarterly expenditure information f. Expenditure categories (listed above) Direct Pavments Greater Than or Eaual to $50.000 a. Payee identifying and demographic information (e.g. DUNS number and location) b. Direct Payments amount and date c. Related project(s) d. Quarterly obligation amount e. Quarterly expenditure amount f. Expenditure categories (listed above) Aaareaate reportina below $50.000 Aggregate reporting is allowed on contracts, grants, transfers made to other government entities, loans, direct payments, and payments to individuals that are below $50,000. Reoortina on Exoenditures Recipients will be required to periodically report on spend and the forecasted spend throughout the grant program. Below are the reporting dates and requirements for each recipient. Templates will be provided in the future for you to use for this reporting. Fiscal Year ending December 30, 2020 Reporting Period Report Due Date October 1, 2020- October31,2020 Novembers, 2020 November 1, 2020- December 30,2020 INovember 5,2020 November 1, 2020 - November 30,2020 December 5, 2020 December 1, 2020 - December 30, 2020 January 5, 2021 December 1, 2020 - December 30, 2020 January 30, 2021 Reporting Requirements (Grant Opening Certification Financial Status Report Expenditure Forecast Report Financial Status Report Financial Status Report Final Financial Status Report Expenditure Location Report Grant Closing Certification All funds that have not been incurred by September 30, 2020 must be returned to the State of Michigan by October 30, 2020. The Financial Status Reoort must be submitted with the Grant Closino Certification, Expenditure Location Report. and Outcome Metric Report by October 5. 2020. PROJECT: CRF Immunizations COVID Response Beginning Date: October 1, 2020 End Date: December 30, 2020 PROGRAM SPECIFIC REQUIREMENTS Program Description and Purpose We have large challenges before us to control and prevent COVID-19 cases in Michigan. As witnessed early in the pandemic, our health care system can be easily overwhelmed with sick individuals and the need for ICU beds and ventilators. During any annual flu season, we have the potential to overwhelm the health care system in the same way with the spread of this respiratory disease. The goal during the upcoming flu season is to get as many individuals vaccinated with influenza vaccine as possible to reduce the burden of influenza in the community and on the health care system given the uncertainty of a resurgence of COVID-19. These vaccination efforts need to target the most vulnerable populations first including those populations who have disproportionally been affected by COVID-19 including minority populations. Funding will be allocated to local health departments based on population size and racial makeup within the jurisdiction. The funding formula will be weighted to assure that underserved black populations in Michigan have the ability to receive this influenza vaccine. Local Health Departments are in the best position to know their communities and therefore get the vaccine to the highest risk individuals within the communities. Local Health Departments will be expected to hold outreach clinics to high risk venues such as long-term care, senior centers, nursing homes, and homeless shelters. They will also assist in coordinating the distribution of influenza vaccine to other high risk providers within their community who will have the ability to administer this vaccine including Community Health Centers and Tribal Health Centers, Local Health Departments will be required to report to MDHHS on a monthly basis on activities related to this funding. Uniform CRF Elioibilitv Payments from the Coronavirus Relief Fund may only be used to cover expenditures that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19); 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government; 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Usage of these funds must comply with the federal requirements of the Coronavirus Relief Fund. The goal during the upcoming flu season is to get as many individuals vaccinated with influenza vaccine as possible to reduce the burden of influenza in the community and on the health care system given the uncertainty of a resurgence of COVID-19. Grant will provide funding to the Local Health Departments to assist with the large-scale distribution of the influenza vaccine during Fall 2020. Ensuring adequate distribution of the influenza vaccine will help protect Michigan residents from influenza and help preserve hospital and health system capacity to manage COVID-19 cases and reduce the likelihood individuals will test positive for both influenza and COVID-19. Funding will support vaccination efforts at community health centers, mobile and community clinics, and outreach and vaccinations of vulnerable and high -risk populations. For a cost to be considered to have been incurred, performance or delivery must occur during the covered period but payment of funds need not be made during that time (though it is generally expected that this will take place within 90 days of a cost being incurred). Administrative Costs • Research and Development costs are not allowed with this program Eligible CRF expenditures under this oroaram Staffing Clinical supplies (Band -aids, syringes, gloves, masks, etc.) VFC approved vaccine refrigerator storage units Communication Campaigns Educational materials Purchase of laptop for offsite vaccine clinic use Nonexclusive examples of ineliaible CRF exoenditures Purchase of vehicles Purchase of vaccine Purchase of clothing Purchase of food Purchase of prizes or incentives Period of Performance October 1, 2020 — December 30, 2020 Proaram Contact Information Bob Swanson Director. Division of Immunization 517-335-8159 Section II. Standard Provisions: Proaram Reauirements Funds were awarded to the State of Michigan as Federal Financial Assistance from the U.S. Department of Treasury. The funds were awarded under the Social Security Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") signed into law March 27, 2020 httos://home.treasurv.aov/DOlicv- issues/cares/state-and-local-governments as the Coronavirus Relief Fund. The State of Michigan was awarded $3.08 billion dollars under the Coronavirus Relief Fund. CFDA #: 21.019 Coronavirus Relief Funds are considered federal financial assistance and have been assigned a Catalog of Federal Domestic Assistance (CFDA) or Assistance Listing Number of 21.019. Fund payments are considered to be federal financial assistance subject to the Single Audit Act (31 U.S.C. Sections 7501 — 7507) and the related provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Section 200.330 — 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements. Under the Single Audit Act, subrecipients will need to report expenditures under this program using the CFDA number 21.019. Each eligible applicant must register with the Federal System for Award Management (SAM) by September 1, 2020. The SAM website is: httos://www.sam.aov/SAM. Use of Funds: The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover expenses that: are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19) and were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Coronavirus Relief Funds expended under this Agreement may only be used for expenses incurred between March 1, 2020, and September 30, 2020, unless the Department notifies the Grantee in writing of a change in the end date of this Agreement. OMB Uniform Guidance for Non-federal Agencies Receiving These Funds The U.S. Department of Treasury has indicated in the Coronavirus Relief Fund Frequency Asked Questions that are accessible at U.S. Department of Treasury Coronavirus Relief Fund FAQ, located at httos://home,treasurv.aov/system/files/1361 Coronavirus-Relief-Fund-Freouently-Asked-Questions.pdf, that the provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Sections 200.330 through 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements are applicable to all CRF subawards at this time. However, guidance is evolving, and jurisdictions will be required to comply with additional guidance as it is published. Effective internal controls must be established and maintained (2 CFR Section 200.303). All reimbursements requested under this program should be accounted for with supporting documentation. Eligible applicants should maintain documentation evidencing that the funds were expended in accordance with federal, state, and local regulations. In accordance with federal Uniform Guidance, funds received under this program shall be included on the eligible applicant's Schedule of Expenditures of Federal Awards (SEFA) and included within the scope of the eligible applicant's Single Audit. The following is a summary of Uniform Guidance provisions that have been identified as significant. Applicants must review the eCFR Uniform Guidance at hftos://www.ecfr.aov/cqi-bin/text-idx?SID=6214841 a79953f26c5c230d72d6b70a 1 &tr)l=/ ecfrbrowse/Title02/2cfr200 main 02.tol for complete requirements. 2 CFR 200.303 Internal Controls The non -Federal entity must: 1. Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non -Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the federal award. 2. Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. 3. Evaluate and monitor the non -Federal entity's compliance with statutes, regulations, and the terms and conditions of Federal awards. 4. Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings. 5. Take reasonable measures to safeguard protected personally identifiable information. 2 CFR 200.330 Subrecioient and contractor determinations The non -Federal entity may concurrently receive Federal awards as a recipient, a subrecipient, and a contractor, depending on the substance of its agreements with Federal awarding agencies and pass -through entities. Therefore, a pass - through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. The Federal awarding agency may supply and require recipients to comply with additional guidance to support these determinations provided such guidance does not conflict with this section. (a) Subrecipients. A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. See §200.92 Subaward. Characteristics which support the classification of the non -Federal entity as a subrecipient include when the non -Federal entity: (1) Determines who is eligible to receive what Federal assistance; (2) Has its performance measured in relation to whether objectives of a Federal program were met; (3) Has responsibility for programmatic decision making; (4) Is responsible for adherence to applicable Federal program requirements specified in the Federal award; and (5) In accordance with its agreement, uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass -through entity. (b) Contractors. A contract is for the purpose of obtaining goods and services for the non -Federal entity's own use and creates a procurement relationship with the contractor. See §200.22 Contract. Characteristics indicative of a procurement relationship between the non -Federal entity and a contractor are when the contractor: (1) Provides the goods and services within normal business operations; (2) Provides similar goods or services to many different purchasers; (3) Normally operates in a competitive environment; (4) Provides goods or services that are ancillary to the operation of the Federal program; and (5) Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. (c) Use of judgment in making determination. In determining whether an agreement between a pass -through entity and another non -Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass - through entity must use judgment in classifying each agreement as a subaward or a procurement contract. [78 FIR 78608, Dec. 26, 2013, as amended at 80 FR 54409, Sept. 10, 2015] 2 CFR 200.331 Reauirements for pass -through entities. All pass -through entities must: (a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass -through entity must provide the best information available to describe the Federal award and subaward. Required information includes: (1) Federal Award Identification. (i) Subrecipient name (which must match the name associated with its unique entity identifier); (ii) Subrecipient's unique entity identifier; (iii) Federal Award Identification Number (FAIN); (iv) Federal Award Date (see §200.39 Federal award date) of award to the recipient by the Federal agency; (v) Subaward Period of Performance Start and End Date; (vi) Amount of Federal Funds Obligated by this action by the pass -through entity to the subrecipient; (vii) Total Amount of Federal Funds Obligated to the subrecipient by the pass -through entity including the current obligation; (viii) Total Amount of the Federal Award committed to the subrecipient by the pass -through entity; (ix) Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA); (x) Name of Federal awarding agency, pass -through entity, and contact information for awarding official of the Pass -through entity; (xi) CFDA Number and Name; the pass -through entity must identify the dollar amount made available under each Federal award and the CFDA number at time of disbursement; (xii) Identification of whether the award is R&D; and (xiii) Indirect cost rate for the Federal award (including if the de minimis rate is charged per §200.414 Indirect (F&A) costs). (2) All requirements imposed by the pass -through entity on the subrecipient so that the Federal award is used in accordance with Federal statutes, regulations and the terms and conditions of the Federal award; (3) Any additional requirements that the pass -through entity imposes on the subrecipient in order for the pass -through entity to meet its own responsibility to the Federal awarding agency including identification of any required financial and performance reports; (4) An approved federally recognized indirect cost rate negotiated between the subrecipient and the Federal Government or, if no such rate exists, either a rate negotiated between the pass -through entity and the subrecipient (in compliance with this part), or a de minimis indirect cost rate as defined in §200.414 Indirect (F&A) costs, paragraph (f); (5) A requirement that the subrecipient permit the pass -through entity and auditors to have access to the subrecipient's records and financial statements as necessary for the pass -through entity to meet the requirements of this part; and (6) Appropriate terms and conditions concerning closeout of the subaward. (b) Evaluate each subrecipient's risk of noncompliance with Federal statutes, regulations, and the terms and conditions of the subaward for purposes of determining the appropriate subrecipient monitoring described in paragraphs (d) and (e) of this section, which may include consideration of such factors as: (1) The subrecipient's prior experience with the same or similar subawards; (2) The results of previous audits including whether or not the subrecipient receives a Single Audit in accordance with Subpart F— Audit Requirements of this part, and the extent to which the same or similar subaward has been audited as a major program; (3) Whether the subrecipient has new personnel or new or substantially changed systems; and (4) The extent and results of Federal awarding agency monitoring (e.g., if the subrecipient also receives Federal awards directly from a Federal awarding agency). (c) Consider imposing specific subaward conditions upon a subrecipient if appropriate as described in §200.207 Specific conditions. (d) Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward; and that subaward performance goals are achieved. Pass -through entity monitoring of the subrecipient must include: (1) Reviewing financial and performance reports required by the pass - through entity. (2) Following -up and ensuring that the subrecipient takes timely and appropriate action on all deficiencies pertaining to the Federal award provided to the subrecipient from the pass -through entity detected through audits, on -site reviews, and other means. (3) Issuing a management decision for audit findings pertaining to the Federal award provided to the subrecipient from the pass -through entity as required by §200.521 Management decision. (e) Depending upon the pass -through entity's assessment of risk posed by the subrecipient (as described in paragraph (b) of this section), the following monitoring tools may be useful for the pass -through entity to ensure proper accountability and compliance with program requirements and achievement of performance goals: (1) Providing subrecipients with training and technical assistance on program -related matters; and (2) Performing on -site reviews of the subrecipient's program operations; (3) Arranging for agreed -upon -procedures engagements as described in §200.425 Audit services. (f) Verify that every subrecipient is audited as required by Subpart F—Audit Requirements of this part when it is expected that the subrecipient's Federal awards expended during the respective fiscal year equaled or exceeded the threshold set forth in §200.501 Audit requirements. (g) Consider whether the results of the subrecipient's audits, on -site reviews, or other monitoring indicate conditions that necessitate adjustments to the pass -through entity's own records. (h) Consider taking enforcement action against noncompliant subrecipients as described in §200.338 Remedies for noncompliance of this part and in program regulations. [78 FR 78608, Dec. 26, 2013, as amended at 79 FR 75885, Dec. 19, 2014; 80 FR 54409, Sept. 10, 2015] 2 CFR 200.332 Fixed amount subawards With prior written approval from the Federal awarding agency, a pass -through entity may provide subawards based on fixed amounts up to the Simplified Acquisition Threshold, provided that the subawards meet the requirements for fixed amount awards in §200,201 Use of grant agreements (including fixed amount awards), cooperative agreements, and contracts. 2 CFR 200.501 — Audit Reouirements (a) Audit required. A non-federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in Federal awards must have a single or program - specific audit conducted for that year in accordance with the provisions of this part. 2 CFR 200.508 —Auditee Responsibilities The auditee must: 1. Procure or otherwise arrange for the audit, if required. 2. Prepare appropriate financial statements, including the schedule of expenditures of Federal awards. 3. Promptly follow up and take corrective action on the audit findings. 4. Provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit. Repavment for ineligible CRF expenditures or under spending Any funds received under the authorizing legislation for this program expended by the eligible applicant in a manner that does not adhere to the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136 or Uniform Guidance 2 CFR 200, as applicable, shall be returned to the state. If it is determined that an eligible applicant receiving funds under this act expends any funds under this act for a purpose that is not consistent with the requirements of the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136, or Uniform Guidance 2 CFR 200, the state budget director is authorized to withhold payment of state funds, in part or in whole, payable from any state appropriation. All subawards are subject to future audits and eligible applicants must allow the State of Michigan, any of its duly authorized representatives and/or State of Michigan's Office of the Auditor General access to the eligible applicant's records and financial statements to ensure compliance with Federal statutes, regulations and the terms and conditions of the grant award. CRF Record Retention Reauirements Recipients of Coronavirus Relief Fund payments shall maintain and make available to the U.S. Department of Treasury, Office of Inspector General, upon request, all documents and financial records sufficient to establish compliance with subsection 601(d) of the Social Security Act as amended, (42 U.S.C. 801(d)). Records shall be maintained for a period of five (5) years after final payment is made using Coronavirus Relief Fund monies. These record retention requirements are applicable to prime recipients and their grantees and subgrant recipients, contractors, and other levels of government that received transfers of Coronavirus Relief Fund payments from prime recipients. Records to support compliance with subsection 601(d) may include, but are not limited to, copies of the following: 1. general ledger and subsidiary ledgers used to account for (a) the receipt of Coronavirus Relief Fund payments and (b) the disbursements from such payments to meet eligible expenses related to the public health emergency due to COVID-19; 2. budget records for 2019 and 2020; 3. payroll, time records, human resource records to support costs incurred for payroll expenses related to addressing the public health emergency due to COVID-19; 4. receipts of purchases made related to addressing the public health emergency due to COVID-19; 5. contracts and subcontracts entered into using Coronavirus Relief Fund payments and all documents related to such contracts; 6. grant agreements and grant subaward agreements entered into using Coronavirus Relief Fund payments and all documents related to such awards; 7. all documentation of reports, audits, and other monitoring of contractors, including subcontractors, and grant recipients and subrecipients; 8. all documentation supporting the performance outcomes of contracts, subcontracts, grant awards, and grant recipient subawards; 9. all internal and external email/electronic communications related to use of Coronavirus Relief Fund payments; and 10. all investigative files and inquiry reports involving Coronavirus Relief Fund payments. Reportina Requirements: Additional information will be communicated to you at a future date as the subrecipient or contractor. Subrecipient must identify and develop additional reporting requirements that is specific for their program. Statewide Reoortina Requirements The State Budget Director will report on the status of these funds to the Senate and House appropriations committees and the Senate and House fiscal agencies periodically until all funds are exhausted. U.S. Treasury reporting requirements are evolving and additional reporting guidance will be issued with more detail but the elements described below are the minimum reporting expectations. Reoortina Requirements The United States Treasury Office of Inspector General has engaged GrantSolutions, a grant and program management Federal shared service provider under the U.S. Department of Health and Human Services, to develop a customized and user-friendly reporting solution to capture the use of Coronavirus Relief Fund payments. In this regard, the GrantSolutions portal will be prepopulated with prime recipient data to include the Coronavirus Relief Fund payment amount, date, recipient Dun & Bradstreet unique identification number (DUNS number), and contact information. It is the responsibility of the prime recipients to report on uses of Coronavirus Relief Fund payments. Accordingly, each prime recipient shall report Coronavirus Disease 2019 (COVID-19) related costs incurred quarterly. The State of Michigan is currently working on a template (financial status report) that will need to be completed by grantees to assist the State with the required reporting. The following delineates the reporting requirements for the State of Michigan as the prime recipient to provide context regarding the type of information that may be collected through the reporting template. Projects List all projects the prime recipient plans to complete with Coronavirus Relief payments. For each project, the prime recipient will be to enter the project name, identification number (created by the prime recipient), description, and status of completion. Once a project is entered into the GrantSolutions portal, the prime recipient will be able to report on the project's obligations and expenditures. Expenditure Cateaories Once expenditures are entered against obligations, the prime recipient will need to select the specific expenditure category from the available options from a dropdown menu: a. Administrative Expenses b. Budgeted Personnel and Services Diverted to a Substantially Different Use c. COVID-19 Testing and Contact Tracing d. Economic Support (Other than Small Business, Housing, and Food Assistance) e. Expenses Associated with the Issuance of Tax Anticipation Notes f. Facilitating Distance Learning g. Food Programs h. Housing Support i. Improve Telework Capabilities of Public Employees j. Medical Expenses k. Nursing Home Assistance I. Payroll for Public Health and Safety Employees m. Personal Protective Equipment n. Public Health Expenses o. Small Business Assistance p. Unemployment Benefits q. Workers' Compensation r. Items Not Listed Above - to include other eligible expenses that are not captured in the available expenditure categories Each prime recipient shall also provide detailed obligation and expenditure information for any contracts and grants awarded, loans issued, transfers made to other government entities, and direct payments made by the prime recipient that are greater than or equal to $50,000 as follows. Contracts Greater Than or Eaual to $50.000 a. Contractor identifying and demographic information (e.g. DUNS number and b. location) c. Contract number d. Contract date, type, amount, and description e. Primary place of contract performance f. Related project name(s) g. Period of performance start date h. Period of performance end date i. Quarterly obligation amount j. Quarterly expenditure amount k. Expenditure categories (listed above) Grants Greater Than or Eaual to $50.000 a. Grantee identifying and demographic information (e.g. DUNS number and b. location) c. Award number d. Award date, amount, and description e. Award payment method (reimbursable or lump sum payment(s)) f. Related project name(s) g. Period of performance start date h. Period of performance end date i. Primary place of performance j. Quarterly obligation amount k. Quarterly expenditure amount I. Expenditure categories (listed above) Loans Greater Than or Eaual to $50,000 a. Borrower identifying and demographic information (e.g. DUNS number and b, location) c. Loan number d. Loan amount, date (date when loan signed by prime recipient and borrower), e. and description f. Loan expiration date (date when loan expected to be paid in full) g. Purpose of loan h. Primary place of performance i. Related project(s) j. Quarterly obligation amount k. Quarterly payments on outstanding loans I. Recipient plans for reuse of Coronavirus Relief Fund loan repayments m. Loan/expenditure categories Transfers to Other Government Entities Greater Than or Eaual to $50,000 a. Transferee/government unit identifying and demographic information (e.g. b. DUNS number and location) c. Transfer date, amount, and description d. Related project(s) e. Quarterly obligation amount f. Quarterly expenditure information g. Expenditure categories (listed above) Direct Pavments Greater Than or Eaual to $50,000 a. Payee identifying and demographic information (e.g. DUNS number and b. location) c. Direct Payments amount and date d. Related project(s) e. Quarterly obligation amount f. Quarterly expenditure amount g. Expenditure categories (listed above) Aaareaate reoortina below $50,000 Aggregate reporting is allowed on contracts, grants, transfers made to other government entities, loans, direct payments, and payments to individuals that are below $50,000. ReDortina on Expenditures Recipients will be required to periodically report on spend and the forecasted spend throughout the grant program. Below are the reporting dates and requirements for each recipient. Templates will be provided in the future for you to use for this reporting. Fiscal Year ending December 30, 2020 Reporting Period Report Due Date Reporting Requirements October 1, 2020- October 31,2020 November 1, 2020- December 30,2020 iNovember 1,2020- November 30,2020 December 1, 2020 - December 30, 2020 December 1, 2020 - December 30, 2020 Grant Opening Certification November 5, 2020 Financial Status Report November 5, 2020 Expenditure Forecast Report December 5, 2020 Financial Status Report January 5, 2021 Financial Status Report Final Financial Status Report January 30, 2021 Expenditure Location Report Grant Closing Certification All funds that have not been incurred by December 30, 2020 must be returned to the State of Michigan by January 30, 2021. The Financial Status Report must be submitted with the Grant Closina Certification. Expenditure Location Report. and Outcome Metric Report by January 30, 2021, PROJECT: CRF Local Health Department Contact Tracing Beginning Date: October 1, 2020 End Date: December 30, 2020 PROGRAM SPECIFIC REQUIREMENTS Proaram Descriotion and Puroose For COVID-19 funding from the Coronavirus Relief Fund for Case Investigation, Contact Tracing and Violation Monitoring. The primary purpose for this project is to support staff time for Case Investigation and Contact Tracing and Violation Monitoring. Uniform CRF Eliaibilitv The funding being used for this project is Federal Coronavirus Relief Fund (CRF). As e result, additional provisions apply and are included in this Attachment. The information contained in this Attachment supersedes the General Provisions of the Agreement, as related to all activities undertaken with CRF funding. Payments from the Coronavirus Relief Fund may only be used to cover expenditures that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19); 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government; 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Usage of these funds must comply with the federal requirements of the Coronavirus Relief Fund. This project is eligible for CRF funds because CRF funds are intended to be used for case investigation, contact tracing, and violation monitoring. For a cost to be considered to have been incurred, performance or delivery must occur during the covered period but payment of funds need not be made during that time (though it is generally expected that this will take place within 90 days of a cost being incurred). Administrative Costs Administrative costs are allowed with this program to the extent that the expenditure can be directly associated to the administration of the program. R&D costs are not allowed with this program Eligible CRF expenditures under this proaram Allowable expenses include staffing, communications, IT, office supplies, computers, phones, access to people finding software or EMIR for COVID-19 Case Investigation and Contact Tracing and Violation Monitoring Nonexclusive examples of ineligible CRF expenditures, • Fund payments may not be used for government revenue replacement, including the provision of assistance to meet tax obligations or unpaid utility fees. • Funds may not be used to fill shortfalls in government revenue to cover expenditures that would not otherwise qualify • Damages covered by insurance. • Payroll or benefits expenses for employees whose work duties are not substantially dedicated to mitigating or responding to the COVID-19 public health emergency. • Reimbursement to donors for donated items or services. • Workforce bonuses other than hazard pay or overtime. • Severance pay. • Legal settlements. Period of Performance October 1, 2020 — December 30, 2020 Program Contact Information Laura de la Rambelje, delarambeliel(a)michiaan.gov with the MDHHS Office of Local Health Services Section II. Standard Provisions: Program Requirements Funds were awarded to the State of Michigan as Federal Financial Assistance from the U.S. Department of Treasury. The funds were awarded under the Social Security Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") signed into law March 27, 2020 https://home.treasurv.aov/policv- issues/cares/state-and-local-governments as the Coronavirus Relief Fund. The State of Michigan was awarded $3.08 billion dollars under the Coronavirus Relief Fund. CFDA #: 21.019 FAIN #: SLT0040 Coronavirus Relief Funds are considered federal financial assistance and have been assigned a Catalog of Federal Domestic Assistance (CFDA) or Assistance Listing Number of 21.019. Fund payments are considered to be federal financial assistance subject to the Single Audit Act (31 U.S.C. Sections 7501 — 7507) and the related provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Section 200.330 — 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements. Under the Single Audit Act, subrecipients will need to report expenditures under this program using the CFDA number 21.019. Each eligible applicant must register with the Federal System for Award Management (SAM) by September 30, 2020. The SAM website is: httos://www.sam.00v/SAM. Use of Funds: The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover expenses that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19) and 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government. 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Coronavirus Relief Funds expended under this Agreement may only be used for expenses incurred between March 1, 2020, and September 30, 2020, unless the Department notifies the Grantee in writing of a change in the end date of this Agreement. OMB Uniform Guidance for Non-federal Agencies Receiving These Funds The U.S. Department of Treasury has indicated in the Coronavirus Relief Fund Frequency Asked Questions that are accessible at U.S. Department of Treasury Coronavirus Relief Fund FAQ, located at httos:/Ihome.treasurv.aov/system/files/136/ Coronavirus-Relief-Fund-Freauentiv-Asked-Questions.Ddf, that the provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Sections 200.330 through 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements are applicable to all CRF subawards at this time. However, guidance is evolving, and jurisdictions will be required to comply with additional guidance as it is published. Effective internal controls must be established and maintained (2 CFR Section 200.303). All reimbursements requested under this program should be accounted for with supporting documentation. Eligible applicants should maintain documentation evidencing that the funds were expended in accordance with federal, state, and local regulations. In accordance with federal Uniform Guidance, funds received under this program shall be included on the eligible applicant's Schedule of Expenditures of Federal Awards (SEFA) and included within the scope of the eligible applicant's Single Audit. The following is a summary of Uniform Guidance provisions that have been identified as significant. Applicants must review the eCFR Uniform Guidance at httos://www.ecfr.gov/cai-bin/text-idx?SID=6214841 a79953f26c5c230d72d6b70a1 &tpl=/ ecfrbrowse/Title02/2cfr200 main 02.tp1 for complete requirements. 2 CFR 200.303 Internal Controls The non -Federal entity must: 1. Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non -Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the federal award. 2. Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. 3. Evaluate and monitor the non -Federal entity's compliance with statutes, regulations, and the terms and conditions of Federal awards. 4. Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings. 5. Take reasonable measures to safeguard protected personally identifiable information. 2 CFR 200.330 — 200.332 Subrecioient Monitorina and Manaaement 2 CFR 200.330 Subrecinient and contractor determinations The non -Federal entity may concurrently receive Federal awards as a recipient, a subrecipient, and a contractor, depending on the substance of its agreements with Federal awarding agencies and pass -through entities. Therefore, a pass - through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. The Federal awarding agency may supply and require recipients to comply with additional guidance to support these determinations provided such guidance does not conflict with this section. (a) Subrecipients. A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. See §200.92 Subaward. Characteristics which support the classification of the non -Federal entity as a subrecipient include when the non -Federal entity: (1) Determines who is eligible to receive what Federal assistance; (2) Has its performance measured in relation to whether objectives of a Federal program were met; (3) Has responsibility for programmatic decision making; (4) Is responsible for adherence to applicable Federal program requirements specified in the Federal award; and (5) In accordance with its agreement, uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass -through entity. (b) Contractors. A contract is for the purpose of obtaining goods and services for the non -Federal entity's own use and creates a procurement relationship with the contractor. See §200.22 Contract. Characteristics indicative of a procurement relationship between the non -Federal entity and a contractor are when the contractor: (1) Provides the goods and services within normal business operations; (2) Provides similar goods or services to many different purchasers,. (3) Normally operates in a competitive environment; (4) Provides goods or services that are ancillary to the operation of the Federal program; and (5) Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. (c) Use of judgment in making determination. In determining whether an agreement between a pass -through entity and another non -Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass - through entity must use judgment in classifying each agreement as a subaward or a procurement contract. [78 FR 78608, Dec. 26, 2013, as amended at 80 FIR 54409, Sept. 10, 20151 2 CFR 200.331 Requirements for pass -through entities All pass -through entities must: (a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass -through entity must provide the best information available to describe the Federal award and subaward. Required information includes: (1) Federal Award Identification. (i) Subrecipient name (which must match the name associated with its unique entity identifier); (ii) Subrecipient's unique entity identifier; (iii) Federal Award Identification Number (FAIN); (iv) Federal Award Date (see §200.39 Federal award date) of award to the recipient by the Federal agency; (v) Subaward Period of Performance Start and End Date; (vi) Amount of Federal Funds Obligated by this action by the pass -through entity to the subrecipient; (vii) Total Amount of Federal Funds Obligated to the subrecipient by the pass -through entity including the current obligation; (viii) Total Amount of the Federal Award committed to the subrecipient by the pass -through entity; (ix) Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA); (x) Name of Federal awarding agency, pass -through entity, and contact information for awarding official of the Pass -through entity; (xi) CFDA Number and Name; the pass -through entity must identify the dollar amount made available under each Federal award and the CFDA number at time of disbursement; (xii) Identification of whether the award is R&D; and (xiii) Indirect cost rate for the Federal award (including if the de minimis rate is charged per §200.414 Indirect (F&A) costs). (2) All requirements imposed by the pass -through entity on the subrecipient so that the Federal award is used in accordance with Federal statutes, regulations and the terms and conditions of the Federal award; (3) Any additional requirements that the pass -through entity imposes on the subrecipient in order for the pass -through entity to meet its own responsibility to the Federal awarding agency including identification of any required financial and performance reports; (4) An approved federally recognized indirect cost rate negotiated between the subrecipient and the Federal Government or, if no such rate exists, either a rate negotiated between the pass -through entity and the subrecipient (in compliance with this part), or a de minimis indirect cost rate as defined in §200.414 Indirect (F&A) costs, paragraph (f); (5) A requirement that the subrecipient permit the pass -through entity and auditors to have access to the subrecipient's records and financial statements as necessary for the pass -through entity to meet the requirements of this part; and (6) Appropriate terms and conditions concerning closeout of the subaward. (b) Evaluate each subrecipient's risk of noncompliance with Federal statutes, regulations, and the terms and conditions of the subaward for purposes of determining the appropriate subrecipient monitoring described in paragraphs (d) and (e) of this section, which may include consideration of such factors as: (1) The subrecipient's prior experience with the same or similar subawards; (2) The results of previous audits including whether or not the subrecipient receives a Single Audit in accordance with Subpart F— Audit Requirements of this part, and the extent to which the same or similar subaward has been audited as a major program; (3) Whether the subrecipient has new personnel or new or substantially changed systems; and (4) The extent and results of Federal awarding agency monitoring (e.g., if the subrecipient also receives Federal awards directly from a Federal awarding agency). (c) Consider imposing specific subaward conditions upon a subrecipient if appropriate as described in §200,207 Specific conditions. (d) Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward; and that subaward performance goals are achieved. Pass -through entity monitoring of the subrecipient must include: (1) Reviewing financial and performance reports required by the pass - through entity. (2) Following -up and ensuring that the subrecipient takes timely and appropriate action on all deficiencies pertaining to the Federal award provided to the subrecipient from the pass -through entity detected through audits, on -site reviews, and other means. (3) Issuing a management decision for audit findings pertaining to the Federal award provided to the subrecipient from the pass -through entity as required by §200.521 Management decision. (e) Depending upon the pass -through entity's assessment of risk posed by the subrecipient (as described in paragraph (b) of this section), the following monitoring tools may be useful for the pass -through entity to ensure proper accountability and compliance with program requirements and achievement of performance goals: (1) Providing subrecipients with training and technical assistance on program -related matters; and (2) Performing on -site reviews of the subrecipient's program operations; (3) Arranging for agreed -upon -procedures engagements as described in §200.425 Audit services. (f) Verify that every subrecipient is audited as required by Subpart F—Audit Requirements of this part when it is expected that the subrecipient's Federal awards expended during the respective fiscal year equaled or exceeded the threshold set forth in §200.501 Audit requirements. (g) Consider whether the results of the subrecipient's audits, on -site reviews, or other monitoring indicate conditions that necessitate adjustments to the pass -through entity's own records. (h) Consider taking enforcement action against noncompliant subrecipients as described in §200.338 Remedies for noncompliance of this part and in program regulations. [78 FR 78608, Dec. 26, 2013, as amended at 79 FR 75885, Dec. 19, 2014; 80 FIR 54409, Sept. 10, 2015] 2 CFR 200.332 Fixed amount subawards With prior written approval from the Federal awarding agency, a pass -through entity may provide subawards based on fixed amounts up to the Simplified Acquisition Threshold, provided that the subawards meet the requirements for fixed amount awards in §200.201 Use of grant agreements (including fixed amount awards), cooperative agreements, and contracts. 2 CFR 200.501 — Audit Requirements (a) Audit required. A non-federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in Federal awards must have a single or program - specific audit conducted for that year in accordance with the provisions of this part. 2 CFR 200.508 — Auditee Responsibilities The auditee must: 1. Procure or otherwise arrange for the audit, if required. 2. Prepare appropriate financial statements, including the schedule of expenditures of Federal awards. 3. Promptly follow up and take corrective action on the audit findings. 4. Provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit. Reoavment for ineliaible CRF expenditures or under spendinq Any funds received under the authorizing legislation for this program expended by the eligible applicant in a manner that does not adhere to the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136 or Uniform Guidance 2 CFR 200, as applicable, shall be returned to the state. If it is determined that an eligible applicant receiving funds under this act expends any funds under this act for a purpose that is not consistent with the requirements of the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136, or Uniform Guidance 2 CFR 200, the state budget director is authorized to withhold payment of state funds, in part or in whole, payable from any state appropriation. All subawards are subject to future audits and eligible applicants must allow the State of Michigan, any of its duly authorized representatives and/or State of Michigan's Office of the Auditor General access to the eligible applicant's records and financial statements to ensure compliance with Federal statutes, regulations and the terms and conditions of the grant award. CRF Record Retention Requirements Recipients of Coronavirus Relief Fund payments shall maintain and make available to the U.S. Department of Treasury, Office of Inspector General, upon request, all documents and financial records sufficient to establish compliance with subsection 601(d) of the Social Security Act as amended, (42 U.S.C. 801(d)). Records shall be maintained for a period of five (5) years after final payment is made using Coronavirus Relief Fund monies. These record retention requirements are applicable to prime recipients and their grantees and subgrant recipients, contractors, and other levels of government that received transfers of Coronavirus Relief Fund payments from prime recipients. Records to support compliance with subsection 601(d) may include, but are not limited to, copies of the following: 1. general ledger and subsidiary ledgers used to account for (a) the receipt of Coronavirus Relief Fund payments and (b) the disbursements from such payments to meet eligible expenses related to the public health emergency due to COVID-19; 2. budget records for 2019 and 2020; 3. payroll, time records, human resource records to support costs incurred for payroll expenses related to addressing the public health emergency due to COVID-19; 4. receipts of purchases made related to addressing the public health emergency due to COVID-19; 5. contracts and subcontracts entered into using Coronavirus Relief Fund payments and all documents related to such contracts; 6. grant agreements and grant subaward agreements entered into using Coronavirus Relief Fund payments and all documents related to such awards; 7. all documentation of reports, audits, and other monitoring of contractors, including subcontractors, and grant recipients and subrecipients; 8. all documentation supporting the performance outcomes of contracts, subcontracts, grant awards, and grant recipient subawards; 9. all internal and external email/electronic communications related to use of Coronavirus Relief Fund payments; and 10. all investigative files and inquiry reports involving Coronavirus Relief Fund payments. Reoortina Requirements: Additional information will be communicated to you at a future date as the subrecipient or contractor. State agencies may identify and develop additional reporting requirements that are specific for their program. Statewide Reoortinq Requirements The State Budget Director will report on the status of these funds to the Senate and House appropriations committees and the Senate and House fiscal agencies periodically until all funds are exhausted. U.S. Treasury reporting requirements are evolving and additional reporting guidance will be issued with more detail but the elements described below are the minimum reporting expectations. Federal Reoortina Requirements The United States Treasury Office of Inspector General has engaged GrantSolutions, a grant and program management Federal shared service provider under the U.S. Department of Health and Human Services, to develop a customized and user-friendly reporting solution to capture the use of Coronavirus Relief Fund payments. In this regard, the GrantSolutions portal will be prepopulated with prime recipient data to include the Coronavirus Relief Fund payment amount, date, recipient Dun & Bradstreet unique identification number (DUNS number), and contact information. It is the responsibility of the prime recipients to report on uses of Coronavirus Relief Fund payments. Accordingly, each prime recipient shall report Coronavirus Disease 2019 (COVID-19) related costs incurred quarterly. The State of Michigan is currently working on a template (financial status report) that will need to be completed by grantees to assist the State with the required reporting. The following delineates the reporting requirements for the State of Michigan as the prime recipient to provide context regarding the type of information that may be collected through the reporting template. Projects List all projects the prime recipient plans to complete with Coronavirus Relief payments. For each project, the prime recipient will be to enter the project name, identification number (created by the prime recipient), description, and status of completion. Once a project is entered into the GrantSolutions portal, the prime recipient will be able to report on the project's obligations and expenditures. Expenditure Cateaories Once expenditures are entered against obligations, the prime recipient will need to select the specific expenditure category from the available options from a dropdown menu: a. Administrative Expenses b. Budgeted Personnel and Services Diverted to a Substantially Different Use c. COVID-19 Testing and Contact Tracing d. Economic Support (Other than Small Business, Housing, and Food Assistance) e. Expenses Associated with the Issuance of Tax Anticipation Notes f. Facilitating Distance Learning g. Food Programs h. Housing Support i. Improve Telework Capabilities of Public Employees j. Medical Expenses k. Nursing Home Assistance I. Payroll for Public Health and Safety Employees m. Personal Protective Equipment n. Public Health Expenses o. Small Business Assistance p. Unemployment Benefits q. Workers' Compensation r. Items Not Listed Above - to include other eligible expenses that are not captured in the available expenditure categories Each prime recipient shall also provide detailed obligation and expenditure information for any contracts and grants awarded, loans issued, transfers made to other government entities, and direct payments made by the prime recipient that are greater than or equal to $50,000 as follows. Contracts Greater Than or Eaual to $50,000 a. Contractor identifying and demographic information (e.g. DUNS number and location) b. Contract number c. Contract date, type, amount, and description d. Primary place of contract performance e. Related project name(s) f. Period of performance start date g. Period of performance end date h. Quarterly obligation amount i. Quarterly expenditure amount j. Expenditure categories (listed above) Grants Greater Than or Eaual to $50.000 a. Grantee identifying and demographic information (e.g. DUNS number and location) b. Award number c. Award date, amount, and description d. Award payment method (reimbursable or lump sum payment(s)) e. Related project name(s) f. Period of performance start date g. Period of performance end date h. Primary place of performance i. Quarterly obligation amount j. Quarterly expenditure amount k. Expenditure categories (listed above) Loans Greater Than or Eaual to $50.000 a. Borrower identifying and demographic information (e.g. DUNS number and location) b. Loan number c. Loan amount, date (date when loan signed by prime recipient and borrower), and description d. Loan expiration date (date when loan expected to be paid in full) e. Purpose of loan f. Primary place of performance g. Related project(s) h. Quarterly obligation amount i. Quarterly payments on outstanding loans j. Recipient plans for reuse of Coronavirus Relief Fund loan repayments k. Loan/expenditure categories Transfers to Other Government Entities Greater Than or Eaual to $50,000 a. Transferee/government unit identifying and demographic information (e.g. DUNS number and location) b. Transfer date, amount, and description c. Related project(s) d. Quarterly obligation amount e. Quarterly expenditure information f. Expenditure categories (listed above) Direct Pavments Greater Than or Eaual to $50.000 a. Payee identifying and demographic information (e.g. DUNS number and location) b. Direct Payments amount and date c. Related project(s) d. Quarterly obligation amount e. Quarterly expenditure amount f. Expenditure categories (listed above) Aaareoate reoortina below $50.000 Aggregate reporting is allowed on contracts, grants, transfers made to other government entities, loans, direct payments, and payments to individuals that are below $50,000. Reoortina on Expenditures Recipients will be required to periodically report on spend and the forecasted spend throughout the grant program. Below are the reporting dates and requirements for each recipient. Templates will be provided in the future for you to use for this reporting. Fiscal Year ending December 30, 2020 Reporting Period Report Due Date October 1, 2020- October 31,2020 November 5, 2020 November 1, 2020- December 30,2020 November 1,2020- November 30 2020 December 1, 2020 - December 30, 2020 i December 1. 2020 - December 30, 2020 November 5, 2020 December 5, 2020 January 5, 2021 January 30, 2021 (Reporting Requirements Grant Opening Certification Financial Status Report Expenditure Forecast Report Financial Status Report Financial Status Report Final Financial Status Report (Expenditure Location Report (Grant closing Certification All funds that have not been incurred by December 30, 2020 must be returned to the State of Michigan by January 30, 2021. The Financial Status Report must be submitted with the Grant Closina Certification, Expenditure Location Report. and Outcome Metric, Report by January 30, 2021. PROJECT: CRF LHD Homeless Match Beginning Date: 10/1/2020 End Date: 12/30/2020 PROGRAM SPECIFIC REQUIREMENTS Proaram Description and Purpose The State of Michigan actively chose non -congregate sheltering to address the immediate public health and safety needs of individuals that were homeless and either COVID-19 positive, symptomatic or high risk due to age or prior health conditions. The State of Michigan conducted assessments to review all possible options, but due to specific needs of the homeless population, establishment of temporary hotel arrangements for the affected population is ultimately the best way forward to preserve the health and safety of the community. The project will pay for costs of non -congregate shelter for COVID positive, exposed and high -risk homeless individuals. Shelter considered to be a location such as a hotel/motel room where they have separate facilities and where they will be isolated for 14 days. Specifically, this project is for: Homeless individuals and families who: o test positive for COVID-19 that do not require hospitalization, but need isolation or quarantine (including those exiting from hospitals); o are COVID-19 symptomatic and are awaiting test results; o have been exposed to COVID-19 (as documented by a state or local public health official, or medical health professional) that do not require hospitalization, but need isolation or quarantine; and o are asymptomatic, but are at "high -risk," such as people over 65 or who have certain underlying health conditions (respiratory, compromised immunities, chronic disease), and who require Emergency NCS as a social distancing measure. Uniform CRF Eliaibilitv The funding being used for this project is Federal Coronavirus Relief Fund (CRF). As a result, additional provisions apply and are included in this Attachment. The information contained in this Attachment supersedes the General Provisions of the Agreement, as related to all activities undertaken with CRF funding Payments from the Coronavirus Relief Fund may only be used to cover expenditures that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19); 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government; 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Usage of these funds must comply with the federal requirements of the Coronavirus Relief Fund. This project will be pay for isolation and quarantine of vulnerable and high risk individuals to COVID and the costs associated for general care such as food while in quarantine. Some health care services are covered, such as telemedicine and visiting medical staffing to individuals who do not need hospital services. These individuals cannot stay in standard congregate housing programs For a cost to be considered to have been incurred, performance or delivery must occur during the covered period but payment of funds need not be made during that time (though it is generally expected that this will take place within 90 days of a cost being incurred). Administrative Costs • Administrative costs not allowed with this program • R&D costs are not allowed with this program Eligible CRF expenditures under this oroaram • Costs related to sheltering based on the type of shelter, the specific needs of those sheltered, and determined necessary to • Daily rate for non -congregate shelter such as camps, hotel and motel rooms • Staffing costs for visiting LHD medical staff to non -congregate shelter population • Other quarantine rooming costs such as food for non -congregate shelter population • Telemedicine expenses Nonexclusive examples of ineligible CRF expenditures Expenses for the State share of Medicaid. Damages covered by insurance. Payroll or benefits expenses for employees whose work duties are not substantially dedicated to mitigating or responding to the COVID-19 public health emergency. Expenses that have been or will be reimbursed under any federal program, such as the reimbursement by the federal government pursuant to the CARES Act of contributions by States to State unemployment funds. Reimbursement to donors for donated items or services. Workforce bonuses other than hazard pay or overtime Severance pay. Legal settlements. Case management Mental Health counseling Period of Performance October 1, 2020 to December 30, 2020 Proaram Contact Information Lynn Hendges henclaes120.michfaan.aov 517-285-1698 Section II. Standard Provisions: Proaram Reauirements Funds were awarded to the State of Michigan as Federal Financial Assistance from the U.S. Department of Treasury. The funds were awarded under the Social Security Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") signed into law March 27, 2020 httr)s://home.treasurv.aov/r)olicv- issues/cares/state-and-local-aovernments as the Coronavirus Relief Fund. The State of Michigan was awarded $3.08 billion dollars under the Coronavirus Relief Fund. CFDA #: 21.019 Coronavirus Relief Funds are considered federal financial assistance and have been assigned a Catalog of Federal Domestic Assistance (CFDA) or Assistance Listing Number of 21.019. Fund payments are considered to be federal financial assistance subject to the Single Audit Act (31 U.S.C. Sections 7501 — 7507) and the related provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Section 200.330 — 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements. Under the Single Audit Act, subrecipients will need to report expenditures under this program using the CFDA number 21.019. Each eligible applicant must register with the Federal System for Award Management (SAM) by September 30, 2020 The SAM website is: httos://www.sam.aov/SAM. Use of Funds: The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover expenses that: 1. are necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease (COVID-19) and 2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the CARES Act) for the State or government. 3. were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020. Coronavirus Relief Funds expended under this Agreement may only be used for expenses incurred between March 1, 2020, and December 30, 2020, unless the Department notifies the Grantee in writing of a change in the end date of this Agreement. OMB Uniform Guidance for Non-federal Agencies Receiving These Funds The U.S. Department of Treasury has indicated in the Coronavirus Relief Fund Frequency Asked Questions that are accessible at U.S. Department of Treasury Coronavirus Relief Fund FAQ, located at httos://home.treasurv.00v/system/files/136/ Coronavirus-Relief-Fund-Freauently-Asked-Questions.odf, that the provisions of the Uniform Guidance, 2 Code of Federal Regulations (CFR) Section 200.303 regarding internal controls, Sections 200.330 through 200.332 regarding subrecipient monitoring and management, and subpart F regarding audit requirements are applicable to all CRF subawards at this time. However, guidance is evolving, and jurisdictions will be required to comply with additional guidance as it is published. Effective internal controls must be established and maintained (2 CFR Section 200,303). All reimbursements requested under this program should be accounted for with supporting documentation. Eligible applicants should maintain documentation evidencing that the funds were expended in accordance with federal, state, and local regulations. In accordance with federal Uniform Guidance, funds received under this program shall be included on the eligible applicant's Schedule of Expenditures of Federal Awards (SEFA) and included within the scope of the eligible applicant's Single Audit. The following is a summary of Uniform Guidance provisions that have been identified as significant. Applicants must review the eCFR Uniform Guidance at httos://www.ecfr.aov/coi-bin/text-idx?SID=6214841 a79953f26c5c230d72d6b70a1 &tr)l=/ ecfrbrowse/Title02/2cfr200 main 02.tol for complete requirements. 2 CFR 200.303 Internal Controls The non -Federal entity must: 1. Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non -Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the federal award. 2. Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. 3. Evaluate and monitor the non -Federal entity's compliance with statutes, regulations, and the terms and conditions of Federal awards. 4. Take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings. 5. Take reasonable measures to safeguard protected personally identifiable information. 2 CFR 200.330 Subrecioient and contractor determinations The non -Federal entity may concurrently receive Federal awards as a recipient, a subrecipient, and a contractor, depending on the substance of its agreements with Federal awarding agencies and pass -through entities. Therefore, a pass - through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. The Federal awarding agency may supply and require recipients to comply with additional guidance to support these determinations provided such guidance does not conflict with this section. (a) Subrecipients. A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. See §200.92 Subaward. Characteristics which support the classification of the non -Federal entity as a subrecipient include when the non -Federal entity: (1) Determines who is eligible to receive what Federal assistance; (2) Has its performance measured in relation to whether objectives of a Federal program were met; (3) Has responsibility for programmatic decision making; (4) Is responsible for adherence to applicable Federal program requirements specified in the Federal award; and (5) In accordance with its agreement, uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass -through entity. (b) Contractors. A contract is for the purpose of obtaining goods and services for the non -Federal entity's own use and creates a procurement relationship with the contractor. See §200.22 Contract. Characteristics indicative of a procurement relationship between the non -Federal entity and a contractor are when the contractor: (1) Provides the goods and services within normal business operations; (2) Provides similar goods or services to many different purchasers; (3) Normally operates in a competitive environment; (4) Provides goods or services that are ancillary to the operation of the Federal program; and (5) Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. (c) Use of judgment in making determination. In determining whether an agreement between a pass -through entity and another non -Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass - through entity must use judgment in classifying each agreement as a subaward or a procurement contract. [78 FR 78608, Dec. 26, 2013, as amended at 80 FR 54409, Sept. 10, 2015] 2 CFR 200.331 Requirements for pass-throuah entities All pass -through entities must: (a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following information at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass -through entity must provide the best information available to describe the Federal award and subaward. Required information includes: (1) Federal Award Identification. (i) Subrecipient name (which must match the name associated with its unique entity identifier); (ii) Subrecipient's unique entity identifier; (iii) Federal Award Identification Number (FAIN); (iv) Federal Award Date (see §200.39 Federal award date) of award to the recipient by the Federal agency; (v) Subaward Period of Performance Start and End Date; (vi) Amount of Federal Funds Obligated by this action by the pass -through entity to the subrecipient; (vii) Total Amount of Federal Funds Obligated to the subrecipient by the pass -through entity including the current obligation; (viii) Total Amount of the Federal Award committed to the subrecipient by the pass -through entity; (ix) Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA); (x) Name of Federal awarding agency, pass -through entity, and contact information for awarding official of the Pass -through entity; (xi) CFDA Number and Name; the pass -through entity must identify the dollar amount made available under each Federal award and the CFDA number at time of disbursement; (xii) Identification of whether the award is R&D; and (xiii) Indirect cost rate for the Federal award (including if the de minimis rate is charged per §200.414 Indirect (F&A) costs). (2) All requirements imposed by the pass -through entity on the subrecipient so that the Federal award is used in accordance with Federal statutes, regulations and the terms and conditions of the Federal award; (3) Any additional requirements that the pass -through entity imposes on the subrecipient in order for the pass -through entity to meet its own responsibility to the Federal awarding agency including identification of any required financial and performance reports; (4) An approved federally recognized indirect cost rate negotiated between the subrecipient and the Federal Government or, if no such rate exists, either a rate negotiated between the pass -through entity and the subrecipient (in compliance with this part), or a de minimis indirect cost rate as defined in §200.414 Indirect (F&A) costs, paragraph (f); (5) A requirement that the subrecipient permit the pass -through entity and auditors to have access to the subrecipient's records and financial statements as necessary for the pass -through entity to meet the requirements of this part; and (6) Appropriate terms and conditions concerning closeout of the subaward. (b) Evaluate each subrecipient's risk of noncompliance with Federal statutes, regulations, and the terms and conditions of the subaward for purposes of determining the appropriate subrecipient monitoring described in paragraphs (d) and (e) of this section, which may include consideration of such factors as: (1) The subrecipient's prior experience with the same or similar subawards; (2) The results of previous audits including whether or not the subrecipient receives a Single Audit in accordance with Subpart F— Audit Requirements of this part, and the extent to which the same or similar subaward has been audited as a major program; (3) Whether the subrecipient has new personnel or new or substantially changed systems; and (4) The extent and results of Federal awarding agency monitoring (e.g., if the subrecipient also receives Federal awards directly from a Federal awarding agency). (c) Consider imposing specific subaward conditions upon a subrecipient if appropriate as described in §200.207 Specific conditions. (d) Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward; and that subaward performance goals are achieved. Pass -through entity monitoring of the subrecipient must include: (1) Reviewing financial and performance reports required by the pass - through entity. (2) Following -up and ensuring that the subrecipient takes timely and appropriate action on all deficiencies pertaining to the Federal award provided to the subrecipient from the pass -through entity detected through audits, on -site reviews, and other means. (3) Issuing a management decision for audit findings pertaining to the Federal award provided to the subrecipient from the pass -through entity as required by §200.521 Management decision. (e) Depending upon the pass -through entity's assessment of risk posed by the subrecipient (as described in paragraph (b) of this section), the following monitoring tools may be useful for the pass -through entity to ensure proper accountability and compliance with program requirements and achievement of performance goals: (1) Providing subrecipients with training and technical assistance on program -related matters; and (2) Performing on -site reviews of the subrecipient's program operations; (3) Arranging for agreed -upon -procedures engagements as described in §200.425 Audit services. (f) Verify that every subrecipient is audited as required by Subpart F—Audit Requirements of this part when it is expected that the subrecipient's Federal awards expended during the respective fiscal year equaled or exceeded the threshold set forth in §200.501 Audit requirements. (g) Consider whether the results of the subrecipient's audits, on -site reviews, or other monitoring indicate conditions that necessitate adjustments to the pass -through entity's own records. (h) Consider taking enforcement action against noncompliant subrecipients as described in §200.338 Remedies for noncompliance of this part and in program regulations. [78 FR 78608, Dec. 26, 2013, as amended at 79 FIR 75885, Dec. 19, 2014; 80 FIR 54409, Sept. 10, 2015] 2 CFR 200.332 Fixed amount subawards With prior written approval from the Federal awarding agency, a pass -through entity may provide subawards based on fixed amounts up to the Simplified Acquisition Threshold, provided that the subawards meet the requirements for fixed amount awards in §200.201 Use of grant agreements (including fixed amount awards), cooperative agreements, and contracts. 2 CFR 200.501 — Audit Reauirements (a) Audit required. A non-federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in Federal awards must have a single or program - specific audit conducted for that year in accordance with the provisions of this part. 2 CFR 200.508 — Auditee Responsibilities The auditee must: 1. Procure or otherwise arrange for the audit, if required. 2. Prepare appropriate financial statements, including the schedule of expenditures of Federal awards. 3. Promptly follow up and take corrective action on the audit findings. 4. Provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit. Reoavment for ineliaible CRF expenditures or under spending Any funds received under the authorizing legislation for this program expended by the eligible applicant in a manner that does not adhere to the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136 or Uniform Guidance 2 CFR 200, as applicable, shall be returned to the state. If it is determined that an eligible applicant receiving funds under this act expends any funds under this act for a purpose that is not consistent with the requirements of the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136, or Uniform Guidance 2 CFR 200, the state budget director is authorized to withhold payment of state funds, in part or in whole, payable from any state appropriation. All subawards are subject to future audits and eligible applicants must allow the State of Michigan, any of its duly authorized representatives and/or State of Michigan's Office of the Auditor General access to the eligible applicant's records and financial statements to ensure compliance with Federal statutes, regulations and the terms and conditions of the grant award. CRF Record Retention Reauirements Recipients of Coronavirus Relief Fund payments shall maintain and make available to the U.S. Department of Treasury, Office of Inspector General, upon request, all documents and financial records sufficient to establish compliance with subsection 601(d) of the Social Security Act as amended, (42 U.S.C. 801(d)). Records shall be maintained for a period of five (5) years after final payment is made using Coronavirus Relief Fund monies. These record retention requirements are applicable to prime recipients and their grantees and subgrant recipients, contractors, and other levels of government that received transfers of Coronavirus Relief Fund payments from prime recipients. Records to support compliance with subsection 601(d) may include, but are not limited to, copies of the following: 1. general ledger and subsidiary ledgers used to account for (a) the receipt of Coronavirus Relief Fund payments and (b) the disbursements from such payments to meet eligible expenses related to the public health emergency due to COVID-19; 2, budget records for 2019 and 2020; 3. payroll, time records, human resource records to support costs incurred for payroll expenses related to addressing the public health emergency due to COVID-19; 4. receipts of purchases made related to addressing the public health emergency due to COVID-19; 5. contracts and subcontracts entered into using Coronavirus Relief Fund payments and all documents related to such contracts; 6. grant agreements and grant subaward agreements entered into using Coronavirus Relief Fund payments and all documents related to such awards; 7. all documentation of reports, audits, and other monitoring of contractors, including subcontractors, and grant recipients and subrecipients; 8. all documentation supporting the performance outcomes of contracts, subcontracts, grant awards, and grant recipient subawards; 9. all internal and external email/electronic communications related to use of Coronavirus Relief Fund payments; and 10. all investigative files and inquiry reports involving Coronavirus Relief Fund payments. Reoortina Reauirements: Additional information will be communicated to you at a future date as the subrecipient or contractor. State aaencies may identify and develop additional reporting requirements that is specific for their program. Statewide Reoortina Reauirements The State Budget Director will report on the status of these funds to the Senate and House appropriations committees and the Senate and House fiscal agencies periodically until all funds are exhausted. U.S. Treasury reporting requirements are evolving and additional reporting guidance will be issued with more detail but the elements described below are the minimum reporting expectations. Federal Reoortina Reauirements The United States Treasury Office of Inspector General has engaged GrantSolutions, a grant and program management Federal shared service provider under the U.S. Department of Health and Human Services, to develop a customized and user-friendly reporting solution to capture the use of Coronavirus Relief Fund payments. In this regard, the GrantSolutions portal will be prepopulated with prime recipient data to include the Coronavirus Relief Fund payment amount, date, recipient Dun & Bradstreet unique identification number (DUNS number), and contact information. It is the responsibility of the prime recipients to report on uses of Coronavirus Relief Fund payments. Accordingly, each prime recipient shall report Coronavirus Disease 2019 (COVID-19) related costs incurred quarterly. The State of Michigan is currently working on a template (financial status report) that will need to be completed by grantees to assist the State with the required reporting. The following delineates the reporting requirements for the State of Michigan as the prime recipient to provide context regarding the type of information that may be collected through the reporting template.