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HomeMy WebLinkAboutResolutions - 2020.12.07 - 33965Projects 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.