HomeMy WebLinkAboutResolutions - 2021.10.28 - 34976participation of staff from various disciplines, ongoing review of performance
measure data and assessment of consumer satisfaction.
b. 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.
c. 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.
11. 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:
• Quality statement
• Quality infrastructure
• Annual quality goals
• Capacity building
• Performance measurement
• Quality improvement
• Engagement of stakeholders
• Procedures for updating the QM plan
• Communication
• Evaluation
• 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.
HRSA Unallowable Costs:
'An expanded list of "unallowable" grant costs is available in the PCN 16-02.
a. 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.
b. Off -premises social or recreational activities (movies, vacations, gym
memberships, parties, retreats)
c. Medical Marijuana
d. Purchase or improve land or permanently improve buildings
e. 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)
g. Clothing: Purchase of clothing
h. Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
Funerals: Funeral, burial, cremation, or related expenses
Household Appliances
k. 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
m. International travel
n. The purchase or improvement of land
o. The purchase, construction, or permanent improvement of any building or other
facility
p. Pets: Pet food or products
q. Taxes: Paying local or state personal property taxes (for residential property,
private automobiles, or any other personal property against which taxes may be
levied)
r. 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
s. Water Filtration: Installation of permanent systems of filtration of all water
entering a private residence unless in communities where issues of water safety
exist.
t. 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.
u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
v. Non -occupational Post -Exposure Prophylaxis (nPEP).
w. 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.
Personnel Transfer/Terminations
1. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS
designated personnel in writing of any personnel transfers or terminations of
personnel who possess information system privileges within CAREWare or
MIDAP online data systems within 24 hours of change.
The Grantee shall notify MDHHS immediatelv through Qualtrics HERE of
CAREWare users who are separated from the agency for deactivation.
Record Maintenance/Retention
1. 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.
2. 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
1. 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.
2. 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:
a. Regular back-up of client records with back-up files stored in a secure
location.
b. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
c. Use of virus protection software to guard against computer viruses.
3. 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 submit the CAREWare user
request form through Qualtrics HERE.
Mandatory Disclosures
1. The Grantee will provide immediate notification to the Department, in writing, in
the event of any of the following:
a. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
b. 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.
c. Any staff vacancies funded for this project that exceed 30 days.
This information may be sent via US Mail to the DHSP in Lansino, MI.
Technical Assistance
To request Technical assistance, please send an email to MDHHS-
HIVSTIogerationse,michigan.gov or complete this form located on the DHSP website
httos:/hNww.michigan.gov/mdhhs/0,5885,7-339-71550 2955 2982---,00.html
ASSURANCES
Compliance with Applicable Laws
1. The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public
Health Service (PHS) Act.
3. The Grantee should have procedures to protect the confidentiality and security of
client information.
PROJECT TITLE: HIV PrEP Clinic
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The purpose of this project is to establish HIV Pre -Exposure Prophylaxis (PrEP) services.
Reporting Requirements (if different or in addition to agreement language)
Report Period Due Date(s) How to Submit Report
PrEP Cascade Monthly loth of the following month ctrsuwDlies(a),michiaan.gov
Data
Billing Revenue Quarterly loth of the following month ctrsupplies@michigan.gov
Report
Any additional requirements (if applicable)
Grant Program Operation
Funds are to be used to operate a Pre -Exposure Prophylaxis (PrEP) program for
individuals at risk of acquiring HIV. These funds can support a Mid -level provider,
supporting staff, and materials to provide and promote Pre -Exposure Prophylaxis (PrEP)
services.
Mandatory Disclosures
The Grantee will provide immediate notification to the Department, in writing, including
but not limited to the following events:
• 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.
• All notifications should be made to the Department by MDHHS-
HIVSTIoperations(-.michiaan.gov.
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 Prevention
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The purpose of this project is to provide comprehensive HIV prevention services to all
priority populations and People Living with HIV (PLWH) to improve overall health and
well-being and reduce the incidence of new HIV infections.
Reporting Requirements:
Report
Period
Due Date(s)
How to Submit
Report
Quality Control Reports
Monthly
10th of the
following month
Department Staff
Daily Client Logs
Monthly
101h of the
following month
Department Staff
HIV Testing Proficiencies
Annually
Reviewed during
Department Staff
site visits
Sent to MDHHS
HIV Testing Competencies
Annually
before the end of
Department Staff
the fiscal year
Reactive Results
As
Within 24 hours of
APHIRM
needed
test
Non -Reactive Results
As
Within 7 days of
APHIRM
needed
test
Linkage to Care and Partner Services
Interview (e.g. client attended a
medical care appointment within 30
As
Within 30 days of
APHIRM
days of diagnosis, and was interviewed
needed
service
by Partner Services within 30 days of
diagnosis)
Internet Partner Services (IPS) and
Partner Services Interview (e.g. client
Ongoing
Within 30 days of
APHIRM
identify dating apps used to meet
service
partners), if applicable
Disposition on Partners of HIV Cases,
Ongoing
Within 30 days of
APHIRM
if applicable
service
Evidence Based Interventions/PrEP
Monthly
10th of the
Intervention/
Navigation
navigation, if applicable
following month
Database
SSP Data Report, if applicable
Quarterly
10th of the
Syringe Utilization
following month
Platform (SUP)
1. The Grantee will clean-up missing data by the 10th day after the end of each calendar
month.
2. The Quality Control and Daily Client Logs may be sent to DHSP via:
• Email - ctrsuoolies(oamichiaan.aov
• Fax - (517) 241-5922
• Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
GRANTEE REQUIREMENTS
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 & STI Programs (DHSP). See "Applicable Laws, Rules,
Regulations, Policies, Procedures, and Manuals."
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.
2. 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
1. 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.
3. 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:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. 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.
d. Submit a budget modification to DHSP in instances where the percentage of
effort of contract staff changes (FTE changes) during the contract period.
4. The Grantee will receive a condom and lubrication allowance. The Grantee must:
a. Distribute condoms and lubrication
b. 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:
a. 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."
b. Ensure provision of Clinical Laboratory Improvement Amendments (CLIA)
certificate.
c. Report discordant test results to DHSP.
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.
e. 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.
Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
g. To maintain active test counselor certification, each HIV test counselor must
submit one competency per year to the appropriate departmental staff.
6. 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:
a. Provide Confidential PS follow-up to infected clients and their at -risk partners to
ensure disease management and education is offered to reduce transmission.
b. Effectively link infected clients and/or at -risk partners to HIV care and other
support services.
c. Work with Early Intervention Specialist to ensure infected clients are retained in
HIV care.
d. Procure TLO or a TLO-like search engine.
e. Ensure staff that are utilizing TLO or TLO-search engine complete the TLO
training to maintain and understand the confidential use of the system.
f. Effectively utilize the Internet Partner Services (IPS) Guidance to provide
confidential PS follow-up to partners named by infected clients who were
identified to have been met through the use of dating apps.
g. Ensure staff and site supervisors successfully complete the Internet Partner
Services Training.
h. Ensure staff conducting Internet Partner Services participant in monthly, bi-
monthly meetings, webinars or calls to discuss best practices and identify
barriers.
7. 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.
a. Grantees will participate on monthly or quarterly conference calls to discuss
best practices and identify barriers.
8. 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
1. The Grantee and its subcontractors are required to use APHIRM (formerly
Evaluation Web) to enter HIV client and service data into the centrally managed
database on a secure server.
2. The Grantee and its subcontractors are required to use APHIRM (formerly Partner
Services Web) to enter Partner Services interview, linkage to care data, and
identified dating apps through the use of Internet Partner Services (IPS) where
appropriate.
Mandatory Disclosures
1. The Grantee will provide immediate notification to DHSP, in writing, including but
not limited to the following events:
a. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
b. 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.
c. Any staff vacancies funded for this project that exceed 30 days.
2. All notifications should be made to DHSP by MDHHS-
H IVSTlooerations(c�m ichigan.gov.
Technical Assistance
To request TA, please send an email to MDHHS-HIVSTIoperations(cilmichioan.gov.
a. This may include issues related to: APHIRM (formerly EvaIWeb and PSWeb),
Intervention Database, Programs, Budget/Fiscal, Grants and Contracts, Risk
Reduction Activities, Training, or other activities related to carrying out HIV
prevention activities.
ASSURANCES
Compliance with Applicable Laws
The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
PROJECT TITLE: HIV Care Ryan White Part B
Start Date: 10/1/2021
End Date: 9/30/2022
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:
1. 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:
a. The RSR shall have no more than 5% missing data variables.
b. Exact dates for the Grantee submission will be provided by the Department
each reporting year.
c. The Department validates the data within the Grantee's RSR submission
before receipt by HRSA.
2. The Grantee shall permit the DHSP or its designee to conduct site visits and to
formulate an evaluation of the project.
3. 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:
a. Enter all Ryan White services delivered to HIV -infected and affected clients.
b. Enter all data by the 10th of the following month.
c. 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.
Grantee Report Submission Schedule
Report Period
All Agencies: Ryan White Monthly
services delivered to HIV -
infected and affected clients
All Ryan White federally Annual
funded agencies: Ryan White
Services Report (RSR)
Due Date(s)
10'h of the
following month
Generally,
Grantee
submission will
open in early
February and
close early
March.
How to Submit
Report
Enter into CAREWare
(CW)
Submission to HRSA
through Electronic
Handbook (EHB)
All Ryan White federally Annual December 31, Email report to
funded agencies providing at 2021 MDHHS-
least one core medical HIVSTIoperations(dmi
service: Quality Management chigan.gov
Plan
All Ryan White federally 10/1/21 — As completed Email report to
funded agencies: Complete 9/30/22 over contract year MDHHS-
and submit at least one Plan- HIVSTIoperations(a)mi
Do -Study -Act worksheets to chigan.aov
document progress of QI project
All Funded agencies: Quarterly Thirty days after Submit in EGrAMS
Complete quarterly workplan the end of the Email report to
progress reports budget period MDHHS-
HIVSTIoperations(a)mi
chiaan.aov
All Ryan White federally Quarterly Thirty days after Attached to quarterly
funded agencies: FY22 actual the end of the FSR
expenditures by service budget period
category, program income, and
administrative costs through the
RW Reporting Tool
All Ryan White federally Annually December 31, Uploaded to EGrAMS
funded agencies: RW Form 2021 Portal Agency Profile
2100 and RW Form 2300
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
The Grantee must establish and implement a process to ensure that they are maximizing
third party reimbursements, including:
a. Requirement, in agreement, that the Grantee maximize and monitor third party
reimbursements.
b. Requirement that Grantee document, in client record, how each client has been
screened for and enrolled in eligible programs.
c. Monitoring to determine that Ryan White is serving as the payer of last resort,
including review of client records and documentation of billing, collection policies
and procedures, and information on third party contracts.
d. Grantee must adhere to the National Monitoring Standards for Rvan White Part B
Grantees: Proqram and the National Monitorinq Standards for Rvan White
Grantees: Fiscal; and bill for services that are billable in accordance with the
above.
e. Ensure appropriate billing, tracking, and reporting of program income to support
appropriate use for program activities.
Program income is added to funding provided by the State of Michigan for the
budget period and used to advance eligible program objectives.
g. Provide a report detailing the expenditure and reinvestment of program income in
the program (template will be provided by MDHHS).
Grant Program Operation
1. The Grantee will participate in the Department needs assessment and planning
activities, as requested.
2. 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.
3. 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.
4. 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:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. 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.
d. Submit a budget modification to the Department in instances where the
percentage of effort of contract staff changes (FTE changes) during the
contract period.
5. 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."
6. The Grantee must adhere to security measures when working with client
information and must:
a. Not email individual health information either internally or externally.
b. Keep all printed materials in locked storage cabinets in locked rooms.
c. 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.
d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs.
CDC Website:
httDs://www.cdc.aovinchhstD/program intecirationIdOCSIDcsidatasecu ritvau idelines.1)
df.
7. 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.
8. Subrecipient quality management program should:
a. 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.
b. 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.
c. 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.
9. 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:
• Quality statement
• Quality infrastructure
• Annual quality goals
• Capacity building
• Performance measurement
• Quality improvement
• Engagement of stakeholders
• Procedures for updating the QM plan
• Communication
• Evaluation
• Work Plan
10. 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.
HRSA Unallowable Costs:
*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.
b. Off -premises social or recreational activities (movies, vacations, gym
memberships, parties, retreats)
c. Medical Marijuana
d. Purchase or improve land or permanently improve buildings
e. Direct cash payments or cash reimbursements to clients
f. 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)
g. Clothing: Purchase of clothing
h. Employment Services: Support employment, vocational rehabilitation, or
employment -readiness services.
Funerals: Funeral, burial, cremation, or related expenses
j. Household Appliances
k. Mortgages: Payment of private mortgages
I. Needle Exchange: Syringe exchange programs, Materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether homosexual
or heterosexual
m. International travel
n. The purchase or improvement of land
o. The purchase, construction, or permanent improvement of any building or other
facility
p. Pets: Pet food or products
q. Taxes: Paying local or state personal property taxes (for residential property,
private automobiles, or any other personal property against which taxes may be
levied)
r. 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
s. Water Filtration: Installation of permanent systems of filtration of all water entering
a private residence unless in communities where issues of water safety exist.
t. 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.
u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
v. Non -occupational Post -Exposure Prophylaxis (nPEP).
w. 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.
Personnel Transfer/Terminations
As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS
designated personnel in writing of any personnel transfers or terminations of
personnel who possess information system privileges within CAREWare or MIDAP
online data systems within 24 hours of change.
The Grantee shall notify MDHHS immediately through Qualtrics HERE of
CAREWare users who are separated from the agency for deactivation.
Record Maintenance/Retention
1. 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.
2. 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.
2. 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:
a. Regular back-up of client records with back-up files stored in a secure location.
b. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
c. Use of virus protection software to guard against computer viruses.
3. 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.
4..New staff needing access to CAREWare are required to submit the CAREWare
user request form through Qualtrics HERE.
Mandatory Disclosures
1. The Grantee will provide immediate notification to the Department, in writing, in the
event of any of the following:
a. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
b. 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.
c. 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
To request technical assistance, please send an email to MDHHS-
HIVSTIoaerations a( ,,michiaan.gov or complete this form located on the DHSP website
httos://www.michiaan.aov/mdhhs/0,5885.7-339-71550 2955 2982---,00.htmi
ASSURANCES
Compliance with Applicable Laws
1. The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public
Health Service (PHS) Act.
3. The Grantee should have procedures to protect the confidentiality and security of
client information.
PROJECT TITLE: HIV STI Partner Services Program
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
Grantee will provide STI and HIV partner services (PS) for select low morbidity health
departments within the State of Michigan in accordance with program standards and
Department oversight.
Reporting Requirements (if different than agreement language):
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) How to Submit Report
HIV testing
10'h of the following
notification/services to
Monthly
Enter in Aphirm I
delivered to individuals
month
Partner Services delivered
Within 72
101h of the following
to individuals
hours
Enter in Aphirm
month
Syphilis Partner Counseling
Within 72
and Referral
hours
Within 72 hours MDSS
• The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by the Contract Manager.
Any additional requirements (if applicable):
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.
4. The Grantee will submit all educational materials (e.g., brochures, posters,
pamphlets, and videos) used in conjunction with program activities to the
Department for review and approval prior to their use, regardless of the source of
funding used to purchase these materials. These materials should be emailed to
MDH H S-H IVST IOoerations(a, mich igan. qov.
Grant Program Operation
Pursuant to a protocol established by the Department, the Grantee will provide
positive test notification, HIV/STD and syphilis partner counseling and referral
services, victim notification and recalcitrant investigation for the following local
health departments: Bay County Health Department, Benzie-Leelanau District
Health Department, Central Michigan District Health Department, Chippewa
County Health Department, Dickinson -Iron District Health Department, District
Health Department # 2, District Health Department # 4, District Health Department
#10, Grand Traverse County Health Department, Luce-Mackinac-Alger-
Schoolcraft District Health Department, Marquette County Health Department,
Mid- Michigan District Health Department, Midland County Health Department,
Northwest Michigan Community Health Agency, Public Health, Delta and
Menominee Counties, and Western Upper Peninsula District Health Department.
2. The Grantee will establish, maintain and document (e.g., via MOU or MCA)
linkages with community resources that are necessary and appropriate to
addressing the needs of clients and that are essential to the success and
effectiveness of services supported under this agreement.
3. The Grantee will provide these services fifty-two weeks a year.
4. The Grantee will participate in the Department needs assessment and planning
activities, as requested.
5. 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 Department.
6. 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:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. 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.
d. Submit a budget modification to the Department in instances where the
percentage of effort of contract staff changes (FTE changes) during the
contract period.
7. 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.
Record Maintenance/Retention
1. 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.
2. The Grantee will maintain client records of HIV Positive or Negative with Syphilis
diagnosis. MDHHS recommends that this information be retained indefinitely or
until it is determined the client is deceased.
Software Compliance
1. The Grantee will adhere to reporting deadlines for all contractual Grantee
Reporting requirements.
2. The Grantee is required to use the following data systems to enter HIV and
Syphilis case investigation data: Aphirm and Michigan Disease Surveillance
System (MDSS)
a. All reactive results must be entered into Aphirm within 48 hours
b. All non -reactive results must be entered into Aphirm within seven days
c. All APhirm must be entered and missing variables entered by the 10th day
after the end of each calendar month.
3. 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:
a. Regular back-up of client records with back-up files stored in a secure location.
b. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
c. Use of virus protection software to guard against computer viruses.
d. 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.
Mandatory Disclosures
1. The Grantee will provide immediate notification to the Department, in writing, in the
event of any of the following:
a. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
b. 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.
c. Any staff vacancies funded for this project that exceed 30 days.
d. This information may be emailed to:
MDHHS-HIVSTIOnerations(@michigan.gov
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 and STI T esting and Prevention
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The City of Detroit bares a disproportionate burden of reported sexually transmitted
infection, 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 STI Section
the quarter
Any additional requirements (if applicable):
1. 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.
2. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
a. Ensure timely entry of client encounter information into Ahirm
3. Conduct community awareness building activities to increase STI and HIV
knowledge, including points of access for service.
4. By September 30, distribute MDHHS determined allocation worth of condoms,
lube, dental dams, and display equipment/materials.
5. By September 30, develop and begin distribution of HIV Prevention
advertising/marketing materials.
PROJECT TITLE: Housing Opportunities for Persons with AIDS PLUS
(HOPWA PLUS)
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The purpose of this project is to increase housing stability, reduce the risk of
homelessness, and increase access to care and support for low-income individuals living
with HIV/AIDS and their families.
Reporting Requirements (if different than agreement language):
Grantees must submit required program data through CAREWare. It is expected
that data entry into CAREWare will be completed within15 days of the event
requiring data entry (entry into the program; end of the operating year; changes in
participant status regarding benefits, income, programs provided, household size,
location of housing, and so on as described by CAREWare guidelines). It is
expected that data in CAREWare be complete, up-to-date, and without errors or
omissions by July 31 (or the first business date immediately following July 31) of
each year.
2. The grantee must submit the Annual Progress Report (APR) each grant term prior
to July 31st. All requirements for reporting are outlined in the HOPWA program
manual. Please contact Lynn Nee, HOPWA Program Specialist, from the Housing
and Homeless Services Division with any questions about reporting requirements.
Lynn Nee
HOPWA Program Specialist
Housing and Homeless Services
NeeL@michigan.gov
517-275-2791
Any additional requirements (if applicable)
The grantee shall undertake, perform, and complete activities and services for the
program as outlined in the Program Manual provided by the Michigan Department of
Health and Human Services (MDHHS) Housing and Homeless Services Division. The
grantee is expected to adhere to all applicable federal and state laws, regulations, and
notices.
PROJECT: IMMUNIZATION VFC/QI SITE VISITS
Beginning Date: 10/01/2021
End Date: 9/30/2022
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).
a. The submission should include, as an attachment, detail all the visits
during the quarter using the current spreadsheet information provided by
the Department.
Any additional requirements (if applicable)
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.
• 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: 10/1/2021
End Date: 9/30/2022
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.
a 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.
a IAP Plan will be submitted electronically using a template provided by the
Department, in accordance with due dates set by the Department.
O 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.
a 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.
Ensure that all providers receiving vaccine from the state screen children
for VFC eligibility for children
0 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, VAER5 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.
u 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
c 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: 10/1/2021
End Date: 9/30/2022
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: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
1=00_190 MAIM'
Marquette,:d 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:
a. VFC program requirements and vaccine distribution and storage.
b. VAERS program
c. Public Health Code
d. Administrative Rules
e. School and childcare legislation and reporting requirements
f. MCIR legislation and rules
a. 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.
f
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.
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: 10/1/2021
End Date: 9/30/2022
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.
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 ASSURANCE
PROGRAM
Beginning Date: 10/01/2021
End Date: 9/30/2022
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 /2021
End Date: 09/30/2022
Project Synopsis:
Local health departments will provide educational activities, conduct community outreach
efforts and/or expand community awareness of infant safe sleep.
Reporting Requirements (if different than agreement language):
LHD will attach completed "Infant Safe Sleep Mini -Grant Work Plan" to the
indirect cost line of the budget for review and approval by the Infant Safe Sleep
program.
2. Prior to the submission of the proposed work plan, LHD will participate in a
meeting (by person or phone) with all mini -grantees facilitated by the Infant Safe
Sleep Program to review current data, discuss infant safe sleep best practices
and answer any questions related to mini -grant requirements.
LHD will attach 'Infant Safe Sleep Mini -Grant Work Plan" with reporting column
completed and completed "Infant Safe Sleep Mini -Grant Report Grid" to the
indirect cost line of the 2nd quarter FSR. The reporting period will cover October
1, 2021 - March 31, 2022. The reports are due by April 30, 2022.
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, 2021
- September 30, 2022. The reports are due by December 15, 2022.
Any additional requirements (if applicable):
Grantee must provide educational activities, conduct community outreach efforts
and/or expand community awareness of infant safe sleep. These efforts must
adhere to the updated policy statement titled "SIDS and Other Sleep -Related
Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping
Environment' issued by the American Academy of Pediatrics in October 2016.
2. Activities are to be data driven, to the extent possible, and culturally relevant to at -
risk, high -risk families in the community and reflect diversity in terms of race,
ethnicity, language, and socioeconomic status. In addition, activities should support
families and encourage open and nonjudgmental conversations with families about
infant sleep practices.
Grantee must participate in and/or coordinate a local advisory team or regional
group (such as the county's Regional Perinatal Quality Collaborative) to coordinate
efforts to promote infant safe sleep and reduce infant deaths related to unsafe
sleep environments.
4. Activities of the grantee must align with the Mother Infant Health and Equity
Improvement Plan to address preventable infant deaths and disparities through
evidence -based infant safe sleep program activities.
Funds may be used for the purchase of demonstration and/or educational items,
however, grantee is encouraged to use department -provided educational materials
when possible. Additionally, a maximum of 15% of the funding may be used for
giveaway items that are directly related to infant safe sleep such as cribs, pack -
and -plays, and/or sleep sacks. A maximum of 15% of the funding may be used for
advertising, including billboards, bus signage and the purchase of radio, TV,
and/or print media.
6. Grantee must adhere to the approved work plan. Deviations to the work plan must
be approved by the Program Coordinator.
Program Coordinator
Colleen Nelson
Washington Square Building
109 Michigan Avenue
3rd floor
P.O. Box 30195
Lansing, Michigan 48909
nelsonc7(Ebmichioan.Qov
517-335-1954
PROJECT: Informed Consent
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The Department will provide funding, at the fixed rate of $50 per woman served, for each
woman that expressly states that she is seeking a pregnancy test or confirmation of a
pregnancy for the purpose of obtaining an abortion and is provided a pregnancy test with
a determination of the probable gestational stage of a confirmed pregnancy.
Reporting Requirements (if different than contract language)
The numberof services, rate per service and total amount due must he noted as a funding
source, under the element where the staff providing the services are funded, on the FSR
through the MI E-Grants system.
Any additional requirements (if applicable)
The following requirements apply to all Grantees, whether the Grantee operates a Family
Planning Clinic or not:
1. When a woman states that she is seeking an abortion and is requesting services
for that purpose the Grantee will provide:
a. A pregnancy test with a determination of the probable gestational stage of a
confirmed pregnancy.
Important Note: The Grantee must destroy the individual "informed consent"
files containing identifying information (Name, Address, etc.) after 30 days.
2. When a woman seeks a pregnancy test and does not explicitly state that she is
doing so for the purpose of obtaining an abortion, she should be directed to a family
planning clinic or to her primary care provider for a pregnancy test. Services to
comply with PA 345 of 2000 should not be provided to a woman in a Title X funded
family planning clinic.
PROJECT: Laboratory Services Bio
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
As part of the emergency preparedness and response efforts, the regional laboratories
have been designated as partner organizations that assist with testing, transport, and
communications related to biothreat agents or other evolving infectious agent issues.
Reporting Requirements (if different than contract language)
Provide the Bureau of Laboratories records and reports as required, at least once per
year or upon special request.
Any additional requirements (if applicable)
Meet established standards of performance and objectives in the following areas:
Public Health Emergency Preparedness:
• Maintain a current list of contact information for local community hospital
laboratories to facilitate communication.
O Facilitate response with local community hospital laboratories in preparation for and
during public health threats.
Coordinate and facilitate specimen collection and transport with facilities within
jurisdiction. This may include specimen packaging and shipping and coordination
with the courier service.
• Provide 24/7 contact information to hospital partners and BOL.
Participate in and provide support for Department PHEP exercises with community
hospital laboratories within jurisdiction.
The Grantee will designate one staff member as a liaison to the Bureau of
Laboratories. Each Grantee must designate appropriate staff to take part in LIMS
training activities.
® Provide information on specimen submission to local health jurisdictions to assure
that specimens are submitted to the BOL LRN laboratory, or other appropriate LRN
laboratory as determined by the Department.
PROJECT: Lactation Consultant
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Reporting Requirements (if different than contract language)
Upon initiation of the FY22 agreement, grantees must submit a Lactation Consultant work
plan to Town send S2(c-michiaan.gov.
The work plan must include:
• Outcome objectives (a minimum of 2) for improved breastfeeding rates in
Genesee County.
• Activities (a minimum of 3 per objective) that include names and numbers of
specific populations targeted for interventions.
• The estimated cost, person responsible and deliverable quantifiable outcomes for
each activity.
Other workplan Information:
• Work plans must be approved by the MDHHS State Breastfeeding Coordinator.
• Changes to the work plan throughout the year can occur with prior approval from
the MDHHS State Breastfeeding Coordinator.
• All activities, as specified in the initial approved work plan, shall be implemented.
Workplan Report Due Dates:
Work plan reports must be submitted quarterly or as requested by MDHHS. The reports
are due 30 days after each quarter and year end and include the following timeframes:
1. Initial work plan due August 1, 2021.
2. First quarter (covering period October 1 through December 31) is due January
30.
3. Second quarter report (covering period January 1 through March 31) is due
April 30.
4. Third quarter report (covering period April 1 through June 30) is due July 30.
5. Fourth quarter report (covering period July 1 through September 30) is due
October 30.
Any additional requirements (if applicable)
PROJECT: Lead Hazard Control
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The LHCCD grant funds local communities to provide residential lead hazard control
(LHC) services within their communities per the Medicaid Children's Health Insurance
Program State Plan Amendment. The purpose is to provide LHC services to eligible
households with a Medicaid -enrolled child to reduce lead exposure in children. The
program consists of outreach, education, identification of sources of lead, as well as
remediation of lead hazards within the home that contribute to elevated blood lead
levels. The grant allows grantees to establish a tailored, high quality, and sustainable
lead hazard control program that best serves the residents in their community.
Reporting Requirements (if different or in addition to contract language)
Grantees must complete and submit monthly Enrollee Engagement Protocol
Tracking Reports via secured MDHHS File Transfer Protocol (FTP) system by
the 15th of each month for the prior month's activity.
2. Grantees must complete and submit MDHHS-HHS Monthly Monitoring Reports
via secured FTP by the 15th of each month for the prior month's activity. The
method of reporting may change following the MiCLEAR application
implementation.
3. Grantees must complete monthly expenditure and general ledger reports by the
301h of each month for the prior month. Monthly financial reports will be submitted
to applicable Program Coordinator on time.
4. Quarterly Financial Status Reports in EGrAMS are due by the 30th of the month
following the end of the quarter. Grantees shall provide applicable general
ledgers attached to the quarterly Financial Status Report in an Excel or PDF
format for reconciliation, review and analysis.
5. Grantees must submit quarterly Work Plan reports via FTP by the 15th of the
month following the end of each quarter, as specified in the Grant Agreement.
6. Grantees must complete benchmark form detailing monthly projected
environmental investigations, cleared projects and funds to be drawn.
Community Development Unit will complete monthly review of benchmarks and
develop a management plan on a quarterly basis for grantees who are not
meeting benchmarks. If management plan does not achieve projected results,
grantee must revise portions of contract including benchmarks and/or total
contract award in the next amendment cycle.
7. Grantees must have at least one representative participate in additional
monitoring and information conference calls as requested by CDU.
8. Any other information as specified in the Statement of Work, shall be developed
and submitted by the Grantee as required by the Contract Manager.
9. Reports and information shall be submitted through the Lead Hazard Control
Community Development File Transfer Protocol (LHCCD FTP) shared area and
EGrAMS. Grantees shall follow the established MDHHS report and document
naming conventions for reports submitted via secured FTP.
10.The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by Contract Manager.
Any additional requirements (if applicable)
1. Ensure compliance with laws, regulations, licensing requirements, protocols, and
guidelines for all funded activities under this RFP. Work must be conducted by
firms and persons certified according to the Michigan Lead Abatement Act and/or
EPA 40 CFR 745 possessing certification as lead abatement firms, EPA certified
renovation firms, risk assessors, inspectors, abatement supervisors, abatement
workers or certified renovators (for workers and supervisors performing non -
abatement work), as applicable to each unit's scope of work. Any abatement
activities conducted under this program require a properly certified abatement
firm, certified abatement supervisor, certified abatement worker credentialing.
Any activities or other renovation activities not performed during abatement
activities under this program requires a properly certified EPA renovation firm
using only EPA -certified renovators. Each project will have a clearance
performed at the end of the abatement work and at the end of the project.
Compliance with the following is required for all sub -contractors, sub -grantees,
sub -recipients, and their contractors:
• U.S. Department of Housing and Urban Development (HUD): 24 CFR 35
• U.S. Occupational Safety and Health Administration (OSHA): 29 CFR
1910.1025,
29 CFR 1926 (Lead Exposure in Construction)
• U.S. Environmental Protection Agency (EPA): 40 CFR 745
• U.S. EPA, National Environmental Policy Act - Tier II Environmental
Review: 29 CFR Part 50-58.
• National Historic Preservation Act. The National Historic Preservation Act
of 1966 (54 U.S.C. §300101) and the regulations at 36 CFR Part 800
apply to the lead -hazard control or rehabilitation activities that are
undertaken pursuant to this RFP.
• State of Michigan regulations, including the Michigan Lead Abatement Act
(MCL 333.5451-333.3477), Lead Hazard Control Administrative Rules
(R325.99101-R325.99409), and Article 24 of Public Act 299 of 1980, as
amended, regarding residential building, maintenance, and alteration
contractor licensing and regulations.
• Local regulations as applicable.
2. Applicants applying as a consortium must identify all partners, one Lead
Applicant, and Authorizing Official in their proposal. Identify the geographic
region each consortium partner is serving and their role.
3. Create an Enrollee Engagement Prioritization Plan that specifies how you will
adhere to the minimum requirements in the Enrollee Engagement Protocol.
Grantees must ensure that prioritized at -risk eligible households receive
adequate outreach for equitable inclusion and enrollment.
a. Grantees shall maintain a documented Enrollee Engagement Prioritization
Plan for their community, prioritizing the most at -risk families (e.g. pregnant
women, children with EBLs, age of child, housing stock, etc.). Upon
completion of a Data Use Agreement, MDHHS-HHS will provide Grantees
with a monthly Medicaid enrollee and Elevated Blood Lead Level (EBLL)
report for their geographic region to support this activity.
b. Grantee's plan shall include enough potential participants to attain
benchmarks. Conversely, Grantee's plan must be targeted to avoid a lengthy
backlog of applicants.
c. Once a Grantee has contacted a potential enrollee, the engagement protocol
shall be followed until an application is received or they are disengaged
according to the disengagement protocol.
d. Grantee enrollee engagement must include application completion
assistance, if needed.
e. Grantee's plan shall address how an applicant backlog will be tracked and
monitored if there are more applicants than they can serve.
f. If Grantee doesn't have a backlog, all eligible applicants shall be served
regardless of their prioritization status.
g. If Grantee plans to use a partner to oversee or conduct their Enrollee
Engagement Prioritization Plan and Tracking, they must identify the partner,
agreements they have in place, and how PII and PHI data are shared and
protected.
If Grantee proceeds with an application that does not follow their Enrollee
Engagement Prioritization Plan, Grantee must document the justification in
their project file.
4. Ensure lead abatement requirements are followed including:
a. A lead abatement supervisor is required for each lead abatement job and
must be present at the job site while all abatement work is being done. This
requirement includes set up and clean up time. The lead abatement supervisor
must ensure that all abatement work is done within the limits of federal, state,
and local laws.
b. Services may be rendered to eligible physical structures and include the
surrounding land up to the property line.
c. Services must be coordinated with water service line removal that occurs
outside of the property line.
d. A certified lead inspector or risk assessor, who is independent of the abatement
company, shall perform clearance testing after abatement work is completed
and at the end of the project.
e. All laboratories selected for use in the lead -based paint hazards and
evaluation reports shall hold and maintain an accreditation to the ISO/IEC
17025:2005 standard, through an appropriate accreditation body, to
conduct lead testing services. The laboratory must be recognized by the
U.S. Environmental Protection Agency (EPA) National Lead Laboratory
Accreditation Program (NLLAP) for the analyses performed under this
contract, and shall, for work under this grant, use the same analytical
method used for obtaining the most recent NLLAP recognition. Additionally,
the laboratory must employ individuals, who perform the testing and review
and report out results, which meet the MDHHS Civil Service requirements
for staffing capabilities, which can be found below.
Grantee has two analytical laboratory options, which are to either (1) identify the
laboratory they plan to use; submit documentation of compliance with the
requirements stated in the RFP; (2) use the MDHHS Trace Metals Laboratory.
Copies of the chain -of -custody and sample results must be included within the
EBL El or Lead Inspection/Risk Assessment report.
Ensure water sampling protocols are followed in compliance with the EPA Lead
and Copper Rule and the MDHHS-HHS Residential Lead Hazard Control -Lead
in Water Protocol. A Michigan Department of Environment, Great Lakes and
Energy Certified Drinking Water Laboratory for Lead and Copper must be used.
All water samples must be analyzed within fourteen (14) days of collection. It is
recommended that all water samples be delivered to the approved laboratory
within ten (10) days of collection. Copies of the chain -of -custody and sample
results must be included within all Lead Hazard Control Environmental
Investigation, Clearance and Addendum reports.
All residences designated within a Historic Preservation District must adhere to
state and local historical preservation requirements.
h. The HHS-Community Development Unit (CDU) is responsible for conducting
the Tier I Environment Review through the issuance of a public notice in the
form of a press release. Grantees are required to complete site specific Tier II
Environmental Reviews in accordance with U.S. EPA National Environmental
Policy Act, 24 CFR 50-58. Grantees must complete the required Tiered
Environmental Review Checklist for each project. The following components
shall be included in the review and adhered to:
1) Airport Runway Clear Zones and Clear Zones Disclosures
2) Coastal Barrier Resources Act
3) Coastal Zone Management
4) Flood Insurance
5) Flood Plain Management
6) Wetland Protection
7) Wild and Scenic Rivers
8) Clean Air Act
9) Contaminated and Toxic Substances
10) Endangered Species
11) Farmlands Protection
12) Explosive and Flammable Operations
13) Environmental Justice
5. Applicants must complete minimum work plan requirements, identify specific
program objectives and activities to be accomplished in a work plan. Objectives
should relate to the identified target community needs and be SMART (specific,
measurable, appropriate, realistic, and time -based). Each objective must have a
minimum of one related activity.
6. The following minimum objectives and activities shall be included in Applicant's work
plan:
Objective: Education & Engagement
Activity: Adhere to Enrollee Engagement Protocol while utilizing
Program Prioritization Plan
Responsible Staff: (i',',:;; , , %nc?:rCl;a rE= ;;ur:rrri;:'".> c: Fi; r, irr-ai<<;c c,.;; : ,r', _ ._
Date Range:
Expected Outcome: Receive and approve applications.
Measurement: Number of applications received/approved and families
contacted.
Objective: Investigations
Activity: Complete ,' EBL/LIRA investigations including water
sampling according to MDHHS Water Protocol
Responsible Staff: (1 -:aa i?l.?(.?cr
,,, iii;; c, r7 "'o
Date Range:
Expected Outcome: :f completed EBL/LIRA investigations
Measurement: Number of EBL/LIRA reports received
Objective: Abatement
Activity: Complete and clear` abatement projects
Responsible Staff: ;'P?-a e
is ;t"r. f in ..,
Date Range:
Expected Outcome: %X projects completed/cleared
Measurement: Number of projects completed/cleared
7. Collaboration and coordination requirements include:
a. If MDHHS-HHS-Lead Safe Home Program (LSHP) receives an application from a
Medicaid resident in a Grantee community, LSHP and the Community
Development Unit (CDU) will determine who shall be responsible for serving the
applicant. CDU will work with Grantees to coordinate referrals.
b. Services performed must be part of a coordinated plan that ensures abatement
activities of the eligible residential unit align with the community's water service line
replacement plan (if applicable). The Grantee must replace the service line if water
test results are above acceptable limits. Applicants must include their coordination
plan as part of their proposal.
c. MDHHS-HHS encourages collaboration and coordination to meet the
requirements of this RFP with other non-profit: communities, agencies, and
partners (such as childhood lead poisoning prevention programs, health agencies,
community development agencies, weatherization assistance agencies, fair
housing organizations, code enforcement agencies, community -based
organizations, faith -based organizations, financial institutions, or other
philanthropic entities).
d. Grantees are required to enter into formal arrangements, such as memorandums
of understanding or similar contractual agreements, with service delivery
organizations receiving funds.
8. All high -cost projects exceeding $70,000 require MDHHS approval prior to abatement.
9. Control/Elimination Strategies: All lead -based paint hazards identified ineligible
housing units and in common areas of multifamily housing enrolled in this Medicaid
CHIP program must be controlled or eliminated in accordance with the Michigan Lead
Abatement Act.
10. Data Collection and Use: Grantees must collect, maintain, assure data integrity, and
provide to MDHHS-HHS the data necessary to document, report, and evaluate
program outputs and outcomes. Grantees must document how PII or PHI data will be
securely shared with partnering entities, including the following components:
a. Data source, purpose, and use
b. Specific data elements (e.g., age, gender, etc.)
c. Time periods (e.g. October 1, 2021 through September 30, 2022)
d. Identify what data transfer medium will be used (e.g., electronic through
secured FTP, hard copy via facsimile, encrypted email, etc.)
e. Identify who will have access to the data (e.g., project director, intake specialist,
etc.), and how access will be controlled.
f. Identify how you will receive authorization from participants to share data with
any subcontractors or partners. Include how you will share the authorized data
with subcontractors or partners, and ensure those accessing data agree to the
same restrictions and conditions.
g. Identify where data will be stored and how access will be restricted to
authorized individuals (e.g. encrypted or password protected)
Identify how data will be retained in secured storage once the program is
completed to comply with records retention. Include how the data is destroyed
at conclusion of the retention period.
i. Grantees are required to immediately notify CDU if a staff member who has
access to FTP or Michigan Comprehensive Lead Abatement and Registry
(MiCLEAR) is no longer employed with the agency and/or permitted to have
access to PHI. CDU will revoke their access immediately.
11. Grantee shall enter and maintain program and project data in an MDHHS online
application, MICLEAR, when available. Until such time, data shall be provided on
Excel spreadsheets or on data collection forms listed in Reporting Requirements.
12. Grantee must obtain Data Use Agreement with CDU if the program is sharing PHI.
13. Required Trainings: Grantees are required to send a minimum of two
representatives to attend an annual Grantee Orientation and any additional Grantee
mandatory meetings scheduled by MDHHS-HHS throughout the fiscal year.
14. Lead -Based Paint and Lead Hazard Identification: A complete lead -based paint
inspection, lead hazard risk assessment, EBL environmental investigation (for children
with a blood level >_5 pg/dL), and lead in water sampling assessment/evaluation will be
conducted; either separate reports or a combined report is required for all properties
enrolled under this program. Presumption of the presence of lead -based paint or lead
hazards is not permitted. Paint inspections and risk assessments must follow the
procedures as defined in the Michigan Lead Abatement Act and HUD Guidelines for
the Evaluation and Control of Lead -Based Paint Hazards in Housing investigation,
abatement and clearance. Lead in water sampling must be conducted in accordance
with MDHHS-HHS Residential Lead Hazard Control -Lead in Water Protocol.
a. Individuals performing EBL/Lead Inspection Risk Assessments and/or water
sampling must use MDHHS approved Lead Hazard Control Environmental
Investigation, Clearance and Addendum report templates.
15. Demolition. In rare cases, a portion of the housing unit or structure with lead hazards
may be determined to be of so little value, unfit for occupancy, or in a state of extreme
disrepair that pursuing lead hazard control may not be cost effective. Partial
demolition and removal of contaminated materials, soil, etc. is a covered service only
if pre -approved in writing by MDHHS-HHS.
16. Minimal residential rehabilitation is allowed to the extent that this work extends the life
of the lead abatement work done consistent with HUD guidelines, including activities
that are specifically required in order to carry out effective hazard control, and without
which the hazard control could not be completed, maintained, and sustained, as
defined by HUD Policy Guidance Number 2008-02
17. Notification Requirements: All lead -based paint testing results, summaries of lead -
based paint hazard control treatments, and clearances must be provided to the owner
of the unit, together with a notice describing the owner's legal duty to disclose the
results to tenants and buyers in accordance with 24 CFR 35.88 of the Lead
Disclosure Rule. Applicants must ensure that this information is provided in a manner
that is effective for persons with disabilities (24 CFR 8.6) and those persons with
limited English proficiency (LEP) will have meaningful access to it (see Executive
Order 13166). Applicant files must contain verifiable evidence of providing lead hazard
evaluation and control reports to owners and tenants, such as a signed and dated
receipt. Applicants must also describe how they will provide owners with lead hazard
evaluation and control information generated by activities under this program, so that
the owner can comply with the Lead Disclosure Rule (24 CFR part 35, subpart A, or
the equivalent 40 CFR part 745, subpart F), the Lead Safe Housing Rule (24 CFR
part 35, subparts B—R), and the EPA's Renovation, Repair, and Painting (RRP) Rule
(see 40 CFR part 745 and http://www2.epa.gov/lead/renovation-repair-and-painting-
program).
18. Procurement Requirements: Recipients must follow State of Michigan or
established grantee policies and procedures.
19. Temporary Relocation: Costs for the temporary relocation for residents required to
vacate housing during abatement activities must be controlled and reasonable for the
area. MDHHS-HHS expects that the lead hazard control work and temporary
relocation will take ten (10) days or less, unless pre -approved by MDHHS-HHS.
Rental unit landlords shall identify alternate relocation for residents during abatement,
if available.
20. If an X-ray fluorescent (XRF) instrument is used, all risk assessors must possess
current training, certification and licensing in the use of the XRF equipment under
appropriate federal, state or local authority.
21. Waste Disposal must adhere to the requirements of the Michigan Lead Abatement
Act, appropriate local, state, and federal regulatory agencies, and HUD Guidelines,
22. Written Policies and Procedures: Grantees will be required to develop written
policies and procedures to comply with the requirements of this RFP within the first
sixty (60) days of the new award. MDHHS-HHS Lead Safe Home Program will
provide Grantees with a minimum set of procedures to be followed. The policies and
procedures must describe how your program will handle items such as, but not
limited, to:
a. Enrollee Engagement Prioritization Plan and Tracking, including a plan for
targeted outreach, prioritization, maintenance of a backlog, documentation, and
reporting.
b. Workforce development related to lead hazard control
c. Processing program applications, validating unit eligibility, prioritization, and
selection
d. All phases of lead hazard evaluation and control, including risk assessments,
inspections, water sampling, reporting, abatement and clearance, development of
specifications for contractor bids
e. Resident temporary relocation
f. Procurement of abatement contractor
g. Quality assurance of program data collection and data entry
h. Financial controls
i. Quality assurance abatement Plan
23. Grantees are required to retain all project records in a secured location for five (5)
years after project closeout.
24. Program administrative costs are recommended to not exceed ten percent (10%) of
the award for payments of reasonable administrative costs related to planning and
executing the project, preparation/submission of CDU reports, etc. Administrative
costs are the reasonable, necessary, allocable, and otherwise allowable costs of
general management, oversight, and coordination of the proposal (i.e., program
administration). Administrative costs must be outlined in the budget narrative. If
administrative costs exceed ten percent (10%), justification must be provided.
25. The Grantee can choose to use one of the approved methods outlined below in their
budget. In any method, grantee must provide appropriate documentation of proof.
a. Federal approved rate
b. State approved rate
c. Cost allocation plans
26. The Grantee is responsible for assuring that environmental and pollution insurance is
obtained by certified abatement contractor and/or abatement firm. Contractor and/or
firm will provide the program with a copy of its current insurance certificate, which will
name the property owner and the State of Michigan as additionally insured. The
appropriate pollution/environmental coverage requirements as stated above will be
included in the certificate. The certificate must be received prior to the issuance of a
purchase order.
27. Eligibility of Expenses
a. Roofs: Medicaid CHIP abatement project is eligible for roof replacement when
roof is beyond minimal rehab and repairable condition. Documentation is
needed stating that roof disrepair would affect the integrity of the lead hazard
control work being completed on the property.
b. Multi -Units: Multi -family rental properties are eligible and follows compliance
with HUD policy 5-66.
c. Public Housing: Following HUD policy, properties that are HUD voucher
based/tenant-based are eligible for lead abatement services. However, project -
based housing owned by HUD is not eligible for the Medicaid CHIP grant.
d. Consent Decree: Following HUD policy, properties that have an existing
consent decree on the property are not eligible for the Medicaid CHIP grant.
e. Demolition: In rare cases, a portion of the residential unit or accessory
structure with lead hazards may be determined to be unfit for occupancy or in
a state of extreme disrepair that pursuing lead hazard control may not be cost
effective or feasible. Partial demolition and removal of contaminated materials,
soil, etc. is a covered service only if pre -approved by MDHHS-HHS and the
following CMS guidelines are adhered to:
• Conduct clearance testing of the site and soil upon completion of the
project to make sure that the demolition did not create new hazards.
• Attest that certified professionals are contracted to work on the
demolition to guarantee that it is conducted safely to protect
neighboring structures and residents.
• Obtain consent from the resident and property owner for the demolition,
to ensure all parties are in agreement.
f. Dumpsters: Dumpsters or storage containers/pods are an allowable expense
for households where there are extreme hoarding issues that would prevent
contractors and inspectors from performing Lead Hazard Control work.
g. Fire Protection: Medicaid CHIP enrolled properties are eligible to receive
carbon monoxide detectors and smoke alarms based on local code-
h. Minimal Rehabilitation: Minimal residential rehabilitation is allowed to the extent
that this work extends the life of the lead abatement work done consistent with
HUD guidelines, including activities that are specifically required in order to
carry out effective hazard control, and without which the hazard control could
not be completed, maintained, and sustained, as defined by HUD Policy
Guidance Number 2008-02.
i. Relocation: Temporary relocation expenses are eligible when family is required
to vacate home during abatement activities. When possible, the State rate for
hotels should be used.
j. Fire Protection: Medicaid CHIP CDU enrolled properties are eligible to receive
carbon monoxide detectors and smoke alarms based on local code.
k. Equipment: Any purchase or lease of equipment having a per -unit cost in
excess of $5,000 must be pre -approved by MDHHS including the
purchase or lease of X-ray fluorescence (XRF) analyzers.
Lead Certifications: Payment of professional certifications and licenses are
eligible which includes securing and maintaining required certification and
licenses for identification, remediation, and clearance of lead and other
housing -related health and safety hazards.
m. Resident blood lead testing and analysis are not eligible services or costs.
n. Costs of case management are not eligible services or costs.
28. Grantee is responsible for overseeing internal Quality Assurance Plan and COVID19
Preparedness Plan. To ensure safety of workers and residents, grantee will confirm
lead safe work practices are being performed as well as COVID19-related precautions
are being adhered to.
a, Vendors must submit a COVID19 Preparedness Plan to grantees and
Community Development Unit before lead hazard control activities can begin.
29. Grantee agrees to follow asbestos recommendations and protocols as prescribed
by Healthy Homes Section.
30. If significant findings are concluded from quarterly reviews including but not
limited to failure to meet projected benchmarks or adhering to reporting
requirements, grantee will develop a Plan of Action. If Plan of Action does not
achieve projected results in specified amount of time, grantee must revise
portions of contract including benchmarks and/or total contract award in next
amendment cycle. After previous measures are implemented and grantee still
fails to comply with grant requirements, MDHHS reserves the right to rescind
grant award.
PROJECT: Local Health Department Sharing
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Local health departments participating in the project will utilize funds to support activities
pertinent to the exploration, preparation, planning, implementing, and improving sharing
of local health department services, programs or personnel.
Reporting Requirements (if different than contract language)
Grantees will receive notification of reports along with reporting templates. Reporting is
twice per year based on reporting dates required by the CDC.
Any additional requirements (if applicable)
Local health departments must submit a continuation workplan and budget for
continuation funding of the project "Local Health Department Collaboration and
Exploration of Shared Approach to Delivery of Services,"
Eligible Activities:
• Meeting activities, including time and travel costs
• Cost of research activities
• Supplies and presentation materials
• Legal fees and other professional services related to the project
• IT cost related to service sharing (grant funds may not be used to reimburse
equipment costs)
PROJECT TITLE: Local Maternal Child Health (LMCH)
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
Local Maternal Child Health (LMCH) funding is made available to local health
departments to support the health of women, children, and families in communities
across Michigan. Funding addresses one or more Title V Maternal and Child Health
Block Grant national and state priority areas and/or a local MCH priority need identified
through a needs assessment process. Local health departments complete an annual
LMCH plan, and a year end report. Target populations are women of childbearing age,
infants, and children aged 1-21 years and their families, with a special focus on those
who are low income. The LMCH allocated funds are to be budgeted as a funding source
in two project categories for FY 22
LMCH Projects
Project Code Project Title
OTHERMCHV MCH - All Other
ESCMCH MCH - Children
Reporting Requirements (if different than agreement language):
1. The LMCH Plan submission and due date will be communicated through a
notification mailing. The department will provide the format for the LMCH Plan.
The LMCH Plan, approved by the department, is to be uploaded with the budget
application into EGrAMS. The Plan and Plan amendments, if needed, need to be
approved in advance of the budget application and budget amendment.
2. The FY 22 LMCH Year -End Report submission and due date will be
communicated through a notification mailing. The department will provide the
format for the LMCH Year -End Report. The Local MCH Year -End Report,
approved by the department, is to be uploaded in EGrAMS with the final FSR. The
Year -End Report must be approved in advance of the final FSR.
Any additional requirements (if applicable):
1, Local MCH funding must be used to address the unmet needs of the maternal
child health population and based on data and need(s) identified through the
Local Health Department community health assessment process,
2. Activities and programs supported with Local MCH funds must be evidence-
based/informed. Exceptions must be submitted in writing and pre -approved by
MDHHS.
3. Local MCH funding cannot be used under the WIC element, except in extreme
circumstances where a waiver is requested in advance of the expenditures and
evidence is provided that the expenditures satisfy all funding requirements.
4. Local MCH funds may not be used to supplant available/billable program income
such as Medicaid or Healthy Michigan Plan fees or additional funding under the
Medicaid Cost -Based Reimbursement process.
5. Local Health Departments should leverage all other funding sources, especially
third -party payers (Medicaid, private insurers) before utilizing LMCH MCH block
grant funds. LMCH funds are to be used for those services that cannot be paid for
through other sources or for gap filling services. Third party fees should be listed
in other funding sources. If no 31d party fees are listed, an explanation must be
noted.
6. The approved LMCH Plan allocation table and the budget application MCH
source of funds must match. If an agency needs to move funds between projects,
an amended LMCH Plan must be approved in advance of the budget amendment
request period. Any specified expenditure in the LMCH Plan must be detailed in
the budget (e.g. incentives).
7. The LMCH program follows the same principle on budget transfers and
adjustments outlined in the comprehensive agreement. The comprehensive
agreement allows for budget transfers and adjustments of $10,000 or 15%,
whichever is greater. However, if the transfer or adjustment is greater than the
$10,000 or 15%, OR there are any changes made to any of the children
performance measures an amended LMCH Work Plan and budget will be
required.
8. LMCH is unable to accept cost distributions from MDHHS-ELPHS due to the
nature of the block grant and LMCH reporting requirements. LMCH will continue
to accept other cost distributions as in the past (such as Family Planning, CSHCS
Outreach and Advocacy, VQA, IAP, and Lead Prevention).
9. LMCH has adopted Title 2 Code of Federal Regulations 200 Cost principles.
PROJECT TITLE: MATERNAL, INFANT, AND EARLY CHILDHOOD
HOME VISITING INITIATIVE RURAL LOCAL HOME VISITING
LEADERSHIP GROUP (MHVRLH)
and
MATERNAL; INFANT, AND EARLY CHILDHOOD HOME VISITING
INITIATIVE RURAL LOCAL HOME VISITING GROUP 3 (MHVRLH3)
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to improvement and coordination of home visiting
programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The LLG shall submit all required reports in accordance with the Department reporting
requirements.
a. Staffing Changes: Within 10 days of a staffing change, notify the ECIC contractor
via e-mail and incorporate the change(s) into the budget and facesheet during the
next amendment cycle as appropriate. The facesheet identifies the agency
contacts and their assigned permissions related to the tasks they can perform in
EGrAMS. The assigned Project Director in EGrAMS can make the facesheet
changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval. See the Michigan
Department of Health and Human Services' (MDHHS) Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30, and October 30).
d. See the MDHHS Home Visiting Guidance Manual for specific CQI reporting
requirements which include monthly data tracking, PDSA cycle updates (due the
15th of each month) and story board and team charter submissions.
e. The Contract Manager or his/her designee shall evaluate the reports submitted as
described for their completeness and adequacy.
f. The Grantee shall permit the Department or its designee to visit, either in person
or virtually, and make an evaluation of the project as determined by the Contract
Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the Home Visiting mailbox at MDHHS-HVlnitiative(a�,michigan.gov.
Any additional requirements (if applicable):
Complv with MDHHS Home Visitinq Proqram Requirements:
1. The Grantee shall operate the program with fidelity to the requirements of MDHHS
as outlined in the MDHHS Home Visiting Guidance Manual.
2. The LLG will work with the MDHHS contractors: Early Childhood Investment
Corporation (ECIC) and the Michigan Public Health Institute (MPHI). See the
MDHHS Home Visiting Guidance Manual for details related to working with ECIC
and MPHI.
3. The LLG will continue the following efforts started in previous years:
a. Ensure recruitment and participation of both required and strongly
encouraged LLG representatives.
b. Integrate parent leaders as active members of the LLG. Membership on
the LLG CQI team must include a parent leader. This includes their
attendance at local CQI meetings and the three LLG Grantee meetings.
c. Implement one strategy from the respective community's local Home
Visiting Continuum of Models Project Plan.
d. Conduct a LLG Quality Improvement project.
e. Implement the community's Sustainability Plan.
See the MDHHS Home Visiting Guidance Manual for requirements related to LLG
membership/participation, development of CQI strategies, as well as the implementation
of Continuum and Sustainability Plans.
Fundinq Requirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting activities as specified in this agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Guidance Manual.
PROJECT TITLE: MATERNAL, INFANT AND EARLY CHILDHOOD
HOME VISITING INITIATIVE LOCAL HOME VISITING LEADERSHIP
GROUP (MIECHVLLG)
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to improvement and coordination of home visiting
programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The LLG shall submit all required reports in accordance with the Department reporting
requirements.
a. Staffing Changes: Within 10 days of a staffing change, notify the ECIC contractor
via e-mail and incorporate the change(s) into the budget and facesheet during the
next amendment cycle as appropriate. The facesheet identifies the agency
contacts and their assigned permissions related to the tasks they can perform in
E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet
changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval. See the Michigan
Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for
requirements related to Work Plan development and reporting.
c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30, and October 30).
d. See the MDHHS Home Visiting Guidance Manual for specific CQI reporting
requirements which include: monthly data tracking, PDSA cycle updates (due the
15th of each month) and story board and team charter submissions.
e. The Contract Manager or his/her designee shall evaluate the reports submitted as
described for their completeness and adequacy.
f. The Grantee shall permit the Department or its designee to visit, either in person
or virtually, and make an evaluation of the project as determined by the Contract
Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the Home Visiting mailbox at MDHHS-HVlnitiative(d)michigan.aov.
Any additional requirements (if applicable):
Comply with MDHHS Home Visitinq Proqram Reauirements:
The Grantee shall operate the program with fidelity to the requirements of MDHHS as
outlined in the MDHHS Home Visiting Guidance Manual.
1. The LLG will work with the MDHHS contractors: Early Childhood Investment
Corporation (ECIC) and the Michigan Public Health Institute (MPHI). See the
MDHHS Home Visiting Guidance Manual for details related to working with ECIC
and MPHI.
2. The LLG will continue the following efforts started in previous years:
a. Ensure recruitment and participation of both required and strongly
encouraged LLG representatives.
b. Integrate parent leaders as active members of the LLG. Membership on
the LLG CQI team must include a parent leader. This includes their
attendance at local CQI meetings and the three LLG Grantee meetings.
c. Implement one strategy from the respective community's local Home
Visiting Continuum of Models Project Plan.
d. Conduct a LLG Quality Improvement project.
e. Implement the community's Sustainability Plan.
See the MDHHS Home Visiting Guidance Manual for requirements related to LLG
membership/participation, development of CQI strategies, as well as the implementation
of Continuum and Sustainability Plans.
Funding Requirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting Unit activities as specified in this
agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Guidance Manual.
PROJECT: Medicaid Outreach
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Medicaid Outreach activities are performed to inform Medicaid beneficiaries or potential
beneficiaries about Medicaid, enroll individuals in Medicaid and improve access and
utilization of Medicaid covered services. All outreach activities must be specific to
Medicaid. Reference bulletin: MSA 18-41
Additional instructions can be found in Attachment I.
Reporting Requirements (if different than contract language)
• Submit quarterly reports no later than 1 month after the end of the quarter. The
exception is the 4th quarter report which is due at the time as the final FSR. If the
report due date falls on a weekend or holiday, the report the next business day.
Reporting Period
October 1 — December 31
January 1 — March 31
April 1 —June 30
July 1 —September 30
Due Date
January 31
April 30
July 31
November 30
• Quarterly reports must be attached/uploaded on the Source of Funds/Federal
Medicaid Outreach line on the FSR in EGrAMS.
• Reimbursements occur based on actual expenditures reported on Financial Status
Reports (FSR) using the reporting format and deadlines as required by the
Department through EGrAMS.
Any additional requirements (if applicable)
• All claimable outreach activities must be in support of the Medicaid program.
Activities that are part of a direct service are not claimable as Medicaid Outreach.
• Must maintain documentation in support of administrative claims which are
sufficiently detailed to allow determination of whether the activities were necessary
for the proper and efficient administration of the Medicaid State Plan.
• Must maintain a system to appropriately identify the activities and costs in
accordance with federal requirements.
• Must provide quarterly summary reports of Medicaid outreach activities conducted
during the quarter. The following reporting elements must be included in the
quarterly report:
1. Name of Health Department
2. Name and contact information of the individual completing the report.
3. Time period the report covers (e.g., FY 20: 1st quarter, or October -
December)
4. Types of services provided during the quarter (Note: the types of services
provided do not have to include every single activity the LHD conducted
during the quarter. Rather, simply include examples of the types of services
provided. The Grantee can include as much or as little detail as they
chose.)
5. Number of clients served.
6. Amount of funds expended during the quarter and total expenditures.
7. Number of FTEs who provided these activities.
0
Successes/Challenges
This is not a reporting requirement but provides an opportunity for the LHD to
share successes during the quarter (e.g., For the first time, someone from the
school board attended the Infant Mortality Reduction Coalition meeting) or to
describe any challenges encountered during the quarter (e.g., the health advocate
quit, and the lactation consultant went on maternity leave, so we are down 2 staff)
PROJECT: Michigan Adolescent Precgnanuv and Parenting Program (MI-
APPP)
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The goal of MI-APPP is to create an integrated system of care, including linkages to
support services, for pregnant and parenting adolescents 15-19 years of age, the fathers,
and their families. MI-APPP grantees implement the Adolescent Family Life Program -
Positive Youth Development (AFLP-PYD; a California model), an evidence -informed case
management curriculum designed to elicit strengths, address various risk behaviors, the
impact of trauma, and provide a connection to health care and community services. In
addition, MI-APPP grantees engage communities through locally driven steering
committees, a comprehensive needs assessment, and creation of support services to
ensure the program is responsive to the needs of pregnant and parenting teens.
MI-APPP aims to:
1. Reduce repeat, unintended pregnancies,
2. Strengthen access to and completion of secondary education,
3. Improve parental and child health outcomes, and
4. Strengthen familial connections between adolescents and their support networks.
Reporting Requirements (if different than contract language)
Report
Time Period
Due Date
Submit To
October 1- December 31, 2021
January 15, 2022
Program
January 1-March 31, 2022
April 15, 2022
Program
Narrative
April 1-June 30, 2022
July 15, 2022
Coordinator
July 1-September 30, 2022
October 15, 2022
Evaluation/Data
Monthly
Submit the 7th of
REDcap
Submission
every month
Any additional requirements (if applicable)
• Information provided must be medically accurate, age -appropriate, culturally
relevant, and up to date.
• Pregnancy prevention education must be delivered separate and apart from any
religious education or promotion. MI-APPP funding cannot not be used to support
inherently religious activities including, but not limited to, religious instruction,
worship, prayer, or proselytizing (45 CFR Part 87).
• Family planning drugs and/or devices cannot be prescribed, dispensed, or
otherwise distributed on school property as part of the pregnancy prevention
education funded by MI-APPP as mandated in the Michigan School Code.
• Abortion services, counseling and/or referrals for abortion services cannot be
provided as part of the pregnancy prevention education funded under MI-APPP.
• Must adhere to the Minimum Program Requirements for MI-APPP.
• MI-APPP funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT TITLE: MI HOME VISITING INITIATIVE RURAL EXPANSION
GRANT (MHVIRE)
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma -informed care. The program is designed to
promote positive parent -child relationships and healthy attachment. It is a strengths -
based and family -centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must
be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HFA model
consultant via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in EGrAMS. The assigned Project Director in EGrAMS can make the
facesheet changes once the agreement is available to be amended.
b. Family Stories: At a minimum, one home visiting experience as told from the
perspective of a currently enrolled family, due within 30 days of the end of the
fourth quarter (October 30).
c. HFA Work Plan: Due annually on June 30 for preapproval. Seethe MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30 and October 30).
All reports and/or information (a-d), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiative(a)-michigan.gov.
e. Implementation Monitoring Date and HRSA data collection requirements due in
REDCap and/or HVOL by the 5th business day of each month.
f. Continuous Quality Improvement (QI) Reporting for the QI Learning Collaborative
is due as follows:
• PDSA Planning Tools should be uploaded to Groupsite by the 15th of each
month from the onset of the QI Learning Collaborative to the final month of
activities.
• Data should be reported via REDCap in accordance with the QI Learning
Collaborative's data collection schedule which will be provided.
• QI story boards for PDSA cycles completed during each action period are
due by the Grantee meeting following the action period and should be
uploaded to Groupsite.
g. Continuous Quality Improvement Reporting for LIA-specific PDSA cycles (i.e.,
team charters) is due in Groupsite as follows:
• An initial team charter with the Plan stage complete needs to be shared
prior to moving to the Do stage for feedback from MPH I.
• An updated team charter that includes feedback from the Plan stage and
with Do, Study and Act completed needs to be shared for feedback from
MPHI.
• A final version of the team charter that includes all components and
feedback needs to be shared.
h. HV ColIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the ColIN'S schedule. Participating LIAs are required to use the
HV ColIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (e-h) shall be submitted as described above. Additional guidance concerning
data collection and Continuous Quality Improvement is provided in the MDHHS Home
Visiting Guidance Manual.
Any additional requirements (if applicable):
Grantee Specific Requirements:
The LIA shall serve families from outreach efforts based on the findings of their
community's Needs Assessment approved by MDHHS.
a. The Healthy Families Northern Michigan HFA Program (operated from the
Health Department of Northwest Michigan in collaboration with District Health
Department #2 and Central Michigan District Health Department) will serve the
applicable number of families in communities experiencing disadvantage per
section d. below.
b. The District Health Department #10 HFA Program will serve the applicable
number of families in communities experiencing disadvantage per section d.
below.
c. The Healthy Families Upper Peninsula (operated from the Luce-Mackinac-
Alger-Schoolcraft Health Department in collaboration with the Western Upper
Peninsula Health Department, Marquette County Health Department,
Dickinson -Iron District Health, and Public Health Delta Menominee counties)
HFA Program will serve the applicable number of families in communities
experiencing disadvantage per section d. (below)
d. In general, across all regions, the home visitor -to -family ratio should agree with
the following:
a. 16 families per 1.0 FTE serving one county.
b. 15 families per 1.0 FTE serving two counties.
c. 14 families per 1.0 FTE serving three or more counties.
See the MDHHS Home Visiting Guidance Manual for requirements related to the
development of a Work Plan and the timeframe for reaching full caseloads.
Maintain Fidelitv to the Model
The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy
Families America affiliates shall comply with the requirements of the Central
Administration for the Multi -Site State System (also known as "The State Office") housed
within the Michigan Public Health Institute. All HFA model -required training will be
accessed through the Central Administration as available. Contact the HFA State Office
for details.
Comniv with MDHHS Program Requirements
The LIA shall operate the program with fidelity to the requirements of MDHHS based on
the agreement executed in EGrAMS and the conditions as outlined in the MDHHS Home
Visiting Guidance Manual. The LIA will fulfill these requirements while strengthening
efforts towards health and racial equity through staff education, programmatic data
evaluation and client supportive services.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Guidance Manual for requirements related to PA 291.
Staffing
The LIA's HFA home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures as described in the MDHHS Home Visiting Guidance Manual.
Program Monitoring. Qualitv Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPH]) with regards to program development and monitoring (including annual
site visits either in -person or virtual), training, support, and technical assistance services.
See the MDHHS Home Visiting Guidance Manual for requirements related to program
monitoring, quality assessment, support, and TA.
Professional Development and Training:
All of the LTA's HFA program staff associated with this funding will participate in
professional development and training activities as required by both HFA and the
Department. All LIA HFA
program staff must receive HFA-specific training from a Michigan -based approved HFA
training entity. See the MDHHS Home Visiting Guidance Manual for requirements
related to professional development and training activities.
Supervision:
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of
individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice
Standards. Written policies and procedures shall specify how reflective supervision is
included in, or added to, that time to ensure provision for each home visitor at a minimum
of one hour per month.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall ensure that there is a broad -based community advisory committee
that is providing oversight for HFA.
The LIA shall build upon and maintain diverse community collaboration and
support with authentic engagement of parent representatives who have the lived
experience and expertise.
3. The LIA shall participate in the Local Leadership Group (LLG) (if not the HFA
community advisory committee) or, if none, the Great Start Collaborative.
4. See the MDHHS Home Visiting Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Horne Visiting Guidance Manual for
requirements related to data collection.
Continuous Quality Improvement (CQII:
The LIA shall participate in all HFA quality initiatives including research, evaluation
and continuous quality improvement.
2. The LIA shall participate in all state and local Home Visiting CQI activities as
required by MDHHS. Required activities include, but are not limited to:
a. QI team participating in one Quality Improvement (QI) Learning Collaborative
per fiscal year, with all required training, reporting requirements and
deliverables.
b. Conducting and completing two LIA-specific PDSA cycles per fiscal year.
c. With prior approval from the MDHHS Model Consultant, a national, regional, or
other quality improvement project can replace one or both of the above
requirements.
d. See the MDHHS Home Visiting Guidance Manual for requirements related to
CQI.
Work Plan Requirements:
By June 30, 2021, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox
(MDHHS-HVlnitiativena,michigan.aov) for preapproval. See the MDHHS Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Guidance Manual.
PROJECT TITLE: MATERNAL INFANT CHILDHOOD HOME VI SITING
PROGRAM (MIECHVP) HEALTHY FAMILIES AMERICA EXPANSION
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma -informed care. The program is designed to
promote positive parent -child relationships and healthy attachment. It is a strengths -
based and family -centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must
be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HFA model
consultant via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the
facesheet changes once the agreement is available to be amended.
b. Family Stories: At a minimum, one home visiting experience as told from the
perspective of a currently enrolled family, due within 30 days of the end of the
fourth quarter (October 30).
c. HFA Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home
Visiting Guidance Manual for requirements related to Work Plan development and
reporting.
d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30 and October 30).
All reports and/or information (a-d), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiative(@.michigan.gov.
a. Implementation Monitoring Data and HRSA data collection requirements due in
REDCap and/or HVOL by the 51h business day of each month.
b. Continuous Quality Improvement (QI) Reporting for the QI Learning Collaborative
is due as follows:
PDSA Planning Tools should be uploaded to Groupsite by the 15th of each
month from the onset of the QI Learning Collaborative to the final month of
activities.
Data should be reported via REDCap in accordance with the QI Learning
Collaborative's data collection schedule which will be provided.
QI story boards for PDSA cycles completed during each action period are
due by the Grantee meeting following the action period and should be
uploaded to Groupsite.
c. Continuous Quality Improvement Reporting for LIA-specific PDSA cycles (i.e.,
team charters) is due in Groupsite as follows:
An initial team charter with the Plan stage complete needs to be shared
prior to moving to the Do stage for feedback from MPH I.
An updated team charter that includes feedback from the Plan stage and
with Do, Study and Act completed needs to be shared for feedback from
MPHI.
A final version of the team charter that includes all components and
feedback needs to be shared.
d. HV ColIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the ColIN's schedule. Participating LIAs are required to use the
HV ColIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (e-h) shall be submitted as described above. Additional guidance concerning
data collection and Continuous Quality Improvement is provided in the MDHHS Home
Visiting Guidance Manual.
Any additional requirements (if applicable):
Grantee Specific Requirements:
The LIA shall serve families from outreach efforts based on the findings of their
community's Needs Assessment approved by MDHHS.
a. The Kalamazoo County Health and Community Services Dept. HFA program
will serve 48 families with children who are at high risk in the areas of
Comstock Township, City of Kalamazoo -Arcadia, Vine, Eastside
neighborhoods, Richland Township, City of Portage, Texas Township,
Oshtemo and Galesburg.
b. The Wayne County Babies HFA program will serve 32 families who are young
parents, through age 24, living in the cities of Hamtramck, Highland Park,
Redford, Inkster, Taylor, Romulus, Van Buren Township and Westland.
See the MDHHS Home Visiting Guidance Manual for requirements related to the
development of a Work Plan and the timeframe for reaching full caseloads.
Maintain Fidelitv to the Model
The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy
Families America affiliates shall comply with the requirements of the Central
Administration for the Multi -Site State System (also known as "The State Office") housed
within the Michigan Public Health Institute. All HFA model -required training will be
accessed through the Central Administration as available. Contact the HFA State Office
for details.
Comply with MDHHS Program Requirements
The LIA shall operate the program with fidelity to the requirements of MDHHS based on
the agreement executed in EGrAMS and the conditions as outlined in the MDHHS Home
Visiting Guidance Manual. The LIA will fulfill these requirements while strengthening
efforts towards health and racial equity through staff education, programmatic data
evaluation and client supportive services.
P.A. 291
The ILIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Guidance Manual for requirements related to PA 291.
Staffing
The LTA's HFA home visiting staff will reflect the community served. The ILIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures as described in the MDHHS Home Visiting Guidance Manual.
Proqram Monitorinq, Qualitv Assessment. Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPHI) with regards to program development and monitoring (including annual
site visits either in -person or virtual), training, support and technical assistance services.
See the MDHHS Home Visiting Guidance Manual for requirements related to program
monitoring, quality assessment, support and TA.
Professional Development and Traininq:
All of the LIA's HFA program staff associated with this funding will participate in
professional development and training activities as required by both HFA and the
Department. All ILIA HFA program staff must receive HFA-specific training from a
Michigan -based approved HFA training entity. See the MDHHS Home Visiting Guidance
Manual for requirements related to professional development and training activities.
Supervision:
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of
individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice
Standards. Written policies and procedures shall specify how reflective supervision is
included in, or added to, that time to ensure provision for each home visitor at a minimum
of one hour per month.
Enqaqe and Coordinate with Community Members, Partners and Parents:
The LIA shall ensure that there is a broad -based community advisory committee
that is providing oversight for HFA.
The LIA shall build upon and maintain diverse community collaboration and
support with authentic engagement of parent representatives who have the lived
experience and expertise.
3. The LIA shall participate in the Local Leadership Group (LLG) (if not the HFA
community advisory committee) or, if none, the Great Start Collaborative.
4. See the MDHHS Home Visiting Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Guidance Manual for
requirements related to data collection.
Continuous Qualitv Improvement (CQI):
1. The LIA shall participate in all HFA quality initiatives including research, evaluation
and continuous quality improvement.
2. The LIA shall participate in all state and local Home Visiting CQI activities as
required by MDHHS. Required activities include, but are not limited to:
a. QI team participating in one Quality Improvement (QI) Learning Collaborative
per fiscal year, with all required training, reporting requirements and
deliverables.
b. Conducting and completing two LIA-specific PDSA cycles per fiscal year.
c. With prior approval from the MDHHS Model Consultant, a national, regional, or
other quality improvement project can replace one or both of the above
requirements.
See the MDHHS Home Visiting Guidance Manual for requirements related to CQI.
Work Plan Requirements:
By June 30, 2021, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox
(MDHHS-HVlnitiativeCa michiaan.gov) for preapproval. See the MDHHS Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Guidance Manual
PROJECT TITLE: NURSE -FAMILY PARNERSH11P (NFP) SERVICES
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
The Nurse -Family Partnership (NFP) program offers families one-on-one home visits with a
registered nurse. The model is grounded in human attachment, human ecology, and self -efficacy
theories. Home visitors use model -specific resources to build on a parent's own interests to
attain the model goals.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with the
Department reporting requirements. See the Michigan Department of Health and Human
Services' (MDHHS) Home Visiting Guidance Manual for details about what must be included in
each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the NFP model consultant
via e-mail and incorporate the change(s) into the budget and facesheet during the next
amendment cycle as appropriate. The facesheet identifies the agency contacts and their
assigned permissions related to the tasks they can perform in E-GrAMS. The assigned
Project Director in E-GrAMS can make the facesheet changes once the agreement is
available to be amended.
b. Family Stories: At a minimum, one home visiting experience as told from the perspective
of a currently enrolled family, due within 30 days of the end of the fourth quarter (October
30).
c. Medicaid Outreach Report (Berrien, Calhoun, Kalamazoo and Kent counties only): Due
within 30 days of the end of each quarter.
d. NFP Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home Visiting
Guidance Manual for requirements related to Work Plan development and reporting.
e. Work Plan Reports: Must be submitted within 30 days of the end of each quarter (January
30, April 30, July 30 and October 30).
All reports and/or information (a-e), unless stated otherwise, shall be submitted electronically to
the MDHHS Home Visiting mailbox at MDHHS-HVlnitiative(a)michigan.pov .
f. Implementation Monitoring Data and HRSA data collection requirements due in REDCap
and Flo on the 51h business day of each month.
g. Continuous Quality Improvement (QI) Reporting for the Cl Learning Collaborative is due
as follows:
• PDSA Planning Tools should be uploaded to Groupsite by the 15th of each month
from the onset of the QI Learning Collaborative to the final month of activities.
• Data should be reported via REDCap in accordance with the QI Learning
Collaborative's data collection schedule which will be provided.
• QI story boards for PDSA cycles completed during each action period are due by
the Grantee meeting following the action period and should be uploaded to
Groupsite.
In. Continuous Quality Improvement Reporting for LIA-specific PDSA cycles (i.e., team
charters) is due in Groupsite as follows:
• An initial team charter with the Plan stage complete needs to be shared prior to
moving to the Do stage for feedback from MPHI.
• An updated team charter that includes feedback from the Plan stage and with Do,
Study and Act completed needs to be shared for feedback from MPHI.
• A final version of the team charter that includes all components and feedback
needs to be shared.
i. HV ColIN Reporting (for those LIAs participating) for QI efforts shall occur in accordance
with the ColIN's schedule. Participating LIAs are required to use the HV ColIN site to
complete monthly submissions of PDSA cycles and required data (the frequency of data
collection may vary).
Reports (f-i) shall be submitted as described above. Additional guidance concerning data
collection and Continuous Quality Improvement is provided in the MDHHS Home Visiting
Guidance Manual.
Any additional requirements (if applicable):
Maintain Fidelitv to the Model:
The LIA shall adhere to the Nurse Family Partnership National Service Office (NSO) program
standards and operate the program with fidelity to the NSO Application Review Team's approved
Implementation Plan.
Comply with MDHHS Program Requirements:
The LIA shall operate the program with fidelity to the requirements of MDHHS based on the
agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting
Guidance Manual. The LIA will fulfill these requirements while strengthening efforts towards
health and racial equity through staff education, programmatic data evaluation and client
supportive services.
Data -Informed Outreach:
Michigan is using NFP as a specialized home visiting service strategy for first-time mothers who
are low-income. This specialized service strategy is a focused way of using limited resources,
directing them to populations who live in communities placing them at higher risk. The LIA will
conduct outreach activities to the population group identified in their Kitagawa analysis AND their
MIECHV Needs Assessment in order to enroll families from those outreach efforts.
The MDHHS expects LIAs to maintain a caseload capacity of 25 families per 1.0 FTE. See the
MDHHS Home Visiting Guidance Manual for requirements related to the development of a Work
Plan and timeframe for reaching full caseloads.
P.A.291:
The LIA shall comply with the provisions of Public Act 291 of 2012- See the MDHHS Home
Visiting Guidance Manual for requirements related to PA 291.
Staffing:
The LIA's NFP home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement within 90
days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Guidance
Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures described in the MDHHS Home Visiting Guidance Manual.
Proaram Monitorina, Qualitv Assessment, Support and Technical Assistance (TAI
The LIA shall fully participate with the NFP NSO, the Department and the Michigan Public Health
Institute (MPH[) with regards to program development and monitoring (including annual site visits
either in -person or virtual), training, support and technical assistance services. See the MDHHS
Home Visiting Guidance Manual for requirements related to program monitoring, quality
assessment, support and TA.
Professional Development and Training:
All of the LIA's NFP staff associated with this funding will participate in professional development
and training activities as required by the NFP, NSO and the Department. See the MDHHS Home
Visiting Guidance Manual for requirements related to professional development and training
activities.
Supervision:
The LIA shall adhere to the NFP supervision requirements.
Enaaae and Coordinate with Communitv Members. Partners and Parents:.
The LIA shall ensure that there is a broad -based community advisory committee that is providing
oversight for NFP.
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have the lived experience and expertise.
The LIA shall participate in the Local Leadership Group (LLG) (if not the NFP community advisory
committee) or, if none, the Great Start Collaborative.
See the MDHHS Home Visiting Guidance Manual for requirements related to engagement with
community partners.
Data Collection:
The LIA shall comply with all NFP and MDHHS data training, collection, entry and submission
requirements. See the MDHHS Home Visiting Guidance Manual for requirements related to data
collection.
Continuous Qualitv Improvement (CQI):
The LIA shall participate in all NFP quality initiatives including research, evaluation, and
continuous quality improvement.
The LIA shall participate in all state and local Home Visiting CQI activities as required by
MDHHS. Required activities include, but are not limited to:
a. QI team participating in one Quality Improvement (QI) Learning Collaborative per fiscal
year, with all required training, reporting requirements and deliverables.
b. Conduct and complete two LIA-specific PDSA cycles per fiscal year.
c. With prior approval from the MDHHS Model Consultant, a national, regional, or other
quality improvement project can replace one or both of the above requirements.
See the MDHHS Home Visiting Guidance Manual for requirements related to CQI
Work Plan Requirements:
By June 30, 2021, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox
(MDHHS-HVlnitiative(@michigan.gov) for preapproval. See the MDHHS Home Visiting Guidance
Manual for requirements related to Work Plan development and reporting.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using grant
agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting
Guidance Manual.
PROJECT: Public Health Ernergency Preparedness (PREP)
0 month Project
Beginning Date: 10/1/2021
End Date: 6/30/2022
3 Month Project
Beginning Date: 7/1//2022
End Date: 9/30/2022
Project Synopsis
As a Grantee of funding provided through the Centers for Disease Control and
Prevention (CDC) National Bioterrorism Hospital Preparedness Program (HPP) and
Public Health Emergency Preparedness (PREP) Cooperative Agreement, each Grantee
shall conduct activities to build preparedness and response capacity and capability.
These activities shall be conducted in accordance with the HPP/PREP Cooperative
Agreement guidance for 2021-2022 plus any and all related guidance from the CDC and
the Department that is issued for the purpose of clarifying or interpreting overall program
requirements.
Reporting Requirements (if different than contract language)
Recipients are required to submit a 9-month (October 1 to June 30) budget and a
3-month (July 1 to Sept 30) for both Base PHEP and CRI funding, including the
10% MATCH for those periods (see below for detail regarding Match). Submitted
to l;i r.';:,-P: ;::-::i:'':`.:'- by May 1, 2021.
2. Recipients provide the required 10% MATCH for July 1 through September 30 and
October 1 through June 30. Recipients are required to submit a letter (on agency
letterhead) stating the source, calculation, and narrative description of how the
match was achieved, unless said match is met using local dollars. This was due
with the narrative budget submission to the Division of Emergency Preparedness
and Response-DEPR.
3. ALL activities funded through the PHEP cooperative agreement must be
completed between July 1, and June 30, and all BP 3-2021 funding must be
obligated by June 30, 2022 and activity completed by the August 15, 2022 FSR
submission deadline.
4. The final Financial Status for funding period ending June 30 reports MUST be
submitted in the MI E-Grants system for this funding source no later than August
15, 2022.
5. Recipients must submit required PHEP program data and reports by the stated
deadlines. This includes, but is not limited to, progress reports, performance
measure data reports, National Incident Management System (NIMS) compliance
reports, CDC Required Pandemic Influenza Plan December 2021,updated
emergency plans, budget narratives, Financial Status Reports (FSR), etc. Failure
to do so will constitute a benchmark failure. All deliverables must be submitted by
the designated due date in the Grantee BP3 work plan.
6. Recipients must maintain National Incident Management System (NIMS)
compliance as detailed in the LHD work plan and submit annually to the
Department — DEPR per the LHD BP3 work plan.
7. Each subrecipient Grantee must retain program -related documentation for
activities and expenditures consistent with Title 2 CFR Part 200; Uniform
Administrative Requirements, Cost Principles and Audit Requirements for Federal
Awards, to the standards that will pass the scrutiny of audit.
Any additional requirements (if applicable)
All Grantee activities shall be consistent with all approved Budget Period 3 work plan(s)
and budget(s) on file with the Department through the MI E-Grants system. In addition to
these broad requirements, the Grantee will comply with the following:
One (1) full time equivalent (FTE) emergency preparedness coordinator (EPC), as
a point of contact. In addition to the Grantee health officer, the EPC shall
participate in collaborative capacity building activities of the PHEP Cooperative
Agreement, all required reporting and exercise requirements and in regional
Healthcare Coalition (HCC) initiatives. Anv chanoes to this staffing model must be
approved by the Public Health Emeraencv Preparedness Program Manaqer at the
Division of Emeraencv Preparedness and Response (517-335-8150).
Under the PHEP cooperative agreements, Grantee's must continue to partner
with the Regional Healthcare Coalition (HCC) and support HCC initiatives to
ensure that healthcare organizations receive resources to meet medical surge
demands. Working well together during a crisis is facilitated by meeting on a
regular basis. To this end, EPCs, supported by CDC PHEP are required to
participate in and support regional HCC initiatives. In addition, the EPC or
designee is required to attend regional HCC planning or advisory board meetings.
The intent is for LHD's that cross regional boundaries to align with one regional
coalition.
There are a number of special initiatives, projects, and/or supplemental funding
opportunities that are facilitated under this cooperative agreement. For example,
the Cities Readiness Initiative (CRI) performance and evaluation initiatives. Each
Grantee that is designated to participate in any of these types of supplemental
opportunities is required to comply with all CDC and the Department — Division of
Emergency Preparedness and Response (DEPR) guidance, and all
accompanying work plan and budgeting requirements implemented for the
purpose of subrecipient monitoring and accountability. Some or all supplemental
opportunities may require separate recordkeeping of expenditures. If so, this
separate accounting will be identified in separate project budgets in the MI E-
Grants system. These supplemental opportunities may also require additional
reporting and exercise activities.
All budget amendments must be submitted to the Division of Emergency
Preparedness and Response (DEPR) for review prior to submitting them in the MI
E-Grants system. Budget amendments that contain line items deviating more than
15% or $10,000 (whichever is greater) from the original budgeted line item must
be approved by DEPR prior to implementation via email to
Supplantation is the replacement of non-federal funds with federal funds to
support the same activities. The Public Health Service Act, Title I, Section 319(c)
specifically states, "SUPPLEMENT NOT SUPPLANT. — Funds appropriated under
this section shall be used to supplement - not supplant - other federal, state, and
local public funds provided for activities under this section." This law strictly and
expressly prohibits using cooperative agreement funds to supplant any current
state or local expenditures.
® In response to repeated communications from CDC strongly urging states to
ensure all funds are spent each year a threshold has been established to limit the
amount of unspent funds. A maximum of 2% of the Grantee allocation or $3,000
(whichever is greater) of unspent funds is allowable each budget period. Failure to
meet this requirement, or misuse of funds, will affect the amount that is allocated
in subsequent budget periods.
Unallowable Costs
• Recipients may not use funds for research.
• Recipients may not use funds for clinic care except as allowed by law.
Recipients may use funds only for reasonable program purposes including
personnel, travel, supplies and services.
• Generally, recipients may not use funds to purchase furniture or equipment. Any
such proposed spending must be clearly identified in the budget.
• Reimbursement of pre -award costs generally is not allowed unless the CDC
provides written approval to the recipient.
• Other than for normal and recognized executive -legislative relationships, no funds
may be used for:
a. Publicity or propaganda purposes, for the preparation, distribution, or use of
any material designed to support or defeat the enactment of legislation
before any legislative body.
The salary or expenses of any grant or contract recipient, or agent acting
for such recipient related to any activity designed to influence the
enactment of legislation, appropriations regulation, administrative action, or
Executive order proposed or pending before any legislative body.
+ Lobbying is prohibited.
• The direct and primary recipient in a cooperative agreement must perform a
substantial role in carrying out project outcomes and not merely serve as a conduit
for an award to another party or provider who is ineligible.
• Recipients may not use funds to purchase vehicles to be used as means of
transportation for carrying people or goods, e.g., passenger cars or trucks,
electrical or gas -driven motorized carts.
• Payment or reimbursement of backfilling costs for staff is not allowed.
• No clothing may be purchased with these funds.
• Items considered as give away such as first aid kits, flashlights, shirts etc., are not
allowable.
+ None of the funds awarded to these programs maybe used to pay the salary
of an individual at a rate in excess of Executive Level 11 or $181,500 per year.
Recipients may not use funds for research.
• Recipients may not use funds for clinical care.
• Recipients may only expend funds for reasonable program purposes, including
personnel, travel, supplies, and services, such as contractual.
• Recipients may not generally use HHS/CDC/ATSDR funding for the purchase of
furniture or equipment. Any such proposed spending must be identified in the
budget.
• The direct and primary recipient in a cooperative agreement program must
perform a substantial role in carrying out project objectives and not merely serve
as a conduit for an award to another party or provider who is ineligible.
• Other than for normal and recognized executive -legislative relationships, no funds
may be used for: publicity or propaganda purposes, the preparation, distribution,
or use of any material designed to support or defeat the enactment of legislation
before any legislative body the salary or expenses of any grant or contract
recipient, or agent acting for such recipient, related to any activity designed to
influence the enactment of legislation, appropriations, regulation, administrative
action, or Executive order proposed or pending before any legislative body.
• Recipients may not use funds for construction or major renovations.
• Recipients may supplement but not supplant existing state or federal funds for
activities described in the budget.
• Recipients may use funds only for reasonable program purposes, including travel,
supplies, and services.
• PHEP funds may not be used to purchase clothing such as jeans, cargo pants,
polo shirts, jumpsuits, sweatshirts, or T-shirts. Purchase of items that can be
reissued, such as vests, may be allowable.
• PHEP funds may not be used to purchase or support (feed) animals for labs,
including mice. Any requests for such must receive prior approval of protocols
from the Animal Control Office within CDC and subsequent approval from the CDC
OGS as to the allowable of costs.
• Recipients may not use funds to purchase a house or other living quarter for those
under quarantine.
+ PHEP recipients may (with prior approval) use funds for overtime for individuals
directly associated (listed in personnel costs) with the award.
• PHEP recipients cannot use funds to purchase vehicles to be used as means of
transportation for carrying people or goods, such as passenger cars or trucks and
electrical or gas -driven motorized carts.
• PHEP recipients can (with prior approval) use funds to lease vehicles to be used
as means of transportation for carrying people or goods, e.g., passenger cars or
trucks and electrical or gas -driven motorized carts.
• PHEP recipients can (with prior approval) use funds to purchase material -handling
equipment (MHE) such as industrial or warehouse -use trucks to be used to move
materials, such as forklifts, lift trucks, turret trucks, etc. Vehicles must be of a type
not licensed to travel on public roads.
PHEP recipients can use funds to purchase caches of medical or non -medical
Counter measures for use by public health first responders and their families to
ensure the health and safety of the public health workforce.
PHEP recipients can use funds to support appropriate accreditation activities that
meet the Public Health Accreditation Board's preparedness -related standards.10.
Audit Requirement
A grantee may use its Single Audit to comply with 42 USC 247d — 3aa)(2) if at least once
every two years the awardee obtains an audit in accordance with the Single Audit Act (31
USC 7501 — 7507) and Title 2 CFR, Part 200 Subpart F; submits that audit to and has the
audit accepted by the Federal Audit Clearinghouse; and ensures that applicable PHEP
CFDA number 93.069 are listed on the Schedule of Expenditures of Federal Awards
(SEFA) contained in that audit.
Administrative preparedness
During BP3, Recipients must continue to strengthen and test their administrative
preparedness plan, to include written policies, procedures, and/or protocols that address
the following:
1. Expedited procedures for receiving emergency funds during a real incident or
exercise.
2. Expedited processes for reducing the cycle time for contracting and/ or
procurement during a real emergency or exercise.
3. Internal controls related to subrecipient monitoring and any negative audit findings
resulting from suboptimal internal controls;
4. Emergency authorities and mechanisms to reduce the cycle time for hiring and/ or
reassignment of staff (workforce surge).
"'All administrative preparedness planning activities should be considered in coordination
with healthcare systems, law enforcement, and other relevant stakeholders as
appropriate.
Pandemic and All Hazards Preparedness and Advancing Innovation Act of 2018
Requires the withholding of amounts from entities that fail to achieve PHEP benchmarks.
The following PHEP benchmarks have been identified by CDC and MDHHS-DEPR for
the Fiscal Year:
Demonstrated adherence to all PHEP application and reportinq deadlines.
Grantees must submit required PHEP program data and reports by the stated
deadlines. This includes, but is not limited to, progress reports, performance
measure data reports, National Incident Management System (NIMS) compliance
reports, updated emergency plans, budget narratives, Financial Status Reports
(FSR), etc. Failure to do so will constitute a benchmark failure. All deliverables
must be submitted by the designated due date in the LHD BP 3-2021 work plan.
Demonstrated capability to receive, stage, store, distribute, and dispense medical
countermeasures (MCM) I during a public health emergency, per the BP 3-2021
LHD Work Plan.
Further guidance related to pandemic preparedness will be included in the LHD
workplan.
Pandemic Influenza Preparedness plans
Further guidance will be included in the Grantee PHEP Work Plan.
Benchmark Failure
Awardees are expected to "substantially meet' the PAHPIA benchmarks. Per the
Cooperative Agreement, failure to do so constitutes a benchmark failure, which carries an
allowable penalty withholding of funds. Failure to meet any one of the two benchmarks
and/or the spending threshold is considered a single benchmark failure. Any awardee (or
sub-awardee) that does not meet a benchmark, and/or the spending threshold will have
an opportunity to correct the deficiency during a probationary period. If the deficiency is
not corrected during this period, the awardee is subject to a 10% withholding of funds the
following budget period. Failure to meet the pandemic influenza plan requirement
constitutes a separate benchmark failure and is also subject to a 10% withholding. The
total potential withholding allowable is 20% the first year. If the deficiency is not
corrected, the allowable penalty withholding increases to 30% in year two and 40% in
yearthree.
Regional Epidemiology Support:
For those recipients receiving additional funds to provide workspace for Regional
Epidemiologists, the grantee must provide adequate office space, telephone connections,
and high-speed Internet access. The position must also have access to fax and
photocopiers.
PROJECT Ti I -LE: Regions l Perinatal Care System
Start Date: 10/01/2021
End Date: 09/30/2022
Project Synopsis:
The aim of the Regional Perinatal Quality Collaboratives (RQPCs) is to develop data -
driven innovative strategies and efforts that are tailored to the strengths and challenges
of each region to improve maternal, infant, and family outcomes; especially looking at
preterm birth, very low birth weight infants, low birth weight infants, and maternal health.
Furthermore, RPQCs ensure statewide alignment with the strategies and goals outlined
in the Michigan Mother Infant Health and Equity Improvement Plan (MIHEIP) and are
tasked with addressing disparities in birth outcomes and health inequities. Each RPQC
engages cross -sector, diverse stakeholders and implements evidence -based, or
promising practice, interventions utilizing quality improvement methodology.
Reporting Requirements (if different than agreement language):
The Grantee shall submit the following reports on a quarterly basis:
Report on Aim statement, measures and corresponding outcomes, as identified by
the grantee and MDHHS, through submission of quarterly progress reports.
• RPQCs will submit quarterly narrative reports summarizing member agency
efforts, new partnerships, community achievements, member participation in and
status of other MDHHS initiatives, as well as the composition and number of
attendees at each Collaborative meeting. This report will be submitted with the
quarterly progress report to the Contract Manager, Emily Goerge, via email at:
GoergeE(amichigan.gov. A template for the narrative report will be provided.
• RPQCs will be required to report on the number of participants with 'active
membership' in their quarterly progress reports. See definitions below for what
qualifies as 'active membership'.
Any such other information as specified above shall be developed and submitted by the
Grantee as required by the Contract Manager.
Any additional requirements (if applicable):
• In alignment with the Regional Perinatal Quality Collaborative's (RPQC) role of
authentically engaging families and convening diverse stakeholders, the
Collaborative must be comprised of a multi -stakeholder and diverse membership;
ensuring to recruit families, faith -based organizations, clinicians, Medicaid Health
Plans, community -based organizations, business partners, and etcetera.
• MDHHS stresses the importance of garnering the input and feedback of families
most impacted by adverse birth outcomes. Therefore, continuing in fiscal year
2022, there must be family representation in the RPQC's membership.
• Family engagement is essential to the success of the RPQCs and can be fostered
via various avenues, for example: family groups through Great Start Collaborative
and Children Special Health Care Services, community centers, local churches,
focus groups, parent panel and etcetera.
• RPQCs are expected to convene periodic (with frequency of at least quarterly)
collaborative meetings, inclusive of diverse regional partners, to garner feedback
and discussion, including but not limited to, regional maternal and infant vitality
concerns, review of data, analysis of gaps in care and birth outcomes, quality
improvement efforts, alignment with the Mother Infant Health and Equity
Improvement Plan and etcetera
*The collaborative meetings are to be in addition to any leadership or steering
team meetings that the RPQC may choose to convene as oversight for the RPQC.
Definitions
Active membership is defined as attending a minimum of two (2) Collaborative
meetings, participating in RPQC quality improvement efforts, reporting out on their
respective agency's efforts related to maternal and infant mortality, and etcetera.
Family active membership is defined as a family presence at a minimum of two
(2) Collaborative meetings and/or garnering family input at least twice per fiscal
year.
• Family and community presence should comprise 10% of the RPQC's active
membership.
Membership includes:
• Families
• Clinicians
• Community -based organizations
• Local public health
• Medicaid health plans
• Faith -based organizations
• Business partners
• Others
To ensure regional stakeholders are aligned with the Mother Infant Health and Equity
Improvement Plan (MIHEIP), RPQCs will need to infuse maternal and infant Statewide
initiatives into their Collaborative (example: MMMS, FIMR, MI AIM, CDR, etc.)
• Each Collaborative will dedicate time during meetings for members to share
updates, as well as time for reporting out on participation in other Statewide
initiatives.
• Continuing in fiscal year 2022, RPQCs will specifically be required to:
1. Invite MI -AIM leads to share region -specific MI -AIM efforts at two (2) fiscal
year 2022 collaborative meetings. A list of MI -AIM leads in the region can
be obtained from your assigned State consultant.
2. Know the MI -AIM designation status of the birthing hospitals in their
respective region.
• The names and titles of the RPQC leadership, and the Quality Improvement
project team leads, for fiscal year 2022, must be identified on the work plans
submitted to the Contract Manager via email, GoeraeE(@michlgan.gov
• Selected quality improvement objective(s), and corresponding evidence -based or
promising practices intervention(s), must align with the MIHEIP.
All quality improvement efforts must:
• Be inclusive of addressing health inequities, the social determinants of health and
actively address disparate outcomes.
• Utilize quality improvement methodology.
• Be data driven.
• Utilize evidence -based and/or promising practices interventions that address
improving outcomes for mothers, infants and families.
• As the RPQCs are a conduit to the community, the region must provide
representation at MIHEIP-related MDHHS meetings, such as the Mother Infant
Health and Equity Collaborative (MIHEC) meeting and the State Perinatal Quality
Collaborative meetings (i.e., RPQC Leadership meetings).
1. Attendance is required unless prior approval received from State consultant.
2. For MIHEC meetings, each RPQC should have two attendees present, with at
least one representing the leadership team.
3. For the quarterly State Perinatal Quality Collaborative meetings, at least two
members of the RPQC leadership team are required to attend.
4. Each region will be required to report on their efforts, challenges, successes
and etcetera at one of the quarterly MIHEC meetings.
5. Regional collaborative leadership is expected to work collectively with assigned
State consultant and other members of the MIHEIP team.
Budget Allowances
To ensure most of the awarded funding is funneled into the community for quality
improvement efforts:
• Budgets line items for external consultants must be capped at 25% for
contractors/consultants who have been hired as subject matter experts.
• Budgets must be capped at 75% for contractors hired to carry out the quality
improvement tasks of the collaborative.
PROJECT TITLE: SEAL! MI
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
SEAL! MI is the School Based Dental Sealant Program, providing oral health
prevention to students in Michigan schools.
Reporting Requirements (if different than agreement language):
A. The Contractor shall submit the following reports on the following dates:
• Quarterly Report Dental Sealant Tracking Form's at the end of each quarter
to the Michigan Department of Health and Human Services Oral Health
Program.
• Submit completed copies of the SEAL! MI MDHHS Student Data and Event
Data forms within two weeks of the end of the fiscal year and upon request.
B. Any other information as specified in the Statement of Work/ Work Plans as
reflected in EGrAMS.
C. Reports and information shall be submitted to the Contract Manager:
Jill Moore RDH, BSDH, MHA, EdD
School Oral Health Consultant
Division of Child and Family Programs
P.O. Box 30195
Lansing, MI 48909
517-241-1502
MooreJ14t7a michioan.gov
D. The Contract Manager shall evaluate the reports submitted as described in
Attachment C for their completeness and adequacy.
E. The Contractor shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by Contract Manger.
Any additional requirements (if applicable):
• All program staff (paid and unpaid) must attend the annual SEAL! MI
Training via webinar.
® At least one person from program must attend the SEAL! MI Annual
Workshop, in person (or virtually if the training is planned in the virtual
format), for the length of the entire training.
® All monies collected from insurance billing from dental sealants must be
allocated back into the SEAL! MI program (equipment, staff, supplies,
travel, incentives etc.).
There must be one EXTRA complete treatment set up available for program
use in the event of equipment failure (including: portable dental unit, curing
light, Isolite other isolation system, patient chair, operator light and operator
chair).
® Patient privacy screens must be available for use.
PROJECT T FLE: Sexually Transmitted InfeUtion (STI) Control
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health
care cost. Women, especially those of child-bearing age, and adolescents are particularly
at risk for negative health outcomes. Local health STI programs ensure prompt reporting
of cases, provide screening and treatment services for Michigan's citizens, and respond to
critical morbidity increases in their jurisdiction.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit Report
STI 340B Tracking Quarterly 10 days after the
Report end of the quarter
Any additional requirements (if applicable):
Grant Program Operation
Email to cemoson(a7.scriotauiderx.com; cc:
Iowe rvd(a michigan. gov
1. For medical providers that identify 5% or more of the County's gonorrhea,
chlamydia, and/or syphilis morbidity, the local STI program will contact them at
least annually to review provider screening, reporting, treatment, and partner
management methods.
2. Participate in technical assistance/capacity development, quality assurance, and
program evaluation activities as directed by Division of HIV and STI
Programs/Sexually Transmitted Infections (DHSP/STI).
3. Implement program standards and practices to ensure the delivery of culturally,
linguistically, and developmentally appropriate services. Standards and practices
must address sexual minorities.
4. For gonorrhea and chlamydia cases in the Michigan Disease Surveillance System,
50% shall be completed within 30 days and 60% within 60 days from the date of
specimen collection.
5. For gonorrhea and chlamydia cases, develop plans to respond to issues in quality,
completeness, and timeliness.
Mandatory Disclosures
1. Inform DHSP/STI at least two weeks prior to changes in clinic operation (hours,
scope of service, etc.).
Project: Sexually Transmitted lntection lSTh Specialty Services
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health
care cost. Women, especially those of child-bearing age, and adolescents are
particularly at risk for negative health outcomes. Local health STI programs ensure
prompt reporting of cases, provide screening and treatment services for Michigan's
citizens, and respond to critical morbidity increases in their jurisdiction. In addition, the
purpose of this project is to provide specialty STI clinical service with a focus on the
LGBTQ+ community.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit
Report
Quarterly Progress Report & Quarterly 30 days after the end Email to MDHHS
Data Report of the quarter contract liaison
Any additional requirements (if applicable):
Mandatory Disclosures
• Inform DHSP/STI at least two weeks prior to changes in clinic operation (key staff,
hours of operation, scope of service, etc.).
PROJ!EfCT� TAKING PRIDE IN PREVENTION
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The purpose of this project is to implement a comprehensive teen pregnancy prevention and
adulthood preparation program for youth 12-19 years of age.
Reporting Requirements
The Grantee shall submit the following reports and data via the appropriate reporting
mechanism on the dates specified below:
Report
Time Period
Due Date
Submit To
October 1 - December 31, 2021
January 31, 2022
Program
January 1 - March 31, 2022
April 15, 2022
EGrAMS
Narrative
April 1 - June 30, 2022
July 31, 2022
httos://egrams-mi.com/mdhhs
July 1 - September 30, 2022
October 15, 2022
October 1 - December 31, 2021
January 15, 2022
Participant
January 1 - March 31, 2022
April 5, 2022
REDCap
Level Data
(Youth)
� April 1 -June 30, 2022
July 15, 2022
� https://chc.mphi.orq
July 1 - September 30, 2022
October 5, 2022
October 1 - December 31, 2021
January 15, 2022
Program
January 1 - March 31, 2022
April 5, 2022
REDCap
Level Data
April 1 — June 30, 2022
July 15, 2022
https://chc.mphi.orq
(Parents)
July 1 - September 30, 2022
October 5, 2022
Program October 1, 2021 —
Level Data September 30, 2022 July 15, 2022 REDCap
(Performance (MPHI will open this data section in https://chc. mphi.orq
Measures) REDCap in June)
Fidelity Logs February 2022 March 31, 2022 Email to MDHHS
May 2022 June 30, 2022 andersonk10(@michigan.gov_
• Any other information, as specified in the Statement of Work and TPIP Report Fact Sheet,
shall be developed and submitted by the Grantee as required by the Contract Manager.
• The Contract Manager shall evaluate the reports submitted as described in Attachment C
(items A and B) for their completeness and adequacy.
• The Grantee shall permit the Department or its designee to visit and to make an evaluation
of the projects as determined by the Contract Manager.
tic', • ' a• '-�
• TPIP programs must serve 80, 175 or 250 unduplicated youth each fiscal year (FY) who
complete at least 75% of the program, which is determined by the intensity level of the
selected curriculum:
Number of unduplicated 90% of the target
youth who complete at performance output
least 75 /o of program
emeasure
each FY
Teen Outreach Program
High
80 72
(TOP)
Michigan Model -Healthy &
Medium
175 156
Responsible Relationships
Reducing the Risk
Medium
175 156
Promoting Health Among
Low
250 225
Teens -Comprehensive
Making Proud Choices
Low
250 225
Cuidate I Low 1 250 225
• TPIP programming must be delivered separate and apart from any religious education or
promotion and funding cannot be used to support inherently religious activities including,
but not limited to, religious instruction, worship, prayer, or proselytizing.
• Family planning drugs and/or devices cannot be prescribed, dispensed, or otherwise
distributed on school property at any time, including as part of the pregnancy prevention
education funded under TPIP.
• Abortion services, counseling and/or referrals for abortion services cannot be provided as
part of the pregnancy prevention education funded under TPIP.
• TPIP funding may not be used to pay for costs associated with health care services, for
which referrals are made.
• TPIP funding may not be used for fundraising activities, political education, or lobbying.
0 TPIP grantees must adhere to all of the TPIP Minimum Program Requirements (MPRs)
PROJECT: Tuberculosis Control
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Each Grantee as a sub -recipient of the CDC Tuberculosis Elimination
Cooperative Agreement shall conduct activities for the purposes of tuberculosis
control and elimination.
Funds may be used to support personnel, purchase equipment and supplies,
and provide services directly related to core TB control front-line activities, with
a priority emphasis on DOT (Directly Observed Therapy) and electronic DOT,
case management, completion of treatment and contact investigations.
Funds may also be used to support incentive or enabler offerings to
mitigate barriers for patients to complete treatment.
Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds
to purchase anti -tuberculosis medications or to pay for inpatient services.
® Examples of appropriate incentive/enabler offerings include retail coupons,
public transit tickets, food, non-alcoholic beverages, or other goods/services that
may be desirable or critical to a particular patient.
For more information and suggested uses of incentive/enabler options, refer to
CDC's Self -Study Module #9, Enhancing Adherence to Tuberculosis Treatment at
httr)://www.cdc.(iov/tb/education/ssmodules/moduIe9/ssgreading3.htm.
Reporting Requirements (if different than contract language)
DOT Logs are maintained on site and available if needed. All other data must be entered
into MDSS as stipulated in contract specific requirements.
Ensure that confidential public health data is maintained and transmitted to the
Department in compliance with applicable standards defined in the "CDC Data
Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted
Diseases, and Tuberculosis Programs"
httD://www.cdc.qov/nchhstr)/Droaramintegration/docs/PCS]DataSecuritvGuidelines.pdf
Any additional requirements (if applicable)
Utilize DOT as the standard of care to achieve at minimum 80% of TB cases
enrolled in DOT or electronic DOT (Jan 1- Dec 31).
Document in Michigan Disease Surveillance System (MDSS) all changes to
treatment regimen using the Report of Verified Case of Tuberculosis (RVCT)
comments field (pg. 12), and completion of therapy using RVCT Follow -Up 2 (pg.
7).
® Maintain evidence of monthly DOT logs on site (to be made available if needed).
Monthly submission of DOT logs is no longer required.
Achieve at least 94% completion of treatment within 12 months for eligible TB
cases. The determination of treatment completion is based on the total number of
doses taken, not solely on the duration of therapy. Consult the most current ATS
document Treatment of Tuberculosis for guidance in the number of doses needed
and the length of treatment required following any interruptions in therapy.
Maintain appropriate documentation on site (to be made available if needed).
Document the appropriate use of expenditures for incentive and enablers for
clients to best meet their needs to complete appropriate therapy.
Ensure >90% completion of RVCT pages 1 - 6 in MDSS within one month of
diagnosis.
Unallowable Costs per federal guidelines
. Funds cannot be used for procurement of anti -tuberculosis medications.
® Funds cannot be used for research.
® Funds cannot be used for inpatient services.
IR jE('T: V_-ctop-BcoCne Disease Surveillance
Beginning Date: 4/1/2022
End Date: 9/30/2022
Project Synopsis
This agreement is intended to support the development of vector -borne disease
surveillance and control capacity at the local health department level. Funds may be used
to support a low-cost, community -level surveillance system for 1) the early detection of
arbovirus threats by identifying potential invasive mosquito vectors or local virus
transmission in mosquitoes and 2) populations of ticks including Ixodes scapularis,
Amblyomma americanum, and Haemaphysalis longicornis. This information can be
utilized by participating local health departments to notify its citizens of any local
transmission risk using education campaigns and to potentially work with local
municipalities to conduct vector control activities such as drain management, scrap -tire
campaigns, breeding site removal, landscape modifications, or pesticide application.
Requirements for participation in this program include providing for the placement of a
minimum number of mosquito traps, operating for at least five "trap -nights" per week,
conducting a minimum number of targeted tick "drags," and identifying ticks and
mosquitoes. Bi-weekly (occurring every two weeks) reporting to MDHHS of grant
activities is also required. MDHHS EZID should be notified immediately if an invasive
mosquito or tick species is identified.
Reporting Requirements (if different than contract language)
The subrecipient shall submit bi-weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe(a,michigan.gov) and
Rachel Wilkins (rwilkins3(amichigan.gov) at the MDHHS EZID Section.
Any additional requirements (if applicable)
• Mosquito and/or Tick Surveillance
• Minimum recommended mosquito and tick surveillance effort according to the
point formula in Table 1 (below) over a period of 14 weeks.
• Provide bi-weekly reporting of surveillance results to MDHHS EZID Section (see
contact information below).
• Use surveillance data to notify the public of risks related to vector borne disease in
mosquitoes or ticks in the jurisdiction.
• The total funds allocated for this project to participating local health departments
must be utilized prior to September 30.
• Each local health department as a sub -recipient of the State of Michigan Emerging
Public Health Funds shall conduct activities for the purposes of mosquito and tick
surveillance in their jurisdiction. For mosquito surveillance, funds may be used to
support personnel, to purchase equipment and supplies related to conducting
mosquito surveillance in areas of historically high incidence of arboviral disease,
and to produce and distribute educational and other materials related to mosquito -
borne disease prevention and control. For tick surveillance, funds may be used to
support personnel, to purchase equipment and supplies, and to produce and/or
distribute educational and other materials related to tick -borne disease prevention
and control.
• Activities can be conducted according to the needs of the local jurisdiction but
must conform to the point allocation formula in the table below. Each activity listed
is awarded 2 points and a local jurisdiction must accumulate at least 64 points
during the funded timeframe (April 1-Sept.30). Mosquito surveillance and tick
surveillance have required minimum efforts totaling 32 points. The remainder of
the required points (32 points) may be accomplished according to the needs of the
local health department. For instance, if mosquitoes are more of a concern in the
jurisdiction, the funded LHD can focus its efforts on mosquito surveillance,
educational activities, etc. If ticks are more of a concern in the jurisdiction, the
funded LHD can focus its efforts on tick surveillance, educational activities, etc.
Local Health Department VBD Surveillance Project, Point Allocation Formula
Activity
Points
Required
Total
Metric Evaluation
Points /
Points
Method
Weeks
5 mosquito collection
2
20/10
At least 20
Report to
devices* placed for 24-hour
MosquitoNET (CDC)
period
2 mosquito collection
2
2/4
At least 8
Report to
devices* placed for 24-hour
MosquitoNET (CDC)
period in August
1,000 meter tick drag 000
2
4/2
At least 4
Report to MDHHS
Educational outreach
2
Report to MDHHS
activity / event**
Press release
2
Report to MDHHS
Coordination of control
2
Report to MDHHS
efforts with local
municipalities / other
prevention efforts
Total Points:
Must equal
at least 64
*Devices can include BG-2 traps, CDC light traps, resting boxes, etc.
"*For 2022, social media posts are limited to 2 points total, 1 point each for mosquito and
tick related content. Please consult in advance with EZID staff if you have questions
about an educational outreach activity.
PROJECT: WEM NILE VIRUS r O>'MUNI T Y SURVEILLANCE
Beginning Date: 5/1/2022
End Date: 9/30/2022
Project Synopsis
This agreement is intended to support the development of a low-cost surveillance
system for the early detection of West Nile virus in mosquitoes at the community level,
for the purpose of educating the pubic and healthcare providers and preventing
outbreaks. This information can be utilized by participating local health departments to
notify its citizens and healthcare providers of any local transmission risk using education
campaigns, press -releases and other means, and to potentially work with local
municipalities to conduct mosquito population mitigation activities such as drain
management, scrap -tire campaigns, breeding site removal, larviciding, and adulticiding.
Requirements for participation in this program include providing for the placement of a
minimum number of mosquito traps, operating for at least two "trap nights" per week,
identifying mosquitoes, and weekly reporting to the Department of surveillance results,
Reporting Requirements (if different than contract language)
The Grantee shall submit weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (din he@michigan.gov),
and Kim Signs (slgn.sk@miehigan.gov) at the MDHHS EZ_ID Section.
Any additional requirements (if applicable)
Each Grantee as a sub -recipient of the Centers for Disease Control and Prevention
(CDC) Epidemiology and Laboratory Capacity Cooperative Agreement shall conduct
activities for the purposes of West Nile vii us (WNV) surveillance among mosquito
populations in their jurisdiction. Funds may be used to support personnel and travel, to
purchase equipment and supplies related to conducting mosquito surveillance in areas
of historically high incidence of WNV. and to produce and/or distribute educational and
other materials related to West Nile virus prevention and control.
Mosquito Surveillance:
Minimum recommended mosquito traps for this project is 5 traps utilized per
county, operating 2 nights per week for a total of 10 "trap nights" per week for
approximately 16 weeks.
Provide weekly reporting of surveillance results to the Department EZID Section
(see contact information below).
Use surveillance data to notify the public and healthcare providers of an risk
related to West Nile Virus in mosquitoes in the jurisdiction.
® The total funds allocated for this project to participating local health departments
must be utilized prior to September 30.
The Department's Emerging & Zoonotic Infectious Diseases (EZID) Section will provide
the Grantee with the following support:
® Training for staff associated with the project (Spring 2022)
• Trapping equipment necessary to collect mosquitoes (traps, batteries,
chargers)
s VecTOR test kits for the rapid, field detection of West Nile Virus
• Entomologic and epidemiologic support to guide trapping efforts
PROJECT 1 i 4 LE: WISEWOMAN
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
WISEWOMAN (Well -Integrated Screening and Evaluation for Women Across the
Nation) is a program designed to screen women for chronic disease risk factors,
counsel them about lifestyle changes to reduce risk factors, and refer them for medical
treatment of hypertension, hyperlipidemia, and/or diabetes mellitus. Thisprogram will
be based within Michigan's Breast and Cervical Cancer Control Program.
Reporting Requirements (if different than agreement language):
All Grantees implementing WISEWOMAN: Quarterly Progress Reports Covering:
Reporting Period Report Due Date
October 1 - December 31 January 31
January -March 31 April 30 l
April 1 - June 30 July 31
October 1 - September 30 (entire FY) October 31
Reports should be submitted to the contract manager
Robin Roberts, Program Director MDHHS WISEWOMAN
P.O. Box 30195 Lansing, MI 48909
Email: Roberts6(@,,michioan.gov
Phone:517-335-1178
Any additional requirements (if applicable):
A statewide database called MBCIS is maintained by MDHHS and the Cancer
Prevention and Control Section (CPCS). Instructions for contractor use of MBCISare
provided in manuals for programs that contribute data to this database. The CPCS will
exchange relevant program reports with appropriate contractors through a secure file
transfer system, as noted in the same program manuals.
For specific WISEWOMAN Program requirements, refer to the most current
WISEWOMAN Program Policies and Procedures Manual.
PROJECT: Wornen Infant Children (WIC)
WIC Breastfeeding
WIC Migrant
WIC Resident
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Women, Infants, and Children (WIC) is a federally funded Special Supplemental
Nutrition Program of the Food and Nutrition Service of the United States Department of
Agriculture and is administered by the Michigan Department of Health and Human
Services to serve low and moderate income pregnant, breastfeeding, and postpartum
women, infants, and children up to age five who are found to be at nutritional risk
through its statewide local WIC agencies.
WIC is a health and nutrition program that has demonstrated a positive effect on
pregnancy outcomes, child growth and development. The program provides a
combination of nutrition education, supplemental foods, breastfeeding promotion and
support, and referrals to health care. Participants redeem WIC food benefits at
approved retail grocery stores and pharmacies. WIC foods are selected to meet nutrient
needs such as calcium, iron, folic acid, vitamins A & C.
Reporting Requirements (if different than contract language)
• A Financial Status Report (FSR) must be submitted to the Department on a
quarterly basis by deadlines as defined by MDHHS Expenditure Operations.
Grantees shall (when requested) annually report expenditures on a supplemental
form, if needed and required, to be provided by the Department and attached to the
final Financial Status Report (FSR) which is due on November 30 after the end of the
fiscal year in EGrAMS.
• As part of the Breastfeeding Peer Counseling Grant, the Grantee must submit
quarterly progress reports to the State Breastfeeding Peer Counselor
Coordinator (or designee) by the 15th of the month following end of quarter.
Funds allocated for the Breastfeeding Peer Counseling Program are exempt
from the WIC Nutrition Education and Breastfeeding Time Study.
Additional Requirements
The Grantee is required to comply with all applicable WIC federal regulations,
policy and guidance.
• The Grantee is required to comply with all State WIC Policies.
The Grantee is required to complete the NE and BF Time Study as instructed by the
MDHHS WIC Program. Breastfeeding Peer Counseling grant, if supported with
funds allocated through the WIC funding formula, must report as time study data.
• The Grantee must follow the allowable expense guidelines provided by USDA
FINS for the Peer Counselor Grant.
The primary purpose of these funds is to provide breastfeeding support services
through peer counseling to WIC participants. The Grantee must follow the
staffing requirements as set forth in the Loving Support Model and through
signed allocation letter for the Breastfeeding Peer Counseling Grant.
® Comply with the requirements of the WIC program as prescribed in the
Code of Federal Regulations (7 CFR, Part 246) including the following special
provisions from Part 246.6 (f)(1)(2):
(f) Outreach/Certification In Hospitals. The State agency shall ensure that
each local agency operating the program within a hospital and/or that has
a cooperative arrangement with a hospital:
(1) Advises potentially eligible individuals that receive inpatient or
outpatient prenatal, maternity, or postpartum services, or that accompany
a child under the age of 5 who receives well -child services, of the
availability of program services; and
(2) To the extent feasible, provides an opportunity for individuals who may
be eligible to be certified within the hospital for participation in the WIC
Program. [246.6(F)(1)].
The Grantee in accordance with the general purposes and objectives of this
agreement, will comply with the federal regulations requiring that any individual
that embezzles, willfully misapplies, steals or obtains by fraud, any funds,
assets or property provided, whether received directly or indirectly from the
USDA, that are of a value of $100 or more, shall be subject to a fine of not more
than $25,000.
® The Grantee is required to operate the Project FRESH Program within the
guidelines as laid out in the "WIC Project FRESH Local Agency Guidebook".
® The Grantee is required to abide by the Dissemination License Agreement
between Michigan State University and Michigan Department of Health and
Human Services for "Mothers in Motion." Any use of these licensed materials in
the provision of program related services is subject to the terms and conditions
outlined in the licensure agreement, which is included in Addendum 1, as
reference.
WIC Resident Services/Migrant/Breastfeeding Peer Counseling Grant Training and
Education Requirements:
The Grantee is required to comply with MI -WIC Policy 1.07L Staff Training Plan as
detailed for applicable staff as it pertains to all State WIC training opportunities.
ADDENDUM 1
Dissemination License Agreement for "Mothers in Motion"
Between
Michigan State University
And
Michigan Department of Health and Human Services
This License Agreement ("Agreement"}, effective as of October 16, 2015 ("Effective Date"), is made by and
between Michigan State University, having offices at 325 E. Grand River, Suite 350, East Lansing, MI
48823 ("Licensor") and State of Michigan Department of Health and Human Services Women, Infants
and Children, having offices at 320 S. Walnut, Lansing, MI 48913 ("Licensee") (individually a "Party" and
collectively, the'Parties").
WHEREAS, Licensor has created the "Mothers in Motion" materials (herein, "Physical Materials"), MSU
reference number TEC2015-0036 utilizing funds from a grant from the National Institutes of Health (NIH),
grant number 1 RI8-DK083934-01 A2 ("Grant").
WHEREAS, Licensor is the ownerof certain rights, title and interest in the Physical Materials and has the
right to grant licenses thereunder.
WHEREAS, Licensee wishes to license the Physical Materials for dissemination purposes and Licensor, in
orderto meet its obligations underthe NIH grant, desires to grant such licenseto Licensee on the terms
and conditions herein.
WHEREAS, Licensee wishes to obtain this Agreement in orderto carry out the intent of their master
agreement between Licensee and Licensor with an effective date of FY 2015-2016.
NOW THEREFORE, the parties agree as follows:
I. Definitions.
a. 'Physical Materials" shall mean all physical items listed in Schedule A.
b. "Sublicenseable Materials" shall mean one electronic copy of the Physical Materials.
c. "Materials Modification Guide" shall mean the specifications outlined in Schedule B.
d.'IDerivative Works" means all works developed by Licensee or Sublicensee which would be
characterized as derivative works of the Physical Materials and/or Sublicenseable Materials under the
United States Copyright Act of 1976, or subsequent revisions thereof, specifically including, but not limited
to, translations, abridgments, condensations, recastings, transformations, or adaptations thereof, or works
consisting of editorial revisions, annotations, elaborations, or other modifications thereof. The term
"Derivative Work" shall not include those derivative works which are developed by Licensor.
c. "Sublicense" means an agreement which may take the form of, but is not limited to, a sublicense
agreement, memorandum of understanding, or special provisions added as an amendment to an existing
agreement between Licensee and a Sublicensee in which Licensee grants or otherwise transfers any of
the rights licensed to Licensee hereunder orother rights that are relevant to using the Sublicenseable
Materials.
AGR2015-01 146
TEC2015-0036
f. "Sublicensee" means any entity to which a Sublicense is granted.
1. Grant of License
1.1 Subject to the terms and conditions of this Agreement, to the extent that Licensee's rights to
Physical Materials as a result of Licensors grant of rights to the Federal Government in accordance
with the terms and conditions of the Grant are insufficient for Licensee's activities hereunder,
Licensor hereby grants to Licensee a nonexclusive, nontransferable, worldwide, license to use,
perform, reproduce, publically display and create Derivative Works (as outlined in the Physical
Materials Modification Guide) of the Physical Materials. Notwithstanding the foregoing, Licensee
may only distribute the Physical Materials within Licensee managed locations within the state of
Michigan. Licensee is not permitted to sell or receive consideration for any of the Physical Materials
or reproductions of the Physical Materials.
1.2. Licensor grants Licensee the right to grant Sublicenses of its rights under Section 1.1 of
the Sublicensable Materials to Sublicensee for the sole purpose of placing the content contained
in the Sublicenseable Materials on a website that is controlled by Sublicensee and that is
access limited, password protected. Any Sublicense shall be in accordance with Article 3 below.
Sublicensee may be granted the right to create Derivative Works of the Sublicenseable Materials
limited to that which is described in the Materials Modification Guide and only to ensure that the
Sublicenseable Materials meet - technical specifications necessary to place the content contained
in the Sublicenseable Materials on Sublicensee's controlled website. Notwithstanding the
foregoing, Sublicensee may create split-up lessons (meaning placing the content of a full-length
lesson into multiple videos) of the full-length lessons contained in the DVD portion of the
Sublicenseable Materials only in order to conform to the technical format of Sublicensee's
website platform; the content, however, shall not be modified. Sublicensee is not permitted to
sell or receive consideration for the Sublicenseable Materials in any format. Any content created
solely by Sublicensee that supports the implementation of the Sublicensable Materials shall be
owned by Sublicensee. If Derivative Work is created by Sublicensee, Sublicensee shall own their
creative contribution to the Derivative Work and Licensor retain all copyright rights to the original
Sublicensable Materials contained in such Derivative Work. Licensee and Sublicensee may address
ownership of Sublicensee's creative contribution to Derivative Works in the Sublicense
agreement.
1.3 In such incidences where, for financial reasons, Licensee is not able to reproduce the
label displayed on the original master copy of the DVD portion of the Physical Materials,
Licensee must ensure that the entire content of the DVD portion of the Physical Materials are
reproduced in its entirety so that the inclusion of the copyright notice, Licensor owned logos
(including wordmark), grant number information, title of each lesson, and acknowledgements are
maintained.
1.4 Except as provided in Section 1.2 and 1.3, Licensee will refrain, and shall require
Sublicensees to refrain, from using the name of the Licensor in publicity or advertising without
the prior written
approval of Licensor. Notwithstanding the foregoing, Licensee may, without- prior approval from
Licensor, use Licensor's name in a manner that is (a) informational in nature (i.e. describes
the existence, scope and/or nature of the relationship of the Parties and/or the fact that the
Physical Materials were developed by Licensor), (b) does not suggest Licensor's endorsement of
Licensee or its goods or services, (c) does not create the appearance that the source of the
communication is Licensor or any party other than Licensee, and (d) otherwise consistent with the
terms of the Agreement.
AGR2015-01 146 2
TEC2015-0036
Except as described in Section 1.2 and 1.3 and this Section 1.4, the use of the name of the Licensor
does not extend to any trademark, logo, or other name or unit of Licensor.
1.5 Licensor shall provide Physical Materials to Licensee by October 31, 2015. Licensor assumes
no responsibility for distributing Physical Materials to the state of Michigan Licensee locations.
2. Licensor's Rights
2.1 Notwithstanding the rights granted in Article I hereof, Licensee acknowledges that all right,
title and interest in the Physical Materials, including any copyright applicable thereto, shall
remain the property of Licensor and/or the third party rights holders. With the exception of the
portion contributed by Licensee or Sublicensee in a Derivative Work of the Physical Materials,
Licensee or Sublicensee shall have no right, title or interest in the Physical Materials, including any
copyright applicable thereto, except as expressly set forth in this Agreement.
2.2 Any rights not granted hereunder are reserved by Licensor and/or the third party rights holders.
2.3 As of Licensor's present knowledge, MSU Extension (which is a unit within Licensor) is the
copyright holder of the pizza recipe included in the Physical Materials. If Licensor is notified that
a third party is the copyright holder to the pizza recipe, Licensor will in good faith attempt to secure
the copyright rights from the third party rights holder in order for Licensor, Licensee and
Sublicensee to maintain using the Physical Materials as described in the Agreement herein. In the
event Licensor is unable to secure such rights, Licensor will use reasonable efforts to identify a
replacement for such third party material.
3. Sublicense
3.1 (a) Any Sublicense entered into hereunder (i) shall contain terms no less protective of
Licensor's rights than those set forth in this Agreement, (ii) shall not be in conflict with this
Agreement, and (iii) shall identify Licensor as an intended third party beneficiary of the Sublicense.
Licensee shall provide Licensor with a complete electronic or paper copy of each Sublicense within
thirty (30) days after execution of the Sublicense. Licensee shall provide Licensor with a copy of
each report received by Licensee pertinent to any data produced by Sublicensee that would pertain
to the report due under Section 4. Licensee shall be fully responsible to Licensor for any breach of
the terms of this Agreement by a Sublicensee. Licensee and Sublicensee may address ownership of
Sublicensee's creative contribution to Derivative Works in the Sublicense agreement.
(b) Upon termination of this Agreement for any reason, all Sublicenses shall terminate. If
a Sublicensee was in compliance with the terms of its Sublicense in effect on the date of
termination, Licensor may grant such Sublicensee that so requests, a license with terms and use _
rights as are acceptable to Licensor. In no event shall Licensor have any obligations of any
nature whatsoever with respect to (i) any past, current or future obligations that Licensee may have
had, or may in the future have, for the payment of any amounts owing to any Sublicensee,
(ii)any past obligations whatsoever, and (iii)any future obligations to any Sublicensee beyond
those set forth in the new license between Licensor and such Sublicensee.
AG R2015-01 146 3
TEC2015-0036
4. Consideration
In consideration of the rights granted herein, Licensee will provide to Licensor two effectiveness and
utilization data reports based on the use of the Physical Materials. One data report shall include:
a) number of clients who access the Physical Materials lessons; h) number of times specific lessons
are completed; c) number of unique users; d) client perceptions for usefulness and helpfulness of
lessons; and e) client beliefs in relation to ability to make changes based on lesson completion and
shall be due to Licensor two years from the Effective Date and one data report containing the
same data as described above shall be due thirty (30) days after the end of the five (5) year term.
The reports shall be sent to Mci-Wei.Chang@.ht.msu.edu and msulagrr@msu.edu.
5. Diligence
Licensee shall use its reasonable efforts to disseminate the Physical Materials in a fashion that
Licensee determines aliens with its mission in order to provide public benefit.
6. Term and Termination
6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five
(5) years unless earlier terminated in accordance with paragraph 6.2 hereof.
6.2. In the event that either Party believes that the other has materially breached any obligation
under this Agreement, such Party shall so notify the breaching Party in writing. The breaching
Party shall have thirty (30) days from the receipt of notice to cure the a Ileged breach and to notify
the non -breaching Party in writing that said cure has been affected. If the breach is not cured
within said period, the non- breaching Party shall have the right to terminate the Agreement without
further notice.
1.3 Effect of Termination.
6.3.1 Upon termination, Licensee shall cease using, distributing and displaying the Physical
Materials, and shall confirm in writing to Licensor that the Physical Materials have either been
returned to Licensor or have been destroyed (in Licensor's sole discretion). All Sublicenses shall
terminate upon termination of this Agreement pursuant to Section 3(b).
6.3.2 Upon termination, the following provisions shall survive and remain in effect; 2.1; 4; 6.3; 8.
7. Representations and Warranties
7.1 Licensor and third parties hereby represent that it has. full right, power and authority to enter
into this Agreement and to provide the license of rights granted under this Agreement.
7.2 LICENSOR, INCLUDING ITS TRUSTEES, OFFICERS AND EMPLOYEES, MAKES NO
REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL
MATERIALS AND SUBLICENSEABLE MATERIALS AND HEREBY DISCLAIMS ALL
REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT
LIMITATION, ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR
PURPOSE OR NONINFRINGEMENT. LICENSEE ASSUMES THE ENTIRE RISK
AGR2015-01 146 4
TEC1015-0036
AND RESPONSIBILITY FOR THE SAFETY, EFFICACY, PERFORMANCE, DESIGN,
MARKETABILITY AND QUALITY OF THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS.
WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE PARTIES, INCLUDING THEIR
OFFICERS AND EMPLOYEES, ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND
SUBLICENSEABLE MATERIALS AND DERIVATIVE WORKS ARE PROVIDED "AS IS";(B) NEITHER THE
PHYSICAL MATERIALS NOR SUBLICENSEABLE MATERIALS MAY BE FUNCTIONAL ON EVERY
MACHINE OR IN EVERY ENVIRONMENT; AND (C) THE PHYSICAL MATERIALS AND SUBLICENSEABLE
MATERIALS ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT IS ERROR -FREE OR THAT
LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS.
8. Limitation of Liability
8.1 Each Party acknowledges and represents that it will be responsible for any claim for
personal injury or property damage asserted by a third party and arising out of or related to its acts or
omissions in the performance of its obligations hereunder to the extent that a court of competent
jurisdiction determines such Party to be at fault or otherwise legally responsible forsuch claim.
8.2 In no event shall either Party be liable to the other Party or to any third party, whether
under theory of contract, tort or otherwise, for any indirect, incidental, punitive, consequential, or
special damages, whether foreseeable or not and whether such Party is advised of the
possibility of such damages.
9. Assignment and Transfer
Neither Party may assign, directly or indirectly, all or part of its rights or delegate its obligations under
this Agreement without the prior written consent of the other Party.
10. Dispute Resolution
10.1 In the event of any dispute or controversy arising out of or relating to this Agreement or
the subject matter hereof, the Parties shall use their best efforts to resolve the dispute as soon as
possible. The Parties shall, without delay, continue to perform their respective obligations under this
Agreement which are not affected by the dispute.
10.2 This Agreement and any disputes arising out of or relating to this Agreement shall be governed
by and construed in accordance with the laws of the State of Michigan without regard to the conflicts of
law provisions thereof. In any action to enforce this Agreement, the prevailing Party will be entitled to
recover reasonable costs and attorneys' fees.
11. Force Majeure
Neither Party shall be liable for damages or subject to injunctive or other relief, or have the right to
terminate this Agreement, for any delay or default in performance hereunder if such delay or default is
caused by conditions beyond its control including, but not limited to, Acts of God or force majeure,
government restrictions (including the denial or cancellation of any necessary license), wars,
insurrections and/or am✓ other cause beyond the reasonable control of the Party whose performance
is affected.
AGR2015-01 146 5
TEC2015-0036
12. Entire Agreement
This Agreement constitutes the entire agreement of the Parties and supersedes all prior communications,
understandings and agreements relating to the subject matter hereof, whether oratorwritten.
U Amendment
No modification or claimed waiver of any provision of this Agreement shall be valid except by written
amendment signed by authorized representatives of Licensor and Licensee.
14 Severability
If any provision of this Agreement is determined to be invalid or unenforceable under applicable law, it
shall not affect the validity or enforceability of the remainder of the terms of this Agreement, and
without further action by the Parties hereto, such provision shall be reformed to the minimum extent
necessary to make such provision valid and enforceable.
15 Waiver
Waiver of any provision herein .shall not be deemed
waiver of any breach of this Agreement be construed
same or other provisions of this Agreement,
fi[:�►RitG�
a waiver of any other provision herein, nor shall
as a continuing waiver of other breaches of the
All notices given pursuant to this Agreement shall be in writing and may be hand delivered, or shall be
deemed received within three (3) days after mailing if sent by registered or certified mail, return receipt
requested. Ifany notice is sent by facsimile, confi rmation copies must be sent by mail or hand delivery to
the specified address. Either party may from time -to -time change its notice address by written notice to
the otherParty.
If to Licensor:
Licensing Notices:
MSU Technologies
Attention: Agreement Coordinator AGR2015-01146
325 E. Grand RiverSuite 350
City Center Building
East Lansing, M148823
517-884.1605
msutagr@.msu.edu
AG R201 5-01 146
TEC2015-0036
If to Licensee:
Michigan Department of Health and Human Services, WIC Division
Attn: Kristen Hanulcik
Manager, Consultation and Nutrition Services Unit
320S.Walnut, Lewis Cass Bldg.,6'h Floor
Lansing, Ml48913
517-335-8545
hanulcikk@michigan.gov
17. Article Headings
The Parties have carefully considered this Agreement and have determined that ambiguities, if any, shall not
be construed or enforced against the drafter. Furthermore, the headings of Articles have been inserted
for convenience of reference only and shall not oontrol or affect the meaning or construction of any of the
agreements,terms, covenants orconditions of this Agreement i nanymanner.
18 Relationship of Parties
Licensor and Licensee each acknowledge ;and agree that the other is an independent contractor in the
performance of each and every part of this Agreement and is solely responsible for all of its employees and
students and such Party's labor costs and expenses arising in connection therewith. The Parties are not
partners, joint venturers orotherwise affiliated, and neither has any right or authority to make any statements,
representations or commitments of any kind, orto take any action, which shall be binding on the other Party,
without the prior written consent ofsuch other Party.
(remainder of page intentionally left blank)
AG R2015-01 146
TEC201 5-0036
IN WITNESS WHEREOF, the Parties have executed this Agreement by their respective, duly
authorized representative as of the date first above written.
LICENSOR: Michigan State University
Signature on file Date: 10/15/15
By: Dr. Richard W. Chylla
Executive Director, MSU Technologies
LICENSEE: State of Michigan Department of Health and Human Services Women; Infants &
Children
Signature on file
By: Kim Stephen Date: 10/16/15
Bureau of Purchasing
Michigan Department of Health and Human Services stephenk@michigan.gov
517-241-1196
Signature on file
By: Stan Bien, Director Date: 10/16/15
WIC Division
Michigan Department of Health and Human Services
320 S. Walnut, Lewis Cass Bldg., 6th Floor
Lansing, M148913 biens@michigan.gov
517-335-8448
AGRZO 15-Ql 146
TEC2QI5-0036
Schedule A
Physical Materials
I. Client Materials
A. Mothers in Motion intervention materials
1.260 sets packaged in Mothers in Motion bag. One set includes:
d. I Mothers in Motion DVD set (I set is comprised of 3 DVDs)
n. I looped DVD of Mothers in Motion Overview and Introduction
�. Folder containing Mothers in Motion worksheets (e.g., "Goal and Plans" and
'Where Do I Go from Here?" worksheets, and stress log) and
reference/guidance sheet detailing contents of each Mothers in Motion lesson
(Total of11lessons)
d. 1 CD containing PDF formatted documents of Mothers in Motion worksheets to
accommodate additional printing needs.
2. All Mothers in Motion intervention materials listed above will also be saved on 2
external drives provided by WIC.
il. Staff Materials
A. "Rethinking How We Listen and Respond in WIC" Videos/DVDs
1. 260 "Rethinking How We Listen and Respond in WIC" DVDs [included in Mothers
In Motion bag described above (I DVD per bag)]
2. "Rethinking How We Listen and Respond in WIC" contents saved in video format
on 2 external drives provided by WIC
**All Items listed above will be saved on total of 4 external drives, provided by WIC"*
AG R2015-01146
TEC2015-0036
Schedule B
Materials Modification Guide
I. Client Materials 1
A. Mothers In Motion DVD
1. The following Items are NOT permitted to be altered on DVDs
a. DVD content
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2)
iii. All lesson module and intervention content [exception: food label reading if
contents become outdated]
iv. Acknowledgement section
v. Copyright notice
b. Label on Disks*
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2)
iii. Title of each lesson
iv. Copyrightnotice
2. Items that may be reproduced
a. Mothers in Motion DVDs
b. CD contains all Mothers in Motion worksheets
B. Mothers In Motion Worksheets
I. The following items are NOT permitted to be altered on worksheets
a. Grant number(NIH-NIDDK, IR18-DK083934-01A2)
b. Mothers In Motion logo
c. Title of each lesson
d. Copyright notice
2. The following items are permitted to be altered on Worksheets
A. Contents in the worksheets
3. Items that maybe reproduced
a. All worksheets
b. Reference/guidance sheet detailing contents of each Mothers In Motion lesson
II. Staff Materials 1
A. 'Rethinking How We Listen and Respond in WIC" Videos/DVD I. Items that are NOT
permitted to be altered on DVD
a. DVD content
i. MSU and Mothers in Motion logo
ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2)
iii. Acknowledgement section
iv. Video/DVD Contents
v. Copyright notice
b. Label on Disks"
i. MSU and Mothers in Motion logo
ii. Grant number(NIH-NIDDK, 1RI8-DK083934-01A2)
iii. Title of each lesson
iv. Copyright notice
AG R2015-01 146
TEC2015-0036
10
*WIC is allowed to duplicate DVDs without label orgrant number on the disks, if necessary. 1 Sublicensee
may create content that supports the implementation of the content contained in the
Mothers in Motion DVDs, Mothers in Motion Worksheets and "Rethinking How We Listen and Respond in
WIC"Videos/DVD. Any content created solely by Sublicensee shall be owned in accordance with Section
1.2 and Section 3.1(a). Implementation of the content contained in the Mothers in Motion DVDs, Mothers in
Motion Worksheets and "Rethinking How We Listen and Respond in WIC' Videos/DVD shall be in
accordance with Section 1.2.
AGR2015-01 146
TEC2015-0036
Dissemination Uveme Agreerasent for°PCommunicate to 14fotivate"
Among
Michigan State University,
Ohio Stake lunovallon Naundaation
Aad
Michigan Deperitritnt of Health and Hunan Services
Ar nckirbi$eta 9
rl (j ud � - 99 t -� S-
This License Agreement ("AgreemenC'}, effective as of January 1,200 (El%etiv+x i�ata"}, is arcade by
and m ong Michigan State University, having offices at 325 E. Grand River, Suite 350, East Litasior,
MI 48923 (" NISU"j Ohio Strata (renovation poundatlon, having offices at 1524 R High Slut,
Columbus„ OH 43201 C'OSIF" (together " Lieeasor) and State of Michigan DeparWmerrt of Heafth and
kurman Services Women, Infants and Children, havingg offices at 120 S. Walnut, Lansing, MI 48913
("Licensee") (individually a "Party" and collectively, thin"Part#es").
WHFREAS, Licensor has int0tectuat property rights In the"Coo rrutnicato to Miotivate"maleriats
(herein, "Physical Miatariats"), MSSU reference number TEC20t64179, OSU reference number T2017-
132, developed utilizing funds front a grant from the National Institutes of 1 iealth (hill), grant number
Rl8-DK-D93't34.0l t"Chant"j,
WHEREAS, Licensor is the owner orca rtaln rights, title and interest in the Physical Materials and has
ahe light to grant licenses thereto der.
WHCRFAS, Licensze Nvishes to license the Physical Materials fordisseminatiun purposes and Licensor
;irsires to grant .such license to Liccnsm on the terms and conditions herein,
NOW 1-HER-1 I;OR , the Parties agree as follows,
€. Deiinittone.
a. "Physical h7atarials shall mean ail Physical items listed in Schedule A.
b. "Subl'icensublo Mtateritits,' shall mean one clecuceflie copy of the Physical Materials.
c, "Materials Modination Oulde" shall mean the speciflcutlans outlined in Schedule H.
d " Deriltativa Works"' means all works devateped by Licensee or Sublicemco which would be
chitmotcrized as derivative works of the Physical Materials awyor suuhlleansable Materials under
the United States Copyright Actor 1,476,or subsequent revisions thereof, spscilically #nctuding,
bat not limited to, translations, abridgments, coudepsadons, rccastings, ttnrlsfoitaiat#ons, or
adaptations thereof, or uvarks consiuina orcditariat revisions, annetallons, elaborations„ or other
modifications thereof. The term "Dcrivalive Work" shell not include thane derivatvs works
which ate developed by Licensor,
e, "Sublicense means an agreement which may take the form or, but Is not limited to, a
sublicense agreement, memorandum of understanding, orspcc3el provisions added as an
amersdment to an eitisting agreement between Licensee and it Sublicensee in which Licensee
Vents orothctay#se ltar"krs imy of the rights licensed to Licensee hereunder or other rights that
axe relevant to using the Sublicenssbic Mvttcrlals.
1. GrEat of License
Ll Sgbject to the terms and conditions of this Agreemenl, to the extent that Licensee"s rights to
Physical lvlatcrials as a result of Liccnsor's grant Of rights to the Federal teovernment in uccord.satcc with
ON: fimns and conditions of the Gum ale insufitciem for Licensee's activities harerrodtr, Licensor
hereby grans to ! itensce a nwxclnsive, nontransferable, worldwide, license to use, ptrfonn,
reproduce, pubtically display the Physical Materials. Licensee is granted die limited sight to create
Derivative R'ntks of the Physical Materials, specifically Liccaisec shall have the right to create
Derivative )Vorks which are (a) companion guideoce handouts to the Physical Materials for educational
use by Instrietors in rite course of employing Physical Materials, (b) materials for promotion of the
availability of educational opportunities employing the Physical Materials, and (c) instmirwas for
collecting evaluations and feedback from course partic'ipmrts. Notwithstanding the foregoin& Licensee
may only disiribwe the Physical Materials within Lictasctyumsged locations within the state of
Michigan, Licensee is not permited to sell or teceive consideration for any of the Physical Materals or
reproductions of the Mysical h4flw.riais.
1,Z, Licensor grains Licensee the right to grant Subilccnaes of its rights imdcr Scetion 1.1 of the
Sublicensoble Nlawriaas to Suleiicrosce Sur the sole parposir of placing the content contained in the
Subllcensable Materials (°secluding the videos) are a wcbslte that is controlled by Suhlicrrnscc and that is
access Iimitnd„ password protreied. Any Subticenso shall be In aecordanca with Article 3 below,
Sublicensee is net permitted to sell or receive consideration for the Sublicensable Materials In any
format, Amy content created solely by uvubiicens,-c that supports the Implementation ofthe Subiicensgble
Materals shall be owned by Sublicensee.
1.1 In such incidences. where, for financial reasons, Licensee is no, able to reprodtue the label
disphtyed on the original master copy of the DVD portion of the Physical ivtatedals, Licensee must
ensure that the entire cmient of the DVD portion of the Physical Materials are teproduced ht itstntitety
so that the inotusion or the copyright notice, grant number inrortrrntiom title or each lesson, and
ee nnowiedgements arc maintained.
IA Licensee will refrain: and shall require Subliteraces to Pewn, from u3iag the Rune: of the
Licensor or The Ohio Stnte University ("OSU") in publicity of advertising vrlthartt the prior written
approval of Liceosar,
I l lctatsor shall provide Physical Materials to Licensee by May 1, 2017. Licensor assumes no
responsibility far distributing Physical Matcrials to the stale of Michigan Licensee locations.
2. Lictn5or'a Rights
2.1 Notwithstanding the rights granted In Article I hereof, Licensee acknowledges that all right, title
and interest in the Physical Materials, iiwlud*tug any copyright applicable thereto, shall remain ate
property of Licensor, Licensee or Subticensee shall have na right, title or interest itr the Physical
Materials, incitrtiing any copyright applicable thereto, except as expressly Bet forth in this Agreement.
2,2 Any rights not granted hereunder are reserved by Ucerrot,
1 Subitcesae
3.1 (a) Any Sublicense entctad into hVICunder (i) Shall I eonfaiu teams nil less protective of
Licenser's rights than those set forth in this Agreement, (ii) shall not he ire conflict with this
AORUTt7.40453 2 OSt1A2a17-kt7x
1EM Ms,ut7s
rlgreeruanL and (40 shall ideotiry Licenser as an Intended third party beneficiary of *10
Subl'.011n5c. Llezrtsee shall provide License€ wills a complete elechtn3c ur paper copy of each
Subltcense within thirty (30) days after exccut:on of the Sublicense. Licensee Shall provide
Licensorwill acopy of each mport received by Licensee pertinent to any data produced by
Sublieensee that would pertai n to the report slue under Section 4, Licensee shall be fully
responsible to Licensor for tiny breach of the icuns of this Agreemem by a Subliccnsee,
(b) upon termination of this Agreettaeni for any reason, all Subliccnscs shall tcrmhutric, If a
Sublicrnsee was in compliance with the terms of its SuMcetase its affect on the date of
temdraithm, licensor may grant such Subllcenwe that so requests, a license with Terms and use
Tights as ore acceptable to L€ccosor. In no event shall Licensor have any obligations of any
nature whatsoever with respect to (i) any past, curcnT or future obligations That Lieeosec may
have had, or may in the iuturc have, for the payment of any amounts owing to any Sublicensce,
(ii) any post obligations whstsonver, and (iii) any fixture obligations to any Soblicensce beyond
those set forth In the new license between I,iceresor and such Sublie-mcc.
4Conslderatlun
Incorasidetadon of the rights granted herein, Licence will provide in Licensor two oaf ectivtness and
uallrats"on data reports based nn the ose of the Physical Materials, One data report shall include: a)
number of clients who access the Physical Materials Icssnns; b) number oftimes speolfc lcaysons are
competed; c) munbarof unique users; d) client perceptions for usefulness and helpfulness of lessons-,
and o) client beliefs in relation to ability to snake changes based on lesson completion anal shall be date to
Licensor two years from the Effective Date and one data report containing the saute data as described
above ahall ba due thirty, (30) days after the end of the five (5) year term. Such data reports shall
segregate the #nfornealfon pmvidvd in a-o by CPA (dletilians and nwscs) or breasifcrding parr
counselors. The reports shall he sent in chengl572@a%,edu, Innavaalorff8'a-u-cdu and
msutagr@msu.edu.
S. Diligence
Licensee shall use its reasonable efforts ta disseminate lite Physical sW+lateriais in a fashion Thai Licensee
deminnlnesaligns with its mission in orderlo provide public benefit.
61 Term and Termination
6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five (5)
years unless earlier tesrttinated in accordance with paragraph 6.2 hereof: 7"11is Agreement may be
renewed or extended by written arnendmeni signed by authorized reproomatlyos of Licensor and
Licensee in accordance with Africk 11
6.2. In the event tbat a Party believes that another Party has materially breached any obliSatimr under
this Agreement, such Party shall to notify the breaching Partyin writing. The breaching party shalt have
thirty (30) days from the mcaipt of notice to cure tic alleged breach and to notify the non-brcachhrp
Party in writing tlsat said cure has been affected, if the breach is not cured within said period, the non -
breaching Party shall have the right to tcunlnaie the Agreement without furthernotIm
63 Effect of Termination.
ACR2O17.00413 Z OSU A20174172
"t'fiR 016.O17H.
6.3.1 Upon tenninalion, Liccrtsea shall cease using, dwribotit<g and displaying the Physical Materials,
curt shall confirm In writing to Licensor chat the Physicsl Materials have cithor been returned to Licensor
or have been destroyed (in Licensot'S sole disCrerien)- All Sublicanscs shall ¢errrinale qon teralnation
of this Agro-went pursuant to Section 3(b).
632 Upon termination, the following provisieas shall survive and remam in effect: 2.1; 4; d, 3; 8,
7, Representations and Warrandes
7A Licensor represents that to the knowledge. of The Ohio State Unimsity"s and MSU's technology
transFcroff€ccs that it has r'ull sight, powor and authority to enter into this Agreement and to provide the
ll+xnu of dgbts granted under this Agreement,
7.2 LICENSOR AND OSU, INCLUDING THEIR CREATORS, TRUSTEES, OFFICL'M
EMPLOY, AGENTS OR AFFILIATED FNTE"RISES MAKE NO REPRESENTATIONS OR
WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL MATERIALS AND
SUBLICENSABLE MATERIALS AND HEREBY DISCLAIM ALL. REPRESENTATIONS AND
WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY
WARRANTIES OF MEIRCHANTAWLITY OR FITNESS FOR A PARTICULAR PURPOSE,
NONINFRINGETa ENT, SAi ETY, EFFICACY, APPROVAHILITY 13Y AEOULATORY
AUTI ORATIFS, TIME AND COST OF DEVELOPMENT, OR PATENTABILITY. LICENSEE
ASSUMES THE ENTIRE RISK AND RESPONSMILITY FOR THE SAFETY, 'EFFICACY,
PERFORMANCE, DESIGN, NVJLK,ETABILITY AND QUALITY OF THE PHYSICAL
MATERIALS AND SUBLIMNSABLE MATERIALS. WITHOUT LIMITING THE GENERALITY
Glt THE FOREGOING, 'CfiiE PARTIES, INCLUDING THEIR OFFICERS AND VMPLOYEES,
ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND SUBLICENSAELE
MATERIALS ARE PROVIDED "AS tS"; (6) NEITHER THE PHYSICAL MATERIALS NOR
SUBLICENSABLE MATERIALS MAY RR FUNCTIONAL ON EVERY MACHINE OR IN EVERY
ENVIRONMENT; AND (C) T14F PHYSICAL MATERIALS AND SUBLICENSABLE MATEMLS
ARE PROVIDED WITHOUT ANY WARRANTIES TFAT IT IS ERROR -FREE OR THAT
LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS,
S. Limitation ofLlabitity
S.t Each Percy acknowkdges and represents that It tvitl be m-%pnasIhlc for mry claim for p onnt
Injury or property darnmge asserted by a third patty and arising out or or related to its acts or omissions
lathe periorrnance of its obligations hereunder w the extent that a court of ootnpetent jurisdiction
detenrtirtes such Patty to beat likult or ❑ herwise legally responsible for such claim. Nothlug in this
Agreement shell be deemed ortrooted as arty waiver of any party's auverelgn Imnsuttity or inununiiy
granted by statuto or case taw, if apptleable.
8.2 In no event shall a Party be liable to another Party or to any third party, whether under theory of
contract, tort or otherwise, for any indirect, Incidental, punitive, consequential, or speciel darnages.
whethtr fanese.eeble or not and wheti:ar such Party is advised of the possibility of such derrtagcs.
9, Asvigument and Transftr
No Party may aselgn, directly or indlrartly, all or past of Its rights or delegate its obligations under this
AgMtraent without the prior written consent ofthe other Partles.
AUR2017-=45} 4 0Str A2017-1172
TSM2 16-0175'
to. Mpute Resolution
10.1 In the event of any dispute or controversy arising <mt of at relating to this Agteemera or mhe
subject matter hereof, the panics shall t:se their best ClTarts to resolve the dispute as saran as paisible,
The Parties shall, vaithou€ delay. continue to perform their respectivC. abligationa under this A me nt.
which are not affected by the dispute.
1 i, force Majeure
No Party shalt be liable for damages or subioct to Injunclive or other relief, or have the tight to ttrminate
this Agreement, for any delay or default in perfartnancc hereunder if such May or default is caused by
cottdg4ons beyond its control including, but not limited to, Acis of Und or force mtajeum government
restrictions (including the denial oresaecilation of any necessary liccrosc), wars, insurrections ar d;1or any
other eesrsc beyond the reasonable control of the Party whose performance is ai%cted.
12. Entire Agrarmnut
This Agreement constitutes the entire agtcement of the parties: and supersedes all prior cvmniunicasions,
understandings and agreements relating to the subject matter hereof whether are? of Written,
13. Amendment
No modification or claimed waiver of any provision of this Agr"rnt vt shall be valid except by vait en
artscndartent Signed hp authorized representatives of Licensor and Uceemsee.
td, Severabitity
tfany, prevision of Ws A,gteereent is determined to be invalid or uncnfocceable under app'kable low, it
ARM not affect the valldlty or enforceability of the ranndndsr of the terms of this Agreement, and
without further action by the Parties hereto, such provision shall be reformed to the miniinn" extent
rouccssary to make such provision valid and enforceable.
15. Waiver
Waiver of any provision heroin shall not be deemed a waiver of any other provision herein, nor shalt
waiver of any breech of ,his Agreement be construtd is a continuing waiver of other breaches of the
sstneor tither provisions of this Agtecmnca
16. Notices
All natlecs given pursuant to this Agreement shrill be in writing anti may be hAnd di:livered, or shall be
deemed received evathin three (3) daps after mailing sf spent by registered or Certified mail, rctsarn rcceipc
rtqucsted. If any notice is sent by faesimile, confirmation copies must be sent by mail or hand delivery
to the specified address. Esther party may from time -to -time changs its notice address by written notice
to the other party.
AGR2017.00451 j OSU A2017-1172
'rer,•mt"lcs
If in Licensor:
M*Sti 3cchnoicrrics
Avcmiom. Aan mtnt Coordinator AOR2017-09451
325 E. Cir rxi River Saito 350
City Ccnter Daitding
kost Lansing, Ml 48823
517484-1605
milta t-643im
Chia State innovation, roarndalion
1524 N High Street
Columbus, GIA 43241
614-292.1315
If to Liecttsec
Michigan Depnrimertt of Health and t-iumnn Services, NVIC: Division
Atin; KrUtert Hanulcik
Manager, Consultation and Nutrition Services Unit
320 S. Waltim Loves Coss Bldg., 61 Floor
Lansing, MI 48913
517-335-8545
hanulcikkigmichigan_gov
ll7 Article Ileadings
The Parties have corcfally considered this Agreement wel have dcietzrtined that ambiguities, if any, shnll
not taa construed or enforced against the drafler. Furnhennare, the headings of Articles have been
inserted for conacnicstce of refcrenrc only anti shall not Cam wl or a[%c_t the meaning or construction of
any ofihe agreements, terms, cavennn:s or eorWWans of ibis Agreement in any manner.
18. Relationship of Pariles
Licensor and Llcesk:ee each achrtotvledg_ and agree that the other is fin independent contructor in the
perfaimunce of each and every part of this Agreement and is solely responsible for flit of its employees
arA students and such Paxty's labor casts and uxpcnses arising in connection theretvilh. The Pailies are
not patlmrs, joint venturers or othenvise afatated, and neither has any right or authurity to make any
stateutcats, mpreseauatlons or commitments of any kind, or to take any nction, which shall be binding an
the other Party, withoul thu prior +xtiRca consent Of such ablser Patsy,
A09-20 t 7.UO453 6 OSU A20 t 7-t 172
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Physical Materials
A, Communicate to-.'ottvrara videos — kip to 10 sets in DVO format
151eswnst 12 video lessons, se€nirider and gtnemt tip lesson, introducl.ion and preview
id. Reti Wdhg w+hm we think and mpond In Wfr'video
C Tip Sheets —650copies (color print, laminatcdand call)
D_ CDs tuna contain the following materials related to CommuaNirvie to Aekf v ate saved in PDF (rap
to 14copies):
a. Tip Sheets;
h. Power point slides of 91.112 lessons, reminder aced general tip lesson;
e. Summmy of key paints in cach video !usson;
d. lastauetions for use al'the videos.
E. External hurd drives (2) thnt vantuln the following matenfuts,
a. Communtcow to Maatlwit vldens; 15 video lessons,
b� RelUnking Am the Mink rmd respond In tick video:
e, 'rip Sheets In PDF;
& Power point Mides nfall 12 lessons, rcminderaA general tip lesson in PDF;
e. Summary of keypoints in each video lesson in FDFF
t Instw6um for use of The vldeas in PDF.
AGIM €7 t53 8 OSU A2017-1 t7'd
TEC291&0178
}c edu'u B
Matariah modit~teatinat GUI&
ixceptas provided in 3etdo t 1.1, modif`acationofPhysical NUteriais is not pordtteaL
AtiMOE7.00453 9 OStl.A8DM t
TS=01"i7n
FY 2022 MDHHS LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND
AND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Data Universal Numbering System (DUNS) #: 088746458
This Agreement is made between Oakland County, a ConstltubonaI Corporation, 1200 North Telegraph,
Pontiac, Michigan 48341 ("County") and Oakland Livingston Human Service Agency (OLHSA), 196
Cesar E Chavez Ave., Pontiac, Michigan 48343-0598, a Michigan Municipal Corporation
("Subrecipient") The County and Subrecipient shall be collectively referred to as the"Parties."
PartI
Purpose
The Parties enter into this Agreement for the purpose of delineating their relationship and
responsibilities regarding the County's use of Grant funds to reimburse the Subrecipient to
implement WIC Resident antl WIC Breasffeeding Peer Counsehng Services
The County has entered into a Grant Agreement with the State of Michigan (State) where the
County is eligible to receive reimbursement for facilitating the delivery of public health services
to the citizens of Michigan within its jurisdiction
The County intends to use a portion of the Grant funds to reimburse the Subrecipient, as
described below, subject to the terms and conditions of this Agreement
In consideration of the mutual promises, obligations, representations, and assurances in this
Agreement, the Parties agree to the following:
Period of Agreement:
This Agreement will Commence on October 1, 2021, and continue through September 30, 2022
No service will be provided and no costs to the County will be incurred by the Subrecipent outside
the Period of the Agreement This Agreement is in full force and effect for the period specified
Proaram Budget and Agreement Amount:
A Agreement Amount
FY 2022 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKUINDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSAI
Page 1 of 19
The total amount of the federal award committed to the Subrecipienl under this
Agreement is not to exceed $602,480 and is allocated as follows'
• $84,867 00 — WC Breasffeeding Peer Counseling and reflects a budget
submitted by OLHSA and approved by OCHD and State WC to fund $84,867 for
L5 FTE peer counseling lime and does not Include Supervisor or mentor time
• $517,613— WC Resident Services and reflects a budget submitted by OLHSA and
approved by OCHD and State WIC to achieve an average monthly caseload of
3,537
Any adjustment to the total amount of this Agreement, must be made in writing and
executed by all parties to this Agreement before the modifications can be implemented.
The grant Agreement is designated as a
X Subrecipienl relationship (federal funding), or
Recipient (non-federal funding)
The grant Agreement is designated as.
Research and development project; or
X Not a research and development project
R Identification of Federal Dollars'Awarded
CFDA Title Special Supplemental Nutrition Program for Women Infants and Children
CFDA Number 10557 1mckay-cmaaom
12021-09-0720 14 54
Award Name Women Infants and Children Award N Number (FAIN). 202M 1013W5003 (Breasifeed Ing P Wailing for the state to provide updated
information
Award Date 21l8/20
Award Number 212M1003W1003 (WICADMIN)
Award Date10/10/20
Federal Agency Name USDA Food and Nutrition Services --------------------------------------------
Awarding Official Contact Information:
Period of Performance October 1, 2021 through September 30, 2022
Pass Through Entity(PTE) Michigan Department of Health& Human ServiCea(MDHHS)
MDH H S Indirect Cost Rate 10%De Minimis
FV 2022 MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKIANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 2 0119
Commented IMIHRI]: The state still has not sent it
and was planning to when they received it
Equipment Purchases and Title
Subreciplent will not purchase capital assets or equipment using funds from this
Agreement without the approval of the County
4. Statement of Work:
The Subreciplent agrees to undertake, perform and complete the services described in Attachment
A, which is part of this Agreement through reference.
5. Ejprnriat Reradrementr
The financial requirements shall be followed as described in Part II of this Agreement and
Attachments B 1 through B4, which are part of this Agreement
6. Performance/Prnnrpcs Renof RemriremenfA,
The progress reporting methods shall be followed as described in Part II and Attachment C,
which are part of this Agreement.
7. General Provisions:
The Subreciplent agrees to comply with the General Provisions outlined in Part II, which are part
of this Agreement The Subreciplent also agrees that it will comply with all of the terms and
conditions of the County's Grant Agreement with the State, which is Included and incorporated
Into this Agreement as Attachment P
8. Administration ofthe Agreement:
The person acting for the County in administering this Agreement (hereinafter referred to as the
Project Manager) Is Lisa McKay-Chiasson, Public Health Administrator (248) 858-1395 mckav_
chiassonl onoakoov com
9. Subrec'o'ent'sFinancal Contact for the Aareement:
The person acting for the Subreciplent on the financial reporting for this Agreement is
Name: Charles Blake, Deputy Director for Financial Compliance
E-Mail Address: Charlestai lhsa ora Telephone No.: (248)209-26321210-8025
FY 2022 MOHHS LOCAL HEATH DEPARTMENT COMPREHENSIVE AGRI
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 3 of 19
10. Special Conditions:
A This Agreement is valid upon approval and execution by the County and Signature by the
Subrecipient
This Agreement is conditionally approved subject to and contingent upon the availability
of funds
The County will not assume any responsibility or liability for costs incurred by the
Subrecipient prior to the signing of this Agreement Upon signature by all parties, the
Agreement shall be effective for the period specified in Section 2 , Period of Agreement
above
Part It General Provisions
Responsibilities- Subrecipient
The Subrecipient in accordance with the general purposes and objectives of this Agreement
shall
A. Royalty Free Rights to Use Software or Documentation Developed
Agree that the federal government reserves a royally -free, non-exclusive, and
irrevocable license to reproduce, publish, or otherwise use, and to authorize others to
use, for federal government purposes, the copyright in any work developed under a
grant, Subpart, or contract under grant or subgrant or any rights of copyright to which
a contractor purchases ownership
B. Fees
Guarantee that any claims made to the County under this Agreement shall not be
financed by any sources other than the County under the terms of this Agreement If
funding is received through any other source, the Subrecipient agrees to budget the
additional source of funds and reflect the source of funding on the Financial Status
Report.
C. Grant Program Operation
Provide the necessary administrative, professional, and technical staff for operation of
the grant program The Subrecipient must obtain and maintain all necessary licenses,
permits, and insurances under Part II 1 L, and any other authorizations necessary for
the performance of this Agreement
D. Reporting
Utilize all report forms and reporting formats required by the County at the effective
date of this Agreement and provide the County with timely review and commentary on
any new report forms and reporting formats proposed for issuance thereafter
FY 1022 MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKIANDANO
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 4 of 19
E. Record Maintenance/Retention
Maintain adequate program and fiscal records and files, Including source
documentation, to support program activities and all expenditures made under the
terms of this Agreement, as required The Subrecipient must assure that all terms of
the Agreement will be appropriately adhered to and that records and detailed
documentation for the grant protect or grant program Identified in this Agreement will
be maintained for a period of not less than four years from the date of termination, the
data of submission of the final expenditure report or until litigation and audit findings
have been resolved This Section applies to Subrecipient, any parent, affiliate, or
subsidiary organization of Subrecipient, and any subcontractor that performs
Agreement activities in connection with this Agreement
Audit and Access to Records
Subrecipient certifies by signing this Agreement that it complies with regulations set forth
in Title 2 Code of Federal Regulations (CPR) Part 200 and will provide notice of the
completion of required audits and any adverse findings which impact this subaward as
required by parts 200 501-200 521, and will provide access to records as required by
parts 200.336, 200.337 and 200 201, as applicable The County, MOHHS or federal
agencies may also conduct or arrange for "agreed upon procedures" or additional audits
to meet their needs
G. Notification of Modifications
Provide timely notification to the County, in writing, of any action by its governing board
or any other funding source that would require or result in significant modification in the
provision of services, funding or compliance with operational procedures
H. Mandatory Disclosures
i disclose to the County in writing within 14 days of receiving notice of any litigation,
investigation, arbitration, or other proceeding (collectively, "Proceeding') involving
Subrecipient, a subcontractor, or an officer or director of Subrecipient or
subcontractor, or that arises during the term of this Agreement including
1 All violations of federal and state criminal law Involving fraud, bribery,
or gratuity violations potentially affecting the Agreement,
2 A cnminal Proceeding,
3 A parole or probation Proceeding,
4 A Proceeding under the Sarbanes-Oxley Act;
5 A civil Proceeding involving
a. A claim that might reasonably be expected to adversely affect
Subrecipient's viability or financial stability, or
b, A governmental or public entity's claim or written allegation of
fraud; or
FY 2022 MDHHS LOCAL HEATH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBREGIPIENT AGREEMENT BETWEEN
THECOUNTYOPOAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY IOLHSA)
Page 5 of 19
C A Proceeding Involving any license that Subrecipient is required to
possess in order to perform under this Agreement
II Notify the County, at least 90 calendar days before the effective date, of a
change in Subrecipient's ownership or executive management
I. Statement of Work Progress Reports
Submit quarterly Statement of Work progress reports to the County Project Manager by
the 15th of the month following the end of the quarter and a final report by November 15th
J. Conflict ofl.terest and Code of Conduct Standards
I The Subreapient is subject to the provisions of 1968 PA 317, as amended, 1973
PA 196, as amended, and Title 2 Code of Federal Regulations, Section
200 318 (c) (1) and (2)
ii. The Subrecipienl will uphold high ethical standards and is prohibited from.
1. Holding or acquiring an interest that would conflict with this Agreement,
2. Doing anything that creates an appearance of Impropriety with respect
to the award or performance of this Agreement;
3 Attempting t0 influence or appearing to influence any County employee
by the direct Or indirect offer of anything of value; or
4. Paying or agreeing to pay any person, other than employees and
consultants working for Subreapient, any consideration contingent
upon the award of this Agreement
iii Immediately notify the County of any violation or potential violation Of these
standards. This Section applies to Subrecipient, any patent, affbate, or subsidiary
orgamzation of Subrecipent, and any subcontractor that performs activdles in
connection with this Agreement
K. Travel Costs
L Be reimbursed for travel cost (including mileage, meals, and lodging) budgeted
and incurred related to services provided under this Agreement
f If the Subrecipienl has a documented policy related to travel
reimbursement for employees and it the Subrecipient follows that
documented policy, the County will reimburse the Subrecipient for travel
.,is at the Subrecipient's documented reimbursement rate for
employees Otherwise, the State of Michigan reimbursement rate for
applies
2. State of Michigan travel rates may be found at the following website
help //www michigan gov/dtmb/0 5552 7-150-9141_13132- 00 html.
3. International travel must be preapproved by the County and item¢ed in
the budget
FY 2022 MDHHG LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANOAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 6 of 19
L. Insurance Requirements
t. Maintain a minimum of the insurances or governmental self insurances listed
below and be responsible for all deductibles All required Insurance or self-
insurance must
1. Protect the stale of Michigan and the County from claims that may arise out
of, are alleged to ariseout of, or result from Subreapient or a
subcontractor's performance,
2 Be primary and non-contnbuling to any comparable liability Insurance
(including self -Insurance) carried by the slate and County; and
3. Be provided by a company with an A.M Best rating of "A" or better and
a financial size of VII or better
Insurance Types
1 Commercial General Liability Insurance or Governmental Self -
Insurance Except for Governmental Self -Insurance, policies must be
endorsed to add "the County of Oakland, and its officers, directors,
employees, appointees, and commissioners' and "the state of Michigan,
Its departments, divisions, agencies, office, commissions, officers,
employees, and agents" as additional Insureds using endorsement CG
20 10 11 05, or both CG 2010 12 19 and CG 20 37 12 19
2 If the Subreapient will Interact with children, schools, of the cognitively
impaired, the Subreapient must maintain appropriate Insurance
coverage related to sexual abuse and molestation liability
3 Workers' Compensation Insurance or Governmental Self -Insurance
Coverage according to applicable laws governing work activities Policies
must include waiver of subrogation, except where waiver is prohibited by
law.
4 Employers Liability Insurance or Governmental Self -Insurance
5. Privacy and Security Liability (Cyber Liability) Insurance cover
information security and privacy liability, privacy notification costs,
regulatory defense and penalties, and websde media content liability.
III. At all times during this Agreement, the Subrecipient shall obtain and maintain
insurance according to this Section and the specific County requirements listed in
Attachment E, which is incorporated into this Agreement
IV Subrecipient must require that subcontractors maintain the required insurances
contained in this Section
V. This Section is not intended to and IS notto be construed in any manneras waiving,
restricting or limiting the liability of the Subrecipient from any obligations under this
Agreement
VI. Each Party must promptly notify the other Party Of any knowledge regarding an
FY 2022 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAHIANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY IOLHSAI
Page 7 of 19
occurrence which the notifying Party reasonably believes may result in a claim
against either Parry. The Parties must cooperate with each other regarding such
claim
M. Fiscal Questionnaire
I. Submit yearly fiscal questionnaire to the County by the 15th of December
It. The fiscal questionnaire template will be provided by Oakland County Fiscal
Services
N. Criminal Background Check
i Conduct or cause to be conducted a search that reveals information similar or
substantially similar to information found on an Internet Criminal History Access
Tool (ICHAT) check and a national and state sex offender registry check for each
new employee, employee, subcontractor, subcontractor employee, or volunteer
who, under this Agreement, works directly with clients or has access to client
information.
1. ICHAT, hlto://aoos michiaan oovhchal
2. Michigan Public Sex Offender Registry:hftp//www mipsor slate Turns
3. National Sex Offender Registry: TUD //www.nsoow Gov
11. Conduct or cause to be Conducted a Central Registry (CR) check for each
employee, subcontractor, subcontractor employee, or volunteer who, under this
Agreement, works directly with children
1. Central Register hftos //www michiaan cov/mdhhs/0 5885 7-339-
73971 7119 50648 48330-180331-00 hunt
Ili. Require each new employee, employee, subcontractor, subcontractor employee,
or volunteer who, under this Agreement, works directly with clients or who has
access to client information to notify the Subrectpient in writing of criminal
convictions (felony or misdemeanor), pending felony charges, or placement on the
Central Registry as a perpetrator, at hire or within 10 days of the event after hiring
iv. Determine whether to prohibit any employee, subcontractor, subcontractor
employee, or volunteer from performing work directly with clients or accessing
Client information under this Agreement, based on a positive ICHAT response or
reported criminal felony conviction or perpetrator identification
V. Determine whether to prohibit any employee, subcontractor, subcontractor
employee, or volunteer from perfonning work directly with children under this
Agreement, based on the results of a positive OR response or reported perpetrator
identification.
Vi Require any employee, subcontractor, subcontractor employee or volunteer who
FY 2022 MONKS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND UVINGSTGN HUMAN SERVICE AGENCY 10LHSA)
Page 8 cf 19
may have access to any databases of Information maintained by the federal
government that contain confidential or personal Information, including, but not
limited to, federal tax Information, to have a fingerprint background check
performed by the Michigan Stale Police
Responsibilities - County
The County in accordance with the general purposes and objectives of this Agreement will.
A. Reimbursement
Provide reimbursement in accordance with the terms and conditions of this Agreement
based upon appropriate reports, records, and documentation maintained by the
Subrecipient
B. Report Forms
Provide any report forms and reporting formats required by the County at the effective
date of this Agreement, and pmvide to the Subrecipient any new report farms and reporting
formats proposed for issuance thereafter at least 90 days prior to their required usage in
order to afford the Subrecipient an opportunity to review.
Assurances
The following assurances are hereby given to the County'
A. Compliance with Applicable Laws
The Subrecipient will comply with applicable federal and stale laws, guidelines, rules and
regulations in carrying out the terms of this Agreement. The Subrecipient will also Comply
with all applicable general administrative requirements, such as Title 2 Code of Federal
Regulations (CFR) covering cost principles, grant/agreement principles, and audits, in
carrying out the terms of this Agreement. The Subrecipient will comply with all applicable
requirements in the original grant awarded to the County. The County may determine that
the Subrecipient has not complied with applicable federal or state laws, guidelines, rules,
and regulations in carrying out the terms of this Agreement and may then terminate this
Agreement under Part II, Section 4, G Agreement Termination
B. Anti -Lobbying Act
The Subrecipient will Comply with the Anti -Lobbying Act, 31 USC 1352 as revised by the
Lobbying Disclosure Act of 1995, 2 USC 1601 el seq, Federal Acquisition Regulations
5220311 and 52.203.12, and Section 503 of the Departments of Labor, Health and Human
Services and Education, and Related Agencies section of the current FY Omnibus
Consolidated Appropriations Act. Further, the Subrecipient shall require that the language
of this assurance be included in the award documents of all subawards at all tiers (including
subcontracts, subgrants, and contracts under grants, loans and cooperative agreements)
and that all subrecipients shall certify and disclose accordingly
C. Non -Discrimination
1 The Subrecipient must comply with MDHHS's non-discrimination statement. The
Michigan Department of Health and Human Services will not discriminate against any
individual or group because of race, sex, religion, age, national origin, color, height,
FY 2022 WERE LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 9 of 19
weight, marital status, gender identification or expression, sexual orientation, partisan
considerations, or a disability or genetic Information that is unrelated to the person's
ability to perform the duties of a particularlob or position The Subrecipient furtheragrees
that every subcontract entered into for the performance of any contract or purchase
order resulting therefrom, will contain a provision requiring non-discrimination in
employment, activity delivery and access, as herein specified, binding upon each
subcontractor This covenant is required pursuant to the Elliot -Larsen Civil Rights Act,
1976 PA 453, as amended, MCL 37 2101 at sag , and the Persons with Disabilities Civil
Rights Act, 1976 PA 220, as amended, MCL 371101 et sag , and any breach thereof
may be regarded as a material breach of this Agreement
II The Subrecipient will comply with all federal statutes relating to nondiscrimination
These include but are not limited to:
1, Title VI of the Civil Rights Act of 1964 (P L 88-352) which prohibits
discrimination based on race, color or national origin,
2. Title IX of the Education Amendments of 1972, as amended (20 U S C
§§1681-1683, and 1685-1686), which prohibits discrimination based on
sex,
3. Section 504 of the Rehabihtation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination based on disabilities,
4. The Age Discrimination Act of 1975, as amended (42 U S C §§6101-
6107), which prohibits discrimination based on age,
5. The Drug Abuse Office and Treatment Act of 1972 (P L. 92- 255), as
amended, relating to nondiscrimination based on drug abuse,
6. The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment
and Rehabilitation Act of 1970 (P.L 91-616) as amended, relating to
nondiscrimination based on alcohol abuse or alcoholism,
7. Sections 523 and 527 of the Public Health Service Act of 1944 (42 U S C.
290dd-2), as amended, relating to confidentiality of alcohol and drug
abuse patient records;
B. Any other nondiscrimination provisions in the specific statute(s) under
which application forfederal assistance is being made; and
9. The requirements of any other nondiscrimination statute(s) which may
apply to the application
Ili. Additionally, assurance is given to the County that proactive efforts will be made to
identify and encourage the participation of minority -owned and women -awned
businesses, and businesses owned by persons with disabilities in contract
solicitations. The Subrecipient shall incorporate language in all contracts awarded
under this Agreement which (1) prohibits discrimination against mmorily-owned and
women -owned businesses and businesses owned by persons with disabilities in
subcontracting; and (2) makes discrimination a material breach of contract
FY 2022 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page is of 19
D. Debarment and Suspension
The Subrecipient will comply with Federal Regulation, 2 CFR part 180 and certifies to the
best of Its knowledge and belief that it, its employees and Its subcontractors'
i Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from covered transactions by any federal department or
contractor,
it Have not within a five-year period preceding this Agreement been convicted of or
had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a
public (federal, state, or local) or private transaction or contract under a public or private
transaction, violation of federal or state antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making
false statements, tax evasion, receiving stolen property, making false claims, or
obstruction of justice,
Ill. Are not presently indicted or otherwise criminally or civilly charged by a government
entity (federal, slate or local) with commission of any of the offenses enumerated in
section 2,
iv. Have not within a five-year period preceding this Agreement had one or more public
transactions (federal, state or local) terminated for cause or default, and
V. Have not committed an act of so serious or compelling a nature that it affects your
present responsibilities
E. Federal Requirement: Pro -Children Act
The Subrecipient will comply with the Pro -Children Act of 1994 (P.L. 103-227; 20 USC
6081, at sag ), which requires that smoking not be permitted in any portion of any
indoorfacility owned or leased or contracted by and used routinely or regularly for the
provision of health, day care, Cady childhood development activities, education or
library activities to children under the age of 18, if the activities are funded by federal
programs either directly or through stale or local governments, by federal grant,
contract, loan or loan guarantee. The law also applies to children's activities that are
provided in indoor facilities that are constructed, operated, or maintained with such
federal funds The law does not apply to children's activities provided in pnvate
residences, portions of facilities used for inpatient drug or alcohol treatment, activity
providers whose sole source of applicable federal funds is Medicare or Medicaid, or
facilities where Women, Infants, and Children (WIC) coupons are redeemed Failure
to comply with the provisions of the law may result in the imposition of a civil
monetary penalty of up to $1 000 for each violation and/or the imposition of an
administrative compliance order on the responsible entity. The Subrecipient also
assures that this language will be included in any subawards which contain provisions
for Children's activities
FY 2022 Nome LOCAL PEALE DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BEMEEN
THE COUNTY OF OAKLANDAND
OAKLANO LIVINGSTON HUMAN SERVICE AGENCY (OLHSAI
Page 11 0l 19
it. The Subrecipient also assures, in addition to compliance with Public Law 103-227,
any activity funded in whole or in part through this Agreement will be delivered in a
smoke -free facility or environment Smoking shall not be permitted anywhere in the
facility, or those parts of the facility under the control of the Subrecipient If activities
are delivered in facilities or areas that are not under the control of the Subrecipient
(e g., a mall, restaurant or private work site), the activities shall be smoke free.
F. Hatch Political Activity Act and Intergovernmental Personnel Act
The Subrecipient will comply with the Hatch Political Activity Act, 5 USC 1501-1508 and
7321-7326, and the I ntergovem mental Personnel Act of 1970 (PL 91-648), as amended by
Till. VI of the Civil Service Reform Act of 1978 (PL 95-454) Federal funds cannot be used
for partisan political purposes of any kind by any person or organization involved in the
administration of federally assisted programs
G. National Defense Authorization Act Employee Whistleblower Protections
The Subrecipient will comply with 41 DISC 4712 and shall insert this clause in all
subcontracts
H. Clean Air Act and Federal Water Pollution Control Act
The Subrecipient will comply with the Clean Air Act (42 U S C 7401-7671(q)) and the
Federal Water Pollution Control Act (33 U S C 1251-1387), as amended
I This Agreement and anyone working on this Agreement will be subject to the Clean
Air Act and Federal Water Pollution Control Act and must comply with all applicable
standards, orders or regulations issued pursuant to these Acts. Violations must be
reported to the County
I. Trafficking Victims Protection Act
The Subrecipient will comply wch the VichmsofTrafficking and Violence Protection Act of 2000
(P L 106-386), as amended
i. This Agreement and anyone working on this Agreement will be subject to P L 106-
386 and must comply with all applicable standards, orders or regulations issued
pursuant to this Act Violations must be reported to the County
J. Procurement of Recovered Materials
The Subrecipient will comply with section 60O2 of the Solid Waste Disposal Act of 1965 (P L.
89-272), as amended
I. This Agreement and anyone working on this Agreement will be subject to section
6002 of P.L. 89-272, as amended, and must comply with all applicable standards,
orders or regulations issued pursuant to this Act Violations must be reported to the
County
K. Procurement
Subrecipient will ensure that all purchase transactions, whether negotiated or advertised,
FY 2022 MOHHs LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKIANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 12 of 19
shall be conducted openly and competitively in accordance with the principles and
requirements of Title 2 Code of Federal Regulations, Part 200 Funding from this
Agreement shall not be used for the purchase of foreign goods or services or both Records
shall be sufficient to document the significant history of all purchases and shall be
maintained for a minimum of four years after the end of the Agreement period
L. Health Insurance Portability, and Accountability Act
To the extent that the Health Insurance Portability and Accountability Act (HIPAA) is
applicable to the Subrecipient under this Agreement, the Subrecipient assures that it is in
compliance with requirements of HIPAA including the following
1. The Subreclpient must not share any protected health data and information
provided by the County that is covered by HIPAA except as permitted or required
by applicable law; or to a subcontractor as appropriate under this Agreement
II. The Subreclpient will ensure that any subcontractor will have the same obligations
as the Subrecipient not to share any protected health data and information from
the County that falls under HIPAA requirements in the terms and conditions of the
subcontract
lii. The Subrecipient must only use the protected health data and information for the
purposes of this Agreement
IV The Subrecipient must have written policies and procedures addressing the use of
protected health data and information that falls under the HIPAA requirements The
policies and procedures must meet all applicable federal and state requirements
including the HIPAA regulations These policies and procedures must include
restricting access to the protected health data and information by the Subrec pient's
employees
V The Subrecipient must have a policy and procedure to immediately report to the
County any suspected or confirmed unauthorized use or disclosure of
protected health information that falls under the HIPAA requirements of which the
Subrecipient becomes aware The Subreclpient will work with the County to
mitigate the breach and will provide assurances to the County of corrective actions
to prevent further unauthorized uses or disclosures The County may demand
specific corrective actions and assurances and the Subrecipient must provide
the same to the County
Vi. Failure to comply with any of these contractual requirements may result in the
termination of this Agreement in accordance with Part 11, Section 4, G. Agreement
Termination
vi In accordance with HIPAA requirements, the Subrecipient is liable for any claim,
loss or damage relating to unauthorized use or disclosure of protected health data
FY 2022 MONKS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY Or OAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 13 of 19
and Information, Including without limitation, the County's and/or state's costs In
responding to a breach, received by the Subreciplent from the State, County, or
any other source
Vil. The Subrenpientwlll enter into a business associate agreement should the County
determine such an agreement Is required under HIPAA.
M. Website Incorporation
The County is not bound by any Content on Subreclplent's website or other internet
communication platforms or technologies, unless expressly incorporated directly into this
Agreement The County is not bound by any end user license agreement or terms of use
unless specifically Incorporated In this Agreement or any other agreement signed by the
County The Subreciplent may not refer to the County on the Subreaplent's website or
other internet communication platforms or technologies without the prior written approval
of the County
N. Survival
The provisions of this Agreement that Impose continuing obligations will survive the
expiration or termination of this Agreement
O. Non -Disclosure of Confidential Information
The Subreclplenl agrees that it will use Confidential Information solely for the purpose of
this Agreement The Subreciplent agrees to hold all Confidential Information In strict
confidence and not to copy, reproduce, sell, transfer or otherwise dispose of, give or
disclose such Confidential Information to third parties other than employees, agents,
or subcontracts of a party who have a need to know in connection with this Agreement or
to use such Confidential Information for any purpose whatsoever other than the
performance of this Agreement The Subreciplent must take all reasonable precautions
to safeguard the Confidential Information These precautions must be at least as
great as the precautions the Subreciplent takes to protect Its own confidential or
proprietary Information
MeamnD of Confidential Information
For the purpose of this Agreement the lens "Confidential Information" means all
Information and documentation that:
f. Has been marked "confidential" of with words of similar meaning, at the
time of disclosure by such party,
2 If disclosed orally or not marked "confidential" or with words of similar
meaning, was subsequently summarized In writing by the disclosing party
and marked 'confidential" or with words of similar meaning,
3 Should reasonably be recognized as confidential information of the
disclosing party,
4. Is unpublished or not available to the general public, or
5. Is designated by law as Confidential
FY 2022 MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGRI
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND LNINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 14019
in The term 'Confidential Information" does not include any information or
documentation that was
1. Subject to disclosure under the Michigan Freedom of Information Act
(FOIA),
2. Already in the possession of the receiving party without an obligation
of confidentiality,
3 Developed Independently by the receiving party, as demonstrated
by the receiving party, without violating the disclosing parry's proprietary
rights,
4. Obtained from a source other than the disclosing party without an
obligation of confidentiality; or
5 Publicly available when received or thereafter became publicly available
(other than through an unauthorized disclosure by, through or on behalf
of, the receiving party).
IV The Subrecipient must notify the County within one (1) business day after
discovering any unauthorized use or disclosure of Confidential Information The
Subrecipient will cooperate with the County in every way possible to regain
possession of the Confidential Information and prevent further unauthorized use
or disclosure.
4. Financial Requirements
A. Requests for Reimbursement
L Invoices shall be prepared and submitted t0 the Project Manager using forms
provided by the County. Invoices must be submitted on a monthly basis, no later
than fifteen (15) days after the close of each calendar month. The monthly invoice
must reflect total actual program expenditures, regardless of the source of
funds. Failure to meet financial reporting responsibilities as identified in this
Agreement may result in withholding future payments.
II. By submitting the invoice, the individual is certifying to the best of their knowledge
and belief that the information included therein is true, complete and accurate and
the expenditures, disbursements, and cash receipts are for the purposes and
objectives set forth in the terms and conditions of this Agreement The individual
submitting the invoice should be aware that any false, fictitious, or fraudulent
information, or the omission of any material facts, may subject them to criminal,
curl or administrative penalties for fraud, false statements, false claims or
otherwise
B. Requests for an Amendment to Budget
i A request for an amendment can be submitted at any time up until June 1, 2022
I. A written request for a budget amendment with revised budget pages is required
FY 2022 MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANOAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 15 of 19
when there is a change in a budget category over $5,000 or 15 % of the category,
whichever constitutes the greater amount The deviation allowance does not
authorize new categories or line Items within the category
A determination of approval, disapproval or pending status will be sent within 10
business days or comments/questions if further clarification is required.
Submit amendment requests to Lisa McKay-Chiasson at mckay_
chiassonlilDoakcov com For questions, call 248-858-1395, Lisa McKay-Chiasson.
C. Reimbursement Method
The Grantee will be reimbursed in accordance with the staffing grant reimbursement
method as follows
Reimbursement from the County is based on the understanding that County funds
will be paid up to the total County allocation as agreed to in the approved budget
County funds are the first source after the application of fees and earmarked
sourcesunless a specific local match condition exists.
If. To request reimbursement for eligible expenditures, the Subrecipient shall submit
to the County the documentation described in the following subparagraphs with
the monthly invoice If the County, in its sole discretion, determines the
documentation submitted by the Subrecipient does not reconcile, then the
Subrecipient shall provide any additional documentation requested by the County
in order to process payment
1. A fully completed and signed invoice using Attachments D1 and D2
2. A payroll report that supports reimbursement requests for salaries and/or
fringe benefits.
3. Employee timesheets with a signature from the protect manager or
supervisor for those individuals whose time is requested for
reimbursement
4 General ledger listing qualified expenditures requested for reimbursement.
5 Receipts or invoices that include date of service, cost, and/rate for
qualified expenditures
6. Data and detail of miles traveled for allowable travel expenditures
D. Final Obligations and Financial Status Reporting Requirements
Obligation Report
The Obligation Report, based on annual guidelines, must be submitted bythe third
Friday in September using the format provided by the County. The Subrecipient
must provide an estimate of total expenditures for the entire Agreement period
The information on the report will be used to record the County's year-end accounts
FY 2022 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGRI
SURRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 16 of 19
payables and receivables for this Agreement.
Final Invoices
Final Invoices are due nine (9) days following the end of the Agreement period
The final invoice must be clearly marked "Final" Final invoices not received by the
due date may result in the loss of funding requested on the Obligation Report and
may result in the potential reduction in the subsequent year's agreement amount
E. Unobllgated Funds
Any unobligated balance of funds held by the Subrecipienl at the end of the Agreement
period well be returned to the County within 30 days of the end of the Agreement or treated
in accordance with instructions provided by the County
F. Indirect Costs
The Subrecipienl is allowed to use a 10% its mmimis rate in accordance with TNe 2 Code
of Federal Regulations (CFR) Part 200 to recover their indirect costs
G. Agreement Termination
The County may terminate this Agreement without further liability or penalty to the County
for any of the following reasons
I. This Agreement may be terminated by either party by giving 30 days written notice
to the other party stating the reasons for termination and the effective date
II This Agreement may be terminated by either party with 30 days prior written notice
upon the failure of either party to carry out the terms and conditions of this
Agreement, provided the alleged defaulting party is given notice of the alleged
breach and fails to cure the default within the 30-day period.
III. This Agreement may be terminated immediately if the Subrecipient or an official of
the Subrecipient or an owner is convicted of any activity referenced in Part 11,
Section 3,D Debarment and Suspension, ofthis Agreement dunng the term ofthis
Agreement or any extension thereof
H. Stop Work Order
The County may suspend any or all activities under this Agreement at any time The County
will provide the Subrecipient with a written slop order detailing the suspension Subrectpient
must comply with the stop work order upon receipt. The County will not pay for activities,
Subrecipient's incurred expenses or financial losses, or any additional compensation during
a stop work order
L Final Reporting Upon Termination
Should this Agreement be terminated by either party, within 30 days after the termination,
the Subrecipient shall provide the County with all financial, performance and other reports
required as a condition of this Agreement. The County will make payments to the
Subrecipient for allowable reimbursable costs not covered by previous payments or other
FY 2022 MOPING LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDAND
OAKIANO LIVINGSTON HUMAN SERVICE AGENCY tOLHSAI
Page 17 of 19
state or federal programs. The Subrecipient shall immediately refund to the County any
funds not authorized for use and any payments or funds advanced to the Subreciplent in
excess of allowable reimbursable expenditures
J. Severability
If any part of this Agreement is held invalid or unenforceable, by any court of competent
jurisdiction, that part will be deemed deleted from this Agreement and the severed part will
be replaced by agreed upon language that achieves the same or similar objectives The
remaining parts of the Agreement will continue in full force and effect.
K. Waiver
Failure to enforce any provision of this Agreement will not Constitute a waiver to enforce
any other provision of this Agreement Any clause or Condition of this Agreement found to
bean impediment to the intended and effective operation of this Agreement maybe waived
in writing by the County or the Subreciplent, upon presentation of wntten justification by the
requesting party Such waiver maybe temporary or for the life of the Agreement and may
affect any or all program elements covered by this Agreement
L. Amendments
Any changes to this Agreement will be valid only If made in writing and accepted by all
Parties to this Agreement Any change proposed by the Subrecipient which would affect
the County's funding of any project, in whole or in part of the Agreement, must be submitted
in writing to the County for approval immediately upon determining the need for such
change
M. Liability
The Subrecipient assumes all liability to third parties, loss, or damage ass result of claims,
demands, costs, or judgments arising out of activities, such as direct service delivery, to be
earned out by the Subreciplent in the performance of this Agreement, under the following
conditions
I The liability, loss, ordamage is caused by, or arises out of, the actions of or
failure to act on the part of the Subrecipient, any of its subcontractors, or anyone
directly or indirectly employed by the Subrecipient
li. Nothing herein shall be construed as a waiver of any governmental immunity that
has been provided to the Subrecplent or its employees by statute or court
decisions
The County is not liable for consequential. Incidental, indirect, or special damages,
regardless of the nature of the action
N. Governing Law
This Agreement must be exclusively governed by the laws and construed by the laws of
Michigan, excluding Michigan's choice -of -law principle. All claims related to or arising out
of this Agreement, or its breach, whether sounding in contract, tort, or otherwise, must
FY 201E MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
SUBRECIPIENI AGREEMENT BETWEEN
THE COUNTY OF OAKIANOANO
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA)
Page 18 of 19
likewise be governed excusively by the laws of Michigan, excludmg Michigan's choice -of -
law principles. Any dispute as a result of this Agreement shall be resolved in the State of
Michigan
O. Entire Agreement
This Agreement represents the entire agreement and understanding between the Padres.
This Agreement supersedes all other oral orwnften agreements between the Parties The
language of this Agreement shall be construed as a whole according to its fair meaning,
and not construed strictly for or against any Party
IN WITNESS WHEREOF, David T_ Woodward, Chairperson, Oakland County Board of Commissioners,
acknowledges that he has been authorized by a resolution of the Oakland County Board of
Commissioners, and hereby accepts and binds the County to the terms and conditions of this Agreement.
EXECUTED:
David T Woodward, Chairperson
Oakland County Board of Commissioners
DATE.
IN WITNESS WHEREOF, , acknowledges that he/she has been authonzed to
sign this Agreement on behalf of the responsible governing board oroffrcial of the Subreciprent, and hereby
accepts and binds the Subreciprent to the terms and conditions of this Agreement
EXECUTED
DATE:
Printed Name
Title:
Oakland Livingston Human Service Agency
FV 1022 MOHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT
sUERECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLANDANO
OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSAI
Page 19 or 19
Attachment A
Min mum Contractor Scoma of Sam ce Requirements
Subrecipient, in accordance with the general purposes and objectives of this Agreement, will provide
Women, Infants and Children's Program (WIC) and Peer Counseling services as follows
• Compliance with the State of Michigan WIC Division Policy and Procedure Manual (Click Here)
• Maintain confidentiality of records on clients served and allow for the sharing of client information
between the County and Contractor staff Obtain signed Release of Information forms for sharing client
information with other community service agencies/providers unless mutual aid agreements are
available from the State WIC agency.
• Cooperate with an annual site visit by OCHD and develop and adhere to a Corrective Action Plan
developed as a result of audit exceptions. The program must comply with all State and Federal audit
requirements as applicable.
• Responsible for all expenses incurred to support and maintain delivering WC services
• Coordinate with the Contract Administrator and comply with all program, financial and reporting
procedures
• Provide for secunty of Project FRESH coupons, as applicable and WIC EBT cards stored prior to
issuance. Subrecipient must notify the Oakland County Health Division WIC program and the Stale
WC Division in writing of any lost, stolen, inappropriately issued or otherwise unaccounted for Project
FRESH coupons or EBT cards, immediately upon recognition of such condition
• Maintain an Inventory of all equipment purchased with WC program funds and maintain such inventory
at each WIC clinic location
• Install and maintain WIC hardware according to guidance provided by the Department WIC Program
• Each OLHSA employee authorized for or requesting access to the automated WIC system must
complete and sign a security agreement
• Any Individual that embezzles, willfully misapplies, steals or obtains by fraud, any funds, assets or
property provided, whether received directly or indirectly from the USDA with a value of $100 or more,
shall be subject to a fine of not more than $25,000
• Provide personnel possessing at least the minimum qualifications as set by MDHHS—\MC Division, to
deliver WIC services to the identified target population
• Create an Outreach Plan per WIC policy and submit to OCHD for review and approval Implement the
plan to conduct outreach to identify and bring difficult to reach women and children into the WIC
Program from commumbes identified as undeserved by the Oakland County Health Division WIC
Program (OCHD WC)
• Provide an annual plan and corresponding budget for the delivery of WIC services and Breastleeding
Peer Counseling Services, specifically dealing with timelines and expected activity and productivity as
defined by OCHD and MDHHS WIC
. Act as a resource to additional health and human services in the community.
All matenals and advertising used to promote the WIC Program shall also include information about
WC services offered by Oakland County Health Division and refer clients to Oakland County Health
Division WIC clinics if those clinics provide the best access to services forthem
Refer all ante partum women to the Oakland County Health Division in partnership with OCHD Infant
Mortality Reduction efforts.
Breastleeding Peer Counseling (BFPC) funds distributed to State agencies by the Food and Nutrition
Service (ENS) are to be used to develop or expand acbvilies necessary to sustain a peer counseling
program based on the ENS Loving Support Model The primary purpose of the funds is to provide direct
breastfeedmg support seances through peer counseling to WC participants. The use of BFPC funds
for expenditures that are not supported by the Levine Support Model are not authorized
Funds allocated for the Breastleeding Peer Counseling Program are exempt from the WIC Nutrition
Education and Breasffeeding Time Study
Comply with MI -WIC Policy 1.07L Staff Training Plan as detailed for applicable staff as it pertains to all
State WIC training opportunities
OLHSA WIC clinic locations and dates and times of servme are listed below. Any change to location must
be approved by Oakland County Health Division by following the procedures described below
- - Clinic location
C.A.R E S of Farmington
27835 Shiawassee Rd
Farmington Hills, MI 48336
Kad Richter Center
300 East St
Holly, MI 48442
Madison Heights
711 West 13 Mile Rd.
Madison Heights, MI 48071
OLHSA Building
196 Cesar E. Chavez Ave.
Pontiac, MI 48342
Holy Cross Lutheran Church
136 S Washington
Oxford, MI 48371
1 - Service Days Open - -Hours
1"and 3-Friday Sam-4 pm
EveryTuesday Sam-4 pm
Tuesday, Wednesday and Thursday 8 am - 4 pm
and third Monday of the month
Monday, Wednesday, Thursday and 8 am-4 pm
Friday
2ntl Monday (Once a Month) 8 am -4 pm
Round remegtsf.,Relocating. Addinn gr Closing a WIC Clinic
A request to move, add or close a WIC clinic shall be submitted to OCHD in writing 60 days prior the clinic
change occumng. The written request must include;
• The reason for the move, closure or additional clinic
• Describe how many clients are impacted by the clinic change and how they will receive information
about the change in WIC services
• Identification of the proposed site
• Justification for the location being proposed including
o Analysis of caseload and how the move or addition of a clinic will impact caseload
o Documentation of need
o Number of clients estimated to be served at the location
• Location of clime including zip codes served
• Frequency of the proposed clinic
The Oakland County Health Division WIC Supervisor shall complete a site visit, if provisional approval is
granted for the proposed site When the site visit is successfully completed and any concerns about the
location addressed, final, written approval will be provided
PROGRAM BUDGET SUMMARY For WIC -Attachment B1
View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Use WHOLE DOLLARS Only
PROGRAM
Oakland Livingston Human Service Agency WIC program
CONTRACTORNAME
Oakland Livingston Human Service Agency
MAILING ADDRESS (Number and Street)
196 Cesar E. Chavez
CITY IS
TATE
Pontiac MT'
EXPENDITURE CATEGORY
1 SALARY & WAGES
1 2. FRINGE BENEFITS
1 3.TRAVEL
1 4 SUPPLIES & MATERIALS
1 5. CONTRACTUAL (SubcontemplSnisdau )ems)
1 6 EQUIPMENT
1 6 OTHER EXPENSES
1
1
1
t
B, TOTAL DIRECT EXPENDITURES
sumof Lei 7)
9 INDIRECT COSTS
INDIRECT COSTS'
10. TOTAL EXPENDITURES
SOURCE OF FUNDS:
11 FEES& COLLECT IONS
12 STATEAGREEMENT
13 LOCAL
14 FEDERAL
15, OTHER(S)
16. TOTAL FUNDING
ZIP CODE
48343
AUTHORITY: PA 31
COMPLETION Is Voluntary, but rs regulred as a condition of funding
DCH-03B5(E) (Rev O1109) (Eacel) Previous Edition Obsolete
ATTACHMENT
B.1
OATEPREPARED
I Page I
Of
7/15/2021
BUDGETPERIOD
From: 10/1/2021
To: 9/30/2022
BUDGETAGREEMENT
AMENOMENT#
2 ORIGINAL FI
AMENDMENT
FEDERAL ID NUMBER
38-1785665
TOTALBUDGET
(Use Whole
Dollars)
$373 391
$9D,11(
$5,80(
$15,00
$7,00
$26,30
$517,B]
$517,611
The Department of Community Health is an equal oppodunity
enpl%eq services and programs provider
PROGRAM BUDGET- COST DETAIL SCHEDULE -Attachment B2
VoewaT LJOE n(LatbeF L1ICHIC-N GEP,RTNFHT OF COh1MUNITYHEALTH Page
Gee WHOLE OOLLARS Ooty
PROGRAM
OLHSA WIC Program
CONTRACTOR NAME
Oakland Livingstrnr, Human San0,p Auency
BIIQGI T PERIGQ
Frem: To:
1 UIDGET 1 4/3W2022
nUDC.ET PGREFMFNT
OWGIQWMQJQMHJT
IS
.1 C PREPARED
7J15+2a]1
AMFNPMENT9
1. SALARY&WAGES:
POSITIONS
POSITION DESCRIPTION COMMENTS
REGUIRED
TOTAL SALARY
.MC Coordinator Associate DirecM ORD 36 hrs per eeekx 52 weeks
0 900 5
55 371
Breas1ii COOidmatoi 35 his%+week, 52 GF.Fa
0,0001 5
42,378
Realsteled Dietitian - Part Tine 1 P 21 hewkx52 aeeka
0 5201 5
28 738
R1,datered Dietitian - PartTlme 10 16 hours I.,ek 1 52 masks
0 400 $
19 734
Reoistered Dietitian - PaDTme Lat 15 horia rssek g-5?saee%s
04 in
19 734
Registered Dietitian - mill Time 1C040 hours+weelv52 weeks
1-0001 5
47866
CPA 1(440 hrs+week z 52 v4ETks
100ol is
40.360
Health Tech Supeniser 1 (,, 40 hrs x 51 e.eek--
1 Fool $
35 450
Health Tech 2@21 hrs:week X 62 weeks
2 0001 $
37 680
CJIC Phone Pecepbomst- <024 hours Wreek X52 c: eeks
0 600
$
16 1166
_ _1
OLHSA Recepbomet Last hours+weekt52 weeks
0 1001
5
2 854
HR Cost Pool $100dtem.Onth
0 048
$
10 567
IT Cost Pool $0 96+Re+month
0 045
$
IT400
1.TOTAL SALARYBWAGES:
8.720 $
373.397
2 FRINGEBENEFITS. (Specify)
compaers Rate'b
O FICA MLEE it's MDFLTAL pi
45°•o full time S
9011fi
D UNEMPLOY 0✓ '•+t510f1 M xoi COMP
189. Part time
o RETIRES MHEARuss
M HOSPRA ❑OTI-ER:sp LTO 2.TOTAL
FRINGE 6ENEFIFS: $
90.11fi
3. TRAVEL: {SRedfy rF category exceeds 10% of Total ENTrainitures)
Conferences- required training -all staff $F 000 60 for conference
Local Travel GAdeage Rate (d 40 cents per mde 2000 mtles - $800.00
3 -07 ,L m.vEL $
5.800
4. SUPPLIES& MATERIALS (Specify If category exceeds 10S of Tomt Expenditures)
Including 0lueae contrnk olficercleamngrsanrtrzmg suppLea and any materials regmred
to no dorms
Including ybees controls vffice+deamn,-sarniznra supRlies+Masks (PPEI and any
materials required
4. TOTAL SUPPLIES&MATERIALS:
$
15.000
5. CONTRACTUAL: (Fulicontracts,Subreciplents)
Name Address
Alnotint
5
TOTAL CONTRACTUAL:
6. EOUIPMFNIP (Specify)
Amount
Replacement of ouMated or non furlctiomng printer scanners computers
as needed to Update technology
e 1OTALEOU1PMENT:
$7.000
7. OTHER EXPENSES: (Specify lfeelagery oX,eedS 10', Of Total Expenditures)
Amount
C.—esehem flyer,- a.tredrzing. bo Orr,s5 card- neas ads
5 1 Goo
51 000
=pace cavt Madison Herghta chink
$ 1(.o00
$10 000
Falnliri,nn, Chnll
$ 2,400
$2400
Telaphones
5 7 600
$7,500
PIT—rexclsr) Audit
$ 600
5600
Madison Heights Cleaning
S 4 000
51 000
Insuranra
$ 8n0
$Ana
Total
$26.300
R. TOTAL DIRECT EXPENDITURES. Sion of TOOIN 1-7) 8.TOTAl
QIRFCTEXPFNQmURES: $
517.613
9. INDIRECT COST CALL ULATIDNS
Rata#1 Ease$ I Rate
-
Rate-2 Easn3 - cRile
-
-
9.TOTAL INDIRECf
EaPENo1TURES' $
-
10.TOTAL ALL EXPENDITURES (Sumeflor-8-9)
oorxr<v+ox-o-.-.,.rm--a...e.-.<o..am-.,orn.e.a
$
517,613
PROGRAM BUDGET SUMMARY For WIC Peer Counselor Attachment 83
vrewetrao%o.La.yer MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Use WHOLE DOLLARS Only
ATTACHMENT B3
PROGRAM
DATE PREPARED
Page
Of
Oakland Livingston Human Service Agency WIC Peer BE
7/19/2021
1
Program
CONTRACTORNAME
BUDGET PERIOD
Oakland Livingston Human Service Agency WIC Program
From: 10/1/2021 To: 913012022
MAILING ADDRESS (Number and Street)
BUDGETAGREEMENT
AMENDMENT#
196 Cesar E. Chavez Pontiac, Michigan 48343
Et ORIGINAL r; AMENDMENT
EXPENDITURE CATEGORY
1. SALARY & WAGES
2. FRINGE BENEFITS
3 TRAVEL
4 SUPPLIES & MATERIALS
5. CONTRACTUAL(subcontracts/Subreopients)
6 EQUIPMENT
7 OTHER EXPENSES -list below
8 TOTAL DIRECT EXPENDITURES
(sum of Lnes 1-7I
9.INDIRECTCOSTS Rate#1%
10. TOTAL EXPENDITURES
SOURCE OF FUNDS:
1
I
I
I
I
I
I
16. TOTAL FUNDING
COMPLETION IS Voluntary, bui is regwretl asamntlRion of footling
DCenzeslE) (Rey 01109)
TOTAL BUDGET
(Use Whole Dollars)
$13,84
$4 301
$16 00(
$6,00'
$84,86;
$84,86S1
PROGRAM BUDGET- COST DETAIL SCHEDULE Attachment B4
VieWat100%aorLjDPT k11CHIGEN DEPARTMENT OF COMMUNITY HEALTH Pace Of
Use WHOLE DOLLARS Only
OLHSA WIC PROGRAM (PEER COUNSELING)
CONTRACTOR NAME
Oakland 1_ivinyston Human Agency
1. SAI ARY & WAGES:
POSITION DESCRIPTION
AeSuciate Director for Nutrition WIC
BHormfieeding Peer Counselor
Senior Peer Counselor
Pear Counselor
FIR Cost Pool
IT Cost Pool
OLHSA Receptionist
BUDGET PERIOD DATEPREPARED
From: To:
T115iZCE1,
10C r2NU 1 I
9130,9022
BUDGETAGREEMENT
hMfNDMENTtl
n ONEURNAL -1 At6IX'8ii
POSITIONS
COMMENTS
REQUIRED
TOTAL SALARY
4 hours/week x52
a 1001 8
4 567
4 hourslweek x52
a 1001 8
3 600
16A10 hours(weakX52
02501 S
9.150
2f7r20 hoursiwae10<52
1 000 5
25 995
100ffteimonth (1.45 free)
0 480 $
5 935
100111e1mopth L95 ftesl
0,450 S
5 833
1(&4 hmLHUV eekX52 weeks
0,100 $
4,800
1. TOTAL SALARY&WAGES
2.380 $
50.713
2. FRINGE BENEFITS: tSperxfy) Cem C,fdu Rate%
Q FICA QLtFE INS DOENIAL INS 18%Part Time
$ 1%S47
Q UBs&LoY SN: Q VISION INS Q wordaz ANRP 48% F LII Time
RETA8IBN{ HiARING INS
rI HOSPITAL INS ❑cOCEU:speVFY- e. IUT.LFRIN.P.ENEI.T.
$ 13,847
3, TRAVEL: I Specify if Category exceeds l O^e of Total Expenditures)
4 Trips to Lansing for 3 staff members, Iocai travel, conferences, and HURT tminings
3,TOTA1 TRAVEL:
$ 4,300
4. SUPPLIES & MATERIALS: {Spenify it category exceeds 10': nt Tntni ExpendVnres)
4. TOTAL SUPPLIES& MATE RIALS:
$ 10,000
S. CONTRACTUAL (Subcontrausi Suhreapients)
Name Address Amount
Audit
UHY. LLP 27725 Stansbury St Suite 200, Farmington Hiff, , 5 294
MI 48334
6. EQUIPMENT: (SPecffH
5. TOTAL CONTRACTUAL $
Amount I
S. TOTAL EOUIPMENOI $ -
7. OTHER EXPENSES:(Specify R category exceeds 10% of Total Expenditures) Amount
Commanrcafron: Flyers, advertising, tipsiness cards. newsm ads T "_ 000
SPoae Co.,.
Others lexpmm): TeleplGame 5 3 419
Insurance $ 294
Audit UHY 27725 Stansbury Ste, 200 Farmington $ 294
T TOTAL OTHER EXPENSES' $ 6,007
8. TOTAL DIRECT EXPENDITURES:(Swn of Totals l 7) s.TOTAL DIRECT EXPENFATURES: $ 84.867
9. INDIRECT COST CALCULATIONS.
Rate #1 Base 5 e Rate S -
Rete#2 Gase3 - .RVt �$
9.TOTAL INDIRECT EXPENDITURES $ -
10.fOTALALLEXPENDITURES {Sum Hrues 8-9) $ 84,867
cxrnrtenax.L•ow..n.,eui-..ae... _. n....-nei.n
Cost, Allows Is. Only With Prior Aonroval - The fallowing costs are allowable only with prior
review/approval of the Michigan Department of Health & Human Services as specified by the U S
Department of Agriculture, Food and Nutrition Service (Ref 7 CFR Part 246, and USDA- WIC
Administrative Cost Handbook 3/66) Prior approval is accomplished by providing appropriate detail in the
budget request to OHCD which is approved by MDHHS or subsequently in a written request to OCHD and
approved in writing by MDHHS and provided to OCHD.
A Automated Information Systems - which are required by a local Grantees except for those used in
general management and payroll, including acquisition of automated data processing hardware or
software whether by outright purchase or rental -purchase agreement or other method of acquisition.
B. Capital Expenditures of E2 600 or More - such as the cost of facilities, equipment, including medical
equipment, other capital assets and any repairs that materially increase the value or useful life of capital
assets
C. Management Studies - performed by agencies or departments other than the local Grantee or those
performed by outside consultants under contract with the local Grantee.
D. Accounting and Auditing Services - performed by private sector firms under professional service
contracts for purposes of preparation or audit of program and financial records/reports
E. Other Professional Services- rendered by individuals or organizations, not a part of the local Grantee,
such as
1. Contractual private physician providing certification data
2. Contractual organization providing laboratory data
3. Contractual translators and interpreters at the local Grantee level
F. Training and Education - provided for employee development, which directly or indirectly benefits the
grant program, to the extent that such training is contracted for or involves out -of -service training over
extended periods of time.
G Buildina Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned
buildings for the benefit of the program.
H Nan-Frinee Insurance and Indemnification Costs- all charges to WIC most be necessary, reasonable,
allowable and allocable for the proper and efficient administration of the program. Further information
and cost standards are provided in federal instructions including Tile 2 CFR, Part 200 and 7 CFR
Part 3015
Breastfeeding Peer Counseling Program
The Grantee must follow the allowable expense guidelines provided by USDA FNS forthe Peer Counselor
Grant The use of BFPC funds for expenditures that are not supported by the Lovmo Su000rt Model are not
authorized Expenses for Breastfeeding education and supplies must be charged to the normal WIC budget;
not the Peer Counselor Grant
Allowable Costs for Breastfeeding Peer Counseling
Programs
Breastfecding peer counseling (BFPC) funds that the Food and Nutrition Services (FNS)
distributes to State agencies are to be used to develop or expand activities necessary to sustain a
peer counseling program based on the FNS WIC Breastfecdine Model for Peer Counselme
The primary purpose of the funds is to provide direct peer counselor to WIC mother
breastiu eding support services A State agency's peer counseling implementation plan and
annual line -item budget addendum to its State Plan most demonstrate an appropriate balance
between direct service delivery by peer counselors, and other staff that manage or provide
expertise to peer counselors and the purchase and use of equipment and materials The use of
BFPC funds for expenditures that are not supported by the WIC Breastfceding Model for Peer
Counseling are not authorized.
The table below helps to identify allowable BFPC cost~'
NSA = Nutrition Services and Administration
iBCLC = international Board Certified Lactation Consultant
Durable Goods and Space
Furniture, Yes
computers/laptops, and
office equipment used to
provide peer counseling
services and training
Phone lines, internetservice, Yes
cell/smartphones, pagers
and answering machines for
contacts between peer
counselors and mothers
Portable baby scales to No
NSA fiords may be used to
weigh infants outside of the
purchase scales for clinical
WIC clinic
assessment for use by staff
other than peer counselors
Space and lease costs for Yes
peer counselors to provide
services
Incentives and Educational Materials to Promote Breastfeeding
Breastteemng educational
No
NSA foods may he used for
materials for mothers such
this purpose
as pamphlets and DVDs
Breast pumps and
No
NSA funds may be used for
breastfeeding aids for
this purpose
mothers
Breast pumps and
Yes
breastfeeding aids for
demonstration purposes by
peer counseling staff
Incentive items distributed to
No
NSA fiords ma_v be used For
WIC participants to
this purpose.
encourage breastfeedmg
Personnel and Compensation
Salaries and compensation
Yes. BFPO funds may be used
BFPC funds cannot be used
for peer counseling staff.
to hire staff to provide
to disproportionately hire
peer counselors, designated
oversight/management ofpeer
lactation management experts
peer counselor coordinators.
counseling programs and/or
versus peer counselors.
and Designated
supervision, mentoring and
Breastfeedug Experts
referral expertise for peer
NSA funds must be used for
(DBE)
counselors.
consultations for WIC
mothers who are not referred
BFPO fiords may also be used
by peer counselors and are
to pay for DBE, time if a peer
not part of a peer counselor's
counselor refers a WIC mother
caseload,
to a DBE for consultation
outside of the peer counselor's
Refer to the Nutrition
scope of practice The DBE
Services Standards for DBE
may be compensated using
qualifications, roles and
BFPC funds if the
responsibilities.
mother continues to be
supported by the peer
counselor and remains part of
the peen counselor's caseload
for dual -role Staff, e g„ part-
time WIC Nutrition
Assistant and part -tune peer
counselor
Males as breastfeeding peer
counselors
Recruitment of peer
counselors and related staff
for the portion of time spent as
peer counselor. The "dual -
rote" staff must meet the
definition of peer counselor in
the WIC Breastfeedine Model
for Peer Counseling. including
being available to participants
outside of regular WIC hours
See FNS Breastfeeding Policy
and Guidance document for
additional information on dual -
role staff. State agency
policies must be approved by
FNS Regional Offices
No. The definition of peer
counselor in the WIC
Breastfeedma Model for Peer
Counseling is based on
research demonstrating the
benefit of hiring peer
counselors from WIC's target
population of WIC -eligible
women
Yes
• Paraprofessional (see
WIC Breastfeedin¢
Model for Peer
Counseling for
definition)
• Rerouted and hired
from target population
and, to the extent
possible, representing
the same racial/ethnic
background as the
mothers they support
• Available to WIC
participants outside
usual clinic hours and
outside the WIC clinic
environment, and
• Previous experience
with breastfeeding,
having breasted at
least one baby
Men can be valuable
members of breastfeeding
promotion and support
activities in WIC, such as
providing lather -to -father
supportgroups however,
these activities are outside of
those defined by the WIC
Breastfeedma Model for Peer
_Counseling and must be
funded through the regular
NSA grant or other sources
See FNS Peer Counseling
Management Curriculum for
additional information
related to breastfeedrg to hue peer counselors to
hotlines and call centers. answer calls to a WIC
breastfeedmg hotline if the
peer counselor meets the
definition of peer counselor
and receives the appropriate
training and supervision as
outlined in the WIC
Breastleedme Model for Peer
CounselmOther expenses
related to the hutline/call
center such as rent, phone
Imes, equipment, are allowable
for any portion of those
expenses that are for the
purpose of a WIC peer
counselor providing WIC
participant contacts through
the hotline/call center. WIC
Veer Counselors may not
provide services to non -WIC
participants.
Staff Training and Resources
Travel for training of peer
counselors and peer
counseling stafVmanagers
Travel for home and hospital
visits by peer counselug
staff
Continuum, education for
DBE's
Yes
Yes, for visits to W [C.
panccipants7 peer counselors
may not provide services to
non -WIC participants
Yes, if relates to servicing
peci counseling programs
(e.g, mentonng, serving as a
referral)
Breastfeeding resources for Yes, if the resources are
pear counseling staff related to peer counseling, e g.,
training materials for peer
counselors
Breastfeeding resources for No
WIC staff not related to peer
counseling
Training and coursework for
peer counselors to become
IBCLCs or Certified
Lactation Counselors
(CLCs)
CLC or IBCLC exam,
renewal or membership fees
No. NSA funds may be used
for CLC or IBCLC training
and coursework
No
Peer Counseling Program Advertising and Promotion
Pamphlets and similar Yes
materials to promote the
peer counseling program
NSA funds may be used to
purchase general
breastleednig resources for
WIC staff
The priority use of BFPO
funds is to hire and train peer
counselors to provide
breastlecding peer counseling
services to WIC participants.
The research recommends
that peer counselors be
provided career path training
options.
At the WIC State agency's
discretion, NSA funds may
be used for CLC or IBCLC
training, exam fees, renewal
and/or association
membership tees The State
agency must determine if it is
necessary and of benefit to
the WIC Program tot the
person in a partictdarlob
position to have the
certification SAsmust also
determine whether or not the
cost fits within its WIC NSA
t ant budget.
placards, to advertise BFPC a disproportionate amount of
programs the BFPC funds spent on
advertising the program at
the expense of direct services
to participants
T-Shirts, buttons and similar Yes
low-cost items that identify
peer counselors
Miscellaneous
Indirect program costs (e.g.,
lease/rental costs, copying
costs, IIR services, legal
services, utilities)
Second nutrition education
contacts
Yes, but only those that are
related to providing a peer
counseling program
No. BFPC funds are for
activities that are in addition to
current required WIC
activities.
Childcare No
Cribs or other materials and No
equipment for infants of peer
counselors who bring their
babies to work
Monitoring and tracking of
program effectiveness.
Yes Funds may be used to
monitor and track program
components (e.g, contacts_
referrals, training) to determine
effectiveness and where
BFPC funds may not be used
for ads that promote
breastfeeding in general —
NSA funds may be used for
those purposes.
NSA funds provide for at
least two nutrition education
contacts; therefore, BFPC
fiords may not be used for the
"second" contact.
In addition, the 1/0 nutrition
education requirement and
breastfeedmg target must be
met with regular NSA funds.
Peer counseling services to
non -WIC participants
Breastfeeding coalitions
However, evaluation studies
may not be paid for using
BFPO funds.
No. Peer counselors should
refer WIC -eligible women to
WIC to apply for WIC
benefits. Peer counselors
should refer women who are
not WIC -eligible to
appropriate non-WiC
resources..
No
BFPC funds can only be used
for services and activities
related directly to peer
counseling
* Updated 11/29/2018 This is not an exhaustive list or allowable costs. Refer to the INS
Regional Office for questions about allowable cost, and to the Breastfeedmg Policy and
Guidance.
Attachment Reporting Requirements
Invoicing process Submit monthly, the actual costs incurred for the WC grant and Breastfeeding Peer
Counselor grant using the electronic invoice provided by OCHD The invoice form reflects the Subrecipient
budget approved by the County and the Stale WIC program
As part of the Breastfeeding Peer Counseling Grant, Subrecipient shall maintain monthly records for each
individual Peer Counselor Specific supplemental reporting forms will be provided by MDDHS WC program
to complete this requirement. Reports are due to f)te Qaklaqd Coupty Health D'vision WIC Supervisor
by the 5" day of January. March, July and October for review and submission to MDHHS WIC
Code
TOTAL
Agency Name: Oakland County Health Division - WIC START
Billing for Period of: Contract Period 10/1/21 - 9/30/22
Description (Ex. Office Supplies, Consumable
Materials etc)
Salaries
Fringes
Travel/Mileage
Supplies & Materials
Equipment
Advertising, flyers, business cards
Space Rental - Madison Hgts, Farmington, Baldwin
Telephones
Audit
Madison Heights Cleaning
Insurance
Category
Number
NOTE: Please e-mail the submission, addressed to: Lisa McKay-Chiasson/mckay-
chiassonl@oakgov.com and cc: Teresa LePoudre, lepoudret@oakgov.com
Budget Amount I YTD Expenditure
$ 373,397.00 $ -
$ 90,11&00 $ -
$ 5,800.00 $ -
$ 15,000.00 $ -
$ 7,000.00 $ -
$ 1,000.00 $ -
$ 12,400.001 $ -
$ 7,500.00 $ -
$ 600.00 $ -
$ 4,000.00 $ -
$800.00 $
517
Remaining
Balance
$
373,397.00
$
90,116.00
$
5,800.00
$
15,000.00
$
7,000.00
$
1,000.00
$
12,400.00
$
7,500,00
$
600.00
$
4,000.00
$
800.00
Agency Name: Oakland Livingston Human Service Agency (OLHSA ) - WIC BREAST FEEDING
Billing for Period of: Contract Period 10/1/21- 09/30/2022
Function Description (Ex. Office Supplies, Cr
Code Materlalsettl
Salaries
Fringes
Travel/Mileage
Supplies & Materials
Advertising, flyers, business cards
Telephones
Audit
Legal
NOTE: Please e-mail the submission, addressed to
Lisa McKay-Onasson - mckay-chiassonl@oakgov.mm
cc Teresa LePoudre-lepoudret@oakgov.com
category I
Remaining
Number Budget Amoun[ Kpen ure
Balance
$
30,713.00 $ -
$ 50,713.00
S
13,M7.00 $ -
$ 13.847.00'
$
4,3oa.oa $ -
S 4300.00�
S
10,000.00
$
2,aoo DD $
$ 2,000.W
$
3,41900 $ -
$ 3,419.00
$
254.00 $
I $ Z94-001
$
294.00 $ -
' $ 2 oo'
t
FAaC-[9G[ill 211!111112
SUBRECIPIENT INSURANCE REQUIREMENTS WITH COUNTY
During this Agreement, the Subrecipient shall provide and maintain, at their own expense, all
insurance as set forth and marked below, protecting the County against any Claims. Claims
means any loss, complaint, demand for relief or damages; lawsuit; cause of action, proceeding;
judgment; penalty; costs or other liability of any kind which is imposed on, incurred by, or asserted
against the County or for which the County may become legally or contractually obligated to pay
or defend against, whether commenced or threatened, including, but not limited to, reimbursement
for reasonable attorney fees, mediation, facilitation, arbitration fees, witness fees, court costs,
investigation expenses, litigation expenses, or amounts paid in settlement. The insurance shall
be written for not less than any minimum coverage herein specified Limits of insurance
required in no way limit the liability of the Subrecipient.
Primary Coverages
Commercial General Liability Occurrence Form including (a) Premises and Operations; (b)
Products and Completed Operations (including On and Off Premises Coverage), (0) Personal
and Advertising Injury, (d) Broad Form Property Damage; (e) Broad Form Contractual including
coverage for obligations assumed in this Agreement;
$1,000,000 — Each Occurrence Limit
$1,000,000— Personal &Advertising Injury
$2,000,000 — Products & Completed Operations Aggregate Limit
$2,000,000 — General Aggregate Limit
$ 100,000 — Damage to Premises Rented to You (formally known as Fire Legal Liability)
Workers' Compensation Insurance with limits statutorily required by any applicable Federal or
State Law and Employers Liability insurance with limits of no less than $500,000 each accident,
$500,000 disease each employee, and $500,000 disease policy limit.
1. ® Fully Insured or State approved self -insurer
2. ❑ Sole Proprietors must submit a signed Sole Proprietor form
3. ❑ Exempt entities, Partnerships, LLC, etc, must submit a State of Michigan form WC-337
Certificate of Exemption
Commercial Automobile Liability Insurance covering bodily injury or property damage arising
out of the use of any owned, hired, or non -owned automobile with a combined single limit of
$1,000,000 each accident This requirement is waived if there are no company owned, hired or
non -owned automobiles utilized in the performance of this Agreement
Commercial Umbrella/Excess Liability Insurance with minimum limits of $2,000,000 each
occurrence Umbrella or Excess Liability coverage shall be no less than following form of
primary coverages or broader. This Umbrella/Excess requirement may be met by increasing the
primary Commercial General Liability limits to meet the combined limit requirement
Third Party Theft Insurance in an amount not less than the grant award with Oakland County
named as an additional insured
Suoolemental Coverages — As Needed
1. Professional Liability/Errors & Omissions Insurance (i e , Consultants, Technology
Vendors, Architects, Engineers, Real Estate Agents, Insurance Agents, Attorneys, etc ) with
minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when
the Subrecipient provides professional services that the County relies upon
2. Cyber Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate
shall be required when the Subrecipient has access to County IT systems and/or stores County data
electronically.
3. Commercial Property Insurance. The Subrecipient shall be responsible for obtaining and
maintaining insurance covering their equipment and personal property against all physical
damage.
4. Liquor Legal Liability Insurance with a limit of $1,000,000 each occurrence shall be
required when liquor is served and/or provided by Subrecipient.
5. Pollution Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000
aggregate shall be required when storage, transportation and/or cleanup & debris removal
of pollutants are part of the services utilized.
6. Medical Malpractice Insurance with minimum limits of $1,000,000 per claim and
$1,000,000 aggregate shall be required when medically related services are provided
7. Garage Keepers Liability Insurance with minimum limits of $1,000,000 per claim and
$1,000,000 aggregate shall be required when County owned vehicles and/or equipment are
stored and/or serviced at the Subrecipient's facilities.
8. Other Insurance Coverages as may be dictated by the provided product/service and
deemed appropriate by the County Risk Management Department.
General Insurance Conditions
The aforementioned insurance shall be endorsed, as applicable, and shall contain the following
terms, conditions, and/or endorsements All certificates of insurance shall provide evidence of
compliance with all required terms, conditions and/or endorsements
1. All policies of insurance shall be on a primary, non-contributory basis with any other
insurance or self-insurance carved by the County,
2. The insurance company(s) issuing the pohcy(s) shall have no recourse against the County
for subrogation (policy endorsed written waiver), premiums, deductibles, or assessments
under any form. Ail policies shall be endorsed to provide a written waiver of subrogation in
favor of the County;
3. Any and all deductibles or self -insured retentions shall be assumed by and beat the sole risk of the
Subrecipient;
4. Subrecipient shall be responsible for their own property insurance for ail equipment and
personal property used and/or stored on County property,
5. The Commercial General Liability and Commercial Automobile Liability policies along with
any required supplemental coverages shall be endorsed to name the County of Oakland
and its officers, directors, employees, appointees and commissioners as additional insureds
where permitted by law and policy form,
6. If the Subrecipient's insurance policies have higher limits than the minimum coverage
requirements stated in this document the higher limits shall apply and in no way shall limit
the overall liability assumed by the Subrecipient under contract.
7. The Subrecipient shall require its contractors or sub -contractors, not protected under the
Subrecipient's insurance policies, to procure and maintain insurance with coverages, limits,
provisions, and/or clauses equal to those required in this Agreement,
8 Certificates of insurance must be provided no less than ten (10) Business Days prior to the
County's execution of the Agreement and must bear evidence of all required terms,
conditions and endorsements; and provide 30 days' notice of cancellation/material change
endorsement.
9. All insurance carriers must be licensed and approved to do business in the State of
Michigan along with the Subrecipienfs state of domicile and shall have and maintain a
minimum A.M Best's rating of A- unless otherwise approved by the County Risk
Management Department.
ATTACHMENT
COUNTY'S GRANT AGREEMENT WITH THE STATE
Agreement #: 20220358-00
Agreement Between
Department of Health and Human Services
hereinafter referred to as the "Department"
and
County of Oakland
hereinafter referred to as the "Local Governing Entity"
on Behalf of Health Department
Oakland County Department of Health and Human Services/ Health Division
1200 N. Telegraph Rd. 34 East
Pontiac MI 48341 1032
Federal I.D.#: 38-6004876, DUNS #: 136200362
hereinafter referred to as the "Grantee"
for
The Delivery of Public Health Services under
the Local Health Department Agreement
Part1
Purpose
This Agreement is entered into for the purpose of setting forth a joint and cooperative
Grantee/Department relationship and basis for facilitating the delivery of public health
services to the citizens of Michigan under their jurisdiction, as described in the attached
Annual Budget, established Minimum Program Requirements, and all other applicable
federal, state and local laws and regulations pertaining to the Grantee and the
Department. Public health services to be delivered under this Agreement include
Essential Local Public Health Services (ELPHS) and Categorical Programs as specified
in the attachments to this Agreement
Period of Agreement
This Agreement will commence on the date of the Grantee's signature or October 1,
2021, whichever is later, and continue through September 30, 2022 Throughout the
Agreement, the date of the Grantee's signature or October 1, 2021, whichever is later,
shall be referred to as the start date. This Agreement is in full force and effectfor the
period specified
Program Budget and Agreement Amount
A. Agreement Amount
In accordance with Attachment IV - Funding/Reimbursement Matrix, the total
State budget and amount committed for this period for the program elements
covered by this Agreement is $11,430,410.00,
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B. Equipment Purchases and Title
Any Grantee equipment purchases supported in whole or in part through this
Agreement must be listed in the supporting Equipment Inventory Schedule
which should be attached to the Final Financial Status Report. Equipment
means tangible, non -expendable, personal property having a useful life of more
than one year and an acquisition cost of $5,000 or more per unit. Title to items
having a unit acquisition cost of less than $5,000 shall vest with the Grantee
upon acquisition. The Department reserves the right to retain ortransfer the title
to all items of equipment having a unit acquisition cost of
$5,000 or more, to the extent that the Department's proportionate interest in
such equipment supports such retention or transfer of title.
C. Budget Transfers and Adjustments
1. Transfers between categories within any program element budget
supported in whole or in part by state/federal categorical sources of
funding shall be limited to increases in an expenditure budget category by
$10,000 or 15% whichever is greater. This transfer authority doesnot
authorize purchase of additional equipment items or new
subcontracts with state/federal categorical funds without prior written
approval of the Department
Except as otherwise provided, any transfers or adjustments involving
state/federal categorical funds, otherthan those covered by C.1, including
any related adjustment to the total state amount of the budget, must be
made in writing through a formal amendment executed by all parties to
this Agreement in accordance with Section IX A. of Part 2.
The C.1 and C.2 provisions authorizing transfers or changes in local funds
apply also to the Family Planning program, provided statewide local
maintenance of effort is not diminished in total
Any statewide diminishing of total local effort for family planning and/or
any related funding penalty experienced by the Department shall be
recovered proportionately from each local Grantee that, during the course
of the Agreement period, chose to reduce or transfer local funds from the
Family Planning program
4. Agreement Attachments
A. The following documents are attachments to this Agreement Part 1 and Part 2
- General Provisions, which are part of this Agreement'
1 Attachment I - Annual Budget
2 Attachment IN - Program Specific Assurances and Requirements
3 Attachment IV - Funding/Reimbursement Matrix
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5. Statement of Work
The Grantee agrees to undertake, perform and complete the activities described in
Attachment III - Program Specific Assurances and Requirements and the other
applicable attachments to this Agreement which are part of this Agreement
6. Financial Requirements
The financial requirements shall be followed as described in Part 2 and Attachment I -
Annual Budget and Attachment IV - Funding/Reimbursement Matrix, which are part of
this Agreement.
7. Performance/Progress Report Requirements
The progress reporting methods, as applicable, shall be followed as described in part
2 and Attachment III, Program Specific Assurances and Requirements, which are part
of this Agreement.
8. General Provisions
The Grantee agrees to comply with the General Provisions outlined in Part 2, which is
part of this Agreement
9. Administration of the Agreement
The person acting for the Department in administering this Agreement (hereinafter
referred to as the Contract Consultant) is:
Name Canssa Reece
Title : Department Analyst
E-Mail Address ReeceC@michigan gov
The financial contact acting on behalf of the Grantee for this Agreement is.
TIFANNY KEYES-BOWIE Accountant
Name Title
KEYESBOWIET@OAKGOV COM (248) 858-0943
E-Mail Address Telephone No
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10. Special Conditions
A. This Agreement is valid upon approval and execution by the Department which
may be contingent upon approval by the State Administrative Board and
signature by the Grantee.
B. This Agreement is conditionally approved subject to and contingent upon
availability of funding and other applicable conditions.
C. Based on the availability of funding, the Department may specify the amount of
funding the Grantee may expend during a specific time period within the
Agreement Period
D The Department has the option to assume no responsibility or liability for costs
incurred by the Grantee prior to the start date of this Agreement.
E. The Grantee is required by 2004 PA 533 to receive payments by electronic
funds transfer
11. Special Certification
The individual or officer signing this Agreement certifies by their signature that they
are authorized to sign this Agreement on behalf of the responsible governing board,
official or Grantee
12. Signature Section
For Oakland County Department of Health and Human Services/ Health Division
Andrea Powers Administrator
Name Title
For the Michigan Department of Health and Human Services
Christine H. Sanches 09/17/2021
Christine H. Sanches, Director Date
Bureau of Grants and Purchasing
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Part 2
General Provisions
I. Responsibilities -Grantee
The Grantee, in accordance with the general purposes and objectives of this Agreement
shall:
A. Publication Rights
1. Copyright materials only when the Grantee exclusively develops books,
films or other such copyrightable materials through activities supported by
this Agreement. The copyrighted materials cannot include recipient
information or personal identification data Grantee provides the
Department a royalty -free, non-exclusive and irrevocable license to
reproduce, publish and use such materials copyrighted by the Grantee
and authorizes others to reproduce and use such materials
2. Obtain prior written authorization from the Department's Office of
Communications for any materials copyrighted by the Grantee or
modifications bearing acknowledgment of the Department's name prior
to reproduction and use of such materials. The state of Michigan may
modify the material copyrighted by the Grantee and may combine it with
other copyrightable intellectual property to form a derivative work. The
state of Michigan will own and hold all copyright and other intellectual
property rights in any such derivative work, excluding any rights onnterest
granted in this Agreement to the Grantee If the Grantee ceases to
conduct business for any reason or ceases to support the
copyrightable materials developed under this Agreement, the state of
Michigan has the right to convert its licenses into transferable licenses
to the extent consistent with any applicable obligations the Grantee has.
3 Obtain written authorization, at least 14 days in advance, from the
Department's Office of Communications and give recognition to the
Department in any and all publications, papers and presentations arising
from the Agreement activities
4 Notify the Department's Bureau of Grants and Purchasing 30 days before
applying to register a copyright with the U S Copyright Office. The
Grantee must submit an annual report for all copyrighted materials
developed by the Grantee through activities supported by this
Agreement and must submit a final invention statement and certification
within 60 days of the end of the Agreement period.
5. Not make any media releases related to this Agreement, without prior
written authorization from the Department's Office of Communications
B. Fees
1 Guarantee that any claims made to the Department under this
Agreement shall not be financed by any sources other than the
Department under the terms of this Agreement If funding is received
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through any other source, the Grantee agrees to budget the additional
source of funds and reflect the source of funding on the Financial Status
Report
2. Make reasonable efforts to collect 1st and 3rd party fees, where
applicable, and report those collections on the Financial Status Report
Any under recoveries of otherwise available fees resulting from failure to
bill for eligible activities will be excluded from reimbursable
expenditures
C. Grant Program Operation
Provide the necessary administrative, professional and technical staff for
operation of the grant program The Grantee must obtain and maintain all
necessary licenses, permits or other authorizations necessary for the
performance of this Agreement.
Use an accounting system that can identify and account for the funds received
from each separate grant, regardless of funding source, and assure that grant
funds are not commingled.
D. Reporting
Utilize all report forms and reporting formats required by the Department at the
start date of this Agreement and provide the Department with timely review and
commentary on any new report forms and reporting formats proposed for
issuance thereafter.
E. Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source
documentation, to support program activities and all expenditures made under
the terms of this Agreement, as required. The Grantee must assure that all terms
of the Agreement will be appropriately adhered to and that records and detailed
documentation forthe grant project or grant program identified in this Agreement
will be maintained for a period of not less than four years from the date of
termination, the date of submission of the final expenditure report or until
litigation and audit findings have been resolved. This section applies tothe
Grantee, any parent, affiliate, or subsidiary organization of the Grantee andany
subcontractor that performs activities in connection with this Agreement
F. Authorized Access
1. Permit within 10 calendar days of providing notification and at
reasonable times, access by authorized representatives of the
Department, Federal Grantor Agency, Inspector Generals, Comptroller
General of the United States and State Auditor General, or any of their
duly authorized representatives, to records, papers, files, documentation
and personnel related to this Agreement, to the extent authorized by
applicable state or federal law, rule or regulation.
2 Acknowledge the rights of access in this section are not limited to the
required retention period. The rights of access will last as long as the
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records are retained
3 Cooperate and provide reasonable assistance to authorized
representatives of the Department and others when those individuals
have access to the Grantee's grant records.
G. Audits
Single Audit
The Grantee must submit to the Department a Single Audit consistent
with the regulations set forth in Title 2 Code of Federal Regulations (CFR)
Part 200, Subpart F. The Single Audit reporting package must include all
components described in Title 2 Code of Federal Regulations,
Section 200.512 (c) including a Corrective Action Plan, andmanagement
letter (if one is issued) with a response to the Department
The Grantee must assure that the Schedule of Expenditures of Federal
Awards includes expenditures for all federally -funded grants.
Other Audits
The Department or federal agencies may also conduct or arrange for
agreed upon procedures or additional audits to meet their needs.
3. Due Date and Where to Send
The required audit and any other required submissions (i.e corrective
action plan, and management letter with a corrective action plan), and/or
Audit Exemption Notice must be submitted to the Department within nine
months after the end of the Grantee's fiscal year by e-mail at, MDHHS-
AuditReports@michigan gov. Single Audit reports must be submitted
simultaneously to the Department and Federal Audit Clearinghouse, in
accordance with 2 CFR 200.512(a), The required submission must be
assembled as one document in a PDF file and compatible with Adobe
Acrobat (read only). The subject line must state the agency name and
fiscal year end The Department reserves the right to request a hard copy
of the audit materials if for any reason the electronic submission process
is not successful.
4. Penalty
a. Delinouent Sinale Audit or Financial Related Audit
If the Grantee does not submit the required Single Audit reporting
package, management letter (if one is issued) with a response,
and Corrective Action Plan within nine months after the end of
the Grantee's fiscal year and an extension has not been
approved by the cognizant or oversight agency for audit, the
Department may withhold from the current funding an amount
equal to five percent of the audit year's grant funding (not to
exceed $200,000) until the required fling is received by the
Department. The Department may retain the amount
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withheld if the Grantee is more than 120 days delinquent in
meeting the filing requirements and an extension has not been
approved by the cognizant or oversight agency for audit. The
Department may terminate the current grant if the Grantee is
more than 180 days delinquent in meeting the filing
requirements and an extension has not been approved by the
cognizant or oversight agency for audit
Delinquent Audit Exemption Notice
Failure to submit the Audit Exemption Notice, when required,
may result in withholding payment from Department to Grantee
an amount equal to one percent of the audit year's grant funding
until the Audit Exemption Notice is received
H. SubrecipientlContractor Monitoring
1 When passing federal funds through to a subrecipient (if the Agreement
does not prohibit the passing of federal funds through to a subrecipient),
the Grantee must:
a. Ensure that every subaward is clearly identified to the
subrecipient as a subaward and includes the information
required by 2 CFR 200 332.
b. Ensure the subrecipient complies with all the requirements of
this Agreement
C. Evaluate each subrecipient's risk for noncompliance as required
by 2 CFR 200.332(b).
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 subawards, that subaward performance goals
are achieved, and that all monitoring requirements of 2 CFR
200 332(d) are met including reviewing financial and
programmatic reports, following up on corrective actions and
issuing management decisions for audit findings
e. Verify that every subrecipient is audited as required by 2 CFR
200 Subpart F
2. Develop a subrecipient monitoring plan that addresses the above
requirements and provides reasonable assurance that the subrecipient
administers federal awards in compliance with laws, regulations and the
provisions of this Agreement, and that performance goals are achieved
The subrecipient monitoring plan should include a risk -based
assessment to determine the level of oversight and monitoring activities,
such as reviewing financial and performance reports, performing site
visits and maintaining regular contact with subrecipients.
3. Establish requirements to ensure compliance for for -profit subrecipients
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as required by 2 CFR 200.501(h), as applicable
4 Ensure that transactions with subrecipients/contractors comply with
laws, regulations and provisions of contracts or grant agreements in
compliance with 2 CFR 200.501(h), as applicable
I. Notification of Modifications
Provide timely notification to the Department, in writing, of any action by its
governing board or any other funding source that would require or result in
significant modification in the provision of activities, funding or compliance with
operational procedures.
J. Software Compliance
Ensure software compliance and compatibility with the Department's data
systems for activities provided under this Agreement, including but not limited to
stored data, databases and interfaces for the production of work products and
reports. All required data under this Agreement shall be provided in an accurate
and timely manner without interruption, failure or errors due to the inaccuracy of
the Grantee's business operations for processing data. All information systems,
electronic or hard copy, that contain state or federal data must be protected from
unauthorized access.
K. Human Subjects
Comply with Federal Policy for the Protection of Human Subjects, 45 CFR 46
The Grantee agrees that prior to the initiation of the research, the Grantee will
submit Institutional Review Board (IRB) application material for all research
involving human subjects, which is conducted in programs sponsored by the
Department or in programs which receive funding from or through the state of
Michigan, to the Department's IRB for review and approval, or the IRB
application and approval materials for acceptance of the review of another IRB.
All such research must be approved by a federally assured IRB, but the
Department's IRB can only accept the review and approval of another
institution's IRB under a formally approved interdepartmental agreement. The
manner of the review will be agreed upon between the Department's IRB
Chairperson and the Grantee's authorized official
L. Mandatory Disclosures
1 Disclose to the Department in writing within 14 days of receiving notice
of any litigation, investigation, arbitration or other proceeding
(collectively, "Proceeding') involving Grantee, a subcontractor or an
officer or director of Grantee or subcontractor that arises during the term
of this Agreement including:
a All violations of federal and state criminal law involving fraud,
bribery, or gratuity violations potentially affecting the
Agreement
b A criminal Proceeding,
c A parole or probation Proceeding;
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d A Proceeding under the Sarbanes-Oxley Act;
e A civil Proceeding involving
1 A claim that might reasonably be expected to
adversely affect Grantee's viability or financial stability;
or
2 A governmental or public entity's claim or written
allegation of fraud, or
f A Proceeding involving any license that the Grantee is required
to possess in order to perform under this Agreement.
2 Notify the Department, at least 90 calendar days before the effective
date, of a change in Grantee's ownership and/or executive
management
M. Minimum Program Requirements
Comply with Minimum Program Requirements established in accordance with
Section 2472 3 of 1978 PA 368 as amended, MCL 333.2472 (3), MSA 14A5
(2472.3), for each applicable program element funded under this Agreement.
N. Annual Budget and Plan Submission
Submit an Annual Budget and Plan request to the Department, in accordance
with instructions established by the Department, to serve as the basis for
completion of specific details for Attachments I, III, and IV of this Agreement via
Grantee/Department negotiated amendment(s) Failure to submit a complete
Annual Budget and Plan by the due date through MI E-Grants will result in the
deferral of Department payments until these documents are submitted.
O. Maintenance of Effort
Comply with maintenance of effort requirements for Essential Local Public
Health Services (ELPHS), as defined in the current Department appropriation
act, and Family Planning in accordance with federal requirements, except as
noted in Section 3.C.3 of Part I
P. Accreditation
1. Comply with the local public health accreditation standards and follow the
accreditation process and schedule established by the Department to
achieve full accreditation status
a Failure to meet all accreditation requirements or implement
corrective plans of action within the prescribed time period will
result in the status of "Not Accredited" Grantees designated as
"Not Accredited" may have their Department allocations
reduced for costs incurred in the assurance of service delivery
b. Submit a written request for inquiry to the Department should the
Grantee disagree with on -site review findings or their
accreditation status The request must identify the
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disagreement and resolution sought. The Inquiry participants will
be comprised of Grantee staff, Department staff, the
Accreditation Commission Chair, and the Accreditation
Coordinator as needed Participants will clarify facts, verify
Information and seek resolution.
2 Consent Agreements/Administrative Compliance
Orders/Administrative Hearings for "Not Accredited" Grantees
a If designated as "Not Accredited", the Grantee will receive a
Consent Agreement Package from the Department. Grantees
and their local governing entities shall be given 75 days to review
the package, meet with the Department, and sign and return the
Consent Agreement
b Fulfillment of the terms and conditions of the Consent
Agreement will not affect accreditation status, but impacts the
Grantees' ability to fulfill its contractual obligations under the
Local Health Department Grant Agreement. Grantees
designated as "Not Accredited", will retain this designation until
the subsequent accreditation cycle
c. Failure to fulfill the terms and conditions of the Consent
Agreement within the prescribed time period will result in the
Issuance of an Administrative Compliance Order by the
Department.
d Within 60 working days after receipt of an Administrative
Compliance Order and proposed compliance period, a local
governing entity may petition the Department for an
administrative hearing If the local governing entity does not
petition the Department for a hearing within 60 days after receipt
of an Administrative Compliance Order, the order and proposed
compliance date shall be final. After a hearing, the Department
may reaffirm, modify, or revoke the order or modify the time
permitted for compliance.
e. If the local governing entity fails to correct a deficiency for which
a final order has been issued within the period permitted for
compliance, the Department may petition the appropriate circuit
court for a writ of mandamus to compel correction
Q. Medicaid Outreach Activities Reimbursement
Report allowable casts and request reimbursement for the Medicaid Outreach
activities it provides in accordance with 2 CFR, Part 200 and the requirements
in Medicaid Bulletin number: MSA 05-29
Submit a Cost Allocation Plan Certification to the Department to bill for the
Medicaid Outreach Activities. The Cost Allocation Plan Certification is validunhl
a change is made to the cost allocation plan or the Department
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determines it is invalid
Submit quarterly FSRs for the Medicaid Outreach activities and an annual FSR
for the Children with Special Health Care Services Medicaid Outreach
activities in accordance with the instructions contained in Attachment I
In accordance with the Medicaid Bulletin, MSA 05-29, agree to target Medicaid
outreach effort toward Department established priorities For fiscal year 2021,
the Department priorities are, lead testing, outreach and enrollment for the
Family Planning waiver, and outreach for pregnant women, mothers and
infants for the Maternal and Infant Health Program The Grantee will submit a
report using the MDHHS Local Health Department Medicaid Outreach form
describing their outreach activities targeting the priorities 30 days after the end
of a fiscal year quarter and at the same time as the final FSR is due to the
Department The Local Health Department Medicaid Outreach reports are to
be sent through MI E-Grants as an attachment report to the Financial Status
Report.
R. Conflict of Interest and Code of Conduct Standards
1. Be subject to the provisions of 1968 PA 317, as amended, 1973 PA
196, as amended, and 2 CFR 200 318 (c)(1) and (2).
2 Uphold high ethical standards and be prohibited from the following
a. Holding or acquiring an interest that would conflict with this
Agreement;
b. Doing anything that creates an appearance of impropriety with
respect to the award or performance of this Agreement,
C. Attempting to influence or appearing to influence any state
employee by the direct or indirect offer of anything of value; or
d Paying or agreeing to pay any person, other than employees and
consultants working for Grantee, any consideration contingent
upon the award of this Agreement
3 Immediately notify the Department of any violation or potential violation of
these standards This section applies to Grantee, any parent, affiliate or
subsidiary organization of Grantee, and any subcontractor that performs
activities in connection with this Agreement
S. Travel Costs
1. Be reimbursed for travel cost (including mileage, meals, and lodging)
budgeted and incurred related to services provided under this
Agreement
a. If the Grantee has a documented policy related to travel
reimbursement for employees and if the Grantee follows that
documented policy, the Department will reimburse the Grantee
for travel costs at the Grantee's documented reimbursement rate
for employees Otherwise, the State of Michigan travel
reimbursement rate aoolies.
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b. State of Michigan travel rates may be found at the following
website: https //www.michigan.gov/dtmb/0,5552,7-358-
82548_13132---,00.html
C. International travel must be preapproved by the Department
and itemized in the budget.
T. Insurance Requirements
1. Maintain at least a minimum of the insurances or governmental self -
insurances listed below and be responsible for all deductibles. All required
insurance or self-insurance must
a. Protect the state of Michigan from claims that may arise out of,
are alleged to arise out of, or result from Grantee's or a
subcontractor's performance,
b. Be primary and non-contributing to any comparable liability
insurance (including self-insurance) carried by the state; and
c Be provided by a company with an A.M Best rating of "A-" or
better and a financial size of VII or better.
2. Insurance Types
a. Commercial General Liability Insurance or Governmental Self -
Insurance Except for Governmental Self -Insurance, policies
must be endorsed to add "the state of Michigan, its
departments, divisions, agencies, offices, commissions,
officers, employees, and agents' as additional insureds using
endorsement CG 20 10 11 85, or both CG 2010 12 19 and CG
2037 12 19
If the Grantee will interact with children, schools, or the
cognitively impaired, the Grantee must maintain appropriate
insurance coverage related to sexual abuse and molestation
liability.
b. Workers' Compensation Insurance or Governmental Self -
Insurance Coverage according to applicable laws governingwork
activities Policies must include waiver of subrogation, except
where waiver is prohibited by law
C. Employers Liability Insurance or Governmental Self -Insurance
d Privacy and Security Liability (Cyber Liability) Insurance: cover
information security and privacy liability, privacy notification
costs, regulatory defense and penalties, and websrte media
content liability
3 Require that subcontractors maintain the required insurances contained
in this Section.
4 This Section is not intended to and is not to be construed in any manner
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J.
V.
as waiving, restricting or limiting the liability of the Grantee from any
obligations under this Agreement
5. Each Party must promptly notify the other Party of any knowledge
regarding an occurrence which the notifying Party reasonably believes
may result in a claim against either Party The Parties must cooperate
with each other regarding such claim
Fiscal Questionnaire
1. Complete and upload the yearly fiscal questionnaire to the EGrAMS
agency profile within three months of the start of the Agreement
2. The fiscal questionnaire template can be found in EGrAMS documents.
Criminal Background Check
1. Conduct or cause to be conducted a search that reveals information
similar or substantially similarto information found on an Internet Criminal
History Access Tool (ICHAT) check and a national and state sex offender
registry check for each new employee, employee, subcontractor,
subcontractor employee, or volunteer who under this Agreement works
directly with clients or has access to client information.
a. ICHAT http //apps.michigan govhchat
b. Michigan Public Sex Offender Registry
http7/www mipsor.state nrl
c National Sex Offender Registry: http //www.nsopw gov
2 Conduct or cause to be conducted a Central Registry (CR) check foreach
employee, subcontractor, subcontractor employee, or volunteer who,
under this Agreement works directly with children
a. Central Registry. https.//www.michigan.gov/mdhhs/0,5885,7-
339-73971_7119_50648_48330-180331--,00.html
3 Require each new employee, employee, subcontractor, subcontractor
employee or volunteer who, under this Agreement, works directly with
clients or who has access to client information to notify the Grantee in
writing of criminal convictions (felony or misdemeanor), pending felony
charges, or placement on the Central Registry as a perpetrator, at hire
or within 10 days of the event after hiring.
4. Determine whether to prohibit any employee, subcontractor,
subcontractor employee, or volunteer from performing work directly with
clients or accessing client information related to clients under this
Agreement, based on the results of a positive ICHAT response or reported
criminal felony conviction or perpetrator identification
5. Determine whether to prohibit any employee, subcontractor,
subcontractor employee or volunteer from performing work directly with
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children under this Agreement, based on the results of a positive CR
response or reported perpetrator identification.
6 Require any employee, subcontractor, subcontractor employee or
volunteer who may have access to any databases of information
maintained by the federal government that contain confidential or
personal information, including but not limited to federal tax information,
to have a fingerprint background check performed by the Michigan State
Police.
II. Responsibilities -Department
The Department in accordance with the general purposes and objectives of this
Agreement will
A. Reimbursement
Provide reimbursement in accordance with the terms and conditions of this
Agreement based upon appropriate reports, records, and documentation
maintained by the Grantee
B. Report Forms
Provide any report forms and reporting formats required by the Department at
the start date of this Agreement, and provide to the Grantee any new report
forms and reporting formats proposed for issuance thereafter at least 90 days
prior to their required usage in order to afford the Grantee an opportunity to
review
C. Notification of Modifications
Notify the Grantee in writing of modifications to federal or state laws, rules and
regulations affecting this Agreement
D. Identification of Laws
Identify for the Grantee relevant laws, rules, regulations, policies, procedures,
guidelines and state and federal manuals, and provide the Grantee with copies
of these documents to the extent they are not otherwise available to the Grantee
E. Modification of Funding
Notify the Grantee in writing within 30 calendar days of becoming aware of the
need for any modifications in Agreement funding commitments made
necessary by action of the federal government, the governor, the legislature or
the Department of Technology Management and Budget on behalf of the
governor or the legislature Implementation of the modifications will be
determined jointly by the Grantee and the Department.
F. Monitor Compliance
Monitor compliance with all applicable provisions contained in federal grant
awards and their attendant rules, regulations and requirements pertaining to
program elements covered by this Agreement
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G. Technical Assistance
Make technical assistance available to the Grantee for the implementation of
this Agreement
H. Accreditation
Adhere to the accreditation requirements including the process for "Not
Accredited" Grantees. The process includes developing and monitoring consent
agreements, issuing and monitoring administrative compliance orders,
participating in administrative hearings and petitioning appropriate circuit courts.
1. Medicaid Outreach Activities Reimbursement
Agrees to reimburse the Grantee for all allowable Medicaid Outreach activities
that meet the standards of the Medicaid Bulletin. MSA 05-29 including the cost
allocation plan certification and that are billed in accordance with the
requirements in Attachment I
In accordance with the Medicaid Bulletin, MSA 05-29, the Department will
identify each fiscal year the Medicaid Outreach priorities and establish a
reporting requirement for the Grantee
Ill. Assurances
The following assurances are hereby given to the Department.
A. Compliance with Applicable Laws
The Grantee will comply with applicable federal and state laws, guidelines, rules
and regulations in carrying out the terms of this Agreement. The Grantee will
also comply with all applicable general administrative requirements, suchas 2
CFR 200, covering cost principles, grant/agreement principles and audits, in
carrying out the terms of this Agreement. The Grantee will comply with all
applicable requirements in the original grant awarded to the Department if the
Grantee is a subgrantee The Department may determine that the Grantee has
not complied with applicable federal or state laws, guidelines, rules and
regulations in carrying out the terms of this Agreement and may then terminate
this Agreement under Part 2, Section V
B. Anti -Lobbying Act
The Grantee will comply with the Anti -Lobbying Act (31 U.S C. 1352) as revised
by the Lobbying Disclosure Act of 1995 (2 US C. 1601 of seg.), Federal
Acquisition Regulations 52203.11 and 52.203.12, and Section 503 of the
Departments of Labor, Health & Human Services and Education, and Related
Agencies section of the current FY Omnibus Consolidated Appropriations
Act Further, the Grantee shall require that the language of this assurance be
included in the award documents of all subawards at all tiers (including
subcontracts, subgrants, and contracts under grants, loans and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly
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C. Non -Discrimination
1. The Grantee must comply with the Department's non-discrimination
statement: The Michigan Department of Health and Human Services will
not discriminate against any individual or group because of race, sex,
religion, age, national origin, color, height, weight, marital status, gender
identification or expression, sexual orientation, partisan considerations, or
a disability or genetic information that is unrelated to the person's ability
to perform the duties of a particular job or position. The Grantee further
agrees that every subcontract entered into for the performanceof any
contract or purchase order resulting therefrom, will contain a provision
requiring non-discrimination in employment, activity delivery and access,
as herein specified, binding upon each subcontractor This covenant is
required pursuant to the Elliot -Larsen Civil Rights Act (1976 PA 453, as
amended, MCL 37.2101 of seq.) and the Persons with Disabilities Civil
Rights Act (1976 PA 220, as amended, MCL 37.1101 etseq.), and any
breach thereof may be regarded as a material breach of this Agreement
2. The Grantee will comply with all federal statutes relating to
nondiscrimination. These include but are not limited to
a. Title VI of the Civil Rights Act of 1964 (P L 88-352) which
prohibits discrimination based on race, color or national origin;
b Title IX of the Education Amendments of 1972, as amended (20
U.S.0 1681-1683, 1685-1686), which prohibits discrimination
based on sex;
C. Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C. 794), which prohibits discrimination based on
disabilities,
J. The Age Discrimination Act of 1975, as amended (42 U.S.0
6101-6107), which prohibits discrimination based on age;
e The Drug Abuse Office and Treatment Act of 1972 (P L 92-
255), as amended, relating to nondiscrimination based on drug
abuse;
If The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (P.L. 91-616) as
amended, relating to nondiscrimination based on alcohol abuse
or alcoholism,
g. Sections 523 and 527 of the Public Health Service Act of 1944
(42 U.S.C. 290dd-2), as amended, relating to confidentiality of
alcohol and drug abuse patient records,
h Any other nondiscrimination provisions in the specific statute(s)
under which application for federal assistance is being made,
and,
gala IN17111 O epahmenlof HeaM1M1 and l,nm 5rrvi—i Page 1701179
Haanh Drv,.mq Local Haanh Da,tn i,ins
I The requirements of any other nondiscrimination statute(s)
which may apply to the application
3. Additionally, assurance is given to the Department that proactive efforts
will be made to identify and encourage the participation of mmonty- owned
and women -owned businesses, and businesses owned by persons with
disabilities in contract solicitations The Grantee shall include language
in all contracts awarded under this Agreement which
(1) prohibits discrimination against minority -owned and women -owned
businesses and businesses owned by persons with disabilities in
subcontracting; and (2) makes discrimination a material breach of
contract
D. Debarment and Suspension
The Grantee will comply with federal regulation 2 CFR 180 and certifies to the
best of its knowledge and belief that it, its employees and its subcontractors
1 Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any federal department or contractor;
2 Have not within a five-year period preceding this Agreement been
convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (federal, state, or local) or
private transaction or contract under a public transaction; violation of
federal or state antitrust statutes or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false
statements, tax evasion, receiving stolen property, making false claims,
or obstruction of justice,
3 Are not presently indicted or otherwise criminally or civilly charged by a
government entity (federal, state or local) with commission of any of the
offenses enumerated in section 2,
4. Have not within a five-year period preceding this Agreement had one or
more public transactions (federal, state or local) terminated for cause or
default, and
5. Have not committed an act of so serious or compelling a nature that it
affects the Grantee's present responsibilities.
E. Federal Requirement: Pro -Children Act
1 The Grantee will comply with the Pro -Children Act of 1994 (P1 103- 227;
20 11,S.C. 6081, of seq ), which requires that smoking not bepermitted in
any portion of any indoor facility owned or leased or contracted by and
used routinely or regularly for the provision of health, day care, early
childhood development activities, education or library activities to children
under the age of 18, if the activities are funded by federal programs either
directly or through state or local governments,
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H-11M1 orveioo. Luaal Healm oep1tl 1Don
by federal grant, contract, loan or loan guarantee The law also applies
to children's activities that are provided in indoor facilities that are
constructed, operated, or maintained with such federal funds The law
does not apply to children's activities provided in private residences,
portions of facilities used for inpatient drug or alcohol treatment, activity
providers whose sole source of applicable federal funds is Medicare or
Medicaid; or facilities where Women, Infants, and Children (WIC) coupons
are redeemed. Failure to comply with the provisions of the law may result
in the imposition of a civil monetary penalty of up to $1,000for each
violation and/or the imposition of an administrative compliance order on
the responsible entity. The Grantee also assures that thislanguage will be
Included in any subawards which contain provisions for children's
activities.
2. The Grantee also assures, in addition to compliance with P L 103-227,
any activity funded in whole or in part through this Agreement will be
delivered in a smoke -free facility or environment. Smoking shall not be
permitted anywhere in the facility, or those parts of the facility under the
control of the Grantee. If activities are delivered in facilities or areas that
are not underthe control ofthe Grantee (e g , a mall, restaurant or private
work site), the activities shall be smoke -free.
Hatch Act and Intergovernmental Personnel Act
The Grantee will comply with the Hatch Act (5 U.S.C. 1501-1508, 5 U S.C. 7321-
7326), and the Intergovernmental Personnel Act of 1970 (P L. 91-648)as
amended by Title VI of the Civil Service Reform Act of 1978 (P L. 95-054)
Federal funds cannot be used for partisan political purposes of any kind by any
person or organization involved in the administration of federally assisted
programs
G. Employee Whistleblower Protections
The Grantee will comply with 41 U.S.C. 4712 and shall insert this clause in all
subcontracts.
H. Clean Air Act and Federal Water Pollution Control Act
The Grantee will comply with the Clean Air Act (42 U.S C. 7401-7671(q)) and
the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended
1. This Agreement and anyone working on this Agreement will be subject
to the Clean Air Act and Federal Water Pollution Control Act and must
comply with all applicable standards, orders or regulations issued
pursuant to these Acts. Violations must be reported to the Department
Victims of Trafficking and Violence Protection Act
The Grantee will comply with the Victims of Trafficking and Violence Protection
Act of 2000 (P.L. 106-386), as amended.
1. This Agreement and anyone working on this Agreement will be subject
to P L 106-386 and must comply with all applicable standards, orders
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or regulations issued pursuant to this Act Violations must be reported to
the Department.
J. Procurement of Recovered Materials
The Grantee will comply with section 6002 of the Solid Waste Disposal Act of
1965 (P.L. 89-272), as amended.
1 This Agreement and anyone working on this Agreement will be subject
to section 6002 of P.L. 89-272, as amended, and must comply with all
applicable standards, orders or regulations issued pursuant to this act
Violations must be reported to the Department
K. Subcontracts
For any subcontracted activity or product, the Grantee will ensure.
1. That a written subcontract is executed by all affected parties prior to the
initiation of any new subcontract activity or delivery of any
subcontracted product. Exceptions to this policy may be granted by the
Department if the Grantee asks the Department in writing within 30 days
of execution of the Agreement
2 That any executed subcontract to this Agreement shall require the
subcontractor to comply with all applicable terms and conditions of this
Agreement In the event of a conflict between this Agreement and the
provisions of the subcontract, the provisions of this Agreement shall
prevail.
A conflict between this Agreement and a subcontract, however, shall not
be deemed to exist where the subcontract
a. Contains additional non -conflicting provisions not set forth in
this Agreement;
b. Restates provisions of this Agreement to afford the Grantee the
same or substantially the same rights and privileges as the
Department; or
c Requires the subcontractorto perform duties and services in less
time than that afforded the Grantee in this Agreement
3. That the subcontract does not affect the Grantee's accountability to the
Department for the subcontracted activity.
4. That any billing or request for reimbursement for subcontract costs is
supported by a valid subcontract and adequate source documentation
on costs and services.
5. That the Grantee will submit a copy of the executed subcontract if
requested by the Department
6. That subcontracts in support of programs or elements utilizing funds
provided by the Department, the State of Michigan or the federal
government in excess of $10,000 shall contain provisions or conditions
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that will.
a. Allow the Grantee or Department to seek administrative,
contractual or legal remedies in instances in which the
subcontractor violates or breaches contract terms, and provide
for such remedial action as may be appropriate.
b. Provide for termination by the Grantee, including the manner by
which termination will be effected and the basis for settlement
7 That all subcontracts in support of programs or elements utilizing funds
provided by the Department, the State of Michigan or the federal
government of amounts in excess of $100,000 shall contain a provision
that requires compliance with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act of 1970 (42 USC
1857(h)), Section 508 of the Clean Water Act (33 U.S C 1368),
Executive Order 11738 and Environmental Protection Agency
regulations (40 CFR Part 15).
8. That all subcontracts and subgrants in support of programs or elements
utilizing funds provided by the Department, the State of Michigan or the
federal government in excess of $2,000 for construction or repair,
awarded by the Grantee shall include a provision
a. For compliance with the Copeland "Anti -Kickback" Act (18
U.S.C. 874) as supplemented in Department of Labor
regulations (29 CFR, Part 3)
b. For compliance with the Davis -Bacon Act (40 U.S.C. 276a to a-
7) and as supplemented by Department of Labor regulations (29
CFR, Part 5) (if required by Federal Program Legislation)
G. For compliance with Section 103 and 107 of the Contract Work
Hours and Safety Standards Act (40 U.S.C. 327-330) as
supplemented by Department of Labor regulations (29 CFR, Part
5) This provision also applies to all other contracts in excess of
$2,500 that involve the employment of mechanics or laborers.
L. Procurement
Grantee will ensure that all purchase transactions, whether negotiated or
advertised, shall be conducted openly and competitively in accordance with
the principles and requirements of 2 CFR 200, Funding from this Agreement
shall not be used forthe purchase of foreign goods orservices or both Records
shall be sufficient to document the significant history of all purchases and shall
be maintained fora minimum of four years after the end of the Ag reement period
M. Health Insurance Portability and Accountability Act
To the extent that the Health Insurance Portability and Accountability Act
(HIPAA) is applicable to the Grantee under this Agreement, the Grantee
fete M11111021 CnnhartM 200' 5&OO,Oa5landCounty OPpadmentufHPalih and Human firrvi[W Page .21 of 179
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assures that it is in compliance with requirements of HIPAA including the
following
t The Grantee must not share any protected health information provided by
the Department that is covered by HIPAA except as permitted or required
by applicable law; or to a subcontractor as appropriate under this
Agreement.
2 The Grantee will ensure that any subcontractor will have the same
obligations as the Grantee not to share any protected health data and
information from the Department that falls under HIPAA requirements in
the terms and conditions of the subcontract.
3 The Grantee must only use the protected health data and information
for the purposes of this Agreement
4. The Grantee must have written policies and procedures addressing the
use of protected health data and information that falls under the HIPAA
requirements The policies and procedures must meet all applicable
federal and state requirements including the HIPAA regulations These
policies and procedures must include restricting access to the protected
health data and information by the Grantee's employees.
5 The Grantee must have a policy and procedure to immediately report to
the Department any suspected or confirmed unauthorized use or
disclosure of protected health information that falls under the HIPAA
requirements of which the Grantee becomes aware The Grantee will
work with the Department to mitigate the breach and will provide
assurances to the Department of corrective actions to prevent further
unauthorized uses or disclosures The Department may demand specific
corrective actions and assurances and the Grantee must provide the
same to the Department
6. Failure to comply with any of these contractual requirements may result
in the termination of this Agreement in accordance with Part 2, Section V.
7 In accordance with HIPAA requirements, the Grantee is liable for any
claim, loss or damage relating to unauthorized use or disclosure of
protected health data and information, including without limitation the
Department's costs in responding to a breach, received by the Grantee
from the Department or any other source
6. The Grantee will enter into a business associate agreement should the
Department determine such an agreement is required under HIPAA
N. Home Health Services
If the Grantee provides Home Health Services (as defined in Medicare Part B),
the following requirements apply.
1 The Grantee shall not use State ELPHS or categorical grant funds
provided under this Agreement to unfairly compete for home health
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services available from private providers of the same type of services in
the Grantee's service area.
2. For purposes of this Agreement, the term "unfair competition" shall be
defined as offering of home health services at fees substantially less than
those generally charged by private providers of the same type of services
in the Grantee's area, except as allowed under Medicare customary
charge regulations involving sliding fee scale discounts for low-income
clients based upon their ability to pay
3. If the Department finds that the Grantee is not in compliance with its
assurance not to use state ELPHS and categorical grant funds to unfairly
compete, the Department shall follow the procedure required for failure
by local health departments to adequately provide required services set
forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public
Health Code), MC1333 2497 and 2498, MSA 1415 (2497) and (2498)
O. Website Incorporation
The Department is not bound by any content on Grantee's website or other
internet communication platforms or technologies, unless expressly
incorporated directly into this Agreement. The Department is not bound by any
end user license agreement or terms of use unless specifically incorporated in
this Agreement or any other agreement signed by the Department. The Grantee
may not refer to the Department on the Grantee's website or other internet
communication platforms or technologies without the prior written approval of
the Department
P. Survival
The provisions of this Agreement that impose continuing obligations will survive
the expiration or termination of this Agreement
Q. Non -Disclosure of Confidential Information
1 The Grantee agrees that it will use confidential information solely for the
purpose of this Agreement. The Grantee agrees to hold all confidential
information in strict confidence and not to copy, reproduce, sell, transfer
or otherwise dispose of, give or disclose such confidential information to
third parties other than employees, agents, or subcontractors of a party
who have a need to know in connection with this Agreement or to use
such confidential information for any purpose whatsoever other than the
performance of this Agreement. The Grantee must take all reasonable
precautions to safeguard the confidential information. These
precautions must be at least as great as the precautions the Grantee
takes to protect its own confidential or proprietary information
2 Meaning of Confidential Information
Forthe purpose of this Agreement the term "confidential information"
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means all information and documentation that.
a Has been marked "confidential" or with words of similar
meaning, at the time of disclosure by such party;
b If disclosed orally or not marked "confidential" or with words of
similar meaning, was subsequently summarized in writing by the
disclosing party and marked "confidential" orwith words of similar
meaning,
C. Should reasonably be recognized as confidential information of
the disclosing party,
d Is unpublished or not available to the general public, or
e Is designated by law as confidential
3. The term "confidential information" does not include any information or
documentation that was
a Subject to disclosure under the Michigan Freedom of
Information Act (FOIA); '
b Already in the possession of the receiving party without an
obligation of confidentiality,
c Developed independently by the receiving party, as
demonstrated by the receiving party, without violating the
disclosing party's proprietary rights,
d Obtained from a source other than the disclosing party without
an obligation of confidentiality, or
e Publicly available when received or thereafter became publicly
available (other than through an unauthorized disclosure by,
through or on behalf of, the receiving party)
4. The Grantee must notify the Department within one business day after
discovering any unauthorized use or disclosure of confidential
information. The Grantee will cooperate with the Department in every way
possible to regain possession of the confidential information and prevent
further unauthorized use or disclosure
R. Cap on Salaries
None of the funds awarded to the Grantee through this Agreement shall be used
to pay, either through a grant or other external mechanism, the salary of an
individual at a rate in excess of Executive Level II. The current rates of pay for
the Executive Schedule are located on the United States Office of Personnel
Management web site, http.//www.opm.gov, by navigating to Policy
— Pay & Leave —Salaries & Wages The salary rate limitation does not restrict
the salary that a Grantee may pay an individual under its employment; rather, it
merely limits the portion of that salary that may be paid with funds from this
Agreement.
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IV. Financial Requirements
A. Operating Advance
Under the pre -payment reimbursement method, no additional operating
advances will be issued
B. Payment Method
1 Prepayments
a. The Department will make monthly prepayments equal to
1/12th of the Agreement amount for each non -fee -for -service
program contained in Attachment IV of this Agreement. One
single payment covering all non -fee -for -service programs will
be made within the first week of each month The Grantee can
view their monthly prepayment within the M I E-Grants system
b Prepayments for the months of October thru January will be
based upon the initial Agreement amounts in Attachment IV.
Subsequent monthly prepayments may be adjusted based upon
Agreement amendments or Grantee adjustment requests.
C. If the sum of the prepayments does not equal at least 90 % of
the Grantee's expenditures for a quarter of the contract period,
the Grantee may submit documentation for an adjustment to the
monthly prepayment amount via the following process
i. Submit a written request for the adjustment to the
Department's Accounting Expenditure Operations Division
ii The adjustment request must be Itemized by program and
must list the amount received from the Department, the
expenditure amount reported per the quarterly Financial
Status Report (FSR), and the difference The amount
received from the Department and the expenditures must
be for the same reporting quarterly FSR period.
iii The Department will review the requests and if an
adjustment is approved, it will be included in the next
scheduled monthly prepayment
iv. Adjustment requests will not be accepted prior to
submission of the FSR for the quarter ending December
31. No adjustments will be made prior to the February
monthly prepayment
v. The ability of the Department to approve adjustments may
be limited by the quarterly allotments of spending authority
in the Department's appropriation account mandated by the
Office of the State Budget Director The quarterly allotment
limits the amount of each account (program) that
Data 0911920n contracta2a2]o35e-no Oakland Cnunt Depanmantd' H.Ah and Henan Scrviwst Page 25 of 179
HnaIN Drvis,on, L.cal HIfth Depaoment-2o22
the Department may expend during each fiscal quarter.
Fixed Fee Reimbursement
a. Quarterly reimbursement for fixed fee protects is based on
Attachment IV and approved quarterly Financial Status Reports.
C. Financial Status Report Submission
1 The Grantee shall electronically prepare and submit FSRs to the
Department via the EGrAMS website (http://egrams-mi com/mdhhs).
A Financial Status Report (FSR) must be submitted on a quarterly basis
no later than 30 days after the close of the calendar quarter for all
programs listed on Attachment IV and fee for services protect budgeted
Failure to meet financial reporting responsibilities as identified in this
Agreement may result in withholding future payments.
2. FSR's must report total actual program expenditures regardless of the
source of funds. The Department will reimburse the Grantee for
expenditures in accordance with the terms and conditions of this
Agreement Failure to comply with the reporting due dates will result in
the deferral of the Grantee's monthly prepayment.
3 The Grantee representative who submits the FSR is certifying to the best
of their knowledge and belief that the report is true, complete and
accurate and the expenditures, disbursements, and cash receipts are for
the purposes and objectives set forth in the terms and conditions of this
Agreement. The individual submitting the FSR should be aware that any
false, fictitious, or fraudulent information, or the omission of anymatenal
facts, may subject them to criminal, civil or administrative penalties for
fraud, false statements, false claims or otherwise.
4. The instructions for completing the FSR form are available on the
website http.//egrams-mi.com/dch. Send FSR questions to
FSRMDHHS@michigan.gov
D. Reimbursement Method
The Grantee will be reimbursed in accordance with the reimbursement methods
for applicable program elements described as follows:
1. Performance Reimbursement - A reimbursement method by which
Grantees are reimbursed based upon the understanding that a certain
level of performance (measured by outputs) must be met in order to
receive full reimbursement of costs (net of program income and other
earmarked sources) up to the contracted amount of state funds Any
local funds used to support program elements operated under such
provisions of this Agreement may be transferred by the Grantee within,
among, to or from the affected elements without Department approval,
subject to applicable provisions of Sections 3.8. and 3.0 3 of Part 1 If
Oalo o9lt1lLG21 ConitactM2B l2nJ5B-n0,0allan�raunly paparimenlof H..11h antl Human Services/ Page 26 or 179
I iealih omsmn, Loaal H-lth oapanmanbQoP—
Grantee's performance falls short of the expectation by a factor greater
than the allowed minimum performance percentage, the state
maximum allocation will be reduced equivalent to actual performance in
relation to the minimum performance
2. Actual Cost Reimbursement - A reimbursement method by which
Grantees are reimbursed based upon the understanding that state
dollars will be paid up to total costs in relation to the state's share of
the total costs and up to the total state allocation as agreed to in the
approved budget. This reimbursement approach is not directly
dependent upon whether a specified level of performance is met by the
local health department. Department funding under this
reimbursement method is allocable as a source before any local funding
requirement unless a specific local match condition exists.
3. Fixed Unit Rate Reimbursement - A reimbursement method by which
Grantee is reimbursed a specific amount for each output actually
delivered and reported.
4 Essential Local Public Health Services (ELPHS) - A reimbursement
method by which Grantees are reimbursed a share of reasonable and
allowable costs incurred for required services, as noted in the current
Appropriations Act.
E. Reimbursement Mechanism
F
G.
All Grantees must sign up through the on-line vendor registration process to
receive all State of Michigan payments as Electronic Funds Transfers
(EFT)/Direct Deposits. Vendor registration information is available through the
Department of Technology, Management and Budget's web site:
http://www.michigan.gov/sigmayss
Unobligated Funds
Any unobligated balance of funds held by the Grantee at the end of the
Agreement period will be returned to the Department or treated in accordance
with instructions provided by the Department.
Final Obligation Reporting Requirements
An Obligation Report, based on annual guidelines, must be submitted bythe due
date using the format provided by the Department through MI E-Grants. The
Grantee must provide, by program, an estimate of total expenditures forthe
entire Agreement period (October 1 through September 30). This report must
represent the Grantee's best estimate of total program expenditures for the
Agreement period The information on the report will be used to record the
Department's year-end accounts payables and receivables by program for this
Agreement. The report assists the Department in reserving sufficient funding to
reimburse the final expenditures that will be reported on the Final FSR
Dam onrnrzozl r,,,mraa01.1n1saoo ana 111,-1-1-1 Page 27 of 179
Heallll D--, Local Healy DepaM1ment-2112_
without materially overstating or understating the year-end obligations for this
Agreement The Department compares the total estimated expenditures from
this report to the total amount reimbursed to the Grantee in the monthly
prepayments and quarterly fee -for -service payments to establish accounts
payable and accounts receivable entries at fiscal year-end. The Department
recognizes that based upon payment adjustments and timing of Agreement
amendments, the Grantee may owe the Department funding for overpayment
of a program and may be due funds from the Department for underpayment of
a program at fiscal year-end
Within 60 days after the Agreement fiscal year-end, the Grantee must liquidate
any unpaid year-end commitments and obligations Any obligation remaining
unliquidated after 60 days from the end of the Agreement period shall revert to
the Department for disposition in accordance with applicable state and/orfederal
requirements, except as specifically authorized in writing by the Department.
H. Final Financial Status Reporting Requirements
Final FSRs are due on the following dates following the Agreement period
end date:
Project Final FSR Due Date
Public Health Emergency Preparedness 11/15/2022
All Remaining Projects 11/30/2022
Upon receipt of the final FSR electronically through MI E-Grants, the
Department will determine by program, if funds are owed to the Grantee or if the
Grantee owes funds to the Department If funds are owed to the Grantee,
payment will be processed. However, if the Grantee underestimated their year-
end obligations in the Obligation Report as compared to the final FSR and the
total reimbursement requested does not exceed the Agreement amount that is
due to the Grantee, the Department will make every effort to process full
reimbursement to the Grantee per the final FSR. Final payment may be delayed
pending final disposition of the Department's year-end obligations.
If funds are owed to the Department, it will generally not be necessary for
Grantee to send in a payment Instead, the Department will make the necessary
entries to offset other payments and as a result the Grantee will receive a net
monthly prepayment. When this does occur, clarifying documentation will be
provided to the Grantee by the Department's Bureau of Finance and Accounting
I. Penalties for Reporting Noncompliance
For failure to submit the final total Grantee FSR report by November 30, through
MI E-Grants after the Agreement period end date, the Grantee may be penalized
with a one-time reduction in their current ELPHS allocation for noncompliance
with the fiscal year-end reporting deadlines. Any penalty funds
Date 09117rz0z1 contraatOA22035e oo, Oakland county Devlh ntotn.aubadHuman semaaaI N, 2e of 179
Health Dvrs,on, Lutal Heellh Depmtnt-In']
will be reallocated to other Local Health Department Grantees Reductions will
be one-time only and will not carryfomard to the next fiscal year as an ongoing
reduction to a Grantee's ELPHS allocation. Penalties will be assessed based
upon the submitted date in MI E-Grants
ELPHS Penalties for Noncompliance with Reporting Requirements
1 1 % - 1 day to 30 days late,
2 2 % - 31 days to 60 days late;
3. 3 % - over 60 days late with a maximum of 3 % reduction in the
Grantee's ELPHS allocation.
Indirect Costs and Cost Allocations/Distribution Plans
The Grantee is allowed to use approved federal indirect rate, 10% de mmimis
indirect rate or cost allocation/distribution plans in their budget calculations.
1 Costs must be consistently charged as indirect, direct or cost allocated,
but may not be double charged or inconsistently charged.
2 If the Grantee does not have an existing approved federal indirect rate,
they may use a 10% de minimis rate in accordance with Title 2 Code of
Federal Regulations (CFR) Part 200 to recover their indirect costs.
3. Grantees using the cost allocation/distribution method must develop
certified plan in accordance with the requirements described in Title 2
CFR, Part 200 which includes detailed budget narratives and is retained
by the Grantee and subject to Department review.
4 There must be a documented, well-defined rationale and audit trail forany
cost distribution or allocation based upon Title 2 CFR, Part 200 Cost
Principles and subject to Department review
V. Agreement Termination
This Agreement may be terminated without further liability or penalty to the Department
for any of the following reasons
A By either party by giving 30 days written notice to the other party stating the
reasons for termination and the effective date.
B. By either party with 30 days written notice upon the failure of either party to carry
out the terms and conditions of this Agreement, provided the alleged defaulting
party is given notice of the alleged breach and fails to cure the default within the
30-day period
C Immediately if the Grantee or an official of the Grantee or an owner is convicted
of any activity referenced in Part 2 Section III. D. of this Agreement during the
term of this Agreement or any extension thereof
Further, this Agreement may be terminated or modified immediately upon a finding by
the Department in accordance with MCL 333.2235 that the Grantee local health
department for the delivery of public health services under this Agreement is unable or
unwilling to provide any or all of the services as provided in this Agreement, and the
Department may redirect funds as necessary to ensure that the public health services
D=t=orrnrzo2t =omn1a2UM_'e-nn,.,W,d 1wnry D=pmimentol H=ffinand .—e$.11=r Page 29 o1 179
H.,Ith orvison, I a=el Heeuh D=panment-2n22
are provided within the Grantee's jurisdiction
VI. Stop Work Order
The Department may suspend any or all activities under this Agreement at any time.
The Department will provide the Grantee with a written stop work order detailing the
suspension. Grantee must comply with the stop work order upon receipt. The
Department will not pay for activities, Grantee's Incurred expenses or financial losses,
or any additional compensation during a stop work period
VII. Final Reporting upon Termination
Should this Agreement be terminated by either party, within 30 days after the
termination, the Grantee shall provide the Department with all financial, performance
and other reports required as a condition of this Agreement The Department will make
payments to the Grantee for allowable reimbursable costs not covered by previous
payments or other state or federal programs The Grantee shall Immediately refund to
the Department any funds not authorized for use and any payments or fundsadvanced
to the Grantee in excess of allowable reimbursable expenditures.
VIII. Severability
If any part of this Agreement is held Invalid or unenforceable by any court of competent
jurisdiction, that part will be deemed deleted from this Agreement and the severed part
will be replaced by agreed upon language that achieves the same or similar objectives
The remaining parts of the Agreement will continue in full force and effect.
IX. Amendments
A. Except as otherwise provided, any changes to this Agreement will be valid
only if made in writing and accepted by all parties to this Agreement.
In the event that circumstances occur that are not reasonably foreseeable, or
are beyond the Grantee's or Department's control, which reduce or otherwise
Interfere with the Grantee's or Department's ability to provide or maintain
specified services or operational procedures, immediate written notification must
be provided to the other party Any change proposed by the Grantee which
would affect the state funding of any project, in whole or in part as provided in
Part 1, Section 3.C. of the Agreement, must be submitted in writingto the
Department for approval immediately upon determining the need for such
change The proposed change may be implemented upon receipt of written
notification from the Department.
B. Except as otherwise provided, amendments to this Agreement shall be made
within thirty days after receipt and approval of a change proposed by the
Grantee.
Amendments of a routine nature including applicable changes in budget
categories, modified indirect rates, and similar conditions which do not modify
the Agreement scope, amount of funding to be provided by the Department or,
Date fl7M1 Oakland County 0,,.o nlmlff—ll, a0.1man Page 30 of 179
Nealm o--Lnxl Heane 1,ft nr:m:
the total amount of the budget may be submitted by the Grantee, in writing, at
any time prior to June 7 The Department will provide a written response within
30 calendar days
All amendments must be submitted to the Department within three weeks of
receipt through MI E-Grants to assure the amendment can be executed prior to
the end of the Agreement period.
X- Liability
A. All liability to third parties, loss, or damage as a result of claims, demands, costs,
or judgments arising out of activities, such as direct service delivery, by the
Grantee, Grantee's subcontractors or anyone directly or indirectly employed by
the Grantee in the performance of this Agreement shall be the responsibility of
the Grantee, and not the responsibility of the Department. Nothing herein shall
be construed as a waiver of any governmental immunity that has been provided
to the Grantee or its employees by law.
B. In the event that liability to third parties, loss, or damage arises as a result of
activities conducted jointly by the Grantee and the Department in fulfillment of
their responsibilities under this Agreement, such liability, loss, or damage shall
be borne by the Grantee and the Department in relation to each party's
responsibilities under these joint activities, provided that nothing herein shall
be construed as a waiver of any governmental immunity by the Grantee, the
state, its agencies (the Department) or their employees, respectively, as
provided by statute or court decisions.
XI. Waiver
Failure to enforce any provision of this Agreement will not constitute a waiver
Any clause or condition of this Agreement found to be an impediment to the intended
and effective operation of this Agreement may be waived in writing by the Department
or the Grantee, upon presentation of written justification by the requesting party Such
waiver may be temporary or for the life of the Agreement and may affect any or all
program elements covered by this Agreement.
XII. State of Michigan Agreement
This is a state of Michigan Agreement and must be exclusively governed by the laws
and construed by the laws of Michigan, excluding Michigan's choice -of -law principle.
All claims related to or arising out of this Agreement, or its breach, whether sounding
in contract, tort, or otherwise, must likewise be governed exclusively by the laws of
Michigan, excluding Michigan's choice -of -law principles. Any dispute as a result of this
Agreement shall be resolved in the state of Michigan.
XIII. Funding
A. State funding for this Agreement shall be provided from the applicable and
available Department appropriations for the current fiscal year. The
Department provided funds shall be as stated in the approved Annual Budget -
Attachment I Instructions for the Annual Budget, Attachment III, Program
oam o9n7rzo21 connaaa2o^_2azsaoa, Oakland county Drvadlnent of Healh and Hunan sera -al Page 31 of 179
Heald, D nl—n Loa'al Health.,n.ent M22
Specific Assurances and Requirements, and as outlined in Attachment IV,
Funding/Reimbursement Matrix.
B. The funding provided through the Department for this Agreement shall not
exceed the amount shown for each federal and state categorical program
element except as adjusted by amendment. The Grantee must advise the
Department in writing by May 1, if the amount of Department funding may not be
used in its entirety or appears to be insufficient for any program element ELPHS
transfer requests between MDHHS, MDARD and MDEQ must also be requested
in writing by May 1. All ELPHS required services must be maintained throughout
the entire period of the Agreement.
C. The Department may periodically redistribute funds between agencies during
the Agreement period in order to ensure that funds are expended to meet the
varying needs for services.
Dare 09117P021 contTl 2a220358 an,oat,land nwmynepammentol Heath and Hyman sem«s/ Page. 32 of 119
Health Hhae,dn, Lo[a l H-Ah Depeft—a '0'2
FY22 Special Revenue Grant Positions
Schedule E - Creation
M2 Pos. Current Job Current Salary
Dept.B N Requested Classification FT/PT Hours Code Plan Grant
1060284 NEW Lactaction Speclanst RE 1 2080 J001427 UNI/10) WIC Breastfakrg
FY22 Special Revenue Grant
Schedule B - Continuations
Dept If
FY22 Budgeted Class
FT/PT
Hours
Filled As
Grant
Pos.n
1060212
14866 Medical Technologist
PTNE
1000
ELC Lab Enhancing Detection
i
1060212
14867 Medical Technologist
PINE
1000
ELC Lab Enhancing Detection
{
1060218
02070 Health Program Coordinator
HE
2080
IAP
1060218
07413 Public Health Nurse 111
HE
2080
IAP
1060218
07414 Office Leader
HE
2090
An 1
1060218
07415 Office Support Clerk -Senior
HE
2080
IAP 1
106OZ30
00752 Public Health Nurse 111
HE
2080
Maternal Children Health- Children and All Other, NFP 1
1060230
00906 Public Health Nurse 111
HE
2080
Nuree-FamIV Partnership i
1060230
03107 Public Health Nurse 111
HE
2080
NurseDahlPartnership +
1060230
03183 Public Health Nurse 111
HE
2080
Nurse-Famlly Partnership
1060230
03427 Public Health Nurse 111
HE
2080
Nurse -Family Partnership
1060234
02436 Vaccine SupplV Coordinator
HE
2080
Vaccine Quality Assurance +
1060234
07559 Vaccine Supply Coordinator
HE
2080
Vacclne Quality Assurance, IAP
1060234
01565 Public Health Nurse 111
HE
2080 Auxiliary Health Clerk -PTNE
Hep C
1060284
00674 Auwbary Health Clerk
HE
2080
WIC
I
1060284
00966 Office Support Clerk - Senior
HE
2080
Lactation Specialist- PTNE
WIC Breastfeeding
1
1060284
00912 Public Health Nutritionist 111
HE
2080
WIC Breastfeeding, WIC
i
1060284
00958 Office Supervlsor ll
HE
2080
WIC
1
1060284
01328 AuxlllaN Health Clerk
HE
2080
WIC
1060284
01865 Public Health Nutrition Supervisor
HE
2080
WIC
1060284
02074 Public Health Nutritionist ll
HE
2080
WIC
1060284
02509 Nutrition Technician - WIC
HE
2080
WIC
1060284
03073 Office Supervisor ll
HE
2080
WIC
1060284
04771 Aux11e" Health Clerk
HE
2080
WIC
1060294
04773 Aux111ary Health Clerk
HE
2080
WIC _
1060284
05204 Office Support Clerk Senior
HE
2080
Lactation Specialist -PTNE
WIC Breastfeedmg
1
1060284
05233 Public Health Npintiomst I
HE
2080
Nutrition Tech nlcian - WIC HE
WIC
1060284
05234 Pin We Health NuhltlonatI
HE
2080
Nutrition Technician - WIC -FTE
WIC
1060284
05235 Public Health Nutritionist ll
HE
2080
Nutrition Technician - WIC HE
WIC
1060284
05693 Public Health Nutritionist ll
HE
2090
WIC
i
1060284
07381 Public Health Nutritionist Ill
HE
2080
WIC
1060284
07382 Nutritlon Technician WIC
HE
2080
WIC
1060294
07384 Auxiliary Health Clerk
HE
2080
WIC
i
1060284
07552 Nutrition Technician - WIC
HE
2080
WIC
1060284
07563 Auxlliery Health Clerk
HE
20BO
WIC
1060284
11579 Lactation specialist
HE
2080
WIC Breastfei
1060284
12441 Lactatlon Specialist
PTNE
1000
WIC Breastfeeding
1060290
03094 Health Program Coordinator
HE
2080
PHEP
1060290
05246 Office Leader
HE
2080
Public Health Educator 11- PTNE
Cities Readiness Initiative
{
1060290
06747 Public Health Nurse 111
HE
2080
Public Health Educator ll-FTE
Cities Readiness Initiative, PREP
1060290
07416 Public Health Educator 111
HE
2060
Cities Readiness Initiative, PHEP
1060290
09999 PH Ends, Preparedness Specialist
HE
2080
_
Cties Readiness initiative, PHEP
1060291
04736 Health Program Coordinator
HE
2080
Maternal Children Health - Children and All Other/NFP
1060291
05129 Office Support Clerk -Senior
HE
2080
Children's Special Health Care Services i
1060291
05130 Supervisor PH Nursing
HE
2080
Children's Special Health Care Services
1060291
05163 Public Health Nurse 111
HE
2090
Public Health Nurse ll -PTNE
Children's Special Health Care Services
1060291
05401 Public Health Nutritionist ll
RE
2080
Maternal Children Health- Children and All Other i
1060291
06824 Auxiliary Health Clerk
HE
2080
Office Support Clerk -Senior-FTE
Chlldren's Spedal Health Care Semces 1�
1060291
07345 Public Health NuhltlonlsHl
HE
2080
Public Health Nutritionist III -PTNE
Maternal Children Health -Children and All Other, WIC B easffeeding 1
1060291
02360 Public Health Nutritionist HI
HE
2080
Public Health Educator 11-FTE
WIC
1060291
O7839 Auxtllary Health Clerk
PINE
1000
children's Special Health Care Services
1060291
12442 0ffice SupPert Clerk
PTNE
1000
Children's Special Health Care Services
1060294
06099 Public Health Nurse 111
HE
2080
Data to Care
1060294
06100 Public Health Nurse 111
HE
2080
Auxiliary Health Clerk -FTE
HIV PrEPCnit
1060294
06426 Health Program Coordinator
HE
2080
HIV Prevention
1060294
06538 Office support Clerk - Senior
HE
2080
HIV Preventlon/Adolescent Screening Prevention
1060294
07557 Public Health Nurse III
HE
2080
Public Health Nurse III - PTNE
HIV Prevention
1060294
09668 Public Health Nurse 111
HE
2080
HIV Prevention
1060294
12443 Clinical Health Specialist
PTNE
1000
HIV PrEP Clinic
FY22 Special Revenue Grant Positions
Schedule C- Reclassifications
FY22
Current lob
Current Salary
Requested lob
Requested Salary
Dept. N
Current Budgeted Classification
FT/PT Hours
Requested Classification
Fos. p
Code
Plan
Code
Plan
1060292
05131
Public Health Nurse ll
PTNE
1000
J001315
HRL/HY
Health Nurse 111
J001316
HRL/HZ
1060292
055260ffice
I Support Clerk
FTE
1 2080
1 J0n0514
( UNI/SOJ
(Public
Offlce Support Clerk -Senior
:0148
UNI/109
Grant
CMldi Saenal Health Care Grant
Children i Steed Health Care Grant
Dept. # FY22 Budgeted Classification
Pos. p
10602841 05205IAuwLary Health Clerk
1060234 0)814 Public Health Nurse III
FY22 Special Revenue Grant Positions
Schedule D - Deletions
FT/PT Hours Job Code Salary Plan
FTE 1 2080 I :06J UNI/109 WIC rant
Grant
IRE 2080 IOOJ)1 048/F
Grant
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