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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 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 Equal 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 Equal 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 Equal 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 Equal 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.
Reporting 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
Grant Opening Certification
(
October 1, 2020-October 31,2020
November 5, 2020
Financial Status Report
November 1, 2020- December 30,2020
November 5, 2020
Expenditure Forecast Report
November 1, 2020 - November 30,2020
December 5, 2020
Financial Status Report
December 1, 2020 - December 30, 2020
January 5, 2021
Financial Status Report
Final Financial Status Report
December 1, 2020 - December 30, 2020
January 30, 2021
I Expenditure Location Report
Grant Closing Certification
All funds that have not been incurred by September 30, 2020 or 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 Closinq Certification, Expenditure Location
Report, and Outcome Metric Report by October 30. 2020 or January 30, 2021.
PROJECT: CRF Local Health Department Lab
Beginning Date: October 1, 2020
End Date: December 30, 2020
PROGRAM SPECIFIC REQUIREMENTS
Prooram Description and Purpose
Local Health Departments or Districts are being regionalized to provide rapid public
health testing response to handle COVID testing (and differentiation from other
respiratory pathogens). The labs will assist immediate need actions in an assigned set
of counties. Seven areas with labs or in the new lab development process will support
these activities. This will provide public health testing to increase the statewide capacity,
allow for outbreak response efforts, and ensure contact tracers have the appropriate
necessary data to follow-up on exposures or known cases. Sites will use funds to
ensure labs spaces are remodeled to ensure appropriate CLIA complexity level is met.
Equipment, instruments, or reagents to perform COVID testing will also be a possibility
for purchase.
Uniform CRF Eligibility
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 laboratory renovation, instruments, equipment and reagents for local health
department COVID-19 response efforts. 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
• Up to $7000, in 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 proqram
Eligible expenditures include
• Maintenance of laboratory spaces
• Purchase of laboratory equipment
• Purchase of laboratory supplies to install laboratory infrastructure (i.e. benches,
shields, etc.)
• communication (i.e. IT support, phone, etc.)
• Indirect
Nonexclusive examples of ineligible CRF expenditures
• Purchase of vehicles
• 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
Proaram Contact Information
Marty K. Soehnlen, PhD, MPH, PHLD(ABB), Director of Infectious Disease,
Bureau of Laboratories,
Michigan Department of Health and Human Services
SoehnlenM(d,michigan.gov
Section II. Standard Provisions: Proaram 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-oovernments 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 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/136/
Coronavirus-Relief-Fund-Freauently-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
https://www.ecfr.aov/cqi-bin/text-idx?SID=6214841 a79953f26c5c230d72d6b70a1 &tpl=/
ecfrbrowse/Title02/2cfr200 main 02.tPI 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, <
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, 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 ineliaible CRF expenditures or under spendina
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.
Federal Renortina Reauirements:
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 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.
Reportina 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 Equal 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 Equal 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 Equal 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)
Aggregate reporting 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.
Reporting 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 repotting.
Fiscal Year ending December 30, 2020
Reporting Period
Report Due Date
I Reporting Requirements
October 1, 2020-October 31,2020
November 5, 2020
Grant Opening Certification
Financial Status Report
November 1, 2020- December 30,2020
November 5, 2020
Expenditure Forecast Report
November 1, 2020 - November 30,2020
December 5, 2020
Financial Status Report
December 1, 2020 - December 30, 2020
(January .5, 2021
Financial Status Report
Final Financial Status Report
December 1, 2020 - December 30, 2020
January 30, 2021 I
Expenditure Location Report
Grant Closing Certification
All funds that have not been incurred by September 30, 2020 or 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 Closino Certification, Expenditure Location
Reoort, and Outcome Metric Report by October 5. 2020 or January 30. 2021.
PROJECT: CRF Local Health Department Testing
Beginning Date: October 1, 2020
End Date: December 30, 2020
PROGRAM SPECIFIC REQUIREMENTS
Program Description and Purpose
For COVID-19 funding from the Coronavirus Relief Fund for LHD COVID Testing. The
primary purpose for this project is to support staff time and supplies for LHD-supported
COVID community testing events.
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. 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.
Eligible 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, and supplies to support
indoor/outdoor public COVID testing events, including PPE, tents, test kits, vehicles, or
trailers.
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
Proaram Contact Information
Laura de la Rambelje, delarambeliel(a)michiaan.aovwith the MDHHS Office of Local
Health Services
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 https://home.treasurv.aov/Dolicv-
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 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:
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.00v/system/files/136/
Coronavirus-Relief-Fund-Freouently-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
httr)s://www.eefr.aov/cai-bin/text-idx?SID=6214841 a79953f26c5c230d72d6b70a1 &tDl=/
ecfrbrowse/-Fitle02/2cfr200 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,
20151
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 FIR 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 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.
Repavment for ineliaible CRF expenditures or under spendina
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.
Reportina Reauirements:
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 Reportinq 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.
Proiects
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.
Exoenditure Cateqories
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
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 Eoual 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 Eoual 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 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.
Reporting 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
I
November 1, 2020- December 30,2020 November 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 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: CSHCS Care Management/Care Coordination
Beginning Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis
Beneficiaries enrolled in CSHCS with identified needs may be eligible to receive Care
Coordination Services as provided by the local health department. In addition,
beneficiaries with either CSHCS, CSHCS and Medicaid, or Medicaid only (no CSHCS)
may be eligible to receive Case Management services if they have a CSHCS medically
eligible diagnosis, complex medical care needs and/or complex psychosocial situations
which require that intervention and direction be provided by the local health department.
LHD staff includes registered nurses (RNs), social workers, or paraprofessionals under
the direction and supervision of RNs. Services are reimbursed on a fee for services
basis, as specified in Attachment IV Notes.
Reporting Requirements (if different than contract language)
See Attachment I for specific budget and financial requirements.
Case Management and Care Coordination services within a specific Case Management
role cannot be billed during the same LHD billing period, which is usually a fiscal quarter
Care Coordination and Case Management Logs are submitted electronically via the
Children's Healthcare Automated Support Services (CHASS) Billing Module to the
Contract Manager. Quarterly logs must be submitted with the financial status report.
The Contract Manager shall evaluate the reports for their completeness and adequacy.
The Contract Manager will conduct case management and care coordination log audits
on a quarterly basis.
Annual Narrative Progress Report
N/A
Any additional requirements (if applicable)
Case Management services address complex needs and services and include an initial
face-to-face encounter with the beneficiary/family. Case Management requires that
services be provided in the home setting or other non -office setting based on family
preference. Beneficiaries are eligible for a maximum of six billing units per eligibility year.
Services above the maximum of six require prior approval by MDHHS. To request
approval, the LHD must submit an exception request, including the rationale for additional
services, to MDHHS. Limitations on the need for and number of Case Management
service units are set by MDHHS and must be provided by a specific Case Management
role, in accordance with training and certification requirements.
Staff must be trained in the service needs of the CSHCS population and demonstrate skill
and sensitivity in communicating with children with special needs and their families.
Care Coordination is not reimbursable for beneficiaries also receiving Case Management
services during the same LHD billing period, which is usually a calendar quarter. In the
event Care Coordination services are no longer appropriate and Case Management
services are needed, the change in services may only be made at the beginning of the
next billing period.
PROJECT: CSHCS Medicaid Elevated Blood Lead Case Management
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
All Local Health Departments in Michigan are eligible to participate in this program.
The grantee will complete in -home elevated blood lead (EBL) case management (CM)
services, with parental consent, for children less than age 6 in their jurisdiction enrolled
in Medicaid with a blood lead level equal to or greater than 4.5 micrograms per deciliter
(>A.5 pg/dL) as determined by a venipuncture test. EBL CM will be conducted according
to the "Case Management Guide for Children with Elevated Blood Lead Levels" that is
provided by the Childhood Lead Poisoning Prevention Program (CLPPP), Michigan
Department of Health and Human Services (MDHHS). For each child eligible for EBL
CM, efforts to contact the family to provide CM services and specific services provided
must be documented in the child's electronic record in the Healthy Homes and Lead
Poisoning Prevention (HHLPPS) database maintained by CLPPP-MDHHS.
Reporting Requirements (if different than contract language)
The Grantee shall submit:
Annual Report
Reporting period for FY21 is October 1, 2020 — September 30, 2021.
Quarterly Case Management Logs
A log of CM activities for is due quarterly, submitted electronically through the CLPPP's
secure File Transfer Site, using a spreadsheet template provided by CLPPP that
specifies the information to be provided on each child for which reimbursement is being
requested on the quarterly Supplemental Attachment to the CPBC FSR. The quarterly
logs will be submitted no later than thirty (30) days after the close of the quarter.
Quarter Reoortina Time Period
1st
October 1- December 31
2nd
January 1— March 31
3rd
April 1 — June 30
4th
July 1 — September 30
Quarterlv Loas Due Date
January 31
April 30
July 30
October 30
The CLPPP EBL CM Project Manager will review the logs for their completeness and
adequacy and provide approval for payment within 30 days of receipt.
Any additional requirements (if applicable)
The grantee shall:
• Have home case management conducted by a registered nurse trained by
MDHHS CLPPP. Training addresses general principals of lead poisoning and lead
poisoning prevention, the Case Management protocol and the use of the HHLPPS
database.
• Sign up for the secure FTP site maintained by MDHHS CLPPP, to be used for
data sharing of confidential information.
• Have an agreement with all Medicaid Health Plans in their jurisdiction that allows
for sharing of Personal Health Information regarding the Plan's children with
EBLLs.
• Identify and Initiate contact with families of all Medicaid venous -confirmed EBLL
children from the lists provided by MDHHS CLPPP to the grantee.
• Complete case management activities according to requirements in the MDHHS
CLPPP Case Management Guide.
• Document all case management activities in the child's electronic file in the
HHLPPS database.
• Provide quarterly summaries of case management activities for all eligible EBLL
children using a spreadsheet template provided by MDHHS CLPPP.
• Submit request for reimbursement through the EGrAMS system based on the
"fixed unit rate" method. The fixed rate for case management services is $201.58
per home visit, for up to 6 home visits.
CLPPP-MDHHS shall provide the Grantee with:
• Weekly list of children in their jurisdiction with a laboratory report received in the
prior week and a faxed report for children with blood lead levels =>20 pg/dl the
day the report is received at MDHHS.
• Written Case Management protocol.
• Instructions for billing and documentation of services for participation in this
project.
• Spreadsheet template for log of CM activities.
• Access to HHLPPS database.
• Access to the CLPPP FTP site for secure file transfer.
• Training in the basics of lead exposure and poisoning, conduct of CM, use of the
HHLPPS database, and use of FTP site for transmission of confidential
information.
• On -going technical support and consultations from an MDHHS CLPPP nurse.
PROJECT: CSHCS Medicaid Outreach
Beginning Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis
Local Health Departments may perform Medicaid Outreach activities for
CSHCS/Medicaid dually enrolled clients and receive reimbursement at a 50% federal
administrative match rate based upon their CSHCS Medicaid dually enrolled caseload
percentage and local matching funds.
Reporting Requirements (if different than contract language)
See Attachment I for specific budget and financial requirements.
Annual Narrative Progress Report
N/A
Any additional requirements (if applicable)
N/A
PROJECT TITLE: CSHCS OUTREACH AND ADVOCACY
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Local Health Departments (LHDs) throughout the state serve children with special health
care needs in the community. The LHD acts as an agent of the CSHCS program at the
community level. It is through the LHD that CSHCS succeeds in achieving its charge to
be community -based. The LHD serves as a vital link between the CSHCS program, the
family, the local community and the Medicaid Health Plan (as applicable) to assure that
children with special health care needs receive the services they require covering every
county in Michigan.
LHD is required to provide the following specific outreach and advocacy services:
• Program representation and advocacy
• Application and renewal assistance
• Link families to support services (e.g. The Family Center, CSHCS Family Phone Line,
the CSHCS Family Support Network (FSN), transportation assistance, etc.)
Implement any additional MPR requirements
• Care coordination
• Budget and Agreement Requirement and Grantee
• Submission of all documents via the document management portal, as required
Reporting Requirements (if different than agreement language):
Annual Narrative Progress Report
A brief annual narrative report is due by November 15 following the end of the fiscal year.
The reporting period is October 1 — September 30. The annual report will be submitted to
the Department and shall include:
Summary of successes and challenges
• Technical assistance needs the Grantee is requesting the Department to address
• Brief description of how any local MCH funds allocated to CSHCS were used (e.g.
CSHCS salaries, outreach materials, mailing costs, etc.), if applicable
The unduplicated number of CSHCS eligible clients assisted with CSHCS enrollment.
The unduplicated number of CSHCS clients assisted in the CSHCS renewal process.
Definitions
Unduplicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment
is defined as:
Number of CSHCS eligible clients the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete the CSHCS enrollment process during the
fiscal year. This assistance includes, but is not limited to, helping the family obtain
necessary medical reports to determine clinical eligibility, completing the CSHCS
Application for Services, completing the CSHCS financial assessment forms, etc.
Unduplicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process
is defined as:
Number of CSHCS enrollees the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete and/or submit documents required for the
Department to make a determination whether to continue/renew CSHCS coverage during
the fiscal year. "Assisted" may also include collaboration with the client's Medicaid Health
Plan.
Any additional requirements (if applicable):
Relationship between Grantees and Medicaid Health Plans:
The Grantee must establish and maintain care coordination agreements with all Medicaid
Health Plans for CSHCS enrollees in the Grantees service area. Grantees and the
Medicaid Health Plans may share enrollee information to facilitate coordination of care
without specific, signed authorization from the enrollee. The enrollee has given consent
to share information for purposes of payment, treatment and operations as part of the
Medicaid Beneficiary Application.
Care coordination agreements between Grantees and the Medicaid Health Plans will be
available for review upon request from the Department.
The agreement must address all the following topics
• Data sharing
• Communication on development of Care Coordination Plan
• Reporting requirements
• Quality assurance coordination
• Grievance and appeal resolution
• Dispute resolution
• Transition planning for youth
PROJECT: Eat Safe Fish
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
The Grantee will collaborate with the Department and the EPA Region V Saginaw
Community Information Office to deliver a uniform message for the Saginaw River and
connected waters regarding the fish and wild game consumption advisories within the tri-
county area (Midland, Saginaw, and Bay).
Bay County Health Department (BCHD) will develop a plan to distribute that message
using existing health department programs, the medical community, special events, and
community service providers to communicate with the at -risk population.
Bay County Health Department (BCHD) will get approval from the Department program
manager and for any changes to the Saginaw and Bay County Cooperative Agreement
Scope of Work including budget and budget narratives
Reporting Requirements (if different than contract language)
Track and report output measures.
Write and Submit quarterly reports and an annual report to the Department.
• Submit draft quarterly reports within 15 days after the end of each
quarter.
Annual reports upon request.
Any additional requirements (if applicable)
The Grantee will provide appropriate staff to fulfill the following objectives and outputs as
detailed:
Comply with the Saginaw and Bay County Cooperative Agreement budget
and budget narratives as describe in the scopes of work provided to the
BCHD program manager as applicable from October 1 to September 30.
0 Provide 30 hours of health education and community outreach per week.
Conduct health education and community outreach in Saginaw, Midland, and
Bay Counties. Activities will include, but not be limited to, internal BCHD
distribution, health care provider outreach, and key event participation.
f Track hours to comply with cost recovery requirements.
Development, Printing, and Distribution of Outreach Materials and implementation
of Display Booth.
Identify, track, and record of materials distributed at additional locations within
Midland, Bay, and Saginaw Counties.
s Make payment for the replacement of signage on the Tittabawasse and Saginaw
Rivers.
f Conduct Capacity Building in Saginaw, Midland and Bay Counties
Actively seek out new community partners in Saginaw, Midland and Bay Counties.
Participate in monthly SBCA teleconference.
Provide Presentation of display booth at select community events incoordination
with EPA Region V Saginaw Community Information Office.
Conduct Outreach though existing BCHD Programs such as WIC, Immunizations,
programs for young mothers, or other programs reaching the target population.
Assist the EPA Region V Saginaw Community Information Office with community
outreach.
Outreach to Health Care Providers.
PROJECT: EGLE Drinking Water and Onsite Wastewater Management
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
State funding for ELPHS shall support, and the Grantee shall provide for, all of the following
required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended,
Part 24 and Act No. 336, of 1998 Section 909:
■ Infectious/Communicable Disease Control
• Sexually Transmitted Disease
■ Immunization
• On -Site Wastewater Treatment Management
• Drinking Water Supply
■ Food Service Sanitation
• Hearing
• Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee's cost allocation plan.
• ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment and Improvement, Public Policy Development,
Health Services Administration, Quality Assurance, Creating and Maintaining a
Competent Work Force and Local Public Health Accreditation. These services may
be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
First and second party fees earned in each required service program may be used
only in that required service program.
• State ELPHS funding is subject to local maintenance of effort compliance.
Distribution of state ELPHS funds shall only be made to agencies with total local
general fund public health services spending in fiscal year (FY) 2021 of at least
the amount expended in FY 92/93. To be eligible for any of the State funding
increases from FY 94/95 through FY 2021, the FY 92/93 Local Maintenance of
Effort Level must be met.
Reporting Requirements (if different than contract language)
All final amendment ELPHS funding shift request memos need to be submitted no
later than May 1. Please send the official memo to request ELPHS funding shifts by
email to Laura de la Rambelje (DelaRambeljeL@michigan.gov) and copy Carissa Reece
(ReeceC@Michigan.gov).
Any Additional Requirements (if applicable)
• Assure the availability and accessibility of services for the following basic health
services: Prenatal Care; Immunizations; Communicable Disease Control; Sexually
Transmitted Disease (STD) Control; Tuberculosis Control; Health/Medical Annex of
Emergency Preparedness Plan.
• Fully comply with the Minimum Program Requirements for each of the required
services.
• Grantee will be held to accreditation standards and follow the accreditation process
and schedule established by the Department for the required services to achieve
full accreditation status. Grantees designated as "not accredited" may have their
Department allocations reduced for Departmental costs incurred in the assurance
of service delivery. The accreditation process is based upon the Minimum Program
Standards and scheduled on a three-year cycle. The Minimum Program Standards
include the majority of the required Department reviews. Some additional reviews,
as mandated by the funding agency, may not be included in the Program
Standards and may need to be scheduled at other times.
Onsite Wastewater Management
The Grantee shall perform the following services for private single- and two-family
homes and other establishments that generate less than 10,000 gallons per day of
sanitary sewage:
• Maintain an up-to-date regulation for on -site wastewater treatment systems
(Systems). The regulation shall be supplemented by established internal policies
and procedures. Technical guidance for staff that defines site suitability
requirements, the basis for permit approval and/or denial, and issues not specifically
addressed by the regulation shall be provided.
• Evaluate all parcels to determine the suitability of the site for the installation of
initial and replacement Systems in accordance with applicable regulation(s).
These evaluations shall be conducted by a trained sanitarian or equivalent and
shall consist of a review of the permit application for the installation of a System
and a physical evaluation of the site to determine suitability.
• Accurately record on the permit to install the initial or replacement System or on an
attachment to the permit the site conditions for each parcel evaluated including soil
profile data, seasonal high-water table, topography, isolation distances, and the
available area and location for initial and replacement Systems. The requirement
for identifying a replacement System applies to issuance of new construction
permits only.
• Issue a permit, prior to construction, in accord with applicable regulation(s) for
those sites that meet the criteria for the installation of a System. The permit shall
include a detailed plan and/or specification that accurately define the location of the
initial or replacement System, System size, other pertinent construction details, and
any documented variances.
Provide and keep on file formal written denials, stating the reason for denial, for
those applications where site conditions are found to be unsuitable.
• Conduct a construction inspection prior to covering each System to confirm that the
completed System complies with the requirements of the permit that has been
issued. Maintain, on file, an accurate individual record of each inspection
conducted during construction of each system. In limited circumstances where
constraints prohibit staff from completing the required construction inspection in a
timely manner, an effective alternate method to confirm the adequacy of the
completed System shall be established. The effective alternative method shall be
utilized for no more than ten (10) percent of the total number of final inspections
unless specific authorization has been granted by the State for other percentage.
The results of all such inspections or an alternate method shall be clearly
documented.
• Maintain an organized filing system with retrievable information that includes
documentation regarding all site evaluations, permits issued or denied, final
inspection documentation, and the results of any appeals.
• Conduct review and approval or rejection of proposed subdivisions, condominiums
and also land divisions under one acre in size for site suitability according to the
statutes and Administrative Rules for Onsite Water Supply and Sewage Disposal
for Land Divisions and Subdivisions.
• Utilize the State's "Michigan Criteria for Subsurface Sewage Disposal" (Criteria) for
Systems other than private single- and two-family homes that generate less than
10,000 gallons per day. Systems treating less than 1,000 gallons per day may be
approved in accordance with the Grantee's regulation. Advise the State prior to
issuance of a variance from the Criteria. Variances are only to be issued by the
Director of Environmental Health of the Grantee after consultation with the State.
Appeals of any decision of the Grantee pursuant to the Criteria including systems
treating less than 1,000 gallons evaluated in accordance with the Grantee's
regulation shall only be made to the State.
• Maintain quarterly reports that summarize the total number of parcels evaluated,
permits issued, alternative or engineered plans reviewed, and number of appeals,
number of inspections during construction, number of failed systems evaluated,
and number of sewage complaints received and investigated for each residential
(single and two-family homes) and non-residential properties. The report forms
EQP2057a.1 (Non -Residential) and EQP2057b.1 (Residential) are available on the
EGLE website. All quarterly reports are to be submitted directly to EGLE, to the
address noted on the form, within fifteen (15) days following the end of each
quarter.
• Review all engineered or alternative System plans. Conduct adequate
inspections during the various phases of construction to ensure proper installation.
• Collect data at the time of permit issuance when a System has failed to document
the System age, design, site conditions, and other pertinent factors that may have
contributed to the failure of the original System. Evaluations shall record
information indicated on the EGLE Onsite Wastewater Program Residential and
Non -Residential Information forms. The results for all failed Systems evaluated
shall be maintained in a retrievable file or database and summarized in an annual
calendar year data report. Annual summaries of failed system data shall be
provided to EGLE for input into the state-wide failed system database. The EGLE
Onsite Wastewater Program Residential and Non -Residential Information forms
shall be provided to the State no later than February 1st of the year following the
calendar year for which the data has been collected.
Provide training for staff involved in the Program as necessary to maintain
knowledge of current regulations and internal policies and procedures and to keep
staff informed of technological improvements and advancements in Systems.
• Establish and maintain an enforcement process that is utilized to resolve violations
of the Local Entity and/or State's rules and regulations.
Maintain complaint forms and a filing system containing results of complaint
investigations and documentation of final resolution. Investigate and respond to all
complaints related to onsite wastewater in a timely manner.
Drinking Water:
The Grantee shall perform the following services including but not limited to:
• Perform water well permitting activities, pre -drilling site reviews, random
construction inspections, and water supply system inspections for code compliance
purposes with qualified individuals classified as sanitarians or equivalent.
Assign one individual to be responsible for quarterly reporting of the data and to
coordinate communication with the assigned State staff. Reports shall be submitted
no later than fifteen (15) days following the end of the quarter on forms provided by
the State. The report form EQP2057 (07/2019) is available on the EGLE website.
All quarterly reports are submitted directly to the EGLE address noted on the form.
Perform Minimum Program Requirements (MPRs) activities and associated
performance indicators. These are available on the EGLE website. Guidance
regarding the MPRs and indicators is available in the "Local Health Department
Guidance Manual for the Private and Type III Drinking Water Supply Systems."
The guidance manual is available online at Michioan.00vANaterWellConstruction.
PROJECT: Epi Lab Capacity Contact Tracing Testing Coordination
Violation Monitoring
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
For COVID-19 funding from ELC CARES and ELC Enhanced for Case Investigations,
testing support, Contact Tracing and violation monitoring. The inability to meet the
following metrics will elicit the following response from MDHHS related to this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS
• Required support from MDHHS
Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase.
Reporting Requirements (if different than contract language)
Violation Monitoring:
Related to monitoring COVID-19 compliance indicators (Number of Violations /
complaints related to mandatory or recommended community mitigation): LHDS will
have 100% completion of sit -rep, including response to number of actions the LHD has
taken in the past 7 days related to violations.
Allowable expenses include staffing, communications, and IT.
Related to Case Investigation Quality:
LHD's will meet the following objectives for COVID-19 Case Investigations including on
weekends and holidays:
COVID 19 Case Interview Attempted on 90% of COVID-19 cases within 1 calendar day
of referral to MDSS
COVID 19 Cases Interviewed Completed on 75% of COVID-19 cases with 1 calendar
day of referral to MDSS
At least 1 contact elicited on 50% of COVID-19 cases within 1 calendar day of referral to
MDSS
Race and Ethnicity Documented on 75% of COVID-19 cases reported to MDSS within 7
days of referral date
LHD's will procure at least one tool to increase case investigation quality (people finding
software, communications, printed materials for testing events, EIVIR access, etc.)
This data will be reported in MDSS. Allowable expenses include staffing, IT,
communications, computers and or phones or other office needs, access to people
finding software or EMR, supports to cases for isolation and quarantine. Funding cannot
be used for clinical care or research.
Related to Contact Tracing:
If the LHD elects to have MDHHS through its staff, contractors, or volunteers to conduct
contract tracing or to conduct case investigations on the LHD's behalf, then:
1. The LHD will provide to MDHHS quality data on contacts especially related to age,
phone number, and name;
2. The LHD will follow-up on high -risk contacts;
3. The LHD will follow-up on contacts who report symptoms consistent with COVID-
19; and
4. The LHD will follow-up on escalations from MDHHS staff on contacts with high -
acuity needs or specific language barriers.
5. MDHHS will provide the LHD contact information for people with high -acuity needs
or specific language barriers;
& MDHHS will move contacts from MDHHS CRF to Traceforce;
7. MDHHS will attempt to eliminate duplicate contact information using name, phone
number, and age;
8. MDHHS will contact contacts and cases within 1 calendar day of the contacts
entry into the CRF
9. MDHHS will provide the LHD with the outcomes of all call attempts each day
10. MDHHS will discuss with the LHD specific barriers to contact tracing such as a
high -refusal rate
11. MDHHS or its delegate will attempt an contact all contacts with 1 calendar day
For local health departments:
Contacts to confirmed and probable COVID cases will be documented in the
MDSS case report form
90% of newly elicited contacts have attempted outreach within 1 day
90% of all contacts in active monitoring have outreach attempted for the contact's
exposure period
50% of contacts will receive active monitoring
LHD's will assess contacts needs for basic needs required for quarantine and
isolation (food, etc.). LHD's will provide education to contacts on COVID public
health recommendations
This data will be reported in Traceforce, OMS, or on the LHD Sit Rep. Allowable
expenses include staffing, IT, communications, computers and or phones or other office
needs, access to people finding software or EMR, supports to cases for isolation and
quarantine. Funding cannot be used for clinical care or research.
This funding can be used to staff testing events or assure testing strategies are
completed.
Any additional requirements (if applicable)
PROJECT: Epi Lab Capacity (ELC) Infection Prevention
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
For COVID-19 funding from ELC CARES for Infection Prevention, Case Investigations,
Contact Tracing and violation monitoring. The inability to meet the following metrics will
elicit the following response from MDHHS related to this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS
• Required support from MDHHS
Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase.
Reporting Requirements (if different than contract language)
Related to Infection Prevention:
• The LHD will designate a staff member or members responsible for leading
infection control assessments.
• The LHD will share the contact information of their infection control lead(s) with the
MDHHS Infection Prevention and Resource and Assessment Team (iPRAT) for
coordination purposes at MDHHS-IPRAT camichigan.gov.
• LHDs shall submit ICARs to MDHHS at
https:lidhhshivstd.iad1.qualtries.comlife/form/SV OdNux70o256K6B7
This data will be reported in the quarterly Egrams workplans. Allowable expenses
include staffing, IT, communications, computers and or phones or other office needs.
Funding cannot be used for clinical care or research.
Any additional requirements (if applicable)
PROJECT TITLE: Hearing ELPHS / Vision ELPHS
Start Date: 10/1/2020
End Date: 913012021
Project Synopsis:
The Hearing and Vision Programs screen over 1 million preschool and school -age
children each year. Screening services are conducted in schools, Head Start, and
preschool centers by local health department (LHD) vision technicians. Children who fail
their vision screening are referred to a licensed eye doctor for an exam and
treatment. Follow-up is conducted by the LHD to confirm that the child gets the care that
they need. Children who do not pass their hearing screening are referred to their primary
care physician or Ear, Nose, and Throat physician for diagnosis, treatment, and
recommendations.
Reporting Requirements (if different than agreement language):
Upon completion of the FY21 contract, grantees must submit a School -Based Hearing
and Vision Program Annual Narrative Progress Report to MDHHS-Hearina-and-
Visiona.michioan.aov The report must include:
1. Successes -accomplishments of the program/technician(s)
2. Challenges- issues that created difficulty in managing the program and/or
performing screening services
3. Technical Assistance Needs- request support from the Hearing and/or Vision
Consultant
4, Additional Feedback -questions in this section will change annually based on
relevant/current program topics/issues
Annual Narrative Reports must be approved by the MDHHS Hearing & Vision
Coordinator for their respective program.
Each Local Health Department (coordinators and technicians) should keep an
ongoing log of Successes and Challenges to compile and share at the end of the
fiscal year.
Final reports are submitted by the grantee to MDHHS, The reports are due 30
days after the end of the fiscal year
0 MDHHS will provide the template for reporting
For questions regarding these reports, please contact:
Jennifer Dakers, MDHHS Hearing Consultant, dakersina michiaan.00v
Dr. Rachel Schumann, MDHHS Vision Consultant, schumannre-michioan.00v
Any additional requirements (if applicable):
Grantees must adhere to established Minimum Program Requirements for School -Based
Hearing & Vision Services as outlined in the Michigan Local Public Health Accreditation
Program 2018 MPR Indicator Guide.
PROJECT: Food Service Sanitation (FOOD ELPHS)
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
State funding for ELPHS shall support and the Grantee shall provide for all the following
required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as
amended, Part 24 and Act No. 336, of 1998 Section 909:
■ Infectious/Communicable Disease Control
■ Sexually Transmitted Disease
• Immunization
■ On -Site Wastewater Treatment Management
■ Drinking Water Supply
• Food Service Sanitation
• Hearing
■ Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee's cost allocation plan.
• ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment & Improvement, Public Policy Development,
Health Services Administration, Qualify Assurance, Creating & Maintaining a
Competent Work Force and Local Public Health Accreditation. These services
may be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
First- and second -party fees earned in each required service program may be
used only in that required service program.
Reporting Requirements (if different than contract language)
All final amendment ELPHS funding shift request memos need to be submitted no later
than May 1st. Please send the memo to Laura de la Rambelje
(DelaRambeljeL@michigan.gov) and copy Carissa Reece (ReeceC(a)michiaan.00v)
Food Service Establishment Licensinq
Provide updates to MDARD on the 1 st and 15th of each month, as necessary to:
o Provide a list of food service establishments approved for licensure/license
issued.
o Provide a list of food service establishment licenses that have not been
approved for licensure and are considered voided or deleted.
o Return the actual licenses to MDARD that are to be voided or deleted.
o Return renewal license applications and licenses that require
correction. Mark the corrections on the renewal application.
Temoorary Food Establishment Licensina.
Provide updates to MDARD on the 1 st and 15th of each month, as necessary, to
provide:
o A copy of each temporary food establishment license issued.
o A list of lost or voided licenses by license number.
Any additional requirements (if applicable)
Food Service Establishment Licensina
Accept responsibility for all licenses specified in the "Record of Licenses
Received."
• Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Temporary Food Establishment Licensina
Upon receipt, sign and return the "Record of Licenses Received" to MDARD.
Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Make every effort to issue temporary food establishment licenses in numerical order.
Michigan Department of Agriculture and Rural Development (MDARD) Agrees to:
Food Service Establishment Licensina
• Furnish pre-printed food service establishment license applications and pre-
printed licenses to the Grantee for each licensing year (May 1 through April 30)
using previous year active license data.
• Provide a count of all licenses sent to the Grantee titled 'Record of Licenses
Received."
• Reprint any licenses requiring correction and send corrected copies to the
Grantee.
• Bill the local health department for state fees upon notification by Grantee that
the license has been approved and issued.
Temporary Food Service Establishment Licensinq
• Furnish blank temporary food service license application forms (forms FI-231, FI-
231 A) and blank Combined License/Inspection forms (FI-229) upon request from
the local health department.
o Furnish a "Record of Licenses Received" with each order of Combined
Licenses/Inspection forms.
o Periodically reconcile temporary food service establishment licenses
sent to the Grantee with the licenses that have been issued (copy
returned to MDARD).
o Bill the local health department for state fees upon notification by the
Grantee that the license has been approved and issued.
PROJECT: MDHHS Essential Local Public Health Services (ELPHS)
Beginning Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis
State funding for ELPHS shall support and the Grantee shall provide for all of the following
required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as
amended, Part 24 and Act No. 336, of 1998 Section 909:
• Infectious/Communicable Disease Control
■ Sexually Transmitted Disease
• Immunization
• EGLE Drinking Water and Onsite Wastewater Management
■ Food Service Sanitation
• Hearing
■ Vision
State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee's cost allocation plan.
ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment & Improvement, Public Policy Development,
Health Services Administration, Quality Assurance, Creating & Maintaining a
Competent Work Force and Local Public Health Accreditation. These services
may be budgeted separately as part of the Administrative Budget element.
Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
• First and second party fees earned in each required service program may be
used only in that required service program.
• State ELPHS funding is subject to local maintenance of effort compliance.
Distribution of state ELPHS funds shall only be made to agencies with total local
general fund public health services spending in FY 20/19 of at least the amount
expended in FY 92/93. To be eligible for any of the State funding increases from
FY 94195 through FY 19/20, the FY 92/93 Local Maintenance of Effort Level
must be met.
Reporting Requirements (if different than contract language)
Local maintenance of effort reports are due:
Projected Current Fiscal Year— October 30
• Prior Fiscal Year Actual — March 31
• A final statewide cost settlement will be performed to assure that all available
ELPHS funds are fully distributed and applied for required services.
All final amendment ELPHS funding shift request memos need to be submitted
no later than May 191. Please send the memo to Laura de la Rambelje
(DelaRambelieLe..michiaan.aov) and copy Carissa Reece
(ReeceC(a-.michiaan.aov)
Any additional requirements (if applicable)
Assure the availability and accessibility of services for the following basic health
services: Prenatal Care; Immunizations; Communicable Disease Control;
Sexually Transmitted Disease (STD) Control; Tuberculosis Control;
Health/Medical Annex of Emergency Preparedness Plan.
Fully comply with the Minimum Program Requirements for each of the required
services.
• Grantee will be held to accreditation standards and follow the accreditation
process and schedule established by the Department for the required services to
achieve full accreditation status. Grantees designated as "not accredited" may
have their Department allocations reduced for Departmental costs incurred in the
assurance of service delivery. The accreditation process is based upon the
Minimum Program Standards and scheduled on a three-year cycle. The
Minimum Program Standards include the majority of the required Department
reviews. Some additional reviews, as mandated by the funding agency, may not
be included in the Program Standards and may need to be scheduled at other
times.
PROJECT: Emerging Threats — Hepatitis C
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Funds are provided to grantees to increase local capacity to make improvements in
hepatitis C virus (HCV) testing, case follow-up, and linkage to care. Progress will be
tracked by monitoring case completion rates and HCV linkage to care within the MDSS
and evaluating HCV testing volumes submitted by grantees through STARLIMS.
Reporting Requirements (if different than contract language)
• Quarterly report cards/progress reports on HCV case completeness will be
complied by MDHHS and sent to grantees.
• Grantees will keep a log of MDSS IDs on client interactions and linkage to care
progress for submission to the MDHHS Viral Hepatitis Unit on a quarterly basis.
• Grantees will participate on semi -routine group conference calls and/or 1:1
technical assistance check in calls to discuss best practices and identify barriers.
• Grantees will collect and submit specimens to the MDHHS Bureau of Laboratories
for HCV testing through their public health clinics.
Target Requirements
Grantees will meet the following objectives for Hepatitis C, Chronic follow-up:
Target 1: Interview attempted on 90% of Hepatitis C, Chronic cases within 30 days of
referral date
Target 2: Interview completed on 50% of Hepatitis C, Chronic cases within 60 days of
referral date
Target 3: Hepatitis C RNA test result on 50% of Probable Hepatitis C, Chronic cases
within 90 days of referral date
Violation Monitoring:
The inability to meet the metrics will elicit the following response from MDHHS related to
this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS
• Reallocation of funds
Any additional requirements (if applicable)
Grantees will document process for carrying out the HCV project during the
current pandemic
• Grantees will document best practices or protocols for HCV case investigation and
linkage to care
• Grantees will document pathways to link patients to medical care
. Grantees may collaborate with the State Viral Hepatitis Unit for assistance
• Grantees can submit HCV specimens to the MDHHS Bureau of Laboratories at no
cost to them or the client
PROJECT TITLE: Family Planning Program
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Michigan Family Planning Program assists individuals and couples in planning and
spacing births, preventing unintended pregnancy, and seeking preventive health
screenings. On -site clinical services are delivered through a statewide network of local
health departments, hospital -based health systems, and federally qualified health centers.
The program's strong educational and counseling components help reduce health risks
and promote healthy behaviors. Family Planning prioritizes serving low-income men and
women, teens, and uninsured or underinsured individuals. The Michigan Family Planning
Program serves as a safety net with providers who have been a reliable and trusted source
of care, and in many cases the only regular source of health care for individuals. Referrals
to other health, behavorial, and social services are provided to clients, as needed.
Services are charged based on ability to pay. No one is denied services because of
inability to pay. Insurance is accepted, including Medicaid.
Reporting Requirements (if different than agreement language):
Each grantee shall submit the required reporting on the following dates:
Report
Time Period
October 1 —
Work Plan
September 30
Needs Assessment &
October 1 —
Health Care Plan
September 30
FPAR Mid -Year Report
January 1 —
June 30
FPAR Year -End Report
January 1 —
December 31
Medicaid Cost -Based
October 1 —
Reimbursement
September 30
Trackinq Form
Due Date to
Submit To
Department "
September 17
Mandy Luft
luftal @..michiaan.aov
September 17
Mandy Luft
luftal ZD.michiaan.aov
July 16
Mandy Luft
luftal (@michiaan.aov
January 15
Mandy Luft
lufta1na michiaan.aov
EGrAMS with Final
November 30
Financial Status
Report
Each grantee shall indicate the following project outputs:
Target Total Performance
State Funded Minimum
Measure Expectation
Performance Expected
Unduplicated
Percent Number
Number of
C
Clinic Users
Any additional requirements (if applicable):
Each grantee must serve a minimum of 95% of proposed Title X users to
access its total amount of allocated funds. Semi-annual Family Planning
Annual Report (FPAR) data will be used to determine total Title X users
served.
Each grantee will be required to adhere to Federal Statue and Regulations
for Title X Family Planning Programs, including legislative mandates,
executive orders, and grant administration regulations.
3. Each grantee will be required to adhere to the current Michigan Title X
Family Planning Program Standards and Guidelines Manual.
4. Each grantee will provide MDHHS a minimum of 30 days advance notice of
any clinic site changes, including additions, closures, or changes to street
address. Service site changes can be sent to each grantee's agency
consultant.
5. Each grantee will be required to participate in program planning and
evaluation, including the completion of an Annual Plan that consists of a
needs assessment, health care plan, and work plan as detailed in the
current Standards and Guidelines Manual.
6. Each grantee will provide family planning clients with a broad range of
acceptable and effective family planning methods and services, including
fertility awareness -based methods, basic infertility services, and services to
minors.
7. Each grantee will provide family planning services on a voluntary basis,
without coercion to accept services or any particular method of family
planning, and without making acceptance of services a prerequisite to
eligibility for any other service or assistance in another program.
8. Each grantee will provide confidential family planning and related
preventive health services to minors and will not require written consent of
parents or guardians for the provision of services to minors.
9. Each grantee will encourage family involvement in the decision of minors to
seek family planning services and must provide counseling to minors on
how to resist efforts to coerce the minor into engaging in sexual activities.
10. Each grantee will comply with Michigan's Child Protection Law (Act 238 of
1975) and will be required to notify or report child abuse and neglect as
defined by the law. Confidentiality cannot be invoked to circumvent
requirements for mandated reporting.
11. Each grantee will provide family planning services in a manner which
protects the dignity of the individual.
12, Each grantee will provide family planning services without regard to religion,
race, color, height, weight, national origin, sex, number of pregnancies,
marital status, age, sexual orientation, gender identification or expression,
partisan considerations, or a disability or genetic information.
13. Each grantee will train all Title X staff on the unique social practices,
customs, and beliefs of the under -served populations within their service
area(s) at least every two years to reduce staff bias and ensure equitable
service provision.
14. Each grantee will not provide abortion as a method of family planning and
will have written policy that no Title X funds are used to provide abortion as
a method of family planning. Pregnant women will receive nondirective
counseling and medically necessary care as outlined in the current
Standards and Guidelines.
15. Each grantee will ensure that low-income clients <_100% of poverty are
given priority to receive family planning services.
16. Each grantee will have a sliding fee schedule, based on current Federal
Poverty Guidelines, to determine a client's ability to pay for family planning
services.
17. Each grantee will have a schedule of fees designed to recover the
reasonable cost of providing services to clients whose income exceeds
250% of poverty.
18. Each grantee where there is legal obligation or authorization for third -party
reimbursement, including public or private sources, all reasonable efforts
must be made to obtain third -party payment without application of any
discounts. Where the cost of services is to be reimbursed under title XIX,
XX, or XXI of the Social Security Act, a written agreement with the title
agency is required.
1 g. Each grantee will convene a Family Planning Advisory Council that will
serve as their governing board, which will be broadly comprised of the
population served and will meet at least once a year.
20. Each grantee will convene an Information and Education Committee
comprised of five to nine members who are broadly representative of the
population served or community that meets at least once a year to review
and approve all informational and educational materials prior to distribution.
21, Each grantee will provide for informational and educational programs
designed to: achieve community understanding of the objectives of the
program; inform the community of the availability of services; and promote
continued participation in the project by person to whom family planning
services may be beneficial.
22. Each grantee will provide, to the extent feasible, an opportunity for
participation in the development, implementation, and evaluation of the
project by persons broadly representative of all significant elements of the
population to be served, and by others in the community knowledgeable
about the community's needs for family planning services.
23. Each grantee will provide for orientation and in-service training for all
project personnel.
24. Each grantee will provide services without the imposition of any durational
residency requirement or requirement that the patient be referred by a
physician.
25. Each grantee will provide that family planning medical services will be
performed under the direction of a physician with special training or
experience in family planning.
26. Each grantee will provide that all services purchased for project participants
will be authorized by the project director or his/her designee on the project
staff.
27, Each grantee will have written clinical protocols that are in accordance with
nationally recognized standards of care that are reviewed and signed
annually by the medical director overseeing Family Planning.
28. Each grantee will have a quality assurance system in place for ongoing
evaluation of family planning services, including a tracking system for
clients in need of follow-up or continued care, quarterly medical audits to
determine conformity with agency protocols, quarterly chart audits/record
monitoring to determine the accuracy of medical records, and a process to
implement corrective actions for deficiencies.
29. Each grantee will have a current list of social services agencies and
medical referral resources that is reviewed and updated annually.
30. Each grantee will address clients' social determinants of health to the extent
feasible through the coordination and use of referral arrangements with
other providers of health care services, local health and welfare
departments, hospitals, voluntary agencies, and health services projects
supported by other federal programs.
31. Each grantee will offer education on HIV and AIDS, risk reduction
information, and either on -site testing or provide a referral for this service.
32. Each grantee will offer client -centered counseling services on -site or by
referral and ensure the information is medically accurate, balanced,
provided in a non -judgmental manner, and is non -coercive.
33. Each grantee will have a separate budget for Title X funds and maintain a
financial management system that meets the standards specified in 45 CFR
Part 74 or Part 92, as applicable.
34. Each grantee assures that Title X funds will be expended solely for the
purpose of delivering Title X Family Planning Services in accordance with
an approved plan & budget, regulations, terms & conditions, and applicable
cost principles prescribed in 45 CFR Part 74 or Part 92, as applicable.
35. Each grantee assures that if family planning services are provided by
contract or other similar arrangements with actual providers of services,
services will be provided in accordance with a plan, which establishes rates
and method of payment for medical care. These payments must be made
under agreements with a schedule of rates and payments procedures
maintained by each grantee. Grantees must be prepared to substantiate
these rates are reasonable and necessary.
36. Each grantee will comply with the Office of Population Affairs (OPA) FPAR
requirements, as well as MDHHS required FPAR elements, for the
purposes of monitoring and reporting performance.
37. Each grantee will have a data collection system in place to assure accurate
FPAR reporting, and will be responsible for updating their system, as
needed, to be in compliance with OPA and MDHHS FPAR reporting
standards.
38. Each grantee will use FPAR to identify program disparities and to the extent
feasible, will use program promotion, community outreach, or other
community -based strategies to address identified disparities (e.g., disparity
in men vs. women served or disparity in low-income clients vs. full -fee
clients served).
39. Each grantee will comply with the MDHHS Medicaid Cost -Based
Reimbursement (MCBR) reporting requirements and attach the MCBR
Tracking Form to their final financial status report. The MCBR Tracking
Form must be completed in its entirety and include Family Planning MCBR
and Other Medicaid MCBR financial information for all programs.
40. The funds appropriated in the current State Public Health Appropriations
Act for pregnancy prevention programs shall not be used to provide
abortion counseling, referrals or services, unless contradicts Title X Federal
Law (Title X of the Public Health Service Act).
41. Pursuant to Public Act (PA) 360 (2002) Section 333.1091, grantees qualify
as priority family planning providers who do not engage in any activities
outlined in PA 360 (2002) Section 333.1091.
42. Grantee funding cannot be used to supplant funding for an existing program
supported with another source of funds.
43. Grantees awarded one-time funding may use these funds on any allowable
Title X expense to support clinical service delivery, program promotion and
outreach, electronic health record system enhancements, and meeting
administrative program requirements. These funds will be monitored during
comprehensive site reviews and monitoring/technical assistance visits.
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Case Abstraction
Start Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
Qualified individuals will perform medical record case abstraction for Fetal Infant
Mortality Review to include the following:
• Review of medical records involved in fetal and infant death to include, but not
limited to hospital records, prenatal records, emergency and medical examiner's
records.
• Interact with other agencies and service providers involved in infant's death
(Child Protective Services, local health department, law enforcement).
• Develop de -identified case summaries from the above abstracted information, as
well as the FIMR interview, using Michigan FIMR Network tools and guidelines.
• Attend the review team meetings to facilitate the presentation of the cases and
develop recommendations.
• Enter cases into the National Fatality Review Case Reporting System (FIMR
database) at the National Center for Fatality Review and Prevention.
Reporting Requirements (if different than agreement language):
Quarterly progress reports following the template supplied by the State coordinator.
Quarterly reports are due the 15'h of the month following the end of the quarter and are
submitted to Audra Brummel, State coordinator, via email at brummelaCa)michiaan.00v.
Reporting Time Period
Due Date
15� Quarter
October 1 — December 31
January 15
2"4 Quarter
January 1 — March 31
April 15
V Quarter
I April 1 — June 30
July 15
41h Quarter
I July 1 — September 30
October 15
Any additional requirements (if applicable):
Each completed case abstraction will be compensated at $270.00 per case.
FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
Maximum Program Reimbursement:
Grantee
Berrien County Health Department
Calhoun County Public Health Department
Detroit Health Department
Genesee County Health Department
Inqham County Health Department
Jackson County Health Department
Kalamazoo County Health and Community
Services Department
Kent County Health Department
Macomb County Health Department
Public Health Muskeqon County
Oakland County Department of Health and
Human Services/Health Division
Saqinaw County Health Department
Maximum Reimbursement Amount
$ 4,050
$ 3,240
$ 2,700
$4,115
$ 3,240
$ 3,240
$ 6,480
$ 9,450
$ 4,050
$ 2,700
$ 6,480
123
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Interviews
Start Date: 10/01/2020
End Date: 09/30/2021
Project Synopsis:
Conduct Fetal Infant Mortality Review (FIMR) interviews with the intent of informing the
FIMR case abstraction process and informing the infant mortality reduction efforts both
locally and statewide.
Reporting Requirements (if different than agreement language):
Mid -year progress report and final report using the FIMR interviews template provided
by the State coordinator, which will address what was learned about preventability at the
individual, clinical care, health system, community, and policy level are due April 15 and
a final report due October 15 by submission to Audra Brummel, State coordinator, via
email at brummelaCa7michigan.aov.
Any additional requirements (if applicable):
• Each completed FIMR interview will be compensated at $125.00 per interview. A
maximum of 6 visits are reimbursable per fetal/infant death up to the contract
allocation.
• FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
Maximum Program Reimbursement:
Grantee
Berrien County Health Department
Calhoun County Public Health Department
Detroit Health Department
Inqham County Health Department
Jackson County Health Department
Kalamazoo County Health and Community
Services Department
Kent County Health Department
Macomb County Health Department
Public Health Muskegon County
Oakland County Department of Health and
Human Services/Health Division
Maximum Reimbursement Amount
$ 1,875
$ 1,500
$ 6,750
$ 2,500
$ 1,250
$ 2,250
$ 1,250
$ 1,500
$ 625
$ 2,000
PROJECT: Gonococcal Isolate Surveillance Project
Beginning Date: 101112020
End Date: 9/30/2021
Project Synopsis
• To monitor trends in antimicrobial susceptibilities in N. gonorrhoeae.
• To characterize patients with gonorrhea (GC), particularly those infected with N,
gonorrhoeae that are not susceptible to recommended antimicrobials.
• To phenotypically characterize antimicrobial -resistant isolates to describe the
diversity of antimicrobial resistance in N. gonorrhoeae.
• To monitor trends in sexually transmitted N. Meningifidis
Reporting Requirements (if different than contract language)
Report Period Due Date(s)
On a quarterly basis, extract
from EMR, and submit to
MDHHS, the number of
culture specimens collected
and number of presumptive Quarterly January 15, April 15,
positive GC and suspected July 15, October 15
N.Men specimens
forwarded to CDC and their
designated laboratories for
further testing.
How to Submit Report
Written report submitted
to
kentiMcDmichioan.00v;
cc:
petersona7@michigan.
gov
On a quarterly basis, for
clients with GC positive Written report submitted
isolates, or suspected N. to
Men, submit demographic
Quarterly January 15, duly 15, October 15, cc:
and behavioral data
MDHHS utilizing the CDC petersona7@michigan.
required format. gov
Any additional requirements (if applicable)
• For each male STD clinic patient suspected of having GC (symptoms, known
partner etc.), collect a urogenital sample using a Modified Thayer Martin (MTM)
plate.
• For male and female STD clinic patient suspected of having oral GC (symptoms,
known partner etc.), collect a pharyngeal sample using a Modified Thayer Martin
(MTM) plate.
• For each male STD clinic patient who reports same sex partners, collect sample
using a MTM plate from extragenital sites of exposure (rectal, pharyngeal),
regardless of symptoms.
• For clients with positive isolates, submit specimen to CDC assigned Regional
Laboratory for further testing; and associated demographic and behavioral data to
the CDC and MDHHS at agreed intervals.
PROJECT: Harm Reduction Support Services
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within their jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on monthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices
Any additional requirements (if applicable)
• MDHHS or other contracted partners are available to provide technical assistance
to grantees
• Funds may not be used to buy sterile needles or syringes
• Grantees must establish relationships to link clients to care for substance use
disorder treatment
• Grantees must be able to provide clients with naloxone
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
PROJECT: Harm Reduction
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within heir jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on monthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices
Any additional requirements (if applicable)
• MDHHS or other contracted partners are available to provide technical assistance
to grantees
• Funds may not be used to buy sterile needles or syringes
• Grantees must establish relationships to link clients to care for substance use
disorder treatment
• Grantees must be able to provide clients with naloxone
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
PROJECT TITLE: HIV and STD Testing and Prevention
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The City of Detroit bares a disproportionate burden of reported sexually transmitted
diseases, including HIV. As a complement to public health clinical services, the Detroit
Health Department provides community level education and awareness building, along
with targeted screening activities to ensure additional access to service for early case
detection and link to care.
Reporting Requirements (if different than agreement language):
How to
Report Period Due Date(s) Submit
Report
Activity Report Quarterly 30 days after the end of STD Section
the quarter
Any additional requirements (if applicable):
• In partnership with MDHHS, provide technical assistance and capacity building to
ensure the Public Health STD Clinic adheres to MDHHS and CDC screening,
diagnostic and treatment recommendations and guidelines
• Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
o Ensure timely entry of client encounter information into EvaluationWeb
(EvalWeb)
• Conduct community awareness building activities to increase STD and HIV
knowledge, including points of access for service.
• By September 30, distribute MDHHS determined allocation worth of condoms,
lube, dental dams, and display equipment/materials.
• By September 30, develop and begin distribution of HIV Prevention
advertising/marketing materials.
PROJECT TITLE: HIV Data to Care
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Data to Care (D2C) is a Centers for Disease Control (CDC) program specifically focused
on people living with HIV (PLWH) that are not engaged in care. D2C employs an
intensive individualized outreach program which works to eliminate barriers
(transportation, insurance, access/knowledge of access to medical care, stigma -related
mental health issues, etc.) to accessing care through a combination of referrals and
linkage to existing Early Intervention Services (EIS) providers, Ryan White Service
providers and other community services. D2C is an essential program that facilitates
access to HIV treatment.
Reporting Requirements:
The Department will update Not in Care (NIC) client list progress monthly. The
Grantee shall maintain up to date information in CAREWare (CW) in preparation
for evaluation:
Report
Period Due Date(s)
How to Submit Report
NIC client level data and
Monthly 10th of the
Enter into CAREWare
services provided list
following month
All Funded agencies:
Quarterly January 30, 2021
Email report to MDHHS-
Complete quarterly
April 30, 2021
HIVSTDooerations<aimichi
workplan progress reports
July 30, 2021
gan.gov
December 15,
2021
The Grantee shall permit the Division of HIV/STD Programs (DHSP) or its
designee to conduct site visits and to formulate an evaluation of the project.
Any additional requirements:
Publication Rights
When issuing statements, press releases, requests for proposals, bid solicitations and
other documents describing projects or programs funded in whole or in part with Federal
money, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
The percentage of the total costs of the program or project that will be financed
with Federal money.
• The dollar amount of Federal funds for the projector program.
• Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Grant Program Operation
• If Grantee is receiving NIC list via secure transfer (e.g. DCH file transfer):
o Grantees must enter NIC lists into CW.
o Grantees must maintain password protected NIC lists on secure server
locations and not in any portable storage devices.
o Grantees must store NIC lists on shared servers and not on desktops or
personal computers.
o Grantees must transmit updated surveillance data to MDHHS in pre -
approved secure manners (e.g. DCH file transfer).
o If NIC lists or partial lists are sent via US Mail, list size must not exceed 10
individuals in a given mailing and words indicating HIV infection must not be
contained in the sent documents.
• If Grantee is receiving NIC list via direct CW import, grantee must complete
necessary fields in CW for transfer back to Surveillance.
• Grantees must not email NIC lists or individual health information contained on
NIC lists either internally or externally.
The Grantee must adhere to security measures when working with client
information and must:
o Not email individual health information either internally or externally.
o Keep all printed materials in locked storage cabinets in locked rooms.
Provide written documentation of annual Security and Confidentiality
training for all staff regarding the Health Insurance Portability Accountability
Act (HIPAA), the Health Information Technology for Economic and Clinical
Health (HITECH), and the Michigan Public Health Code.
o Maintain the standards of CDC's Data Security and Confidentiality
Guidelines for HiV, Viral Hepatitis, Sexually Transmitted Disease, and
Tuberculosis Programs
httDs://www. cdc.aov/nch hstD/Droaramintearation/dOCS/Dcsidatasecu ritva u id
elines.Ddf.
• Grantees will document all data sharing agreements and share a copy with the
Department. The data sharing agreements may be emailed to MDHHS-
H IVSTDooerations(@michioan.aov.
• Grantees must provide written documentation of annual Security and
Confidentiality training for all staff that have access to NIC lists.
• Grantees will maintain the standards of CDC's Data Security and Confidentiality
Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and
Tuberculosis Programs,
httDs://www.cdc.aov/nch hstD/prop ramintearation/docs/Dcsidatasecu ritvau ideli nes. o
df
• The Grantee will participate in the DHSP needs assessment and planning
activities, as requested.
o The Grantee will participate in regular Grantee meetings which may be
face-to-face, teleconferences, webinars, etc. The Grantee is highly
encouraged to participate in other training offerings and information -sharing
opportunities provided by the DHSP.
o The Grantee will use CW to report program activities, the Grantee must
include the following language in all Client Consent and Release of
Information forms used for services in this agreement: "I also understand
that some limited information in the electronic data may be shared with
other agencies if they also provide me with services and are part of the
same care and data network. [AGENCY] is mandated to collect certain
personal information that is entered and saved in a database system called
CAREWare. CW records are maintained in an encrypted and secure
statewide database. The CW database program allows for certain medical
and support service information to be shared among providers involved with
your care, this includes but is not limited to medical visits, lab results,
medications, case management, transportation, substance abuse, and
mental health counseling.
o In CW, the Grantee will complete the collection of all required data variables
and clean-up any missing data or service activities by the 10th day after the
end of each calendar month.
o The Grantee must consult and adhere to the Policy Clarification Notice
(PCN) #16-02 established by Health Resources and Services
Administration (HRSA). PCN #16-02 describes the core medical and
support services that HRSA considers allowable uses of Ryan White grant
funds and the individuals eligible to receive those services. A copy of the
revised PCN 16-02 is available at this link.
o An expanded list of "unallowable" grant costs is available in the PCN 16-02.
o HRSA RWHAP funds may not be used to make cash payments to
intended clients of HRSA RWHAP-funded services. This prohibition
includes cash incentives and cash intended as payment for HRSA RWHAP
core medical and support services. Where a direct provision of the service
is not possible or effective, store gift cards, vouchers, coupons, or tickets
that can be exchanged for a specific service or commodity (e.g., food or
transportation) must be used.
HRSA RWHAP recipients are advised to administer voucher and store gift
card programs in a manner which assures that vouchers and store gift
cards cannot be exchanged for cash or used for anything other than the
allowable goods or services and that systems are in place to account for
disbursed vouchers and store gift cards
HRSA Unallowable Costs;
• Off -premise social or recreational activities (movies, vacations, gym
memberships, parties, retreats)
• Medical Marijuana
• Purchase or improve land or permanently improve buildings
• Direct cash payments or cash reimbursements to clients
• Clinical Trials: Funds may not be used to support the costs of operating clinical
trials of investigational agents or treatments (to include administrative
management or medical monitoring of patients)
• Clothing: Purchase of clothing
• Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
• Funerals: Funeral, burial, cremation or related expenses
• Household Appliances
• Mortgages: Payment of private mortgages
• Needle Exchange: Syringe exchange programs, Materials, designed to
promote or encourage, directly, intravenous drug use or sexual activity,
whether homosexual or heterosexual
• International travel
• The purchase or improvement of land
• The purchase, construction, or permanent improvement of any building or other
facility
• Pets: Pet food or products
• Taxes: Paying local or state personal property taxes (for residential property,
private automobiles, or any other personal property against which taxes may be
levied)
• Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a
privately -owned vehicle or any additional costs associated with a privately -
owned vehicle, such as a lease, loan payments, insurance, license or
registration fees
• Water Filtration: Installation of permanent systems of filtration of all water
entering a private residence (If water filtration/ purification systems are
provided, the community has water purity issues)
• It is unallowable to divert program income (income generated from charges/
fees and copays from Medicare, Medicaid, other third -party payers collected to
cover RW services provided) toward general agency costs or to use it for
general purposes
• Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
• Non -occupational Post -Exposure Prophylaxis (nPEP)
General -use prepaid cards are considered "cash equivalent' and are therefore
unallowable. Such cards generally bear the logo of a payment network, such as
Visa, MasterCard, or American Express, and are accepted by any merchant
that accepts those credit or debit cards as payment. Gift cards that are
cobranded with the logo of a payment network and the logo of a merchant or
affiliated group of merchants are general -use prepaid cards, not store gift
cards, and therefore are unallowable.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot
be exchanged for cash or used for anything other than the allowable goods or
services, and that systems are in place to account for disbursed vouchers and
store gift cards,
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the
grant period, program, fiscal records, including documentation to support program
activities and expenditures, under the terms of this agreement, for clients residing
in the State of Michigan.
The Grantee will maintain client files, charts, and electronic records from last date
of service plus seven (7) years. For minors, Grantee will maintain client files and
records from last date of service and until minor reaches the age of 18, whichever
is longer, plus seven (7) years.
Software Compliance
The Grantee and its subcontractors are required to use the HRSA-supported software
CW to enter client and service data into the centrally managed database on a secure
server. The Grantee must:
• Enter all Ryan White services delivered to HIV -infected and affected clients.
Enter all data by the 10th of the following month.
Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
The Grantee must establish written procedures for protecting client information kept
electronically or in charts or other paper records. Protection of electronic client -level data
will minimally include:
• Regular back-up of client records with back-up files stored in a secure location.
• Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
• Use of virus protection software to guard against computer viruses.
• Provide annual training to staff on security and confidentiality of client level
data and sharing of electronic data files according to MDHHS policies
concerning Sharing and Secured Electronic Data.
New staff needing access to CAREWare are required to email the CAREWare user
request form to MDHHS-CAREWareSupport@michigan.gov. The Grantee shall notify
MDHHS within 30 days CAREWare users who are separated from the agency for
deactivation.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, in the event
of any of the following:
Any formal grievance initiated by a client and subsequent resolution of that
grievance.
Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of, or a
defendant in, legal action. This includes, but is not limited to, events or notices
related to grievances by service recipients or Grantee or subcontractor employees.
Any staff vacancies funded for this project that exceed 30 days.
This information may be sent via US Mail to the DHSP in Lansing, MI.
Technical Assistance
The Department will provide technical assistance (TA), as requested, on the
implementation of the Ryan White program. This may include issues related to:
CAREWare, Quality Management, Programs, Budget/Fiscal, Grants and Contracts,
ADAP, or other activities related to carrying out Ryan White activities. To request TA,
please send an email to MDHHS-HIVSTDooerationse.michiaan.aov or complete this
form located on the DHSP website httos://www.michiaan.aov/mdhhs/0,5885,7-339-
71550 2955 2982---,00,html
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan
White HIV/AIDS Treatment Extension Act.
The Grantee should have procedures to protect the confidentiality and security of
client information.
PROJECT TITLE: HIV Prevention
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The purpose of this project is to provide comprehensive HIV prevention services to all
priority populations and People Living with HIV (PLWH) in order to improve overall health
and well-being and reduce the incidence of new HIV infections.
Grantees will provide HIV Counseling, Testing, and Referral (CTR) and, if applicable,
Partner Services (PS), and Syringe Service Programs (SSP) within their jurisdiction,
pursuant to applicable federal and state laws; and policies and program standards
issued by the Division of HIV & STD Programs (DHSP). See "Applicable Laws, Rules,
Regulations, Policies, Procedures, and Manuals."
Reporting Requirements:
Report
Quality Control Reports
Daily Client Logs
Reactive Results
Non -Reactive Results
Linkage to Care and Partner
Services Interview (e.g. client
attended a medical care
appointment within 30 days of
diagnosis, and was interviewed by
Partner Services within 30 days of
diagnosis)
Condom Distribution Data
Disposition on Partners of HIV
Cases, if applicable
HIV Testing Competencies
SSP Data Report, if applicable
Period Due Date(s)
10th of the
Monthly
following month
10th of the
Monthly
following month
As
Within 24 hours
needed
of test
As
Within 7 days of
needed
test
How'?
Submit Report
Department
Staff
Department 1
Staff
EvalWeb
EvalWeb
As
Within 30 days of
EvalWeb,
needed
service
PSWeb
Quarterly
10th of the
following month
CTR Supplies
Ongoing
g g
Within 30 days of
PSWeb
service
Annually
Reviewed during
Department
site visits
Staff
Quarterly
10th of the
SUP
following month
The Grantee will clean-up missing data by the 10th day after the end of each
calendar month.
The Quality Control and Daily Client Logs may be sent to the Contract Manager
via:
Email - ctrsuDDlies(a)michioan.aov
Fax - (517) 241-5922
Mailed - HIV Prevention Unit, Attn: CTR Coordinator, 109 W. Michigan
Ave., 10rh Floor, Lansing, MI 48913
The Contract Manager shall evaluate the reports submitted as described in
Attachment III, Item D. for their completeness and accuracy.
Publication Rights
When issuing statements, press releases, requests for proposals, bid solicitations and
other documents describing projects or programs funded in whole or in part with Federal
funds, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
The percentage of the total costs of the program or project that will be financed
with Federal funds.
The dollar amount of Federal funds for the project or program.
Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Grant Program Operation
The Grantee will participate in DHSP needs assessment and planning activities,
as requested.
The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, etc. The Grantee is highly encouraged to
participate in other training offerings and information -sharing opportunities
provided by DHSP.
Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
o Have policies and procedures to ensure time and effort reporting.
o Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
o Denote accurately the percent of effort to the project. The percent of effort
may vary from month to month, and the effort recorded for funds must
match the percentage claimed on the FSR for the same period.
o Submit a budget modification to DHSP in instances where the percentage
of effort of contract staff changes (FTE changes) during the contract period.
o The Grantee will receive a condom and lubrication allowance. The Grantee
must:
o Distribute condoms and lubrication
o Place orders for condoms/lubrication by emailing ctrsupplies@michigan.gov
If conducting HIV testing using rapid HIV testing, the Grantee will comply with
guidelines and standards issued by DHSP and:
o Conduct quality assurance activities guided by written protocol and
procedures. Protocols and procedures, as updated and revised Quality
assurance activities are to be responsive to: Quality Assurance for Rapid
HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals."
o Ensure provision of Clinical Laboratory Improvement Amendments (CLIA)
certificate.
o Report discordant test results to DHSP.
o Ensure that staff performing counseling and/or testing with rapid test
technologies has successfully completed rapid test counselor certification
course or Information Based Training (as applicable), test device training,
and annual proficiency testing.
o Ensure that all staff and site supervisors have successfully completed
appropriate laboratory quality assurance training, blood borne pathogens
training and rapid test device training and reviewed annually.
o Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
If conducting PS, the Grantee will comply with guidelines and standards issued by
the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures,
and Manuals." The Grantee must:
o Provide Confidential PS follow-up to infected clients and their at -risk
partners to ensure disease management and education is offered to reduce
transmission.
o Effectively link infected clients and/or at -risk partners to HIV care and other
support services.
o Work with Early Intervention Specialist to ensure infected clients are
retained in HIV care.
o Procure TLO or a TLO-like search engine.
If conducting SSP, the grantee will develop programs using MDHHS guidance
documents and will address issues such as identification and registration of
clients, exchange protocols, education, and trainings for staff, and referrals.
Grantees will participate on monthly or quarterly conference calls to discuss
best practices and identify barriers.
o The Grantee shall permit DHSP or its designee to visit and to make an
evaluation of the project as determined by DHSP.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State of
Michigan.
Software Compliance
The Grantee and its subcontractors are required to use Evaluation Web (EvalWeb) to
enter HIV client and service data into the centrally managed database on a secure
server.
The Grantee and its subcontractors are required to use Partner Services Web (PSWeb)
to enter Partner Services interview and linkage to care data, where appropriate.
Mandatory Disclosures
The Grantee will provide immediate notification to DHSP, in writing, including but
not limited to the following events:
o Any formal grievance initiated by a client and subsequent resolution of that
grievance.
o Any event occurring or notice received by the Grantee or subcontractor,
that reasonably suggests that the Grantee or subcontractor may be the
subject of, or a defendant in, legal action. This includes, but is not limited to,
events or notices related to grievances by service recipients or Grantee or
subcontractor employees.
o Any staff vacancies funded for this project that exceed 30 days.
o All notifications should be made to DHSP by MDHHS-
HIVSTDooerationsa.michiaan.00v.
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
PROJECT TITLE: HIV Care Ryan White Part B MAI
Start Date: 11/1/2020
End Date: 3/31/2021
Project Synopsis:
The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary
medical care, essential support services, and medications for low-income people living
with HIV who are uninsured and underserved. The program provides funding to provide
care and treatment services to people living with HIV to improve health outcomes and
reduce HIV transmission among hard -to -reach populations.
Reporting Requirements:
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) How to Submit
Report
All Agencies: Ryan White Monthly 10th of the Enter into CAREWare
services delivered to HIV- following month (CW)
infected and affected clients
All Ryan White federally Annual Generally, Submission to HRSA
funded agencies: Ryan White Grantee through Electronic
Services Report (RSR) submission will Handbook (EHB)
open in early
February and
close early
March.
All Ryan White federally Annual December 31, Email report to
funded agencies providing at 2020 MDHHS-
least one core medical HIVSTDoperations(a),
service: Quality Management michigan.gov
Plan
All Ryan White federally 10/1/20 — As completed Email report to
funded agencies: Complete 9/30/21 over contract year MDHHS-
and submit at least one Plan- HIVSTDoperations(c
Do -Study -Act worksheets to michigan.gov
document progress of QI project
All Funded agencies: Quarterly January 30, 2021 Submit in EGrAMS
Complete quarterly workplan April 30, 2021 Email report to
progress reports July 30, 2021 MDHHS-
December 15, HIVSTDoaerationsna,
2021 michigan.gov
Report Period Due Date(s) How to Submit
Report
All Ryan White federally Quarterly January 30, 2021 Attached to quarterly
funded agencies: FY21 actual April 30, 2021 FSR
expenditures by service July 30, 2021
category, program income, and December 15,
administrative costs through the 2021
RW Reporting Tool
All Ryan White federally Annually December 31, Uploaded to EGrAMS
funded agencies: RW Form 2020 Portal Agency Profile
2100 and RW Form 2300
To complete the Ryan White Services Report (RSR), a Health Resources and Services
Administration (HRSA) required annual data report, the Grantee must assure that all CW
data is complete, cleaned, and entered into an online form via the HRSA EHB. RSR
submission requirements include:
• The RSR shall have no more than 5% missing data variables.
Exact dates for the Grantee submission will be provided by the Department
each reporting year.
The Department validates the data within the Grantee's RSR submission
before receipt by HRSA.
Reports and information shall be submitted to the Division of HIV/STD Programs (DHSP).
Please refer to the table in Section D for where to submit reports and information.
The DHSP shall evaluate the reports submitted for their completeness and accuracy.
The Grantee shall permit the DHSP or its designee to conduct site visits and to formulate
an evaluation of the project.
Any additional requirements:
Publication Rights
When issuing statements, press releases, requests for proposals, bid solicitations and
other documents describing projects or programs funded in whole or in part with Federal
money, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
1. The percentage of the total costs of the program or project that will be financed
with Federal money.
2. The dollar amount of Federal funds for the project or program.
3. Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Fees
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act and bill for services that are billable.
Grant Program Operation
The Grantee will participate in the Department needs assessment and planning
activities, as requested.
The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged
to participate in other training offerings and information -sharing opportunities
provided by the Department.
The Grantee is responsible for ensuring that staff retain minimum educational
requirements for staff positions and are proficient in Ryan White -funded service
delivery in their respective roles within the organization. Ensure that Ryan White
funded staff receive MDHHS required case management training within one (1)
year of hire.
Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
1. Have policies and procedures to ensure time and effort reporting.
2. Assure the staff member clearly identifies the percentage of time
devoted to contract activities in accordance with the approved
budget.
3. Denote accurately the percent of effort to the project. The percent of
effort may vary from month to month, and the effort recorded for
Ryan White funds must match the percentage claimed on the Ryan
White FSR for the same period.
4. Submit a budget modification to the Department in instances where
the percentage of effort of contract staff changes (FTE changes)
during the contract period.
The Grantee must include the following language in all Client Consent and Release of
Information forms used for services in this agreement:
"Consent for the collection and sharing of client information to
providers for persons living with HIV under the Ryan White Program
provided through (grantee name) is mandated to collect certain
personal information that is entered and saved in a federal data
system called CAREWare. CAREWare records are maintained in an
encrypted and secure statewide database. I understand that some
limited information in the electronic data may be shared with other
agencies if they also provide me with services and are part of the
same care and data network for the purpose of informing and
coordinating my treatment and benefits that I receive under this
Program. The CAREWare database program allows for certain
medical and support service information to be shared among
providers involved with my care, this includes but is not limited to
health information, medical visits, lab results, medications, case
management, transportation, Housing Opportunities for Persons with
AIDS (HOPWA) program, substance abuse, and mental health
counseling. I acknowledge that if I fail to show for scheduled medical
appointments, I may be contacted by an authorized representative of
(grantee name) in order to re-engage and link me back to care."
The Grantee must adhere to security measures when working with client information
and must:
1. Not email individual health information either internally or externally.
2. Keep all printed materials in locked storage cabinets in locked rooms.
3. Provide written documentation of annual Security and Confidentiality training
for all staff regarding the Health Insurance Portability Accountability Act
(HIPAA), the Health Information Technology for Economic and Clinical Health
(HITECH), and the Michigan Public Health Code.
4. Maintain the standards of CDC's Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs
httDs://www.cdc.gov/nchhstr)/program integration/docs/Dcsidatasecu ritvguideli n
es.pdf.
The Grantee will complete the collection of all required data variables and clean-up
any missing data or service activities by the 10th day after the end of each calendar
month.
Subrecipient quality management program should:
1. Include: leadership support, dedicated staff time for QM activities,
participation of staff from various disciplines, ongoing review of
performance measure data and assessment of consumer satisfaction.
2. Include consumer engagement which includes, but is not limited to, agency -
level consumer advisory board, participation on quality management
committee, focus groups and consumer satisfaction surveys.
3. Include conduction of at least one quality improvement (QI) project
throughout the year, using the Plan -Do -Study -Act (PDSA) method to
document progress. This QI project must be aimed at improving client care,
client satisfaction, or health outcomes.
If the Grantee is federally funded for Ryan White services (one of which is a core
medical service), the Grantee will develop and/or revise a Quality Management Plan
(QMP) annually, to be kept on file at agency. QM Plans must contain these eleven
components:
1. Quality statement
2. Quality infrastructure
3. Annual quality goals
4. Capacity building
5. Performance measurement
6. Quality improvement
7. Engagement of stakeholders
8. Procedures for updating the QM plan
9. Communication
10. Evaluation
11. Work Plan
The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02
established by Health Resources and Services Administration (HRSA). PCN #16-02
describes the core medical and support services that HRSA considers allowable uses of
Ryan White grant funds and the individuals eligible to receive those services. A copy of
the revised PCN 16-02 is available at this link.
An expanded list of "unallowable" grant costs is available in the PCN 16-02.
HRSA RWHAP funds may not be used to make cash payments to intended
clients of HRSA RWHAP-funded services. This prohibition includes cash
incentives and cash intended as payment for HRSA RWHAP core medical
and support services. Where a direct provision of the service is not possible
or effective, store gift cards, vouchers, coupons, or tickets that can be
exchanged for a specific service or commodity (e.g., food or transportation)
must be used.
• HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot
be exchanged for cash or used for anything other than the allowable goods or
services and that systems are in place to account for disbursed vouchers and
store gift cards
HRSA Unallowable Costs;
• Off -premise social or recreational activities (movies, vacations, gym memberships,
parties, retreats)
• Medical Marijuana
• Purchase or improve land or permanently improve buildings
• Direct cash payments or cash reimbursements to clients
• Clinical Trials: Funds may not be used to support the costs of operating clinical trials
of investigational agents or treatments (to include administrative management or
medical monitoring of patients)
• Clothing: Purchase of clothing
• Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
• Funerals: Funeral, burial, cremation or related expenses
• Household Appliances
• Mortgages: Payment of private mortgages
• Needle Exchange: Syringe exchange programs, Materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether homosexual or
heterosexual
• International travel
• The purchase or improvement of land
• The purchase, construction, or permanent improvement of any building or other
facility
• Pets: Pet food or products
• Taxes: Paying local or state personal property taxes (for residential property, private
automobiles, or any other personal property against which taxes may be levied)
• Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -
owned vehicle or any additional costs associated with a privately -owned vehicle,
such as a lease, loan payments, insurance, license or registration fees
• Water Filtration: Installation of permanent systems of filtration of all water entering a
private residence (If water filtration/ purification systems are provided, the
community has water purity issues)
• It is unallowable to divert program income (income generated from charges/ fees
and copays from Medicare, Medicaid, other third -party payers collected to cover RW
services provided) toward general agency costs or to use it for general purposes
• Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
• Non -occupational Post -Exposure Prophylaxis (nPEP)
General -use prepaid cards are considered "cash equivalent" and are
therefore unallowable. Such cards generally bear the logo of a payment
network, such as Visa, MasterCard, or American Express, and are accepted
by any merchant that accepts those credit or debit cards as payment. Gift
cards that are cobranded with the logo of a payment network and the logo of
a merchant or affiliated group of merchants are general -use prepaid cards,
not store gift cards, and therefore are unallowable.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot be
exchanged for cash or used for anything other than the allowable goods or services,
and that systems are in place to account for disbursed vouchers and store gift cards.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State
of Michigan.
The Grantee will maintain client files and charts from last date of service plus seven
(7) years. For minors, Grantee will maintain client files and records from last date of
service and until minor reaches the age of 18, whichever is longer, plus seven (7)
years.
Software Compliance
The Grantee and its subcontractors are required to use the HRSA-supported software
CW to enter client and service data into the centrally managed database on a secure
server. The Grantee must:
1. Enter all Ryan White services delivered to HIV -infected and affected clients.
2. Enter all data by the 10th of the following month.
3. Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
The Grantee must establish written procedures for protecting client information kept
electronically or in charts or other paper records. Protection of electronic client -level data
will minimally include:
1. Regular back-up of client records with back-up files stored in a secure location.
2. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
3. Use of virus protection software to guard against computer viruses.
Provide annual training to staff on security and confidentiality of client level data and
sharing of electronic data files according to MDHHS policies concerning sharing and
Secured Electronic Data.
New staff needing access to CAREWare are required to email the CAREWare user
request form to MDHHS-CAREWareSupport@michigan.gov. The Grantee shall notify
MDHHS within 30 days CAREWare users who are separated from the agency for
deactivation.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, in the event
of any of the following:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of,
or a defendant in, legal action. This includes, but is not limited to, events or
notices related to grievances by service recipients or Grantee or subcontractor
employees.
3. Any staff vacancies funded for this project that exceed 30 days.
• This information may be sent via US Mail to the DHSP in Lansing, MI,
DEPARTMENT REQUIREMENTS
Technical Assistance
The DSHP will provide technical assistance (TA), as requested, on the implementation of
the Ryan White program. This may include issues related to: CAREWare, Quality
Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or
other activities related to carrying out Ryan White activities. To request TA, please send
an email to MDHHS-HIVSTDonerationsamichioan.00v or complete this form located on
the DHSP website httos://www.michigan.ciov/mdhhs/0.5885.7-339-71550 2955 2982---
,00.html
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act.
PROJECT TITLE: HIV Care Ryan White Part B
Start Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary
medical care, essential support services, and medications for low-income people living
with HIV who are uninsured and underserved. The program provides funding to provide
care and treatment services to people living with HIV to improve health outcomes and
reduce HIV transmission among hard -to -reach populations.
Reporting Requirements:
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) How to Submit
Report
All Agencies: Ryan White Monthly 101h of the Enter into CAREWare
services delivered to HIV- following month (CW)
infected and affected clients
All Ryan White federally Annual Generally, Submission to HRSA
funded agencies: Ryan White Grantee through Electronic
Services Report (RSR) submission will Handbook (EHB)
open in early
February and
close early
March.
All Ryan White federally Annual December 31, Email report to
funded agencies providing at 2020 MDHHS-
least one core medical HIVSTDonerations(aD,
service: Quality Management michigan.gov
Plan
All Ryan White federally 10/1/20— As completed
funded agencies: Complete 9/30/21 over contract year
and submit at least one Plan -
Do -Study -Act worksheets to
document progress of QI project
All Funded agencies:
Complete quarterly workplan
progress reports
Quarterly January 30, 2021
April 30, 2021
July 30, 2021
December 15,
2021
Email report to
MDHHS-
HIVSTDooerationse,
michigan.gov
Submit in EGrAMS
Email report to
MDHHS-
HIVSTDooerations(aD
michigan.gov
Report Period Due Date(s) How to Submit
Report
All Ryan White federally Quarterly January 30, 2021 Attached to quarterly
funded agencies: FY21 actual April 30, 2021 FSR
expenditures by service July 30, 2021
category, program income, and December 15,
administrative costs through the 2021
RW Reporting Tool
All Ryan White federally Annually December 31, Uploaded to EGrAMS
funded agencies: RW Form 2020 Portal Agency Profile
2100 and RW Form 2300
To complete the Ryan White Services Report (RSR), a Health Resources and Services
Administration (HRSA) required annual data report, the Grantee must assure that all CW
data is complete, cleaned, and entered into an online form via the HRSA EHB. RSR
submission requirements include:
The RSR shall have no more than 5% missing data variables.
Exact dates for the Grantee submission will be provided by the Department
each reporting year.
The Department validates the data within the Grantee's RSR submission
before receipt by HRSA.
Reports and information shall be submitted to the Division of HIV/STD Programs (DHSP)
Please refer to the table in Section D for where to submit reports and information.
The DHSP shall evaluate the reports submitted for their completeness and accuracy.
The Grantee shall permit the DHSP or its designee to conduct site visits and to formulate
an evaluation of the project.
Any additional requirements:
Publication Rights
When issuing statements, press releases, requests for proposals, bid solicitations and
other documents describing projects or programs funded in whole or in part with Federal
money, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
1. The percentage of the total costs of the program or project that will be financed
with Federal money.
2. The dollar amount of Federal funds for the project or program.
3. Percentage and dollar amount of the total costs of the project or program that will
be financed by non -governmental sources.
Fees
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act and bill for services that are billable.
Grant Program Operation
The Grantee will participate in the Department needs assessment and planning
activities, as requested.
The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged
to participate in other training offerings and information -sharing opportunities
provided by the Department.
The Grantee is responsible for ensuring that staff retain minimum educational
requirements for staff positions and are proficient in Ryan White -funded service
delivery in their respective roles within the organization. Ensure that Ryan White
funded staff receive MDHHS required case management training within one (1)
year of hire.
Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
1. Have policies and procedures to ensure time and effort reporting.
2. Assure the staff member clearly identifies the percentage of time
devoted to contract activities in accordance with the approved
budget.
3. Denote accurately the percent of effort to the project. The percent of
effort may vary from month to month, and the effort recorded for
Ryan White funds must match the percentage claimed on the Ryan
White FSR for the same period.
4. Submit a budget modification to the Department in instances where
the percentage of effort of contract staff changes (FTE changes)
during the contract period.
The Grantee must include the following language in all Client Consent and Release of
Information forms used for services in this agreement:
"Consent for the collection and sharing of client information to
providers for persons living with HIV under the Ryan White Program
provided through (grantee name) is mandated to collect certain
personal information that is entered and saved in a federal data
system called CAREWare. CAREWare records are maintained in an
encrypted and secure statewide database. I understand that some
limited information in the electronic data may be shared with other
agencies if they also provide me with services and are part of the
same care and data network for the purpose of informing and
coordinating my treatment and benefits that I receive under this
Program. The CAREWare database program allows for certain
medical and support service information to be shared among
providers involved with my care, this includes but is not limited to
health information, medical visits, lab results, medications, case
management, transportation, Housing Opportunities for Persons with
AIDS (HOPWA) program, substance abuse, and mental health
counseling. I acknowledge that if I fail to show for scheduled medical
appointments, I may be contacted by an authorized representative of
(grantee name) in order to re-engage and link me back to care."
The Grantee must adhere to security measures when working with client information
and must:
1. Not email individual health information either internally or externally.
2. Keep all printed materials in locked storage cabinets in locked rooms.
3. Provide written documentation of annual Security and Confidentiality training
for all staff regarding the Health Insurance Portability Accountability Act
(HIPAA), the Health Information Technology for Economic and Clinical Health
(HITECH), and the Michigan Public Health Code.
4. Maintain the standards of CDC's Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs
httos://www.cdc.ciovinchhsto/prociramintearation/docs/Dcsidatasecuritvauidelin
es. df.
The Grantee will complete the collection of all required data variables and clean-up
any missing data or service activities by the 10th day after the end of each calendar
month.
Subrecipient quality management program should:
1. Include: leadership support, dedicated staff time for QM activities,
participation of staff from various disciplines, ongoing review of
performance measure data and assessment of consumer satisfaction.
2. Include consumer engagement which includes, but is not limited to, agency -
level consumer advisory board, participation on quality management
committee, focus groups and consumer satisfaction surveys.
3. Include conduction of at least one quality improvement (QI) project
throughout the year, using the Plan -Do -Study -Act (PDSA) method to
document progress. This QI project must be aimed at improving client care,
client satisfaction, or health outcomes.
If the Grantee is federally funded for Ryan White services (one of which is a core
medical service), the Grantee will develop and/or revise a Quality Management Plan
(QMP) annually, to be kept on file at agency. QM Plans must contain these eleven
components:
1. Quality statement
2. Quality infrastructure
3. Annual quality goals
4. Capacity building
5. Performance measurement
6. Quality improvement
7. Engagement of stakeholders
8. Procedures for updating the QM plan
9. Communication
10. Evaluation
11. Work Plan
The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02
established by Health Resources and Services Administration (HRSA). PCN #16-02
describes the core medical and support services that HRSA considers allowable uses of
Ryan White grant funds and the individuals eligible to receive those services. A copy of
the revised PCN 16-02 is available at this link.
An expanded list of "unallowable" grant costs is available in the PCN 16-02.
HRSA RWHAP funds may not be used to make cash payments to intended
clients of HRSA RWHAP-funded services. This prohibition includes cash
incentives and cash intended as payment for HRSA RWHAP core medical
and support services. Where a direct provision of the service is not possible
or effective, store gift cards, vouchers, coupons, or tickets that can be
exchanged for a specific service or commodity (e.g., food or transportation)
must be used.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot
be exchanged for cash or used for anything other than the allowable goods or
services and that systems are in place to account for disbursed vouchers and
store gift cards
HRSA Unallowable Costs:
• Off -premise social or recreational activities (movies, vacations, gym memberships,
parties, retreats)
• Medical Marijuana
• Purchase or improve land or permanently improve buildings
• Direct cash payments or cash reimbursements to clients
• Clinical Trials: Funds may not be used to support the costs of operating clinical trials
of investigational agents or treatments (to include administrative management or
medical monitoring of patients)
• Clothing: Purchase of clothing
• Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
• Funerals: Funeral, burial, cremation or related expenses
• Household Appliances
• Mortgages: Payment of private mortgages
• Needle Exchange: Syringe exchange programs, Materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether homosexual or
heterosexual
• International travel
• The purchase or improvement of land
• The purchase, construction, or permanent improvement of any building or other
facility
• Pets: Pet food or products
• Taxes: Paying local or state personal property taxes (for residential property, private
automobiles, or any other personal property against which taxes may be levied)
• Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -
owned vehicle or any additional costs associated with a privately -owned vehicle,
such as a lease, loan payments, insurance, license or registration fees
• Water Filtration: Installation of permanent systems of filtration of all water entering a
private residence (If water filtration/ purification systems are provided, the
community has water purity issues)
• It is unallowable to divert program income (income generated from charges/ fees
and copays from Medicare, Medicaid, other third -party payers collected to cover RW
services provided) toward general agency costs or to use it for general purposes
• Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
• Non -occupational Post -Exposure Prophylaxis (nPEP)
General -use prepaid cards are considered "cash equivalent" and are
therefore unallowable. Such cards generally bear the logo of a payment
network, such as Visa, MasterCard, or American Express, and are accepted
by any merchant that accepts those credit or debit cards as payment. Gift
cards that are cobranded with the logo of a payment network and the logo of
a merchant or affiliated group of merchants are general -use prepaid cards,
not store gift cards, and therefore are unallowable.
HRSA RWHAP recipients are advised to administer voucher and store gift card
programs in a manner which assures that vouchers and store gift cards cannot be
exchanged for cash or used for anything other than the allowable goods or services,
and that systems are in place to account for disbursed vouchers and store gift cards.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State
of Michigan.
The Grantee will maintain client files and charts from last date of service plus seven
(7) years. For minors, Grantee will maintain client files and records from last date of
service and until minor reaches the age of 18, whichever is longer, plus seven (7)
years.
Software Compliance
The Grantee and its subcontractors are required to use the HRSA-supported software
CW to enter client and service data into the centrally managed database on a secure
server. The Grantee must:
1. Enter all Ryan White services delivered to HIV -infected and affected clients.
2. Enter all data by the 10th of the following month.
3. Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
The Grantee must establish written procedures for protecting client information kept
electronically or in charts or other paper records. Protection of electronic client -level data
will minimally include:
1. Regular back-up of client records with back-up files stored in a secure location.
2. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
3. Use of virus protection software to guard against computer viruses.
Provide annual training to staff on security and confidentiality of client level data and
sharing of electronic data files according to MDHHS policies concerning sharing and
Secured Electronic Data.
New staff needing access to CAREWare are required to email the CAREWare user
request form to MDHHS-CAREWareSupport@michigan.gov. The Grantee shall notify
MDHHS within 30 days CAREWare users who are separated from the agency for
deactivation.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, in the event
of any of the following:
Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of,
or a defendant in, legal action. This includes, but is not limited to, events or
notices related to grievances by service recipients or Grantee or subcontractor
employees.
3. Any staff vacancies funded for this project that exceed 30 days.
This information maybe sent via US Mail to the DHSP in Lansing, MI.
DEPARTMENT REQUIREMENTS
Technical Assistance
The DSHP will provide technical assistance (TA), as requested, on the implementation of
the Ryan White program. This may include issues related to: CAREWare, Quality
Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or
other activities related to carrying out Ryan White activities. To request TA, please send
an email to MDHHS-HIVSTDooerationsr&michioan.aov or complete this form located on
the DHSP website httos://www.michiaan.aov/mdhhs/0.5885,7-339-71550 2955 2982---
O0.html
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan White
HIV/AIDS Treatment Extension Act.
PROJECT: IMMUNIZATION VFC/QI SITE VISITS
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
The format of the site visit will be based on the completed site visit questionnaires, the
CDC -PEAR and CDC-IQIP database systems reviewed at the most recent Fall IAP
meeting, web -training with MDHHS VFC and QI coordinators, in -person training with
Field Reps and the site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the appropriate
database as required by CDC (PEAR and QI database system) within 10 days of the site
visit by the individual who conducted the site visit. VFC site visit documentation must be
entered online within PEAR during the time of the site visit.
Reporting Requirements (if different than contract language)
All reimbursement requests should be submitted on the quarterly Comprehensive
Financial Status Report (FSR).
The submission should include, as an attachment, detail all the visits
during the quarter using the current spreadsheet information provided by
the Department.
The rate of reimbursement is $150 for a VFC Enrollment, AVP Only visit, or VFC
Only visit, $100 for a VFC Unscheduled Storage and Handling Visit, $350 for a
Combined VFC/QI site visit or Birthing Hospital visit, and $200 for a QI Only visit.
A VFC Enrollment visit is required for all new VFC enrolled provider sites.
Unannounced Storage and Handling Visits are not required but when performed,
must occur in conjunction with Immunization Nurse Education Sessions required
for VFC Providers that experience a loss exceeding a VFC dollar amount of
$1500. These visits can only be completed if eligible according to current CDC
requirements (e.g., visits cannot be performed for providers who have any visit
that is either in "In Progress" or "Submitted" status). Notify MDHHS VFC staff for
approval prior to performing these visits. MDHHS VFC will monitor the number of
Unannounced Storage and Handling visits performed and, if necessary, may limit
the allowable number of those that can be performed.
All LHD staff involved with any site visits must complete the Department site visit
training webinar, presented by the Department VFC and QI Coordinator, prior to
conducting any site visits. Annual VFC and QI visit guidance and review materials
will be provided to each LHD at the IAP Meetings and consult will be conducted by
the Department Immunization Field Representative for each Grantee.
Data from the CDC PEAR and CDC IQIP databases regarding the number and
type of site visits will be used to reconcile the agency request for reimbursement.
For additional detail on the program requirements, refer to the Resource Guide for
Vaccine for Children Providers and the current Department site visit guidance
documents, as well as other current guidance provided by the
Department/Immunization Program in correspondence to Immunization Action
Plan (IAP), Immunization Coordinators, or through health officers.
Any additional requirements (if applicable)
Every VFC visit performed for a QI-eligible provider must receive a QI visit within
the same site visit cycle. This may be performed as either a Combined VFC-QI
visit or separate VFC Only and QI Only visit, according to current MDHHS
guidelines. A QI visit can only be conducted within a cycle in which a VFC visit has
also been conducted for the same provider.
Local health departments must complete an in -person VFC or VFC/QI site visit for
every VFC provider at minimum, every 24-months, using the date of their previous
visit as a starting point. Site visits will vary in time an average of 1 hour for QI and
2 hours for VFC Compliance and must not exceed the two-year time frame.
Annual visits are encouraged but must not be conducted sooner than 11 months
from the previous site visit date.
Combined VFC/QI site visits will be conducted using MCIR QI reports and QI tools
developed by the Department. All VFC and QI follow-up activities and outstanding
issues must be completed within CDC guidelines.
Detroit Department of Health and Wellness Promotion Immunization Program is
required to complete visits annually to 100% of the VFC providers in accordance
with the SEMHA Quality Assurance Specialist (QAS) contractual obligations,
including the completed site visit questionnaires and the CDC -PEAR and the
CDC-IQIP database systems reviewed at the most recent Fall IAP meeting, web -
training with MDHHS VFC and QI coordinators, in -person training with Field Reps
and the current site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the
appropriate database as required by CDC (PEAR and QI database system) within
10 days of the site visit by the individual who conducted the site visit. VFC site visit
documentation must be entered online within PEAR during the time of the site
visit.
PROJECT: IMMUNIZATION ACTION PLAN
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Offer immunization services to the public.
• Collaborate with public and private sector organizations to promote childhood,
adolescent and adult immunization activities in the county including but not limited
to recall activities.
Educate providers about vaccines covered by Medicare and
Medicaid.
• Provide and implement strategies for addressing the immunization rates of
special populations (i.e., college students, educators, health care workers, long
term care centers, detention centers, homeless, tribal and migrant and childcare
employees).
• Develop mechanisms to improve jurisdictional and LHD immunization rates for
children, adolescents and adults.
• Ensure clinic hours are convenient and accessible to the community, operating
both walk-in and scheduled appointment hours.
• Coordinate immunization services, including WIC, Family Planning, and STD,
developing plans or memorandums of understanding.
• Collaboratively work with regional MCIR staff to ensure providers are using
MCIR appropriately.
• Develop strategies to identify and target local pocket of need
areas.
Reporting Requirements (if different than contract language)
• IAP Reports are submitted electronically in accordance with due dates set by the
Department.
• IAP Plan will be submitted electronically using a template provided by the
Department, in accordance with due dates set by the Department.
• Utilize VAERS to report all adverse vaccine reactions
• Ensure that all reportable diseases are reported to the Department in the time
specified in the public health code and appropriate case investigation is
completed.
• By April 1, of each year provide one copy of the VFC provider with an online re -
enrollment form which includes a profile for each provider who receives vaccine
from the state. These documents must be submitted electronically in MCIR no
later than April 1.
Any additional requirements (if applicable)
Adhere to federal and state appropriation laws pertaining to use of programmatic
funds. See Immunization Allowable Expenditures in Attachment I for appropriate
use of Federal Funds.
Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993,
section 1928 Part IV — Immunizations and the most current CDC Vaccines for
Children Operations Manual, Michigan Resource Book for VFC Providers, and
documents that are updated throughout the year pertaining to the Vaccines for
Children (VFC) Program.
Ensure that federally procured vaccine is administered to eligible children only
and is properly documented per VFC guidelines.
o The VFC Program provides VFC vaccine to only eligible children who meet
the following criteria: are Medicaid eligible, have no health insurance, are
American Indian or Alaskan Native, are served at a Federally Qualified
Health Center (FQHC), a Rural Health Center (RHC) or a public health
clinic affiliated with a FQHC and are also under -insured.
o Ensure state -supplied vaccines provided in the jurisdiction are
administered only to eligible clients as determined by the state. This
program allows for the immunization of select populations who are
underinsured and not served at a FQHC, RHC, or a public health
immunization clinic affiliated with a FQHC as defined by current state
program requirements.
o Ensure that all providers receiving vaccine from the state screen children
for VFC eligibility for children
6 Fraud or abuse of federally procured vaccine must be monitored and reported.
Adhere to all Federal and Michigan Laws pertaining to immunization administration
and reporting including reporting to the MCIR, VAERS and schools and daycare
reporting
Coordinate the submission of immunization data from schools and childcare
centers in your jurisdiction and follow-up with programs providing incomplete or
inaccurate data. Assure compliance levels are adequate to protect the public.
Provide education to the parents of children seeking a non -medical exemption in
your jurisdiction.
Monitor any provider receiving federally procured vaccine including but not limited to
VFC/QI site visit.
Ensure on -site attendance of at least 1 LHD immunization program staff to two (2)
Immunization Action Plan (IAP) meetings each year.
Implements Perinatal Hepatitis B program activities to prevent the spread of
Hepatitis B Virus (HBV) from mother to newborn.
o Verify pregnancy status on all hepatitis B surface antigen (HBsAg)
positive pregnant women of childbearing years (10-60 years of age.)
o Ensure HBsAg positive pregnant women are reported to the Perinatal
Hepatitis B case manager and according to the Public Health Code.
o Coordinate Perinatal Hepatitis B case management activities between
local health department, provider, and Perinatal Hepatitis B Case Manager
to:
Ensure that all infants, born to women who are HBsAg positive receive hepatitis B
vaccine and hepatitis B immune globulin (HBIG) within 12 hours of life, a complete
hepatitis B vaccine series with post vaccination serology testing and program
support services.
• Ensure that all susceptible household and sexual contacts associated with HBsAg
positive women receive appropriate testing, vaccination, and support services.
• Ensure birthing hospitals are able to offer hepatitis B vaccine to all newborns
prior to hospital discharge by enrolling them in the Universal Hepatitis B
Vaccination Program for Newborns.
• Surveillance of vaccine preventable disease (VPD) activities
o Conduct active surveillance when indicated (i.e. during an outbreak)
and contact hospitals, laboratories, and/or other providers on a
regular basis.
PROJECT: Immunization Action Plan- Pilot
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis:
Project to increase immunization rates within the jurisdiction with a focus on influenza
vaccination.
. Staffing to work with schools on implementing school located vaccination clinics.
. Staff school located vaccination clinics and provide vaccines to eligible students.
Distribute report cards to providers within the jurisdiction and research methods
to increase immunization rates within the practice.
. Work with MDHHS staff to coordinate immunization services to schools.
Reporting Requirements (if different than contract language)
On a quarterly basis provide number of clinics held and number of students
vaccinated at school located clinics
On a quarterly basis report the number of interventions initiated with provider
offices to improve immunization rates
On a quarterly basis report any other immunization outreach efforts completed
using this funding
Any additional requirements (if applicable)
PROJECT: IMMUNIZATION — FIELD SERVICE REPRESENTATIVES
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
Ir"S
Marquette, and St. Clair Counties
This position serves as a liaison, resource person and as a regional expert for local
health jurisdictions regarding all the Department immunization programs and initiatives.
PROGRAM SUPPORT:
• Assist with the regional MCIR activities and act as a regional resource on MCIR
processes and assessment protocols.
• Assist with the local implementation and monitoring of all state programs at the
regional level- including IAP implementation, VFC, IQIP, Accreditation, Perinatal
Hepatitis B, School / Childcare reporting, special projects and the INE program.
• Participate in planning for regional conferences, IAP Coordinator meetings, and
other Department programs and initiatives as needed.
• Assist state, regional and local epidemiologists and communicable disease staff as
needed with VPD surveillance and outbreak control.
PROGRAM QUALITY ASSURANCE:
• Assist in the orientation of new IAP Coordinators.
• Work with local health departments to assess and increase immunization levels for
all age groups, especially identifying and targeting pockets of need.
• Identify evidence -based strategies that support improved coverage levels in the
region, including use of recall, support for the IQIP program, coordination of LHD
services, and provider and LHD staff education.
• Consult with the local health department on the immunization component of the
accreditation process, including preparation for reviews and conducting a walk
through or mock accreditation review.
• Consult with local coalitions and private stakeholders to promote immunizations
and ensure consistent messages are relayed to the public.
• Consult with local health departments on the school and day care assessment
process.
• Encourage or provide educational updates and interventions on all immunization
issues with staff at local health departments, healthcare providers, school and
childcare staff and other stakeholders, may also include INE presentation if
applicable.
PROGRAM COMPLIANCE:
• Monitor compliance with policies/legislation at national/state and local levels such as:
o VFC program requirements and vaccine distribution and storage.
o VAERS program
o Public Health Code
o Administrative Rules
o School and childcare legislation and reporting requirements
o MCIR legislation and rules
o Communicable Disease Rules
PROGRAM OVERSIGHT and PROGRAM REVIEW:
Perform oversight of the following programs with assigned local health
departments.
• Accreditation -Conduct reviews and monitor corrective actions.
• VFC including orientation and observation of LHD staff to annual VFC site visit
process, monitoring of VFC vaccine losses, submission of mandatory reports,
annual LHD VFC site visits and quality assurance review of all provider public
vaccine orders, perform E-VFC site visits to all LHD clinics, and unannounced
VFC storage and handling site visits.
IQIP—including the required IQIP follow-up with VFC providers, and full
implementation of recommendations.
• Perinatal Hepatitis B-regional birth dose levels and universal vaccine program.
Review and summarize LHD IAP Annual Plans and Biannual IAP Reports.
Monitor LHD compliance with Comprehensive agreements and special
requirements relating to the Immunization program.
• Subrecipient monitoring of funds.
• Employ and oversee a full-time Immunization Field Representative for the
Immunization Program who shall be acceptable to the Department and who shall
be supported by this agreement, understanding that their full time is to be devoted
for regional immunization related activities, including travel time.
• Provide the Immunization Field Representative with permanent office space and
supplies, including, but not limited to a telephone, general office supplies, a
computer with high speed internet capabilities, a printer, a cellular telephone and a
use of vehicle or reimbursement mechanism for transportation unless otherwise
arranged.
Ensure the Immunization Field Representative will be available to all local health
departments in the assigned regions to provide Immunization Program activities
equitable and at the direction of the Department. Refer to field representative
responsibilities as defined by the Department and distributed to the Grantee.
Provide for reimbursement for reasonable telephone charges incurred in the
conduct of business by the Immunization Field Representative unless otherwise
arranged.
Provide reasonable reimbursement for any travel and subsistence expenses
incurred by the Immunization Field Representative necessary to the conduct of the
Immunization Program. Travel could include the annual National Immunization
Conference or other professional immunization related conferences, attendance at
the Department Immunization staff meetings and trainings, and accreditation visits
made in other areas of the state, as determined by the Division of Immunization.
Kent, Livingston and Monroe Counties
• Provide adequate office space, telephone connections, high-speed internet
access, as well as access to fax and photocopiers.
• Provide feedback to Section Manager as needed, on employee work related
conduct.
PROJECT: IMMUNIZATION MICHIGAN CARE IMPROVEMENT
REGISTRY (MCIR) REGIONAL
Beginning Date: 10/1/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements
• Ensure the quarterly submission of status reports on work plan progress. Reports
are due within 30 days of the end of each quarter:
Report Period
October 1 — December 31
January 1 - March 31
April 1 - June 30
July 1 - September 30
Report Due
January 31
April 30
July 31
October 31
Final quarterly report shall be an annual report. The annual report will be distributed
to the Department. The report shall include a summary of all the required activities
listed above in the quarterly reports.
• Any other information as specified in the special requirements shall be developed
and submitted by the Grantee as required by the Department.
o Reports and information should be submitted to:
Bea Salada, MCIR Coordinator
Michigan Department of Health & Human Services
Immunization Division
333 South Grand Ave
Lansing, MI 48909
Phone: (517) 284-4889
• The Grantee shall permit the Department or its designee to visit and to evaluate
on an as- needed basis.
Any additional requirements (if applicable)
• The Grantee shall ensure the performance of the following activities on behalf of
the Department to support the MCIR:
• Promote and train providers and Health Care Organizations (HCOs) on all features
of the MCIR Web application.
• Support regional MCIR users by operating the regional help desk in accordance
with Department approved procedures.
• Monitor and develop strategies to increase private provider and HCO enrollment
and participation in the MCIR which includes development of strategies to
encourage all providers to fully participate with the MCIR, (such as sites of
excellence awards).
• Process all user/usage agreements, according to the Department's approved
procedures, to create user accounts.
• Implement and update marketing plans in support of increased provider and
parent acceptance and use of the MCIR.
• Keep regional users updated on MCIR status and system changes.
• Conduct ad hoc reporting and querying on behalf of MCIR users.
• Work with local health departments to establish a mechanism and internal
process to assure persons who have died within their county are appropriately
flagged in the MCIR.
Maintain a listing of HCO private and public immunization providers. This listing
should be as comprehensive as possible and should include all providers in the
region.
• Conduct regular de -duplication activities to assure that duplicate records are
removed from the MCIR as quickly as possible.
• Process user petitions to change MCIR data according to Department approved
procedures.
Monitor ongoing immunization data submission for all local health departments
and private providers.
• Conduct training functions as needed to assure that local health department staff
can train and educate providers on how to access and submit data into MCIR.
• Maintain a policy/procedure manual, approved by the Department.
• Process and file all `opt out' forms according to the Department approved
procedures.
• Attend regular MCIR regional Grantee/coordinator meeting.
• Conduct Onboarding activities as required for providers submitting immunization
data via HL7 messaging to MCIR.
• Perform quality assurance checks on the MCIR data for the region as
prescribed by the Department.
Assist local health departments and private providers with
methodologies to "clean up" their data.
• Provide assistance to the Department on User Acceptance Testing
(UAT) when required to verify MCIR system releases of bug fixes
and enhancements.
• Attend all UAT training sessions as required by the Department.
• The Grantee shall provide to the MCIR Regional Coordinator:
a) permanent office space
b) general office supplies
c) a land -based telephone
d) a computer with high speed internet capabilities
e) a printer
f) a cellular telephone
g) use of a vehicle or in the alternative reimbursement mechanism for
transportation unless otherwise arranged
• When sufficient funding is available, provide to the MCIR Regional Coordinator
reimbursement for travel to attend the National Registry related meetings if
approved by the Department. This includes travel related expenses concerning air
fare, lodging, baggage processing, taxi services, etc.
• Consult with the Department on any personnel or performance issues that could
affect the above -mentioned contract requirements.
Facilitate the Department's attendance in the interview process for hiring of a
MCIR Regional Coordinator / MCIR staff. This process includes consultation
with the Department regarding selection of interview candidates as well as
participation in the hiring determination.
PROJECT: IMMUNIZATION VACCINE QUALITY IMPROVEMENT
ASSURANCE
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
The rate of reimbursement per completed QI follow-up visit is $100 for the 2-month and
6-month check in calls and the 12-month follow-up (either an in -person or phone call
following current Department guidance) after the QI site visit. The $100 is reimbursable
only if all 3 activities occur within the Department guidance.
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
Conduct the 2-month and 6-month QI check -in calls with each VFC provider that
received a QI site visit during the previous or current CDC cycle (using current
Department guidance).
Conduct the 12-month QI follow-up with each VFC provider that received a QI site
visit during the previous or current CDC cycle (using current Department
guidance).
Complete data entry of each site -visit, 2-month check -in call, 6-month check -in
call and 12-month follow-up in the CDC-IQIP database using current Department
guidance within 10 business days of each QI activity.
PROJECT: IMMUNIZATION —VACCINE QUALITY ASSURANCE
PROGRAM
Beginning Date: 10/01/2020
End Date: 9/30/2021
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
• Follow-up on vaccine losses and replacement for compromised vaccines for
immunization providers within the jurisdiction.
• Monitor and approve all temperature logs, doses administered reports and ending
inventory reports received from participating VFC providers within the jurisdiction.
• Monitor and approve vaccine orders for participating VFC providers within the
jurisdiction.
• Act as the Primary Point of Contact (PPOC) for VFC providers within the
jurisdiction.
• Provide education and intervention on inappropriate use of publicly purchased
vaccine.
• Follow-up on VFC site visit non-compliance issues.
• Assist VFC providers within the jurisdiction on issues related to balancing vaccine
inventories.
• Assist with the redistribution of short dated vaccine for providers within the
jurisdiction.
• Assist with the equitable allocation of vaccines to providers in the jurisdiction
during a vaccine shortage.
PROJECT TITLE: Infant Safe Sleep
Start Date: 10/1/2020
End Date: 09/30/2021
Project Synopsis:
Local health departments will provide educational activities, conduct community outreach
efforts and/or expand community awareness of infant safe sleep.
Reporting Requirements (if different than agreement language):
LHD will attach completed 'Infant Safe Sleep Mini -Grant Work Plan" to the
indirect cost line of the budget for review and approval by the Infant Safe Sleep
program.
Prior to the submission of the proposed work plan, LHD will participate in a
meeting (by person or phone) with all mini -grantees facilitated by the Infant Safe
Sleep Program to review current data, discuss infant safe sleep best practices
and answer any questions related to mini -grant requirements.
3. LHD will attach `Infant Safe Sleep Mini -Grant Work Plan" with reporting column
completed and completed 'Infant Safe Sleep Mini -Grant Report Grid" to the
indirect cost line of the 2nd quarter FSR. The reporting period will cover October
1, 2020 - March 31, 2021. The reports are due by April 30, 2021.
4. LHD will participate in a technical assistance call with the Infant Safe Sleep
Program to review progress to date.
5. LHD will attach 'Infant Safe Sleep Mini -Grant Work Plan" with reporting column
completed and completed "Infant Safe Sleep Mini -Grant Report Grid" to the
indirect cost line of the final FSR. The reporting period will cover October 1, 2020
- September 30, 2021. The reports are due by December 15, 2021.
Any additional requirements (if applicable):
1. Grantee must provide educational activities, conduct community outreach efforts
and/or expand community awareness of infant safe sleep. These efforts must
adhere to the updated policy statement titled "SIDS and Other Sleep -Related
Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping
Environment' issued by the American Academy of Pediatrics in October 2016.