HomeMy WebLinkAboutResolutions - 2022.04.14 - 35454r
BOARD OF COMMISSIONERS
April 14, 2022
MISCELLANEOUS RESOLUTION #22-127
Sponsored By: Penny Luebs
Health & Human Services - Health Division - Grant Amendment #3 to the FY 2022 Emerging Threats
Local Health Department Agreement
Chairperson and Members of the Board:
WHEREAS Oakland County Health Division has received Amendment #3 to the Michigan Department of
Health and Human Services (MDHHS) Fiscal Year (FY) 2022 Emerging Threats Local Health Department
Agreement in the amount of $189,404 for the period November 1, 2021, through September 30, 2022; and
WHEREAS Amendment 43 changes the total amount of the agreement from $10,677,527 to $10,866,931, an
increase of $189,404; and
WHEREAS Amendment #3 provides American Rescue Plan funding to assist the Home Visiting Program and
associated families with the means to respond to immediate needs resulting from the impacts of COVID-19; and
WHEREAS this funding will support the costs of providing services and supplies to families, including
program costs and training needs for the Home Visiting Program for the period November 1, 2021 through
September 30, 2022; and
WHEREAS the Health Division is requesting to create one (1) Special Revenue (SR) Full -Time Eligible (FTE)
Public Health Nurse III position within the Public Health Nursing Services unit (41060230); and
WHEREAS no County match is required; and
WHEREAS Amendment #3 has completed the Grant Review Process in accordance with the Grants Policy
approved by the Board of Commissioners at their January 21, 2021, meeting.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
authorizes Amendment 43 to the Fiscal Year 2022 Emerging Threats Local Health Department Agreement
totaling $189,404 for the period of November 1, 2021, through September 30, 2022.
BE IT FURTHER RESOLVED to create one (1) Special Revenue Full -Time Eligible (FTE) Public Health
Nurse III position (#1060230).
BE IT FURTHER RESOLVED acceptance of this grant does not obligate the county to any future
commitment and continuation of this position and program is contingent upon continued future levels of grant
funding.
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute this agreement and to
approve any grant extensions or changes, within fifteen percent (15%) of the original award, which is consistent
with the agreement as originally approved.
BE IT FURTHER RESOLVED the FY 2022 Special Revenue budget is amended per the attached Schedule
a
Chairperson, the following Commissioners are sponsoring the foregoing Resolution: Penny Luebs.
(W-"" d Date: April 14, 2022
David Woodward, Commissioner
Date: April 22, 2022
Hilarie Chambers, Deputy County Executive II
Date: April 25 2022
Lisa Brown, County Clerk / Register of Deeds
COMMITTEE TRACKING
2022-04-05 Public Health & Safety - Recommend to Board
2022-04-14 Full Board
VOTE TRACKING
Motioned by Commissioner Gwen Markham seconded by Commissioner Penny Luebs to adopt the attached
Grant Amendment: #3 to the FY 2022 Emerging Threats Local Health Department Agreement.
Yes: David Woodward, Michael Gingell, Michael Spisz, Karen Joliat, Kristen Nelson, Eileen Kowall,
Christine Long, Philip Weipert, Gwen Markham, Angela Powell, Thomas Kuhn, Charles Moss, Marcia
Gershenson, William Miller III, Yolanda Smith Charles, Charles Cavell, Penny Luebs, Janet Jackson, Robert
Hoffman, Adam Kochenderfer (20)
No: None (0)
Abstain: None (0)
Absent: (0)
Passed
ATTACHMENTS
1. FY22 LHD Emerging Threats Amend#3_Schedule A
2, Grant Review Sign -Off - FY22 LED Emerging Threats Amendment #3
3. Health - FY22 Emerging Threats Local Health Dept Grant.Write Up
4. Draft Contact
5. ATT I
6. ATT III
7. ATT IV
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and
accurate copy of a resolution adopted by the Oakland County Board of Commissioners on April 14, 2022, with
the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court at Pontiac,
Michigan on Thursday, April 14, 2022.
Lisa Brown, Oakland County Clerk/Register of Deeds
Oakland County, Michigan
Health 6 Human Services / Health Division - FY 20U Emerging Threats Local Health Department Agreement -Amendment 3
Schedule "A" DETAIL
Fund Budget
FY 2022
FY 2023 FY 2024
R/E
Fund Name
Division
Name Fund#
Division #
Program
(Operating'
#Account#
Unit (OU) AfFliate Reference
I
IProject
Unit I Project#
Activity
Analysis
Account Title
Amendment
Amendment Amendment
R
COVID 19
Health
28630
1060201
133095
610313
2022
GRANT GR0000001163
GLB
GLB
Federal Operating Grants
$
189,404
$ - $ -
Total Revenue
$
189,404
$ - $
E
COVID 19
Health
28630
1060201
133095
702010
2022
GRANT GR0000001163
GLB
GLB
Salaries Regular
$
66,487
$ - $ -
E
COVID 19
Health
28630
1060201
133095
722740
2022
GRANT GR0000001163
GLB
GLB
Fringe Benefits
35,021
- -
E
COVID 19
Health
28630
1060201
133095
730072
2022
GRANT GR0000001163
GLB
GLB
Advertising
10,000
- -
E
COVID 19
Health
28630
1060201
133095
730373
2022
GRANT GR0000001163
GLB
GLB
Contractual
4,000
- -
E
COVID 19
Health
28630
1060201
133095
730926
2022
GRANT GR0000001163
GLB
GLB
Indirect Costs
9,189
- -
E
COVID 19
Health
28630
1060201
133095
730982
2022
GRANT GR0000001163
GLB
GLB
Interpreter Fees
2,500
- -
E
COVID 19
Health
28630
1060201
133095
731458
2022
GRANT GR0000001163
GLB
GLB
Professional Services
250
- -
E
COVID 19
Health
28630
1060201
M095
732018
2022
GRANT GR0000001163
GLB
GLB
Travel and Conference
6,170
- -
E
COVID 19
Health
28630
1060201
133095
750399
2022
GRANT GR0000001163
GLB
GLB
Office Supplies
50,654
- -
E
COVID 19
Health
28630
1060201
133095
774636
2022
GRANT GR0000001163
GLB
GI9
Into Tech Operations
3,376
- -
E
COVID 19
Health
28630
1060201
1M095
774677
2022
GRANT GR0000001163
GLB
GLB
Insurance Fund
457
- -
E
COVID 19
Health
28630
1060201
133095
778675
2022
GRANT GR0000001163
GLB
GLB
Telephone Communications
1,300
- -
Total Expenditures
$
189,404
$ - $
E
ELC Enhancing Detection
Health
28631
1060201
133095
702010
2022
GRANT GR0000001090
GLB
GLB
Salanes Regular
$
4,740
$ - $ -
E
ELC Enhancing Detection
Health
28631
1060201
1M095
722740
2022
GRANT GR0000001090
GLB
GLB
Fringe Benefits
249
- -
E
ELC Enhancing Detection
Health
28631
1060201
133095
730373
2022
GRANT GR0000001090
GLB
GLB
Contracted Services
(300,000)
- -
E
ELC Enhancing Detection
Health
28631
1060201
133095
730926
2022
GRANT GR0000001090
GLB
GLB
Indirect Costs
655
- -
E
ELC Enhancing Detection
Health
28631
1060201
133095
750168
2022
GRANT GR0000001090
GLB
GLB
FA Proprietyar Equip Exp
(12,420)
E
ELC Enhancing Detection
Health
28631
1060201
133095
750294
2022
GRANT GR0009801090
GLB
GLB
Material and Supplies
35,953
- -
E
ELC Enhancing Detection
Health
28631
1060201
133095
760157
2022
GRANT Gft0000001090
GLB
GLB
Equipment
12,420
E
ELC Enhancing Detection
Health
28631
1060201
133095
760160
2022
GRANT GR0000001090
GLB
GLB
Furniture and Futures
258,403
- -
Total Expenditures
$
-
$ - $
GRANT REVIEW SIGN -OFF — Health & Human Services / Health Division
GRANT NAME: FY 2022 Emerging Threat Local Health Department Agreement
FUNDING AGENCY: Michigan Department of Health & Human Services
DEPARTMENT CONTACT: Stacey Smith 248-452-2151
STATUS: Grant Amendment #3 (less than 15%)
DATE: 3/9/2022
Please be advised the captioned grant materials have completed internal grant review. Below are the returned comments
The Board of Commissioners' liaison committee resolution and grant amendment package (which should include this
sign -off and the grant amendment with related documentation) may be requested to be placed on the agenda(s) of the
appropriate Board of Commissioners' committee(s) for grant amendment by Board resolution.
111DIZ I3IIIt9101►1117 R OW I1111
Management and Budget:
Approved by M & B — Lynn Sonkiss 3/7/2022 if Risk Management's insurance concerns are addressed. In addition, need
to monitor the federal funds awarded for the County's local health department. The County will need to follow the
requirement for indirect cost rate authorization from the Federal Cognizant Agency if federal awards exceed $35M (FY
2021 was about $29M).
Also, the draft resolution is to be update with the applicable budget amendment language and Schedule A budget
amendment document for the amendment #3 grant award.
Human Resources:
Approved by Human Resources.
Creates one (1) FTE position, so HR action is needed. HR Department write up is attached for
submittal with the grant packet to CivicClerk. — Heather Mason 3/2/2022
Risk Management:
Approved by Risk Management with Modification to Attachment III: PROGRAM SPECIFIC ASSURANCES AND
REQUIREMENTS as detailed below in red.
• Insurance Requirements. Grantee, at its sole expense, must maintain the insurance or governmental self-
insurance coverage identified below. All required insurance must: (i) protect the State from claims that arise out
of, are alleged to arise out of, or otherwise result from Grantee's performance; (ii) be primary and non-
contributing to any comparable liability insurance (including self-insurance) carried by the State; and (iii) be
provided by a company with an A.M. Best rating of "A-" or better, and a financial size of VII or better except for
governmental self-insurance.
• b) Grantee must: (i) provide insurance or governmental self-insurance certificates to the Grant Administrator,
containing the agreement or delivery order number, at Grant formation and within twenty (20) calendar days of
the expiration date of the applicable policies; (ii) require that subgrantees maintain the required insurances
contained in this Section; (iii) notify the Grant Administrator within five (5) business days if any policy is
cancelled; and (iv) waive all rights against the State for damages covered by insurance. Failure to maintain the
required insurance does not limit this waiver.
Since Oakland County is self -insured for many of its' insurance exposures including general liability and medical
malpractice it cannot comply with the terms of the grant without this modification. -R.E. 3/2/2022
[ Department response -I spoke with the State and they confirmed that Oakland County did not receive funding for the
COVID49 Mobile testing project so the language on pages 12-14 of the attachment III (attached) would not be applicable
to Oakland County. — Stacey Smith 3/3/2022]
Understood, since the section titled PROJECT: COVID-19 Mobile Testing does not apply and there are no other
insurance requirements detailed in the documentation Risk Management Approves the grant without modifications.- R.E.
3/3/2022
Corporation Counsel:
I have reviewed the grant agreements and I have no legal issues with the documents, approved. — Bradley Bern 3/3/2022
REQUEST:
Create one (1) Special Revenue (SR) Full Time Eligible Public Health Nurse III position within the Health
Community Nursing unit (#1060230).
PROPOSED FUNDING:
FY2022 Emerging Threats Local Health Department Agreement
OVERVIEW:
The American Rescue (ARP) Plan funding is issued to create one (1) FTE Public Health Nurse III to assist
Home Visiting programs and associated families with the means to respond to immediate needs resulting
from the impacts of COVID-19 by providing services and supplies to families, while also supporting the
programmatic costs and training needs of Home Visiting agencies. Continuation of this position beyond
September 30, 2022, will be dependent on continued grant funding.
COUNTY EXECUTIVE RECOMMENDATION:
PERTINENT SALARIES FY 2022
Class Period Base
Annual 59,174
Public Health Nurse III
Biweek 2,275.91
Recommended as Requested.
1 Year 1 2 Year 3 Year
62,724 66,487 70,476
2,412.45 2,557.20 2,710.62
*Note: Annual rates are shown for illustrative purposes only.
SALARY AND FRINGE BENEFIT SAVINGS
4 Year 5 Year
74,705 76,991
2,873.26 2,961.18
**Note: Fringe benefit rates displayed are County averages. Annual costs are shown for illustrative
purposes only. Actual costs are reflected in the Miscellaneous Resolution.
Create one (1) FTE SR Public Health Nurse III
Salary @ 1 year step 62,724
Fringes @ 35.01% 21,960
Direct Contract Charge 11,744
Total Cost $ 96,428
02/22/2022
Contract #: 20220207-02
Amendment Number: 3 to the
Between
Michigan Department of Health and Human Services
and
County of Oakland
hereinafter referred to as the "Local Governing Entity"
on Behalf of Health Department
Oakland County Department of Health and Human Services/ Health Division
AMENDMENT PURPOSE AND JUSTIFICATION
1. The purpose of this amendment is to:
1. Add/revise information in Attachment I - Annual Budget Instructions;
2. Add/revise information in Attachment III - Program Specific Assurance and
Requirements; and
3. Incorporate Attachment IV- Funding/Reimbursement Matrix as revised for the
Essential Local Public Health Service (ELPHS) and categorical budget details, output
measures and performance criteria.
4. Increase the Department's agreement amount from $10,677,527 to $10,866,931,
as shown on the Attachment B budget pages.
2. Amendment Revisions:
The following are the additions/revisions to Attachment I and III
A) The following projects include additions/revisions as highlighted in Attachment I -
Annual Budget Instructions:
No Change
B) The following projects include additions/revisions as highlighted in Attachment III -
Program Specific Assurance and Requirements:
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 1 of 10
02/22/2022
1. American Rescue Plan - New
Following are adjustments to funding levels of the Local Health Department
agreement as reflected in Attachment IV:
Budget line item changes are reflected in the attached budgets for the
following elements:
Project Title
Current
Amended
New Project
ARM un-77mo�
---A-mou—nT
American Rescue Plan
0
189,404
189,404
Total Comprehensive Funding
0
189,404
189,404
Performance Level Adjustments
N/A
Budget category Adjustments
Contract # Project Title
E20223121-00 ELC Regional Lab
It is understood and agreed that all other conditions of the original agreement remains
the same.
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 2 of 10
02=12022
3. Signing this amendment
The individual or officer sigining this amendment certifies by his or her signature that
he or she is authorized to sign this amedment on behalf of the reponsible governing
board official or agency.
Signature Section
For Oakland County Department of Health and Human Services/ Health Division
Andrea Powers
Administrator
Name (please print) Title
For the Michigan Department of Health and Human Services
Christine H. Sanches
02/1612022
Christine H. Sanches, Director Date
Bureau of Purchasing
Emerging Threats. Local Health [Department- 2022, Date: 02/22/2022 Page: 3 of 10
02/22/2022
Attachments
Attachment I - Instructions for the Annual Budget
Attachment III - Program Specific Assurances and Requirements
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 4 of 10
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTACHMENT IV - Emerging Threats- Local Health Department- 2022
CONTRACT MANAGEMENT SECTION
Oakland County Department of Health and Human Services/ Health Division
Program Element/Funding Source
MDHHS
Fed/St
Funding Reimbursement
(a)
Source
Amount Method
(b)
American Rescue Plan
Reg. Alloc.
F
189,404 Actual Cost
Reimbursement
COVID Immunization
Reg. Alloc.
F
5,163,603 Actual Cost
Reimbursement
ELC Contact Tracing,
Reg. Alloc.
F
3,488,890 Actual Cost
Investigation, Testing Coord.,
Reimbursement
Monitoring and Wrap Around
ELC COVID-19 Infection
Reg. Alloy
F
337,500 Actual Cost
Prevention
Reimbursement
ELC Regional Lab
Reg. Alloc.
F
512,420 Actual Cost
Reimbursement
ELC Sewer Network
Reg. Alloc.
F
1,113,527 Actual Cost
Reimbursement
PFAS Response - Airport
Reg. Alloc.
S
60,390 Actual Cost
Reimbursement
PFAS Response - Falk Rd
Reg. Alice.
S
1,197 Actual Cost
Reimbursement
Contract# Date: 02/22/2022
Performance
Total (c)
State (d)
State Funded Minimum Contractor!
Target
Perform
Funded
Subrecepient
Output
Expect
Target
Performance
Percent (�
Measurement
Perform
Numt±r (e)
N/A
N/A
N/A
N/A
N/A Subrecepient
N/A
N/A
N/A
N/A
N/A Subrecepient
WA
N/A
N/A
N/A
N/A Subrecepient
N/A
N/A
N/A
N/A
N/A Subrecepient
N/A
N/A
N/A
N/A
N/A Recepient
N/A
N/A
N/A
N/A
N/A Subrecepient
N/A
N/A
N/A
N/A
N/A Recepient
N/A
N/A
N/A
WA
N/A Recepient
TOTAL MDHHS FUNDING 10,866,931
'SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIAAMENDMENT
Attachment IV Notes
Emerging Threats Loral Health Department-2022, Dale: 02/22/2022 Page: 5 of 10
Contract # Date: 02/22/2022
Project Budgets
Program Budget Summary
PROGRAM/PROJECT
Emerging Threats- Local Health Department- 2022 / ELC
DATE PREPARED
Regional Lab
2/22/2022
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
OD
BUDGET PERIOD
Health Division
From : 10/1 To : 9/30/2022
MAILING ADDRESS (Number and Street)
BUDGET AGREEMENT
1200 N. Telegraph Rd.
34 East
I" Original r Amendment
CITY
(STATE
(ZIP CODE
FEDERAL ID NUMBER
Pontiac
MI
48341-1032
38-6004876
I Category I Total
DIRECT EXPENSES
Program Expenses
1 Salary &Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County -City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Total Program Expenses
TOTAL DIRECT EXPENSES
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Total Indirect Costs
TOTAL INDIRECT EXPENSES
TOTAL EXPENDITURES
0.00
0.00
12,420.00
300,000.00
0.00
0,00
0.00
0.00
0.00
200,000.00
512,420,00
512,420.00
512,420.00
AMENDMENT#
3
Amount I
0.00
0.00
12,420.00
300,000.00 l
0.00 1
0.00
0.00
0.00
0.00
200,000.00
512,420.00
512,420.00
1
1
512,420.00
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 6 of 10
2 Program Budget - Source of Funds
SOU 2CE OF FUNDS
Category
1 Source of Funds
Fees and Collections - 1st and 2nd
Party
Fees and Collections - 3rd Party
Federal or State (Non MDHHS)
Federal Cost Based Reimbursement
Federally Provided Vaccines
Federal Medicaid Outreach
Required Match - Local
Local Non-ELPHS
Local Non-ELPHS
Local Non-ELPHS
Other Non-ELPHS
MDHHS Non Comprehensive
MDHHS Comprehensive
MCH Funding
Local Funds - Other
Inkind Match
MDHHS Fixed Unit Rate
Totals
Contract # Date: 02/22/2022
Total I
Amount I
Cash I
inkind
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00I
0.00
0.00
0.00
0.00I
0,00
0.00
0.00
0.00I
0.00
0.00
0.00
0.00I
0.00
0.00
0.00
0.00I
0,00
0.00
0.00
0.00)
0.00
0.00
0.00
0.00I
0.00
0.00
0.00
0.00I
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00I
512,420.00
512,420,00
0.00
0.00I
0.00
0.00
0,00
0,00'
0.00
0.00
0.00
0.00)
0.00
0.00
0.00
0.00I
512,420.00 1 512,420.00 1 0.00 1 0.00
Emerging Threats- Local Health Department. 2022, Date: 02/22/2022 Page: 7 of 10
3 Program Budget - Cost Detail
l ILine Item l Qtyl
(DIRECT EXPENSES
(Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fee.
Equipment I 0.00001
4 Contractual
Contracted Services 1 0.00001
5 Supplies and Materials
6 Travel
7 Communication
8 ICounty-City Central Services
9 ISpace Costs
1 10 JAII Others (ADP, Con. Employees, Misc.)
i(Furniture and Fixtures I 0.0000
(Total Program Expenses
(TOTAL DIRECT EXPENSES
IINDIRECT EXPENSES
lindirect Costs
11 Indirect Costs
1 2 Cost Allocation Plan / Other
(Total Indirect Costs
(TOTAL INDIRECT EXPENSES
(TOTAL EXPENDITURES
Contract # Date: 02/22/2022
Rate
UnitslUOM
l Totall
l
1
1
0,0001
0.0001
1
l
1 12,420.001
l
0,0001
0.0001
1 300, 000.001
1
1
1
0.0001
0.0001
1
1
1
200, 000.00
512,420.O01
512,420,001
0.001
0.001
512,420.001
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 8 of 10
Contract # Dale: 02/22/2022
Summary of Budget
PROGRAM/PROJECT
Emerging Threats- Local Health Department- 2022 /
DATE PREPARED
DATE
Emerqinq Threats- Local Health Department- 2022
CONTRACTOR NAME
PERI
BUDGET ERR OD
Oakland County Department of Health and Human Services/
From : To : 9/30/2022
Health Division
MAILING ADDRESS (Number and Street)
BUDGET AGREEMENT AMENDMENT#
1200 Telegraph Rd.
34 Eastst
Original Amendment 3
� ry
CITZIP CODE
ATE I4
FEDERAL ID
I38-6004876 NUMBER I
Pontiac MI341- 032
Category I Total I Amount I
DIRECT EXPENSES
Progra n Expenses
1 Salary & Wages 4,430,796.00 4,430,796.00
2 Fringe Benefits
243,839.00
243,839.00
3 Cap. Exp. for Equip & Fac.
62,420.00
62,420.00
4 Contractual
4,776,153.00
4,776,153.00
5 Supplies and Materials
179,275.00
179,275.00
6 Travel
6,037.00
6,037.00
7 Communication
30,000.00
30,000.00
8 All Others (ADP, Con. Employees, Misc.)
505,853.00
505,853.00
Total Program Expenses
10,234,373.00
10,234,373.00
TOTAL DIRECT EXPENSES
10,234,373.00
10,234,373.00
INDIRECT EXPENSES
Indirect Costs
1 I Cost Allocation Plan / Other 443,154.00 443,154.00
(Total Indirect Costs
443,154.00
443,154.00I
(TOTAL INDIRECT EXPENSES
443,154.00
443,154.00
(TOTAL EXPENDITURES
10,677,527.00
10,677,527.00
SOURCE OF FUNDS
Category
Total
Amount
Cash
Inkind
(1 Fees and Collections - 1st and 2nd
0.00
0.00
0.00
0.00
Party
12 Fees and Collections - 3rd Party
0.00
0.00
0.00
0.001
13 Federal or State (Non MDHHS)
0.00
0.00
0.00
0.001
Emerging Threats- Local Health Department-2022, Date: 02/22/2D22
Page: 9 of 10
Contract # Date: 02/22/2022
14
Federal Cost Based Reimbursement
0.00
0.00
0.00
0.001
15
Federally Provided Vaccines
0.00
0.00
0.00
0.001
16
Federal Medicaid Outreach
0.00
0.00
0.00
0.001
17
Required Match - Local
0.00
0.00
0.00
0.001
18
Local Non-ELPHS
0.00
0.00
0.00
0.001
19
Local Non-ELPHS
0.00
0.00
0.00
0.001
110
Local Non-ELPHS
0.00
0.00
0.00
0,001
I11
Other Non-ELPHS
0,00
0.00
0.00
0.001
112
MDHHS Non Comprehensive
0.00
0.00
0.00
0.001
113
(MDHHS Comprehensive
10,677,527,00
10,677,527.00
0,00
0.001
114
IMCH Funding
0.00
0.00
0.00
0.001
115
(Local Funds - Other
0.00
0.00
0.00
0.001
116
I Inkind Match
0.00
0.00
0.00
0.001
117
IMDHHS Fixed Unit Rate
0.00
0.00
0.00
0.001
IITOTAL
10,677,527.00
10,677,527.00
0.00
0.001
Emerging Threats- Local Health Department- 2022, Date: 02/22/2022 Page: 10 of 10
ATTACHMENT
MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
Local Health Department Agreement
October 1, 2021- September 30, 2022
Fiscal Year 2022
INSTRUCTIONS
FOR THE
ANNUALBUDGET
INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES
TABLE OF CONTENTS
Page
I.
INTRODUCTION............................................................................................................
2
II.
MINIMUM BUDGETING REQUIREMENTS...................................................................2
III.
REIMBURSEMENT CHART...........................................................................................
3
IV.
LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION
PROCEDURES..............................................................................................................
3
V.
FORM PREPARATION - GENERAL..............................................................................
4
VI,
FORM PREPARATION - EXPENDITURE CATEGORIES .............................................
4
VII.
FORM PREPARATION -SOURCE OF FUNDS.............................................................
6
VIII.
SPECIAL BUDGET INSTRUCTIONS
A. Public Health Emergency Preparedness(PHEP)....................................................
9
B. Program Budget Detail- Cost Detail Schedule Preparation ....................................
10
C. Immunization 317 and VFC Allowable Expenditures ............................................
18
i
INSTRUCTIONS FOR THE
ANNUAL BUDGET
FOR LOCAL HEALTH SERVICES
ILIIZT61.11Z+3fro]
The Annual Budget for Local Health Services is completed on a state fiscal year basis and is
used to establish budgets for many Department programs. In the Annual Budget, the
Department consolidates many of its categorical programs' funding and Essential Local Public
Health Services (ELPHS) (formerly known as the local public health operation's funding) into a
single, Comprehensive Agreement for local health departments. The Department's Plan and
Budget Framework serves as a principal reference point for budget development.
The Annual Budget for Local Health Services must be completed in accordance with and adhere
to the established requirements as specified in these instructions and submitted to the
Department as required by the agreement.
II. MINIMUM BUDGETING REQUIREMENTS
A. Cost Principles - Types or items of cost which will be considered for reimbursement are
generally consistent with definitions contained in Title 2 Code of Federal Regulations
CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards.
B. Federal Block Grant Funds - Maternal & Child Health and Preventive Health Block
Grant funds may not be used to: provide inpatient services; make cash payments to
intended recipients of health services; purchase or improve land; purchase, contract or
permanently improve (other than minor remodeling defined as work required to change
the interior arrangements or other physical characteristics of any existing facility or
installed equipment when the cost of the remodeling incident does not exceed $2,000)
any building or other facility; or purchase major medical equipment (any item of medical
equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of
patients, excluding equipment typically used in a laboratory); satisfy any requirement for
the expenditure of non-federal funds as a condition for the receipt of Federal funds; or
provide financial assistance to any entity other than a public or nonprofit private entity.
C. Expenditure and Fundina Source Breakdown - For purposes of development, analysis
and negotiation activities must be budgeted at the individual expenditure and funding
source category level on the Annual Budget for Local Health Services.
D. Special Budaet Reauirements for Certain Cateaorical Proaram Elements - The
Annual Budget for Local Health Services is completed in the MI E-Grants System
through the application budget to include details for all program elements (excluding
Administration and Grantee Support).
III. REIMBURSEMENT CHART
A. Program Element/Funding Source
The Program Element/Funding Source column has been moved to Attachment III and
provides the listing of all currently funded MDHHS programs that are included in the
Comprehensive Local Health Department Agreement.
B. Tvpe of Project
The type of project designation is indicated by footnote and is used if the project meets
the Research and Development Project criteria. Research and Development Projects
are defined by Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.
Research and development (R&D) means all research activities, both basic and applied,
and all development activities that are performed by non -Federal entities. Research is
defined as a systematic study directed toward fuller scientific knowledge or
understanding of the subject studied. The term research also includes activities involving
the training of individuals in research techniques where such activities utilize the same
facilities as other research and development activities and where such activities are not
included in the instruction function. Development is the systematic use of knowledge and
understanding gained from research directed toward the production of useful materials,
devices, systems, or methods, including design and development of prototypes and
processes.
C. Reimbursement Chart
The Reimbursement Chart notes elements/funding sources, applicable payment
methods, target levels, output measures foreach program/element having a performance
reimbursement option. In addition, the chart also provides the subrecipient, contractor, or
recipient designations, as in prior years:
IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION
PROCEDURES
As in past years, no additional accounting system detail is being required beyond local uniform
accounting procedures prescribed by the Michigan Department of Treasury, Local Financial
Management System requirements, documentation requirements of categorical program funding
sources and any local requirements. Some agencies may already have separate cost centers in
their accounting system to directly identify costs and related funding of required services, but
such breakdowns are not essential to being able to meet minimum reporting requirements if
proper allocation procedures are used and adequate documentation is maintained. All
allocations must have clearly measurable bases that directly apply to the amounts being
allocated, must be documented with work papers that will provide an adequate audit trail and
must result in a representative reporting of costs and funding for affected programs. More
specific guidance can be found in Title 2 CFR, Part 200 Appendix V State/Local Government
and Indian Tribe -Wide Central Service Cost Allocation Plans and the brochure published by the
Department of Health and Human Services entitled "A Guide for State, Local and Indian Tribal
Governments: Cost Principles and Procedures for Developing Cost Allocation Plans and Indirect
Cost Rates for Agreements with the Federal Government.
V. FORM PREPARATION - GENERAL
The MI E-Grants System on-line application, including the budget entry forms, are utilized to
develop a budget summary for each program element administered by the local Grantee. The
system is designed to accommodate any number of local program elements including those
unique to a particular local Grantee. Applications, including budget forms, are completed for all
program elements, regardless of the reimbursement mechanism, including Agency
administration(s) fee for service program elements, categorical program elements, performance -
based program elements and Medicaid Outreach associated program elements. Budget entry is
required for each major expenditure and source of fund categories for which costs/funds are
identified.
VI. FORM PREPARATION - EXPENDITURE CATEGORIES
Budaeted expenditures are to be entered for each program element, project or group of
services by applicable major category.
A. Salaries and Waaes- This category includes the compensation budgeted for all permanent
and part-time employees on the payroll of the Grantee and assigned directly to the program.
This does not include contractual services, professional fees or personnel hired on a private
contract basis. Consulting services, vendor services, professional fees or personnel hired on
a private contracting basis should be included in "Other Expenses." Contracts with
secondary recipient organizations such as cooperating service delivery institutions or
delegate agencies should be included in Contractual (Sub -contract) Expenses.
B. Frinae Benefits - This category is to include, for at least the specified elements, all Grantee
costs for social security, retirement, insurance and other similar benefits for all permanent
and part-time employees assigned to the specified elements.
C. Cap ExD for EauiD & Fac - This category includes expenditures for budgeted stationary and
movable equipment used in carrying out the objectives of each program element, project or
service group. The cost of a single unit or piece of equipment includes necessary
accessories, installation costs, freight and other applicable expenses associated with the
purchase of the equipment. Only budgeted equipment items costing $5,000 or more may be
reported under this category. Small equipment items costing less than $5,000 are properly
classified as Supplies and Materials or Other Expenses. This category also includes capital
outlay for purchase or renovation of facilities.
D. Contractual (Subcontracts/Subrecinient) - Use for expenditures applicable to written
contracts or agreements with secondary recipient organizations such as cooperating service
delivery institutions or delegate agencies. Payments to individuals for consulting or
contractual services, or for vendor services are to be included under Other Expenses.
Specify subcontractor(s) address, amount by subcontractor and total of all subcontractors.
E. Supplies and Materials - Use for all consumable items and materials including equipment -
type items costing less than $5,000 each. This includes office, printing, janitorial, postage
and educational supplies; medical supplies; contraceptives and vaccines; tape and gauze;
prescriptions and other appropriate drugs and chemicals. Federal Provided Vaccine Value
should be reported and identified on in Other Cost Distributions category. Do not combine
with supplies.
F. Travel - Travel costs of permanent and part-time employees assigned to each program
element. This includes costs of mileage, per diem, lodging, meals, registration fees and
other approved travel costs incurred by the employee. Travel of private, non -employee
consultants should be reported under Other Expenses.
G. Communication Costs - These are costs for telephone, Internet, telegraph, data lines,
websites, fax, email, etc., when related directly to the operation of the program element.
H. County/City Central Services -These are costs associated with central support activities of
the local governing unit allocated to the local health department in accordance with Title 2
CFR, part 200.
I. Space Costs - These are costs of building space necessary for the operation of the
program.
J. All Others (Line 11) - These are costs for all other items purchased exclusively for the
operation of the program element and not appropriately included in any of the other
categories including items such as repairs, janitorial services, consultant services, vendor
services, equipment rental, insurance, Automated Data Processing (ADP) systems, etc.
K. Total Direct Expenditures — The MI E-Grants System sums the direct expenditures
budgeted for each program element, project or service grouping and records in the Total
Direct Expenditure line of the Budget Summary.
L. Indirect Cost —These cost categories are used to distribute costs of general administrative
operations that have not been directly charged to individual subrecipient programs. The
Indirect Cost expenditures distribute administrative overhead costs to each program element,
project or service grouping. Two separate local rates may apply to the agreement period
(i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the
first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter
part. Indirect costs are not allowed on programs elements designated as vendor relationship.
An indirect rate proposal and related supporting documentation must be retained for audit in
accordance with records retention requirements. In addition, these documents are reviewed
as part of the Single Audit, subrecipient monitoring visit, or other State of Michigan reviews.
Following is further clarification regarding indirect rate and/or cost allocation approval
requirements to distribute administrative overhead costs, in accordance with Title 2 CFR Part
200 (formerly Circular A-87 2 CFR Part 225, Appendix E), for Local Health Departments
budgeting indirect costs:
1. Local Health Departments receivinq more than $35 million in direct Federal awards are
required to have an approved indirect cost rate from a Federal Cognizant Agency. If your
Local Health Department has received an approved indirect rate from a Federal
Cognizant agency, attach the Federal approval letter to your MI E-Grants Grantee Profile.
2. Local Health Departments receiving $35 million or less in direct Federal awards are
required to prepare indirect cost rate proposals in accordance with Title 2 CFR and
maintain the documentation on file subject to review.
3. Local Health Departments that received approved indirect cost rates from another State
of Michigan Department should attach their State approval letter to their MI E-Grants
Grantee Profile.
4. Local Health Departments with cost allocation plans should reflect these allocations in the
Other Cost Distributions budget category. See Section M. Other Cost Distribution for
budgeting guidance.
5. As a Subrecipient of federal funds from MDHHS, a Local Health Department that has
never received a negotiated indirect cost rate, your Local Health Department may elect to
charge a de minimis rate of 10% of modified total direct costs (MTDC) based on Title 2
CFR part 200 requirements.
MTDC includes all direct salaries and wages, fringe benefits, supplies and materials,
travel, services, and contractual expenses up to the first $25,000 of each contract.
MTDC excludes all equipment, capital expenditures, charges for patient care, rental
costs, tuition remission, scholarships and fellowships, participant support costs, and
portions subcontractual/subaward expenses in excess of $25,000 per contract.
Attach a current copy of the letter stating the applicable indirect costs rate or calculation
information justifying the de minimis rate calculation to you MI E-Grants Grantee profile.
Detail on how the indirect costs was calculated must be shown on the Budqet
Detail Schedule.
The amount of Indirect Cost should be allocated to all appropriate program elements with the
total equivalent amount reflected as a credit or minus in the Administration projects.
M. Other Cost Distributions — Use to distribute various contributing activity costs to
appropriate program areas based upon activity counts, time study supporting data or other
reasonable and equitable means. An example of Other Cost Distributions is nursing
supervision. The distribution process permits costs reflected in a single program element to
be subsequently distributed, perhaps only in part, to other programs or projects as
appropriate. If an allocation is made, the charges must be reflected in the appropriate
program element and the offsetting credit reflected in the program element being distributed.
There must be a documented, well-defined rationale and audit trail for anv cost
distribution or allocation based upon Title 2 CFR. Part 200 Cost Principles Local Health
Departments using the cost distribution or cost allocation must develop the plan in
accordance with the requirements described in Title 2 CFR, Part 200. Local Health
Departments should maintain supporting documentation for audit in accordance with record
retention requirements. The plan should include a Certification of Cost Allocation plan in
accordance with Title 2 CFR, Part 200 Appendix V. The cost allocation plan documentation
is not required to be submitted unless specifically requested.
Cost associated with the Essential Local Public Health Services (ELPHS), Maternal and
Child Health (MCH) Block Grant and Fixed Fee may be budgeted in the associated program
element and distributed to the associated projects.
Federal Provided Vaccine Value should be reported on a separate line and clearly identified.
N. Total Direct & Admin. Expenditures — The MI E-Grants System sums the indirect
expenditures program element and records in the Total Indirect Expenditure line of the
Budget Summary.
O. Total Expenditures — The MI E-Grants System sums the direct and indirect expenditures
and records in the Total Expenditure line of the Budget Summary.
VII. FORM PREPARATION -SOURCE OF FUNDS
Source of Funds are to be entered for each program element, project or group of services by
applicable major category as follows:
A. Fees & Collections - Fees 15t & 2nd Party—
i. 15t party funds projected to be received from private payers, including patients, source
users and any member of the general population receiving services.
ii. 2nd party funds received from organizations, private or public, who might reimburse
services for a group or under a special plan.
ill. Any Other Collections
B. Fees & Collections - 3rd Partv — 3rd Party Fees - Funds projected to be received from
private insurance, Medicaid, Medicare or other applicable titles of the Social Security Act
directly related to the cost of providing patient care or other services (e.g., includes Early
Periodic Screening, Detection and Treatment [EPSDT] Screening, Family Planning.)
C. Federal/State Fundina (Non-MDHHS) - Funds received directly from the federal
government and from any state Contractor other than MDHHS, such as the Department of
Natural Resources and Environment (MDNRE). This line should also be used to exclude
state aid funds such as those provided through the Michigan Department of Treasury under
P.A. 264 of 1987 (cigarette tax).
D. Federal Cost Based Reimbursement — Funds received for Federal Cost Based
Reimbursement which should be budgeted in the program in which they were earned.
E. Federally Provided Vaccines — The projected value of federally provided vaccine.
F. Federal Medicaid Outreach — (Please note: to be used only for Medicaid Outreach,
CSHCS Medicaid Outreach or Nurse Family Partnership Medicaid Outreach program
elements.) Funds projected to be received from the federal government for allowable
Medicaid Outreach activities. This amount represents the anticipated 50% federal
administrative match of local contributions.
G. Required Match - Local — Funds projected to be local contribution for programs that have a
match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid
Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50%
matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid
Outreach and Required Local match amounts should equal each other.)
H. Local Non-ELPHS - Local funds budgeted for the following expenditures:
Expenditures for services not designated as required and allowable for ELPHS funding
(e.g., medical examiner and inpatient maternity services); expenditures determined notto
be reasonable; and, expenditures in excess of the maximum state share of funds
available.
2. Any losses arising from uncollectible accounts and other related claims. Under -recovery
of reimbursable expenditures from, or failure to bill, available funding sources that would
otherwise result in exclusions from ELPHS funding, if recovered.
However, no exclusion is required where the local jurisdiction has made and documented
a decision to have local funds underwrite:
a. The cost of uncollectible accounts or bad debts incurred in support of providing
required or allowable health services. An example of this condition would be for
services provided to indigents who are billed as a matter of procedure with little
chance for receipt of payment.
b. Potential recoveries or under -recoveries from other sources for the principal purpose
of providing required and allowable health services at free or reduced cost to the
public served by the Grantee. An example would be keeping fees for services at a
reduced level for the benefit of the people served by the Grantee while recognizing
that to do so limits recovery from third parties for the same types of services.
3. Contributions to a contingency reserve or any similar provisions for unforeseen events.
4. Charitable contributions and donations.
5. Salaries and other incidental expenditures of the chief executive of a political subdivision
(i.e., county executive and mayor).
6. Legislative expenditures, such as, salaries and other incidental expenditures of local
governing bodies (i.e., county commissioners and city councils). Do not enter board of
health expenses.
7. Expenditures for amusements, social activities and other incidental expenditures related
to, such as, meals, beverages, lodging, rentals, transportation and gratuities.
8. Fines, penalties and interest on borrowings.
9. Capital Expenditures - Local capital outlay for purchase of facilities and equipment
(assets) are excluded from ELPHS funding.
I. Other Non- ELPHS - Funds budgeted from sources other than state, federal and local
appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local
substance abuse coordinating grantee, local area on aging grantees).
J. MDHHS - NON -COMPREHENSIVE - Funds budgeted for services provided under separate
MDHHS agreements. Examples include funding provided directly by the Community
Services for Substance Abuse for community grants, etc.
K. MDHHS - COMPREHENSIVE - This section includes all funding projected to be due under
the Comprehensive Agreement from categorical programs and needs to equal the allocation.
L. ELPHS - MDHHS Hearina, — This section includes all funding projected to be due under
Comprehensive Agreement specific to the ELPHS MDHHS Hearing program and has to
equal the MDHHS ELPHS Hearing allocation. Additional ELPHS to be budgeted for the
Hearing Program must be entered into ELPHS — MDHHS Other. Hearing allocations may
only be spent on the Hearing Program.
M. ELPHS - MDHHS Vision — This section includes all funding projected to be due under
Comprehensive Agreement specific to the ELPHS MDHHS Vision program and has to equal
the ELPHS MDHHS Vision allocation. Additional ELPHS to be budgeted for the Vision
Program must be entered into ELPHS — MDHHS Other. Vision allocations may only be
spent on the Vision Program.
N. ELPHS — MDHHS Other — This section includes all funding projected to be due under
Comprehensive Agreement specific to the ELPHS MDHHS Other program for eligible
program elements. Please note: The MI E-Grants System validates the ELPHS MDHHS
Other budgeted funds across the applicable program elements to assure the agreement
does exceed the ELPHS — MDHHS Other allocation.
O. ELPHS — Food -This section includes all funding projected to be due under Comprehensive
Agreement specific to the ELPHS Food program and has to equal the ELPHS Food
allocation.
P. ELPHS — Drinkina Water - This section includes all funding projected to be due under
Comprehensive Agreement specific to the ELPHS Drinking Water program and has to equal
the ELPHS Drinking Water allocation.
Q. ELPHS — On -site Sewage - This section includes all funding projected to be due under
Comprehensive Agreement specificto the ELPHS On -site Sewage program and has to equal
the ELPHS On -site Sewage allocation.
R. MCH Funding -This section includes all funding projected to be due under Comprehensive
Agreement specific to the MCH eligible program elements. Please note: The MI E-Grants
System validates the MCH budgeted funds across applicable program elements to assure
the agreement does exceed the MCH allocation.
S. Local Funds - Other - Enter all local support in the appropriate element, project or service
group column. This may include local property tax, and other local revenues (does not
include fees).
T. Inkind Match — Enter Local Support from donated time or services.
U. MDHHS Fixed Unit Rate —Select the type of fee -for -services from the lookup to correspond
with the program element.
Vill. SPECIAL BUDGET INSTRUCTIONS
Certain elements are supported by federal or other categorical program funds for which special
budgeting requirements are placed upon grantees and subgrantees. These include:
Element Federal or Other Funding Contractor
Public Health Emergency U.S. Department of Health & Human Services, Centers for Disease Control
Preparedness
In general, subgrantee budgets must provide sufficient budget detail to support grantee budget
requests and be in a format consistent with grantor Contractor requirements. Certain types of
costs must receive approval of the federal grantor Contractor and/or the grantee prior to being
incurred.
A. Public Health Emergencv Preparedness (PREP) Special Budqet Requirements
Local Health Departments will receive the initial FY 21/22 allocation of the CDC Public
Health Emergency Preparedness (PREP) funds in nine equal prepayments for the period
October 1, 2021 through June 30, 2022. LHDs must submit a nine -month budget and a
quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE
Local Health Department program elements:
1. Public Health Emergency Preparedness (PHEP) (October 1 — June 30)
2. Public Health Emergency Preparedness (PHEP)— Cities of Readiness (October 1 —
June 30)
3. Laboratory Services - Bioterrorism (October 1 — September 30)
Costs Allowable Only With Prior Approval - The following costs are allowable only
withprior review/approval of the Michigan Department of Health & Human Services as
specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR
Part 246, and USDA -WIC Administrative Cost Handbook 3/86). Prior approval is
accomplished by providing appropriate detail in the budget request approved by MDHHS
or subsequently in a written request approved in writing by MDHHS.
A. Automated Information Svstems -which are required by a local Grantees except
for those used in general management and payroll, including acquisition of
automated data processing hardware or software whether by outright purchase
or rental -purchase agreement or other method of acquisition.
B. Capital Expenditures of $2.500 or More - such as the cost of facilities,
equipment, including medical equipment, other capital assets and any repairs
that materially increase the value or useful life of capital assets.
C. 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. Accountina and Auditina Services - performed by private sector firms under
professional service contracts for purposes of preparation or audit of program
and financial records/reports.
E. Other Professional Services - rendered by individuals or organizations, not a part
of the local Grantee, such as:
Contractual private physician providing certification data.
Contractual organization providing laboratory data.
Contractual translators and interpreters at the local Grantee level.
F. Trainina and Education - provided for employee development, which directly or
indirectly benefits the grant program, to the extent that such training is contracted
for or involves out -of -service training over extended periods of time.
G. Buildina Space and Related Facilities - the cost to buy, lease or rent space in
privately or publicly owned buildings for the benefit of the program.
H. Non-Frinae Insurance and Indemnification Costs
All charges to WIC must be necessary, reasonable, allowable and allocable for
the proper and efficient administration of the program. Further information and
cost standards are provided in federal instructions including Title 2 CFR, Part
200 and 7 CFR Part 3015.
B. Proaram Budaet - Online Detail Budaet ADDlication Entry
Complete the appropriate budget forms contained within the MI E-Grants System for each
program element. An example of this form is attached (see Attachment 1 for reference).
Salary and Waaes -
a. Position Descriotion - Select from the expenditure row look -up all position titles
orjob descriptions required to staff the program. If the position is missing from the
list, please use Other and type in the position in the drop -down field provided.
b. Positions Reauired - Enter the number of positions required for the program
corresponding to the specific position title or description. This entry may be
expressed as a decimal (e.g., Full -Time Equivalent — FTE) when necessary. If
other than a full-time position is budgeted, it is necessary to have a basis in terms
10
of time reports to support time charged to the program.
c. Amount —The MI E-Grants System calculates the salary for the position required
and records it on the Budget Detail. Enter this amount in the Amount column.
d. Total Salary —The MI E-Grants System totals the amount of all positions required
and records it on the Budget Summary.
e. Notes - Enter any explanatory information that is necessary for the position
description. Include an explanation of the computation of Total Salary in those
instances when the computation is not straightforward (i.e., if the employee is
limited term and/or does not receive fringe benefits).
2. Frinae Benefits— Select from the expenditure row look -up applicable fringe benefits
for staff working in this program. Enter the percentage for each. The MI E-Grants
system updates the total amount for salary and wages in the unit field and calculates
the fringe benefit amount. If the "Composite Rate" fringe benefit item is selected from
the expenditure row look up, record the applicable fringe benefit items (i.e. FICA, Life
insurance, etc.) in the "Notes" tab.
3. Eauivment - Enter a description of the equipment being purchased (including
number of units and the unit value), the total by type of equipment and total of all
equipment purchases.
4. Contractual - Specify subcontractor(s)/subrecipient(s) working on this program,
including the subcontractor's/subrecipient's address, amount by
subcontractor/subrecipient and total of all subcontractor(s)/subrecipient(s). Multiple
small subcontracts can be grouped (e.g., various worksite subcontracts).
5. Supplies and Materials - Enter amount by category. A description is required if
the budget category exceeds 10% of total expenditures.
6. Travel - Enter amount by category. A description is required if the budget
category exceeds 10% of total expenditures.
7. Communication - Enter amount by category. A description is required if the
budget category exceeds 10% of total expenditures.
8. County -City Central Services - Enter amount by category and total for all
categories.
9. Space Costs - Enter amount by category and total for all categories.
10. Other Expenses - Enter amount by category and total for all categories. A
description is required if the budget category exceeds 10% of total
expenditures.
11. Indirect Cost Calculation - Enter the base(s), rate(s) and amount(s).
12. Other Cost Distributions - Enter a description of the cost, percent distributed to this
program and the amount distributed.
13. Total Exp. - MI E-grants totals the amount of all positions required and records it on
the Budget Summary.
Program Budget -Cost Detail Schedule Preparation
11
B1 Attachment B1-Proaram Budaet Summary
Agamcy ABC Health DBPaNmant Program Comprehensive Agreement- FY 20M
APphcailm Family Planning Sews BAMPLE Show DoWrnanls
faccshae[ CeHlflmtlons 8u450 M1ilacallanavus rode; Fx Ciuse
vaimate �� � PUF � conr k show xae !� fG)
Budget Summary
1.
DIRECTEXPEN6ES �I
I Puceprom Expenses
Salary 8lNages
83419001
03,419 o0, I
OODLEI
IFnnye Benefits
3120200,1
'I.
31202001 I
D.Do
DDDIi �*9,
Cap Eup far Eqwp 8 Fac
Cnmradual
Supplies and Materials
23MOO::
23,275,OO,,
000'o
D.Uo 19
Teral
33400011
3,340001i
000E
o001
Cominvnlcabon
2,2200;
7,26200',
a00i
-o'k
County -City Carrel Services
it91
fED
Space Costa
10,13100 _
10,131,Do
spoil I
_ 0,00
lAll Others (ADP Con Employees. Mrsc)
'I 3.994A0: li
3,694.00'
000'li
000;1, b
Toml Pmgmm EXpermas
! 155523 DO'
165,523A01,
000"
0.00.
TOTAL DIRECT EXPENSES
16562300'
165.523 UO1,
000,
000
INDIRECT EXPENSES
Irdrecl Cosls
Indirect Costs
29,405,OoI
29,40E 00'1 1,
DDoi' I
000, d
Other Costs Dislrihutions
I'. 1,fiE6.00i
1,685.00;
0.00!• [>.j
TONS lnMrord Costs
1, 31,090001.
3,,09000, 'I
0oul
Q.00j�
t1DiPECT EXPENSES
TOTAL-
31 � ,090 09D DO' 1
31,090 D01,
-- _ _
_ o0a
TOTAL EXPENDITURES
195,61300
196.61300:
000
no,
12
Source of Funds
Agency ABC Health Department Program Comprehensive Agreement -FY 20;(X
Application' Famlly Planning Services SAMPLE Show Documanis)
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li 0.001,
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'
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13
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classi0sa0on Be, : 11 Sub Trpe Dired Nanatlae:
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❑ % Nurse Pradl9oner
1_Jf 0MI 91000000 FTE I,�_)
17,290,001
17,29000'i
6,00 0.00 Cl
❑ % Public Nealih Nara
8 0461'' 34932430, UE �,
16,069.00'i
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20,92'00�1
20.925001�
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29,1350011
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propel Detail
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'be dappled and manuals fine
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calegory Pinglam Rpenses- Gonlradeal Type' Epanddure
ClaeslOeatlon Seq.t 111 Sub Tlpe Datd
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classwoddlon Seq. 11 i lend: 0. Urn, llem 0 Category
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14
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❑ >• Rend IU 8,923.00 1 6,22300,1
% Other - - - - ini 2,508.00' 2,608.00�1
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Budget Detail
Category Pmgram Expenses- At Othom(ACE Can Employees, Idlsp Type Expenditure
CWsslfica9on Seq.' 1 Level' l±Limllem()Category Sub Tvpe' Direct
limenctlans: 1,
❑ SUPpowng5arvlces
U
2,279 DO 2,279.00
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n
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Bud get Doran ._
Category: 1 Indirect Costs -Indirect Costs
Type;
Expenditure
Cla milmitlon Part; 1,3
End Time Indited
jnshudlons. I
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Category Indtred Costs -Other Costs DnAllin6ore Type: ardso lWre
Claasllxadml5.q ' 3 Sub Type 'Indirect NarraWe' 19
Instructions'
n ❑ 1,68500' 1,68500' 000 LJ
Y Nursing Adm Dlslribuilon 0.Oo
O, I ea
is
I. Budget Preparation
A. Sources of Local Fund Tvnes
Local Health Departments may utilize their county appropriation, funds received from
local or private foundations, local contributors, or donators, and from other non-
state/non-federal grant agreements that are specific to Medicaid Outreach or are to be
used at the discretion of the Health Department as a source for matching funds.
B. Indirect Costs
There are three (3) options for indirect costs. They are:
1. an approved federal or state indirect rate
2. a 10% de minimis rate; or
3. a cost allocation/distribution plan
Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go
to VI. Form Preparation, L. Indirect Cost section on this document.
C. Cost Allocation Certification
The Cost Allocation Certification remains on file with the Department until there is a change in
the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS-
Medicaid-Outreach), the local health department must: 1) submit a copy of the revised cost
allocation plan with the budget request; and 2) complete a revised cost allocation methodology
certification. Both documents are to be attached to a Detailed Budget line in EGrAMS.
II. Financial Status Report (FSR) — LHDs seeking 50% federal administrative match must
request reimbursement by submitting their actual expenses for allowable Medicaid Outreach
activities on their quarterly FSRs through MI E-Grants.
A. Quarterly and Final FSR
LHDs must reflect the actual Medicaid Outreach expenses incurred on the quarterly and
final FSR. Actual expenses incurred must be specific to Medicaid Outreach as defined by
the MSA Bulletin 05-29 and not part of a direct service. All expenses should be supported
by an approved methodology and appropriate support documentation.
1. Required Match - Local
Should be used to report the local match for Medicaid Outreach, both the federal
and local amounts must match.
2. Source of Funds Cateoory
Other source of funds that are non -reimbursable for Medicaid Outreach (i.e.,
other federal grants, other MDHHS grants, etc.) should be reported on the
M
appropriate line has indicated in the Comprehensive Budget Instructions -
Attachment I (e.g., Local non-ELPHS or Local Funds — Other).
Total Source of Funds must equal Total Expenditures.
111. Comprehensive Local Health Department Agreement Obligation Report — filed in
September.
The Obligation report is used to estimate the payable amount due to Local Health
Departments from MDHHS for each program element.
A. In the Estimate Column, enter the maximum projected federal administrative match
earnings for allowable Medicaid Outreach Activities to be earned from Medicaid
Outreach on the Federal Medicaid Outreach row.
B. In the Estimate Column, enter the maximum projected federal administrative match
earnings for allowable Medicaid Outreach activities to be earned from CSHSC —
Medicaid Outreach. This should reflect the local contribution multiplied by the Medicaid
enrollment participation rate x 50% federal match rate.
C. In the Estimate Column, enter the maximum projected federal administrative match
earnings for allowable Medicaid Outreach activities to be earned from Nurse Family
Partnership Outreach. This should reflect the local contribution multiplied by the
Medicaid enrollment participation rate x 50% federal match rate.
17
Object Mass CategorylExpenses Allowable
with 317
operations
funds
VFC-only site Visits
i AFIX-only Site vis1S5
j Combined (AFiX &. VFC site visitil J+/
Perinatal hospital record rer'imuc's
i
d
Equipment*
'Fazmacbinsfor vaccine orderine
J
Vaccine stor-4c equipment for WC
✓
Vaccine
Copy anauhines
r
*Egtiiptrerr: a€t article of tangible
i nonex ndable perswnal property haviAg
usejid iffe gfmore Man one yrcr and an
atcgutrittan cost of 15.iittfi or more her
urlft. I1 east is btlow this threshold
mount, diem nzery be includLd in
supplies.
Allowable ..allowable_
:Allowable '- Allowable 4
Allowable with
1 Allowable
with VF&
with-NTC'
_ with with Pan i
VFC DisMbution
with PPiiR
operation..,
ordering
'Tdl''Cl:O'1it' Fin funds
funds
s funds
funds
funds
(where ry tzluahtei
d
d
; If
J
✓
j d
J i
J
✓
r
✓ 05Y
r
m J
,�'
J d
.f
� ✓
Supplies (
1
Vaccine administration supplies
(including,, but not limled to- nasal
pharvnaeal swabs, *Tinges for
d
? emergency vaccination clsnics)
i Dff -ice.. sttpplIcs-computers, gcenl office
(pens, paper, paper clips, etc.), ink
✓ ✓
cartridges, calculators
i Per oral computers 1 Laptops 1 Tablets
�
iPink Books, Red Books, Yellow Books j
f
Printcrs
d ✓
916/2016
W
d J
✓ d
✓ d
Section t—The Basics p.22
1POM- 2017
d
J
d
4 Y'
d
✓
✓
d
✓
d
✓
CtbjectClaseCafcgutc(lape s
; :Allowable
AllowAble
Allowable ARawable Allowable
A:llowablewith I
AlloWairle
{ wrtb 3l l
w`stlE'iTC
ivlfh'VFC wltli
-with Nn'
VFC Distilbution
wA P)PRI'
operations .
operation
ordering. VFCIAF€X
( Fla funds
fronds " 1
funds .
tends :
s funds
funds funds : -
;
(wkfrr aPA&Ahe) i
Laboratory supplies (influenza cultures
and MU. cultures and malerular- lab
✓
!
�
media serott Rlnv
Digif.ai data 1pgger with valid mrtif care
ofCalil>YatSfl Valid113Oh6eStia r port
Vaccine chipp[ngsupplits (storage
✓
✓
$
Containers, ice packs, babble K•rap, etc.)
—
—
Contractual----
Ststvlacal £onforcncCf cxnenses
'
i
(conference site, meerials prir,€ing, hatel
✓
✓
✓
✓
accammodatioas,mPttrzM speaker fees)
Food cost is not crllowa61e,
ltegional,Iocal meetings
✓
✓
✓
✓ j
Genrral Contractual Smiecs (C g- IAN,
local health departments. conttcemal
r
staff, advisor} commit ce media,
'%
✓
+� ✓
✓
!F.-2:rnls}
pmt,iGler trainings)
GSA Contracuml Se MicrR {CDC
✓
✓
managed)
Other II5 ceutracwal .grcctntnt-
✓
(snppart, enhance€nent. upgrades)
✓
i ✓
rpre,^are��rvs
�
�/
i :3'FC-re;n:zc, I-r..�n�ril � •F.i cr:ty
i
Financial Assistance (FA)
'tion-CDC Contract vaccines
' I1 i vamne funds must_ 1�- mquestcd in funding i
avoicationWrAnSIunder 34?PAi,accines
G I I
9I 20i6 Section I —Tire Basics 23
IPOM 2017
tlbject class CategerryXW tses i
Allowable,
' Allowable € A Omnble
Allowable ; tlowable-
Allowable with-
Allowable l
with317
withVFC withVFC
.,. with with Pam i.VFCDisAhation
with.PPEF
O YCY@ti4SIS-.
- 6Pei'dti, f ,f�lYaC�#n
VTGAFM FI�Efunds t
foods
Muds .
. ; funds ..
s funds t funds
funds 1 i
.{avhtteapp7itbd j
Indirect
Indirect costs i
J J
V
Miscellaneous
�
11ccountm--services
✓
+°
�. ..
Advertising (restricted to recruitment of
staff or ttaatees, procurement of goads
and sen-ices, disposal of strap or surplus
materialsY
Aadit Fees
✓
BRFSS 5urvet-
Committee me:tims iroom rental,
equipment rental, ctc.)
V
Communication (electronicicamputcr
trznsmittal, messenger, postage, local and'
✓
long distance telephone)
Consumer information actMacs
J
Conscaner f provider board participation ,
(travel reimbursement)
%
Data pretessine _
✓
Ldboratory services (tests conducted for
immunization prnngraan.sj
V
Local service ddivgy activities
✓
Maintenance operationlrepnirs
✓
Malpractice insurance for volunteers
✓
�tcmttershipslsubscrloti€rns
✓
NIS Oversamplina
✓
Pa er&�cell photos
✓
;printing of vaccine accountability fours j
✓
W 16,'2a 16
N
O
✓
J
J
✓
i
i
i
✓ J
F 1
Section i—I"ne Basic& p.24
IPOMI 2017
J
ObjectClass Caiegoryl�s�ettses
Professional service costs directly related j
to :mmuniiation activities (limited term
sait"h, AttomeY General Office service. i
Public relations
Publicati.=Trinting cow {all other
imraunizationrelated publication and
printing expenses)
Rent (regwres explanation of why these
costs are not included in :be indiree( cost
rate sercetncnt or cast allocation plan)
Shipping for materials (other than
wacrinC)
I Shtpp�ng i,�2.CCif3B
Sof ware lieerscrRcnenals (ORACL£,
i etc.)
: Stipend kcirnbursernetts
i Toll -free phone lines for vaccine
ordering j
Training costs--Stateavade, staff.
providers
'1'ranslat€ens (translating materials)
Vehicle lease (restricted to awandees with
policies that prohibit IDeal travel
reimbursement)
i VFC: enrollment materials
j VFC: provider feedback surveys
V1S esmere-reads° Copies
911692016
N
F�
Allowable
Allowable i:Allowable
Allowable
;. Allowable
Allowable with
' Allowable
with317,
With-VFC i *dth'4'�C_'
with
'With Pan
. NRCSNSWbutias
vii#hPI'HF
operati61m
opemtion ordering
WO-AFM
j_ .f'la foods _
fends
lands
feuds
i foods p .feuds
funds `
_.
{where applicabCe)
..
✓
✓
v`
✓
J
✓
J
✓
i
f
✓
f 1
f
frtiuR£.fiidf.":hN^'Ot1
✓
jai if:il
1
�
✓
-
eFA omhli
J
✓ J
✓
J
✓
J ✓
✓
J
✓
J
✓
Section [ The Basics p.24
MOM 2017
'Ton -Allowable Expenses with Federal
Immunization Funds
Expense
Honoraria
Ad'vcrtising cods (V9'. convarrtiou, rdicfd4ow,.Wdhitv,+nr. dirr;.c,
t7if+iPUY4'Ydlidd{J, bild,Y, .WJltCk`)11N.V�
AluSttol ie bev..ra�as
Ruilding luarchascs, cons€ruction, caoital iiN19vemerr"
Land 13t@YClta}tl _ _._.
Lc,gislrativedlobbyingactivitie5r
Bonding _.. ._ .
Dopreciatiun on use char$v:
Research
1'ua8cltaiaiasg
hatcr+.'.st on luam for tho aactluisidun and/or rnodurvirsttion of
an cxisting budding
C;iirafaal I: na'C (rcpr Jwr++tu+trs rfriu .rerwtra.sJ
Yntartainrnent
Payment of bad debt
Dry cfeat�ing_
vehicle Purchase
Promotional and/or I.nt:cntivc Matcrials (e,g, fr(r.YfuWs, clod]ri+rg mid
cvmrrYemurr+five i1com.mCft its Pew, Icy •.s:!jrl irus, lagr vrda,
conkrrrrr¢ bggy)
Purchase of fund (trniess pare of regtrixref tr•rrvel pe+-edie»r eaar.YJ
ptOTallowablt with federal
itm uniration funds
Other restrictions which Heusi be taker) ink) mxmint white writing the buklgct:
Funds may by :imit only tier acaivitius and lwnonnol ooA1, tbad are directly rehttvAl to thu
Namunirallora and vaccines for Children t ooperativo Agreomontr funding rucluests nut
directly related to immuni-/,ation activities are outside die r+cope are this coaperative
agreement program and will no bte funded.
Pre-uwurd casts will not bo mimburscd,
Sccdon I —The Basics p26
11'OM 2017
22
ATTACHMENT III
MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
LOCAL HEALTH DEPARTMENT AGREEMENT
October 1, 2021 — September 30, 2022
Fiscal Year 2022
PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS
Local health service program elements funded under this agreement will be administered by
the Grantee and the Department in accordance with the Public Health Code (P.A. 368 of
1978, as amended), rules promulgated under the Code, minimum program requirements and
all other applicable Federal, State and Local laws, rules and regulations. These
requirements are fulfilled through the following approach:
A. Development and issuance of minimum program requirements, further describing the
objective criteria for meeting requirements of law, rule, regulation, or professionally
accepted methods or practices for the purpose of ensuring the quality, availability and
effectiveness of services and activities.
B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting
formats, source documentation, timeframes and utilization needs for required local
data compilation and transmission on program elements funded under this agreement.
C. Utilization of annual program and budget instructions describing special program
performance and funding policies and requirements unique to each State fiscal year.
D. Execution of an agreement setting forth the basic terms and conditions for administration
and local service delivery of the program elements.
E. Emphasis and reliance upon service definitions, minimum program requirements, local
budgets and projected output measures reports, State/local agreements, and periodic
department on -site program management evaluation and audits, while minimizing local
program plan detail beyond that needed for input on the State budget process.
Special requirements are applicable for the program elements listed in the attached pages.
Attachment IV Reimbursement Chart
• ..
The Program Element indicates currently funded Department programs that are included in
the Comprehensive Local Health Department Agreement.
The Reimbursement Methods specifies the type of method used for each of the program
element/funding sources. Funding under the Comprehensive Local Health Department
Agreement can generally be grouped under four (4) different methods of reimbursement.
These methods are defined as follows:
Performance Reimbursement
A reimbursement method by which local agencies are reimbursed based upon the
understanding that a certain level of performance (measured by outputs) must be met in order
to receive full reimbursement of costs (net of program income and other earmarked sources)
up to the contracted amount of state funds prior to any utilization of local funds. Performance
targets are negotiated startina from the last year's negotiated target and the most recent year's
actual numbers except for programs in which caseload targets are directly tied to funding
formulas/annual allocations. Other considerations in setting performance targets include
changes in state allocations from past years, local fiscal and programmatic factors requiring
adjustment of caseloads, etc. Once total performance targets are negotiated, a minimum state
funded performance target percentage is applied (typically 90% unless otherwise specified). If
local Grantee actual performance falls short of the expectation by a factor greater than the
allowed minimum performance percentage, the state maximum allocation for cost
reimbursement will be reduced equivalent to actual performance in relation to the minimum
performance.
Fixed Unit Rate Reimbursement
A reimbursement method by which local health departments are reimbursed a specific amount
for each output actually delivered and reported.
A reimbursement method by which local health departments are reimbursed a share of
reasonable and allowable costs incurred for required Essential Local Public Health Services
(ELPHS), as noted in the current Appropriations Act.
A reimbursement method by which local health departments are reimbursed based upon the
understanding that State dollars will be paid up to total costs in relation to the State's share of
the total costs and up to the total state allocation as agreed to in the approved budget. This
reimbursement approach is not directly dependent upon whether a specified level of
performance is met by the local health department. Department funding under this
reimbursement method is allocable and a source before any local funding requirements unless
a special local match condition exists.
The Performance Level column specifies the minimum state funded performance target
percentage for all program elements/funding sources utilizing the performance reimbursement
method (see above). If the program elements/funding source utilizes a reimbursement method
other than performance or if a target is not specified, N/A (not available) appears in the space
provided.
Performance Target Output Measures
Performance Target Output Measure column specifies the output indicator that is applicable for
the program elements/ funding source utilizing the performance reimbursement method. Output
measures are based upon counts of services delivered.
The Subrecipient, Contractor, or Recipient Designation column identifies the type of relationship
that exists between the Department and grantee on a program -by -program basis. Federal
awards expended as a subrecipient are subject to audit or other requirements of Title 2 Code of
Federal Regulations (CFR). Payments made to or received as a Contractor are not considered
Federal awards and are, therefore, not subject to such requirements.
Subrecipient
A subrecipient is a non -Federal entity that expends Federal awards received from a pass -
through entity to carry out a Federal program, but does not include an individual that is a
beneficiary of such a program; or is a recipient of other Federal awards directly from a
Federal Awarding agency. Therefore, a pass -through entity must make case -by -case
determinations whether each agreement it makes for the disbursement of Federal program
funds casts the party receiving the funds in the role of a subrecipient or a contractor.
Subrecipient characteristics include:
0 Determines who is eligible to receive what Federal assistance;
• Has its performance measured in relation to whether the objectives of a Federal
program were met;
• Has responsibility for programmatic decision making;
• Is responsibility for adherence to applicable Federal program requirements specified
in the Federal award; and
• In accordance with its agreements uses the Federal funds to carry out a program for
a public purpose specified in authorizing status as opposed to providing goods or
services for the benefit of the pass -through entity.
Contractor
A Contractor is for the purpose of obtaining goods and services for the non -Federal entity's
own user and creates a procurement relationship with the Grantee. Contractor
characteristics include:
• Provides the goods and services within normal business operations;
• Provides similar goods or services to many different purchasers.
• Normally operates in a competitive environment.
• Provides goods or services that are ancillary to the operation of the Federal program;
and
• Is not subject to compliance requirements of the Federal program as a result of the
agreement, though similar requirements may apply for other reasons.
In determining whether an agreement between a pass -through entity and another non -Federal
entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more
important than the form of the agreement. All of the characteristics listed above may not be
present in all cases, and the pass -through entity must use judgment in classifying each
agreement as a subaward or a procurement contract.
Recipient
A Recipient is for grant agreement with no federal funding.
Amendment Schedule
Amendment Anticipated
Request Due Date Consolidation Date
FY 2022
Original Agreement Completed by August 31, 2021
Program office
Amendment #1 -New Completed by October 19, 2021
Projects Only program office
Amendment #2 February 1, 2022 April 21, 2022
Amendment #3 May 13, 2022 July 15, 2022
Key Terms
New Project Start /
Effective Date
October 1, 2021
November 1. 2021
May 1, 2022
August 1, 2022
• Amendment Request Due Date —The date amendment requests are due to the
program office.
a. Budget category amendment requests need to be submitted to the program
office.
• Anticipated Consolidation Date — The day the agreement (original/amendment) will
be released to the health department for final signature.
• New Project Start/Effective Date — The date new projects are expected to start, unless
otherwise communicated by the program office.
PROJECT
American Rescue Plan
City of Detroit COVID Testina
COVID Immunization
COVID-19 Mobile Teshnq
ELC Contact Tracina. Testina Coordination. Monitodria. and Wraparound
ELC COVID-19 Infection Prevention
ELC Reaional Lab
ELC Sewer Network
Lead Response
PPAS Response (All Locations)
Reopening Schools HRA
Water Response- Giardia
PROGRAM CONTACT
EMAIL
Charisse Sanders
sandersc2@michigan.gov
Laura de la Rambelje
DelaRambelleL(aa)miohlgan,qOV
Terri Adams
adamst2(O,michwan.gov
Brenda Jeqede
iegedebpmichigan.gov
Laura de la Rambehe
DelaRambelieL anmichioan.aov
Joseph Coyle
coylej(dimichigan.gov
Mary Soehnlen
soehnlenm(dmichigan.gov
Mary Stobierski
stobierskim(a)michigan.gov
Laura de Is Rambelle
DelaRambelieL(oDmichigan.gov
Laura de la Rambehe
DelaRambe1e1-0),michigan.gov
Joseph Coyle
coylej@michigan.gov
Laura de la Rambelle
DelaRambelie1-(3-)michigan.gov
PROJECT TITLE: AMERICAN RESCUE PLAN
Start Date: 11/1/2021
End Date: 9/30/2022
Project Synopsis:
The American Rescue Plan (ARP) funding is federal funding issued to assist Home Visiting
programs and associated families with the means to respond to immediate needs resulting from
the impacts of COVID-19. This funding will assist Home Visiting programs with addressing the
impacts of COVID-19 by providing services and supplies to families while also supporting the
programmatic costs and training needs of Home Visiting agencies.
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.
Staffing Changes: Within 10 days of a staffing change, notify the appropriate
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. ARP Work Plan: Due September 10, 2021 for preapproval. Seethe 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. ARP Quarterly Report: This report is unique to ARP funding and should be
included as an attachment to each Work Plan Report submission. The ARP
Quarterly Report asks for specific information relating to the allowable uses of the
ARP funds. These reports will assist the MDHHS Home Visiting Unit in complying
with HRSA requirements.
All reports and/or information (a-d), unless stated otherwise, shall be submitted
electronically to the MDHHS Home Visiting mailbox at MDHHS-
HVlnitiativeemichician.gov.
PROJECT: City of Detroit Testing
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
For COVID-19 funding from ELC CARES and ELC Enhanced for Case Investigations,
testing support, Contact Tracing and violation monitoring. The inability to meet the
following metrics will elicit the following response from MDHHS related to this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS.
• Required support from MDHHS.
Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase.
Reporting Requirements (if different than contract language)
Allowable expenses include:
Test Kits and contract staffing.
Violation Monitoring:
Related to monitoring COVID-19 compliance indicators (Number of Violations /
complaints related to mandatory or recommended community mitigation): LHDS will
have 100% completion of sit -rep, including response to number of actions the LHD has
taken in the past 7 days related to violations.
Allowable expenses include staffing, communications, and IT.
Related to Case Investigation Quality:
LHD's will meet the following objectives for COVID-19 Case Investigations including on
weekends and holidays:
a) COVID 19 Case Interview Attempted on 90% of COVID-19 cases within 1
calendar day of referral to MDSS.
b) COVID 19 Cases Interviewed Completed on 75% of COVID-19 cases with 1
calendar day of referral to MDSS.
c) At least 1 contact elicited on 50% of COVID-19 cases within 1 calendar day of
referral to MDSS.
d) Race and Ethnicity Documented on 75% of COVID-19 cases reported to MDSS
within 7 days of referral date.
e) LHD's will procure at least one tool to increase case investigation quality (people
finding software, communications, printed materials for testing events, EMIR
access, etc.)
This data will be reported in MDSS. Allowable expenses include staffing, IT,
communications, computers and or phones or other office needs, access to people
finding software or EMR, supports to cases for isolation and quarantine. Funding cannot
be used for clinical care or research.
Related to Contact Tracing:
If the LHD elects to have MDHHS through its staff, contractors, or volunteers to conduct
contract tracing or to conduct case investigations on the LHD's behalf, then:
The LHD will provide to MDHHS quality data on contacts especially related to age,
phone number, and name.
2. The LHD will follow-up on high -risk contacts.
3. The LHD will follow-up on contacts who report symptoms consistent with COVID-
19.
The LHD will follow-up on escalations from MDHHS staff on contacts with high -
acuity needs or specific language barriers.
For local health departments:
• Contacts to confirmed and probable COVID cases will be documented in the
MDSS case report form.
• 90% of newly elicited contacts have attempted outreach within 1 day.
• 90% of all contacts in active monitoring have outreach attempted for the contact's
exposure period.
• 50% of contacts will receive active monitoring.
• LHD's will assess contacts needs for basic needs required for quarantine and
isolation (food, etc.). LHD's will provide education to contacts on COVID public
health recommendations.
This data will be reported in Traceforce, OMS, or on the LHD Sit Rep. Allowable
expenses include staffing, IT, communications, computers and or phones or other office
needs, access to people finding software or EMR, supports to cases for isolation and
quarantine. Funding cannot be used for clinical care or research.
This funding can be used to staff testing events or assure testing strategies are
completed.
Any additional requirements (if applicable)
PROJECT: COVID IMMUNIZATION
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
This grant should be directed to increase COVID vaccination within Michigan. will be
used to support awardee and local Health Department (HD) staffing, communications
campaigns, pandemic preparedness, mass vaccination and all COVID-19 vaccine
response work.
Reporting Requirements (if different than contract language)
Completion of the Vaccination Situation Report.
Any additional requirements (if applicable)
Allowable expenses include staffing, communications, and supplies to support COVID-19
vaccination events, including PPE, vaccine refrigerators, data loggers, vaccine coolers,
and indirect costs for COVID-19 related work.
Are not allowable expenses: Vehicles purchasing, Food, Alcoholic beverages, Building
purchases, construction, capital improvements, Entertainment Cost, Goods and services
for personal use and Promotional and/or Incentive Material such as: Mugs/Cups, Pens, or
Bags.
PROJECT: COVID-19 Mobile Testing
Beginning Date: 10/1/ 2021
End Date: 9/30/2022
Project Synopsis
Mobile testing deployment to high -risk areas of need. Walk or drive up testing.
Partnerships with community organizations. Eliminate barriers by offering no
appointments or prescription. Testing and include vaccinations and health screening.
Services include social determinant assessments and linkage to services and care.
Reporting Requirements (if different than contract language)
Quarterly Financial Status Reports (FSR)
FSRs should be submitted no later than thirty (30) days after the close of each quarter
and must reflect actual program expenditures, regardless of the source of funds.
Quarterly Narrative Progress Report
Submit quarterly narrative progress reports via email to Shronda Grigsby at
Griasbvsl (d),Michiaan.aov in accordance with the following dates:
Reoortina Time Period Due Date
October 1, 2021 — December 31, 2021 January 31, 2022
January 1, 2022 — March 31, 2022 April 30, 2022
April 1, 2022 — June 30, 2022 July 31, 2022
July 1, 2022 — September 30, 2022 October 31, 2022
Any additional requirements (if applicable)
1. Ensure that activities implemented under this grant award are in accordance with
established MDHHS program standards, as well as State and Federal policy and
statutes, including HIPAA.
2. Adhere to timelines and work plans, budgets, and staffing plans submitted and
approved by MDHHS. Deviations from approved timelines, work plans, budgets
and staffing plans must receive advance authorization from MDHHS. Failure to
make reasonable progress in program development may result in revocation or
reduction of the grant award.
3. Collaborate with and build on other MDHHS COVID-19 response programs
wherever possible, rather than duplicating or rebuilding efforts.
4. Ensure that services and materials are culturally and linguistically appropriate to
meet the needs of the respective client populations.
5. Utilize results from the Social Vulnerability Index/mortality analysis from the State
of Michigan at the census tract level for Southeast Michigan to help identify priority
areas for the mobile testing program within high priority census tracts, and share
data maps of COVID-19 "hot spots" with MDHHS.
6. Assess insurance status of each individual being tested. Bill relevant insurers,
including private insurers, Medicaid health plans, and the Health Resources and
Services Administration for COVID-19 testing costs when possible.
7. Store, refuel, and maintain vehicles to ensure optimum vehicle performance. Take
all reasonable precautions to keep vehicles safe against fire, water, and traffic
damage, and maintain cleanliness of the vehicles. Submit documentation and
billing for storage, fuel, and maintenance reimbursement.
8. As part of any vaccination activities, follow all relevant MDHHS protocols, including
record and account of all doses of vaccine administered in the Michigan Care
Improvement Registry (MCIR) and assuring vaccines are stored at recommended
temperatures at all times.
a) Reports from temperature data logger showing temperatures within
recommended range may be requested at any time by MDHHS.
The terms below are in addition to the standard terms in the County Health
Department Agreement, and apply only to this specific project:
Insurance Requirements. Grantee, at its sole expense, must maintain the insurance
coverage identified below. All required insurance must: (i) protect the State from claims
that arise out of, are alleged to arise out of, or otherwise result from Grantee's
performance; (ii) be primary and non-contributing to any comparable liability insurance
(including self-insurance) carried by the State; and (iii) be provided by a company with an
A.M. Best rating of "A-" or better, and a financial size of VII or better.
Required Limits ( Additional Requirements
Commercial General Liability Insurance
Minimum Limits:
$1,000,000 Each Occurrence
$1,000,000 Personal & Advertising
Injury
$2,000,000 Products/Completed
Operations
$2,000,000 General Aqqreqate
Coverage must not have
exclusions or limitations related
to sexual abuse and molestation
liability.
Automobile Liability Insurance
Minimum Limits:
$1,000,000 Per Accident
Workers' Compensation Insurance
Minimum Limits:
Coverage according to applicable
laws governing work activities
Employers Liability Insurance
Minimum Limits:
$500,000 Each Accident
$500,000 Each Employee by Disease
$500,000 Aggregate Disease
Policy must include Hired and
Non -Owned Automobile
coverage.
Waiver of subrogation, except
where waiver is prohibited by
law.
Privacy and Security Liability (Cyber Liability) Insurance
Minimum Limits:
$1,000,000 Each Occurrence
$1,000,000 Annual Aggregate
Medical Malpractice Insurance
Minimum Limits:
$1,000,000 Each Occurrence
$3,000,000 Annual Aggregate
Policy must cover information
security and privacy liability,
privacy notification costs,
regulatory defense and penalties,
and website media content
liability.
a) If any required policies provide claims -made coverage, the Grantee must: (i)
provide coverage with a retroactive date before the Effective Date of the Grant or
the beginning of Grant Activities; (ii) maintain coverage and provide evidence of
coverage for at least three (3) years after completion of the Grant Activities; and
(iii) if coverage is cancelled or not renewed, and not replaced with another claims -
made policy form with a retroactive date prior to the Effective Date of this Grant,
Grantee must purchase extended reporting coverage for a minimum of three (3)
years after completion of work.
b) Grantee must: (i) provide insurance certificates to the Grant Administrator,
containing the agreement or delivery order number, at Grant formation and within
twenty (20) calendar days of the expiration date of the applicable policies; (ii)
require that subgrantees maintain the required insurances contained in this
Section; (iii) notify the Grant Administrator within five (5) business days if any
policy is cancelled; and (iv) waive all rights against the State for damages covered
by insurance. Failure to maintain the required insurance does not limit this waiver.
c) This Section is not intended to and is not to be construed in any manner as
waiving, restricting, or limiting the liability of either party for any obligations under
this Grant (including any provisions hereof requiring Grantee to indemnify, defend
and hold harmless the State).
PROJECT: ELC (Epi Lab Capacity) Contact Tracing, Testing Coordination,
Monitoring, and Wraparound Services
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
For COVID-19 funding from ELC Supplemental for Case Investigations, Contact Tracing
and wraparound services. The inability to meet the following metrics will elicit the
following response from MDHHS related to this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS
• Required support from MDHHS
Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase.
Reporting Requirements (if different than contract language)
Related to Case Investigation Quality:
LHD's will meet the following objectives for COVID-19 Case Investigations including on
weekends and holidays:
• COVID 19 Case Interview Attempted on 90% of COVID-19 cases within 1
calendar day of referral to MDSS.
• COVID 19 Cases Interviewed Completed on 75% of COVID-19 cases with 1
calendar day of referral to MDSS.
• At least 1 contact elicited on 50% of COVID-19 cases within 1 calendar day of
referral to MDSS.
• Race and Ethnicity Documented on 75% of COVID-19 cases reported to MDSS
within 7 days of referral date.
LHD's will procure at least one tool to increase case investigation quality (people finding
software, communications, printed materials for testing events, EMIR access, etc.)
This data will be reported in MDSS. Allowable expenses include staffing, IT,
communications, computers and or phones or other office needs, access to people
finding software or EMR, supports to cases for isolation and quarantine. Funding cannot
be used for clinical care or research.
Related to Contact Tracing:
If the LHD elects to have MDHHS through its staff, contractors, or volunteers to conduct
contract tracing or to conduct case investigations on the LHD's behalf, then:
1. The LHD will provide to MDHHS quality data on contacts especially related to age,
phone number, and name;
2. The LHD will follow-up on high -risk contacts;
3. The LHD will follow-up on contacts who report symptoms consistent with COVID-
19; and
4. The LHD will follow-up on escalations from MDHHS staff on contacts with high -
acuity needs or specific language barriers.
5. MDHHS will provide the LHD contact information for people with high -acuity needs
or specific language barriers;
6. MDHHS will move contacts from MDHHS CRF to Traceforce;
7. MDHHS will attempt to eliminate duplicate contact information using name, phone
number, and age;
8. MDHHS will contact contacts and cases within 1 calendar day of the contacts
entry into the CRF
9. MDHHS will provide the LHD with the outcomes of all call attempts each day
10. MDHHS will discuss with the LHD specific barriers to contact tracing such as a
high -refusal rate
11. MDHHS or its delegate will attempt an contact all contacts with 1 calendar day
For local health departments:
• Contacts to confirmed and probable COVID cases will be documented in the
MDSS case report form.
• 90% of newly elicited contacts have attempted outreach within 1 day.
• 90% of all contacts in active monitoring have outreach attempted for the contact's
exposure period.
• 50% of contacts will receive active monitoring.
• LHD's will assess contacts needs for basic needs required for quarantine and
isolation (food, etc.). LHD's will provide education to contacts on COVID public
health recommendations.
This data will be reported in Traceforce, OMS, or on the LHD Sit Rep. Allowable
expenses include staffing, IT, communications, computers and or phones or other office
needs, access to people finding software or EMR, supports to cases for isolation and
quarantine. Funding cannot be used for clinical care or research.
This funding can be used to staff testing events or assure testing strategies are
completed.
Wraparound Services
This funding only may be used to support Isolation/Quarantine for families including rent,
mortgage, utilities, groceries, etc.
Any additional requirements (if applicable)
PROJECT: ELC (Epi Lab Capacity) COVID-19 Infection Prevention
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
This project aims to provide local health departments with resources to support
investigation and mitigation of COVID-19 and other emerging pathogens in healthcare
facilities — including the ability for LHD staff to perform onsite infection prevention
assessments and review of facility policies, procedures, and practices to ensure
observation of best practice guidelines.
Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase.
Reporting Requirements (if different than contract language)
Related to Infection Prevention:
• The LHD will designate a staff member or members responsible for leading
infection control assessments.
The LHD will share the contact information of their infection control lead(s) with the
MDHHS Infection Prevention and Resource and Assessment Team (iPRAT) for
coordination purposes at MDHHS-IPRATta michigan.aov.
LHDs shall submit ICARs to MDHHS at
https:l/dhhshivstd.ladl.qualtrics.com/ife/form/SV OdNux7Oo256K6B7
This data will be reported quarterly and sent to program office via email. Allowable
expenses include staffing, IT, communications, computers and or phones or other office
needs. Funding cannot be used for clinical care or research.
Any additional requirements (if applicable)
PROJECT: ELC Regional Lab
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
ELC Regional Lab funds are dedicated to developing lab, epi, and other public health
efforts to modernize and expand testing and response capabilities of pandemics with
special emphasis on the responses to COVID-19. The Regional laboratory system is
intended to serve as a "hub -and -spoke" model in conjunction with the state public health
laboratory to rapidly respond to community needs. Funding is expected in personnel,
equipment, overhead (discreationary of county or district needs if in support of public
health), and lab supplies/consumables or materials that directly support sampling for
return to the lab.
Reporting Requirements (if different than contract language)
None, but sites may be asked to provide tally counts of testing if not directly available
from Starl-IMS or to answer occasional question from CDC on capabilities.
Any additional requirements (if applicable)
PROJECT: ELC SEWER Network
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The State of Michigan SARS-CoV-2 Epidemiology - Wastewater Evaluation and
Reporting Network, also known as the SEWER Network, is a wastewater monitoring
project that utilizes locally coordinated projects to conduct surveillance for SARS-CoV-2
virus shed into Michigan public sewer systems. The overarching goal of the Michigan
SEWER Network is to rapidly detect circulation of SARS-CoV-2 virus within specific
communities via wastewater testing. The SEWER Network is designed to support local
project participation through the collection, transportation, and testing of wastewater
samples, analysis and reporting of results, coordination and communications within local
projects and with state agencies, and submission of results to MDHHS and EGLE. The
emphasis for this funding is that the funded activities provide useful, timely, and
consistent wastewater data to support local COVID-19 public health responses.
Reporting Requirements (if different than contract language)
All local projects may be required to submit a weekly summary of project activities to
MDHHS via email or uploading to the existing Microsoft Teams site for the project. This
could include information on sample collection, testing, data reporting and utility, and
partner communication. A template for this report will be provided by MDHHS. MDHHS
will communicate any changes in reporting requirements to project participants.
Quarterly workplan updates will be required from all local projects. Lead agencies who
are not local health departments will be required to complete a quarterly workplan report
in EGrAMS that details the activities and objectives during that time period. LHD leads for
local projects will submit quarterly workplan reports directly to MDHHS project staff.
Failure to implement project requirements or submit required financial and performance
reports in accordance with this agreement may result in reduction of funds or non -
renewal of future contracts.
Any additional requirements (if applicable)
This agreement reflects the sampling commitments written in the proposal. Any changes
in the sampling plan need to be discussed with SEWER Network project staff.
PROJECT TITLE: Lead Response
Start Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis:
Lead Action Level Exceedance (ALE) response capacity encompasses public outreach,
including education on water testing and results, water filter usage, flushing
recommendations, and the interim provision of water filtration systems.
The Michigan Department of Health and Human Services (MDHHS), through a legislative
funding allocation, can provide lead -reducing water filter systems and replacement
cartridges if the local water supply cannot provide them, and if the LHD or local unit of
government doesn't have the resources to provide them.
Filters from MDHHS can be offered at no cost to low-income households that meet these
criteria:
Requirement 1: To qualify for a filter, both requirements must be met:
o Household receives water from the ALE Community Water Supply
o Household has NOT received a water filter from ALE Community Water Supply, the
Local Health Department, or the Michigan Department of Health and Human
Services.
Requirement 2: To qualify for a filter, one requirement must be met:
o A child under age 18 lives at the applicant's address.
o A child under age 18 spends a few hours a day and several days a week at the
applicant's address for at least 3 months of the year.
o A pregnant woman lives at the applicant's address.
Requirement 3: To qualify for a filter, one requirement must be met:
o Household includes a person who receives WIC benefits or Medicaid insurance.
o Household attests they can't afford a filter and replacement cartridges (filters cost
about $35 and replacement cartridges cost about $15.)
If an eligible household's water test result is above the action level (AL = 15 ppb) for lead,
or the resident's home is on the public water system experiencing an ALE for lead, a
faucet mount filter and 2 replacement cartridges will be offered. A pitcher filter and 3
replacement cartridges may be offered, when necessary (e.g., faucet mount does not fit
their faucet).
These measures will be provided until a permanent solution can be identified and
implemented, as resources allow, or a determination is made by MDHHS Division of
Environmental Health that filtration is no longer recommended or advised.
Reporting Requirements
By Wednesday at noon each week, grantees are required to enter all data collected on
the Water Filter Request Forms in the attached Excel file. The file will be submitted to
Gabriella Dionise, at dioniseo1Ca)michioan.crov.
Additional Requirements:
Requesting Funding
Local Health Departments requesting funds for Lead ALE response will provide an
estimated budget, as well as a description of expenses on Form DCH-0385(E) and DCH-
0386(E).
Lead ALE response funds are not capacity building funds but are limited -term funding to
achieve a critical public health response on behalf of the MDHHS for environmental
public health needs related to lead in drinking water.
Eligible Expenses Include:
• Staff time and fringe dedicated to Lead ALE response in association with the
interim response;
o Eligible staff activities for Lead ALE response include filtration system
distribution, home visits, organizing and hosting town hall meetings or other
public education, phone banks, water sample collection or other activities
approved by and conducted in collaboration with MDHHS Division of
Environmental Health.
• Printing materials associated with ALE response;
• Mileage associated with lead ALE response and MDHHS-provided training;
• Lead and copper analysis fees for health departments with certified drinking water
laboratories when costs are in alignment with the Michigan Department of
Environment, Great Lakes, and Energy's (EGLE) Drinking Water Laboratory fees
($26/sample).
• Other items as need is determined, such as public meeting venue rental or phone
bank expenses.
Other expenses that are not on this list must receive prior approval by DEH before
submission to Division of Local Health Services. Any deviation or amendment to existing
Lead ALE response projects requires DEH approval. Local Health Departments submit
all budget requests to DEH Community Engagement Unit.
Ineligible Expenses Include:
• Training;
• Association membership fees; and
• Travel not associated with direct Lead ALE service delivery.
Providing Interim Filtration Systems
When distributing water filters to residents, health departments will obtain a signed Water
Filter Request Form from each resident. A site -specific form will be provided as a fillable
PDF. Health Departments may choose to type resident's information into the fillable PDF
or print off the form. Residents will complete Page 1 of the form, and health department
staff (or their designees) will complete Page 2 of the form. Grantees are requested to
maintain hard copies of the Water Filter Request Forms for audit purposes. Completion of
the Water Filter Request Form is NOT intended to be a barrier to the provision of filtration
systems for households with pregnant women and children under age 18.
A note here: sometimes the filter distributions happen at CE events that are not
run by LHDs, in that case, Lakecia holds onto the PDF forms.
PROJECT: PFAS Response
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
Program Purpose: PFAS response capacity, which encompasses the components below.
• Educational outreach such as, but not limited to, education regarding drinking water
testing and results
• Interim provision of water filtration systems or an alternate source(s) of water until a
permanent solution can be identified and implemented, as resources allow, or a
determination is made by the Michigan Department of Health and Human Services
(MDHHS) Division of Environmental Health (DEH) that filtration or alternate water is no
longer recommended or advised
• Follow-up with residents who have received a water filter to offer free replacement filter
cartridges every six months.
Reporting Requirements (if different than contract language)
By the first Wednesday of each month, grantees are required to submit:
• Site -specific, updated tracking forms including:
a) Site name
b) Resident's name, address, contact information
c) Water filter or alternate water type provided
d) Water filter or alternate water quantity distributed
e) Filter replacement cartridges distributed
f) Date of each distribution
g) Staff name
h) Permission to contact resident
i) Filter declination
• Site -specific updated information on number of bottles of water distributed
Submit tracking forms to Gabriella Dionise, MDHHS DEH, via email to
DioniseG1 @michigan.gov.
Any additional requirements (if applicable)
• Local Health Departments requesting funds for PFAS response will provide an estimated
budget, as well as a description of expenses on forms DCH-0385E and-0386E.
• PFAS response funds are not capacity building funds but are limited -term funding to
achieve a critical public health response on behalf of MDHHS DEH for environmental
public health needs related to PFAS.
Eligible expenses Include:
• Water filters certified for PFAS reduction
• Installation of certified water filters by a plumber licensed in the State of Michigan
• Replacement water filter cartridges provided approximately every 6 months or after 800
gallons of water has been filtered, depending on residents' water usage
• Alternate water such as water coolers/dispensers or bottled water, as need is determined
and approved by MDHHS DEH
• Mileage
• Supplies
• Other items as need is determined, such as public meeting venue rental or phone bank
expenses
• Staff time and fringe dedicated to PFAS response in association with interim response
Required staff activities for PFAS response include:
a) Distribution of certified water filtration systems and replacement cartridges
b) Coordination of water filter installation by a licensed plumber when requested by the
resident
c) Semi-annual filter replacement cartridge offers and reminders. These offers and
reminders would go to residents previously provided with water filters until a
permanent solution can be identified and implemented, as resources allow, or a
determination is made by MDHHS DEH that water filtration is no longer recommended
or advised
d) Documenting water filter and replacement cartridge distribution
e) Data entry and submission to MDHHS DEH
f) may include when necessary:
• Bottled water distribution
• Home visits
• Organizing and hosting town hall meetings or other public education
• Phone banks
• Water sample collection support when requested by MDHHS DEH
• Indirect costs
• Expenses not on this list must receive prior approval by MDHHS DEH before submission.
Any deviation from or amendment to existing PFAS response projects requires MDHHS
DEH approval.
Y Local Health Departments submit all budget requests to MDHHS DEH for approval.
• Application for funds in subsequent fiscal years is expected where there is an ongoing
recommendation for water filtration or an alternate water source.
0 LHDs are to maintain number of staff hours expended on the grant at the LHD.
Ineligible expenses include:
• Training
• Association membership fees
• Travel not associated with direct PFAS service delivery
• Cost to remove filters unless removal and replacement of a faulty filter is necessary
Acknowledgement of Receiving or Declining Water Filter Form
When providing a water filter to a resident, grantees will complete the Acknowledgement of
Receipt of Water Filter form, or similar acknowledgment form based on the grantee's legal
review, including the resident's signature. The forms will be retained by the grantees.
*Please note that an acknowledgement form is NOT intended to be a barrier to provision of
water assistance.
PROJECT: Reopening Schools HRA
Beginning Date: 10/01/2021
End Date: 09/30/2022
Project Synopsis
The Michigan Department of Health and Human Services (MDHHS) is offering a
voluntary program to provide rapid antigen and/or pooled PCR testing to educators,
staff, and students at public and private schools. In addition, MDHHS is providing funds
to school districts that have indicated they need additional technical support and intent
to participate in testing, among other factors, so they can hire health resource
advocates (HRAs). These HRAs will provide front-line support for COVID testing and
reporting, help districts identify emerging COVID-related health concerns, and amplify
best health practices.
Reporting Requirements (if different than contract language)
Monthly reports by school district to include the following:
1. Total enrollment
2. PCR tests conducted
3. Antigen tests conducted
4. Total positive cases
5. # HRAs hired
6. Qualitative feedback on:
• barriers
• successes
• lessons learned
Y verification of funding use for HRA positions
Reports should be submitted via email to Danielle Lepar at LeParDlna,michioan.gOV
and Jason Wilkinson at WilkinsonJ5 ).michigan.gov
Any additional requirements (if applicable)
Funding may only be used for hiring an HRA(s). The funding shall not be used for any
other purpose beyond hiring and/or funding an HRA(s), which may include supporting
existing positions. These funds must also be accompanied by a plan to conduct
COVID-19 testing in school settings.
PROJECT TITLE: Water Response- Giardia
Start Date: 10/1/2021
End Date: 9/30/2022
Project Purpose
This funding is necessary due to the threat of giardia to residents served by the Ironwood
water supply. Current cases of giardia indicate they could be associated with the
Ironwood water supply system. The funding covers staff time and expenses to collect
water samples.
Additional Reporting Requirements (if applicable)
Additional Requirements
PROJECT: Water Response - Lake Mine
Beginning Date: 10/1/2021
End Date: 9/30/2022
Project Synopsis
The purpose of the Lake Mine Site response budget is for metals sampling and analysis of an
unknown source of drinking water to determine if contaminants are present at levels that could be
a threat to human health. While sampling and analysis are underway, bottled water will be
provided to two residences as a precautionary measure in order to protect the residents' health.
The Western Upper Peninsula Health Department is requesting funds for the Lake Mine Site
response will provide an estimated budget, as well as a description of expenses on forms DCH-
0385E and-0386E.
Reporting Requirements (if different than contract language)
The Lake Mine Site funding is not capacity building funding but is limited -term funding to achieve
a critical public health response on behalf of the MDHHS Division of Environmental Health (DEH)
for environmental public health needs related to the site
Eligible Expenses Include:
• Bottled water, as need is determined by MDHHS DEH
• Sanitarian wages and fringe benefits
• Mileage
• Laboratory analysis
• Indirect costs
• Other expenses that are not on this list must receive prior approval by DEH before
submission. Any deviation or amendment to the budget requires DEH approval.
Ineligible expenses include:
• Training;
• Association membership fees; and
• Travel not associated with direct Lake Mine Site service delivery.
Grantees are required to report cumulative numbers for the fiscal quarter:
• Bottled water expense
• Sanitarian wages and fringe benefits
• Mileage
• Laboratory analysis
• Indirect costs
Any additional requirements (if applicable)
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