Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Resolutions - 2022.06.23 - 37433
BOARD OF COMMISSIONERS June 23,2022 MISCELLANEOUS RESOLUTION #22-236 Sponsored By: Penny Luebs Health & Human Services - Grant Application with the Michigan Department of Health and Human Services for the FY 2023 Local Health Department (Comprehensive) Agreement Chairperson and Members of the Board; WHEREAS the Oakland County Health Division is applying for funding through the Michigan Department of Health and Human Services (MDHHS) Fiscal Year (FY) 2023 Local Health Department (Comprehensive) Agreement (fonnerly the Comprehensive Planning, Budgeting, and Contracting agreement - CPBC) for the period October 1. 2022 through September 30, 2023 in the amount of S11,782,611; and WHEREAS funding will be used to support the delivery of public health services to the citizens of Oakland Comity; and WHEREAS the FY2023 application in the amount of $11,782,611 is all increase of $352,201 from the FY2022 grant application totaling $11,430,410; and WHEREAS the FY 2023 application includes funding .in the annorurt of $639,867 to continue the subrecipnent agreement for reimbursement of services provided to Woman, Infants and Children ( WIC) program parlicipauts for the period October 1, 2022 through September 30, 2023; and WHEREAS the application includes the continuation of fifty-six (56) Special Revenue (SR) positions as identified in Schedule B: and WHEREAS the application includes the deletion of five (5) SR positions as identified in Schedule D — Deletions; and WHEREAS the application includes the creation of three (3) SR positions as identified in Schedule E — Creation; and WHEREAS the Local Health Department (Comprehensive) Agreement application has completed the Grant Review Process in accordance with the Grants Policy approved by tine Board at their January 21, 2021 meeting. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves the FY 2023 Local Health Department (Comprehensive) Agreement application for finding in the amount of S11,782,611 for the period of October 1, 2022 through September 30. 2023. BE IT FURTHER RESOLVED the application includes the continuation of fifty-six (56) Special Revenue (SR) positions as identified in Schedule B — Continuations. BE IT FURTHER RESOLVED the application includes the deletion of five (5) SR positions as identified in Schedule D — Deletions. BE IT FURTHER RESOLVED the application includes the creation of three (3) SR positions as identified in Schedule E — Creation. BE IT FURTHER RESOLVED that application and fimtre acceptances of this grant does not obligate the county to any future conunitment and continuation of this program is contingent upon continued future levels of grant finding. BE IT FURTHER RESOLVED a budget amendment,is not required at this time. Chairperson, the following Commissioners are sponsoring the foregoing Resolution: Penny Luebs. Date: June 23, 2022 David Woodward, Commissioner Lau� Date: June 24, 2022 Hilarie Chambers, Deputy County Executive it �I Date: June 27 2022 Lisa Brown, County Clerk / Register of Deeds COMMITTEE TRACKING 2022-06-14 Public Health & Safety - recommend and forward to Finance 2022-06-15 Finance - recommend to Board 2022-06-23 Full Board VOTE TRACKING Motioned by Conunissioner Charles Cavell seconded by Commissioner Michael Gingell to adopt the attached Grant Application: with the Michigan Department of Health and Human Services for the FY 2023 Local Health Deparriuent (Connprelnensive) Agreement . Yes: David Woodward, Michael Gingell, Karen Joli'at, Kristen Nelson, Eileen Kowall, Angela Powell. Thomas Kuhn, Chuck Moss, Marcia Gershenson. William Miller III, Yolanda Smith Charles. Charles Cavell, Penny Luebs, Janet Jackson, Gary McGillivray, Robert Hoffman, Adam Kochenderfer (17) No: Christine Long, Philip Weipert (2) Abstain: None (0) Absent: (0) Passed ATTACHMENTS 1. Health - FY2023 LHD Agreement Schedule B - Continuations Draft 5-31-22 (1) 2. Health - FY2023 LHD Agreement Schedule C - Reclass 4-21-22 (1) 3. Health - FY2023 LHD Agreement Schedule D - Deletions Draft 4-21-22 4. FY2023 LHD Agreement Schedule E - Creation 5-31-22 (1) 5. Grant Review Sign -off - FY23 LHD Agreement Application 6. WIC 7. WIC Mothers in motion 8. NII Home Visiting Guidance Manual (1) 9. Med Outreach and CSHCS 10. LaNvs and Rees 11. Fiscal Questionnaire FY'_023 12. Att B4 DeMiuimisRate FY23 (1) 13, Art B3 14, An 1 15. Add A 16, ATT IV 17. ATT III 18. FY2023 Boilerplate contract STATE OF MIC'HIGAN) 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 Conunissioners on June 23, 2022, Nvith 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, June 23, 2022. Lisa Brown', n, n,rlrlanrl Coanm Clerk /Register ofpeeds Dept N FY23 Budgeted Class Pos. If 10602:1 05129 Office Support Clerk - Senior 1060291 05130 Supervisor PH Nursing 1060291 D5131 Public Health N urse l I 1060291 05163 Public Health Nurse l I 1050291 05526 Office Support Clerk -Senior 1060291 06824 Amiliary Health Clerk 1060291 07839 Aux111ark Health Clerk 1050291 12442 Office Suppprt Clerk 1060290 06742 Publlc Health Nurse III 1060290 07416 Public Health Emergency Preparedness Specialist 1060290 09999 Public Health Emergency Preparedness Specialist 1060234 02565 Public Health Nurse 111 1060294 06100 Public Health Nurse III 1060294 06426 Health Program Coordinator 1e60294 02557 Public Health Nurse 111 1060294 09668 Public Heelth Nurse 111 1060294 06538 Office SupportClerk Senior 1060218 02020 Health Program Coordinator 1060218 07413 Public Health Nurse 111 1060218 07414 Office Leader 1060218 02415 Office Support Clerk -Senior 1060291 05401 Public Health Nutntionlst 111 1060291 15530 Public Health Nutritionist III 1060230 00752 Public Health Nurse 111 1060291 04236 Health Program Coordinator 1060230 00906 Public Health Nurse 111 1060230 03107 Public Health Nurse 111 1060230 03183 Public Health Nurse 111 1060230 03427 Public Health Nurse 111 1060290 03094 Health Program Coordinator 1060234 02436 Vaccine Supply Coordinator 1060234 O7559 Vaccine Supply Coordinator 1060284 00624 Auxiliary Health Clerk 1060284 00958 Office Supervisor 11 1060284 01329 Auxiliary Health Clerk 10602" 01865 Public Health Nutrition Supervisor ( 10602M 02074 Public Health Nutritionist II 1060284 02509 IN Techince WIC 1050284 03023 Office Supervisor ll 1060284 04771 Auxlllary Health Clerk 1060284 04773 Auxiliary Health Clerk 1060284 05233 Public Health Nutritionist ll 1060284 05234 Public Health Nutritionist 1060284 05235 Public Health Nutritionist ll 1060284 05693 Public Health Nuehl.rict ll 1060291 02360 Public Health Nutritionist III 1060284 O7381 Public Health Nutritonist 111 1060284 D2382 Nutrition Technician - WIC 10602M 07384 Auxiliary Health Clerk 1060284 02562 Nutrition Technician - WIC 1060284 07563 Auxiliary Health Clerk 1060284 00866 Office Support Clerk -Senior 1060284 11529 Lactation Specialist FY23 Special Revenue Grant Schedule B - Continuations FT/PT Hours Filled As RE RE PINE RE RE RE PINE PINE RE RE RE RE RE RE RE RE RE RE RE RE RE RE PINE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE RE 2080 2080 1000 Public Health Nurse II PINE 2080 Public Health Nurse II - PTNE 2080 2080 Office Support Clerk - Senior- FTE 1000 100D 2080 Public Health Educator ll - RE 2080 2080 2080 2080 Auxiliary Health Clerk - RE 2080 2090 Public Health Nurse III -PTNE 2080 2080 2080 2080 Public Health Nurse II - PTNE 2080 2080 2080 1000 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2080 2090 2080 2080 2090 Nutrition Technician - WIC - FTE 2080 Nutrition Technician -WIC -RE 2080 Nutrition Technician -WIC -RE 2080 2080 Public Health Educator II - RE 2080 2080 2080 2080 2080 2080 Lactatmn5peaahet-PTNE 2080 Grant Chlldren's Special Health Care Services Children's special Health Care 5ervmes Children's Spenal Health Care Services Children's Special Health Care Services Children's special Health Care Services Children's Special Health Care Services Children's Spedal Health Care services Children's Special Health Care Services Cities Readiness Initiative, PHEP Cities Readiness initiative, PHEP Cities Readiness Initiative, PHEP Hem C HIV PrEP Clinic HIV Prevention HIV Prevention HIV Prevention HIV Prevention/Adolescent Screening Prevention IAP AP IAP IAP Maternal Children Health- All Other Maternal Children Health - All Other Nurse -Family Partnership Maternal Children Health- All Other, NFP Nurse -Faintly Partnership Nurse -Family Partnership NurseFairlyPartnership Maternal Children Health- All Other, NFP PHEP Vaccine Quality Assurance Vaccine Quality Assurance, IAP WIC WIC WIC WIC WIC WIC WIC WIC WIC WIC WIC WIC WIC (1,580 hours) and 500 hour on non-LHO grant WIC, WIC BreasHeeding WIC WIC WIC WIC WIC WIC Breasdeeding WIC Breasdeeding FY23 Special Revenue Grant Positions Schedule C- Reclassifications FY23 Current Job Current Salary Requested Job Requested Salary Dept. a Current Budgeted Classification W/PT Hours Requested Classification Pos. # Code Plan Code Plan Gran[ FY23 Special Revenue Grant Positions Schedule D - Deletions Dept # 1"P23 Budgeted Classification FT/PT Hours lob Code Salary Plan Grant Pos.# 10602941 060991 Public Health Nurse 111 17E 1 20801 J000771 I 048/F IDate to Care 10602841 052041 Office Support Clerk - Senior IFTE 1 20801 J000148 [ IINI/109 IWIC Breast/eed]ng FY23 Special Revenue Grant Positions Schedule E - Creation FY23 Pos. Current Job Current salary .a'CN N Requested Classification FT/PT Haurs Code Plan Gran[ 106029a NEW Auxilhary Health Clerk FiE 2080 HIV PrEP Cbnm Please Note: The attached Miscellaneous Resolution is subject to further revision once posted to the Board of Commissioners' Civic Clerk site. GRANT REVIEW SIGN -OFF — Health & Human Services/Health Division GRANT NAME: FY 2023 Local Health Department (Comprehensive) Agreement Application FUNDING AGENCY: Michigan Department of Health & Human Services DEPARTMENT CONTACT: Stacey Smith/248 452-2151 STATUS: Grant - Application (Greater than $50,000) DATE: 06/07/2022 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 application package (which should include this sign - off and the grant application with related documentation) may be requested to be placed on the agenda(s) of the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. DEPARTMENT REVIEW Management and Budget: The draft resolution should be updated to reflect language that this is an application. The RESOLVE paragraphs that reference position changes should be updated to state that the APPLICATION includes the continuation/deletion/creates of xx positions. Also, a resolve should be added to note that no budget amendment is required at the application stage. In addition, the fiscal questionnaire will need to be completed for the submission. Approved —Lynn Sonkiss 06/07/2022. Human Resources: Approved — Heather Mason 06/02/2022 Risk Management: Approved - Robert Erlenbeck 06/02/2022 Corporation Counsel: Approved. — Heather Lewis 06/06/2022 Dissemination License Agreement for "Communicate to Motivate" Among Michigan State University, Ohio State Innovation Foundation And Michigan Department of Health and Human Services This License Agreement ("Agreement"), effective as of January 1, 2017 ("Effective Date"), is made by and among Michigan State University, having offices at 325 E. Grand River, Suite 350, East Lansing, MI 48823 ("MSU"), Ohio State Innovation Foundation, having offices at 1524 N. High Street, Columbus, OH 43201 ("OSIF") (together "Licensor") and State of Michigan Department of Health and Human Services Women, Infants and Children, having offices at 320 S. Walnut, Lensing, Ml 48913 ("Licensee") (individually a "Petty" and collectively, the "Parties"). WHEREAS, Licensor has intellectual property rights in the "Communicate to Motivate" materials (herein, "Physical Materials"), MSU reference numberTEC2016.0I78, OSU reference number T2017- 132, developed utilizing fonds from a grant from the National Institutes of Health (NIH), grant number R18-DK-083934-01("Grant"). WHEREAS, Licensor Is the owner of certain rights, title and interest in the Physical Materials and has the right to grant licenses thereunder. WHEREAS, Licensee wishes to license the Physical Materials for dissemination purposes and Licensor desires to grant such license to Licensee on the terms and conditions herein. NOW THEREFORE, the Parties agree as follows: L Definitions. a. "Physical Materials" shall mean all physical items listed in Schedule A. b. "Sublicensable Materials" shell mean one electronic copy of the Physical Materials. c. "Materials Modification Oulde" shall mean the specifications outlined in Schedule B. d. "Derivative Works" means all works developed by Licensee or Sublicensee which would be characterized as derivative works of the Physical Materials and/or Sublicensable Materials under the United States Copyright Act of 1976, or subsequent revisions thereof, specifically including, but not limited to, translations, abridgments, condensations, reeastings, transformations, or adaptations thereof, or works consisting of editorial revisions, annotations, elaborations, or other modifications thereof. The term "Derivative Work" shall not include those derivative works which are developed by Licensor. e. "Sublicense" means an agreement which may take the form of, but is not limited to, a sublicense agreement, memorandum of understanding, or special provisions added as an amendment to an existing agreement between Licensee and a Sublicensee in which Licensee grants or otherwise transfers any of the rights licensed to Licensee hereunder or other rights that are relevant to using the Sublicensable Materials. E "Sublicensee" means any entity to which a Sublicense Is granted. AOR2017-00453 ] OSU A2017-1172 TEC201"178 1. Grant of License 1.1 Subject to the terms and conditions of this Agreement, to the extent that Licensee's rights to Physical Materials as a result of Licensor's grant of rights to the Federal Government in accordance with the terms and conditions of the Grant are insufficient for Licensee's activities hereunder, Licensor hereby grants to Licensee a nonexclusive, nontransferable, worldwide, license to use, perform, reproduce, publically display the Physical Materials. Licensee is granted the limited right to create Derivative Works of the Physical Materials, specifically Licensee shall have the right to create Derivative Works which are (a) companion guidance handouts to the Physical Materials for educational use by instructors in the course of employing Physical Materials, (b) materials for promotion of the availability of educational opportunities employing the Physical Materials, and (c) instruments for collecting evaluations and feedback from course participants. Notwithstanding the foregoing, Licensee may only distribute the Physical Materials within Licensee -managed locations within the state of Michigan. Licensee is not permitted to sell or receive consideration for any of the Physical Materials or reproductions of the Physical Materials. 1.2. Licensor grants Licensee the right to grant Sublicenses of its rights under Section 1.1 of the Sublicensable Materials to Sublicensee for the sole purpose of placing the content contained in the Sublicensable Materials (including the videos) on a website that is controlled by Sublicensee and that is access limited, password protected, Any Sublicense shall be In accordance with Article 3 below. Sublicensee is not permitted to sell or receive consideration for the Sublicensable Materials in any formal. Any content created solely by Sublicensee that supports the implementation of the Sublicensable Materials shall be owned by Sublicensee. 1.3 In such incidences where, for financial reasons, Licensee is not able to reproduce the label displayed on the original master copy of the DVD portion of the Physical Materials, Licensee must ensure that the entire content of the DVD portion of the Physical Materials are reproduced in its entirety so that the inclusion of the copyright notice, grant number information, title of each lesson, and acknowledgements are maintained. 1.4 Licensee will refrain, and shall require Subiicensees to refrain, from using the name of the Licensor or The Ohio State University ("OSU") in publicity or advertising without the prior written approval of Licensor. 1.5 Licensor shall provide Physical Materials to Licensee by May 1, 2017. Licensor assumes no responsibility for distributing Physical Materials to the state of Michigan Licensee locations. 2. Licenser's Rights 2.1 Notwithstanding the rights granted in Article 1 hereof, Licensee acknowledges that all right, title and interest in the Physical Materials, including any copyright applicable thereto, shall remain the property of Licensor. Licensee or Sublicensee shall have no right, title or interest in the Physical Materials, including any copyright applicable thereto, except as expressly set forth in this Agreement. 2.2 Any rights not granted hereunder are reserved by Licensor. 3. Sublicense 3.1 (a) Any Sublicense entered into hereunder (i) shall contain terms no less protective of Licensor's rights than those set forth in this Agreement, (ii) shall not be in conflict with this AOR2017-00453 2 OSU A2017-1172 TEC2016-0I79 Agreement, and (iii) shall identify Licensor as an intended third party beneficiary of the Sublicense. Licensee shall provide Licensor with a complete electronic or paper copy of each Sublicense within thirty (30) days after execution of the Sublicense. Licensee shall provide Licensor with a copy of each report received by Licensee pertinent to any data produced by Sublicensee that would pertain to the report due under Section 4. Licensee shall he fully responsible to Licensor for any breach of the terms of this Agreement by a Sublicensee. (b) Upon termination of this Agreement for any reason, all Sublicenses shall terminate. If a Sublicensee was in compliance with the terms of its Sublicense in effect on the date of termination, Licensor may grant such Sublicensee that so requests, a license with terms and use rights as are acceptable to Licensor. In no event shall Licensor have any obligations of any nature whatsoever with respect to (1) any past, current or tbture obligations that Licensee may have had, or may in the future have, for the payment of any amounts owing to any Sublicensee, (ii) any past obligations whatsoever, and (iii) any future obligations to any Sublicensee beyond those set forth in the new license between Licensor and such Sublicensee. d. Consideration In consideration of the rights granted herein, Licensee will provide to Licensor two effectiveness and utilization data reports based on the use of the Physical Materials. One data report shall include: a) number of clients who access the Physical Materials lessons; b) number of times specific lessons are completed; c) number of unique users; d) client perceptions for usefulness and helpfulness of lessons; and e) client beliefs in relation to ability to make changes based on lesson completion and shall be due to Licensor two years from the Effective Date and one data report containing the some data as described above shall be due thirty (30) days after the end of the five (5) year term. Such data reports shall segregate the information provided in a-e by CPA (dietitians and nurses) or breastfeeding peer counselors. The reports shall be sent to chang1572Qosu.edu, tnnovation@osu.edu and msutagr@msu.edu. 5. Diligence Licensee shall use its reasonable efforts to disseminate the Physical Materials in a fashion that Licensee determines aligns with its mission in order to provide public benefit. 6. Term and Termination 6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five (5) years unless earlier terminated in accordance with paragraph 6.2 hereof. This Agreement may be renewed or extended by written amendment signed by authorized representatives of Licensor and Licensee in accordance with Article 13. 6.2. In the event that a Party believes that another Party has materially breached any obligation under this Agreement, such Party shall so notify the breaching Party in writing, The breaching Party shall have thirty (30) days from the receipt of notice to cure the alleged breach and to notify the non -breaching Party in writing that said ewe has been affected. If the breach is not cured within said period, the non - breaching Party shall have the right to terminate the Agreement without further notice. 63 Effect of Termination. AO112017-0003 3 OSU A2017-1172 TEC2016.0178 6.3.1 Upon termination, Licensee shall cease using, distributing and displaying the Physical Materials, and shall confirm in writing to Licensor that the Physical Materials have either been returned to Licensor or have been destroyed (in Licensor's sole discretion). All Sublicenses shall terminate upon termination of this Agreement pursuant to Section 3(b). 6.3.2 Upon termination, the following provisions shall survive and remain in effect: 2.1; 4; 6.3; 8. 7. Representations and Warranties 7.1 Licensor represents that to the knowledge of The Ohio State University's and MSU's technology transfer offices that it has full right, power and authority to enter into this Agreement and to provide the license of rights granted under this Agreement. 7.2 LICENSOR AND OSU, INCLUDING THEIR CREATORS, TRUSTEES, OFFICERS, EMPLOYEES, AGENTS OR AFFILIATED ENTERPRISES MAKE NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS AND HEREBY DISCLAIM ALL REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, NONINFRINGEMENT, SAFETY, EFFICACY, APPROVABILITY BY REGULATORY AUTHORITIES, TIME AND COST OF DEVELOPMENT, OR PATENTABILITY. LICENSEE ASSUMES THE ENTIRE RISK AND RESPONSIBILITY FOR THE SAFETY, EFFICACY, PERFORMANCE, DESIGN, MARKETABILITY AND QUALITY OF THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE PARTIES, INCLUDING THEIR OFFICERS AND EMPLOYEES, ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS ARE PROVIDED "AS IS"; (B) NEITHER THE PHYSICAL MATERIALS NOR SUBLICENSABLE MATERIALS MAY BE FUNCTIONAL ON EVERY MACHINE OR IN EVERY ENVIRONMENT; AND (C) THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT IS ERROR -FREE OR THAT LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS. 8. Limitation of Liability 8.1 Each Party acknowledges and represents that It will be responsible for any claim for personal injury or property damage asserted by a third party and arising out of or related to its acts or omissions in the performance of its obligations hereunder to the extent that a court of competent jurisdiction determines such Party to beat fault or otherwise legally responsible for such claim. Nothing in this Agreement shall be deemed or treated as any waiver of any Party's sovereign immunity or immunity granted by statute or case law, if applicable, 8.2 In no event shall a Party be liable to another Party or to any third party, whether under theory of contract, tort or otherwise, for any indirect, incidental, punitive, consequential, or special damages, whether foreseeable or not and whether such Party is advised of the possibility of such damages. 9. Assignment and Transfer No Party may assign, directly or indirectly, all or part of its rights or delegate its obligations under this Agreement without the prior written consent of the other Parties. AGR2017.00453 4 OSU A2017-1172 TEC2016.0178 10. Dispute Resolution 10.1 In the event of any dispute or controversy arising out of or relating to Ails Agreement or the subject matter hereof, the Parties shall use their best efforts to resolve the dispute as soon as possible. The Parties shall, without delay, continue to perform their respective obligations under this Agreement which are not affected by the dispute. 11. Force Majeure No Party shall be liable for damages or subject to injunctive or other relief, or have the right to terminate this Agreement, for any delay or default in performance hereunder if such delay or default is caused by conditions beyond Its control Including, but not limited to, Acts of pod or force majeure, government restrictions (including the denial or cancellation of any necessary license), wars, insurrections and/or any other cause beyond the reasonable control of the Party whose performance is affected. 12, Entire Agreement This Agreement constitutes the entire agreement of the Parties and supersedes all prior communications, understandings and agreements relating to the subject matter hereof, whether oral or written. 13. Amendment No modification or claimed waiver of any provision of this Agreement shall be valid except by written amendment signed by authorized representatives of Licensor and Licensee. 14. 5everabllity If any provision of this Agreement is determined to be Invalid or unenforceable under applicable law, it shall not affect the validity or enforceability of the remainder of the terms of this Agreement, and without further action by the Parties hereto, such provision shall be reformed to the minimum extent necessary to make such provision valid and enforceable. 15. Waiver Waiver of any provision herein shall not be deemed a waiver of any other provision herein, nor shall waiver of any breach of this Agreement be construed as a continuing waiver of other breaches of the same or other provisions of this Agreement. 16. Notices All notices given pursuant to this Agreement shall be in writing and may be hand delivered, or shall be deemed received within three (3) days after mailing If sent by registered or certified mail, return receipt requested. If any notice is sent by facsimile, confirmation copies must be sent by mail or hand delivery to the specified address. Either party may from time•to-time change its notice address by written notice to the other Patty. AGa2017-00453 $ OSU A2017-1172 TEC2016-0178 Ifto Licensor: MSU Technologies Attention: Agreement Coordinator ACR2017-00453 325 E. Grand River Suite 350 City Center Building East Lansing, M148823 517-884-1605 msulear(@msu.edu Ohio Stele innovation Foundation 1524 N High Street Columbus, OH 43201 614-292-1315 If to Licensee: Michigan Deportment of Health and Human Services, WIC Division Attn: Kristen Hanulcik Manager, Consultation and Nutrition Services Unit 320 S. Walnut, Lewis Cass Bldg., 6' Floor Lansing, MI 48913 517-335-8545 hanuleikk@michigen.gov 17. Article Headings The Parties have carefully considered this Agreement and have determined that ambiguities, if any, shall not be construed or enforced against the drafter. Furthermore, the headings of Articles have been inserted for convenience of reference only and shall not control or affect the meaning or construction of any of the agreements, terns, covenants or conditions of this Agreement in any manner. 18. Relationship of Parties Licensor and Licensee each acknowledge and agree that the other is an independent contractor in the performance of each and every part of this Agreement and is solely responsible for all of its employees and students and such Party's labor costs and expenses arising in connection therewith. The Parties are not partners, joint venturers or otherwise affiliated, and neither has any right or authority to make any statements, representations or commitments of any kind, or to take any action, which shall be binding on the other Party, without the prior written consent of such other Party. AGIL2017.00453 6 OSU A2017-1172 TEC2016.0178 64/04/2017 18:20 215-923-2560 FE'DtX OFFICE 0669 PAGE: 02 IN WITNESS WH rREOF, the Parties have executed this Agreerncnt by their respective, duly authorized repCesentntives as of the date first above wrhten, LICENSOR: Michigan State University ' D't•, Richard' 1Y: Chylla Executive Director, MSU Technologies Ohio State Innovation Foundation By:.. / Dipanjan Nag Vice President Date: 3 12 0%' Date: •. I �1 LIC>;NSM State of Michigan Deportment ofHealtb ttnd Human Services Women, Infants & Children By-. 7t -- Dale: Jeanette Hensler, Director Grants Division, Bureau of Purchasing t By: .�� Date: Stan Bien, Director WIC Division Miehigan Department of Health and Human Services 320 S, Walnut, Lewis Cass Bldg., 61h Floor Lansing, MI 48413 biens@michignn.gov 517-335-8448 AOR?0 t 7.00463 7 4SU P.2017-11 T2 TRC2016.0178 Schedule A Physical Materials A. Communicate to Motivate videos —up to 10 sets In DVD format 15 lessons: 12 video lessons, reminder and general Up lesson, introduction and preview B. Rethinking what we think and respond In WIC video C. Tip Sheets — 650 copies (color print, laminated and coil) D. CDs that contain the following materials related to Communicate to Motivate saved in PDF (up to 10 copies): a. Tip Sheets; b. Power point slides of all 12 lessons, reminder and general Up lesson; c, Summary of key points in each video lesson; d. Instructions for use of the videos. E. External hard drives (2) that contain the following materials: a. Communicate to Motivate videos: 15 video lessons; b. Rethinking what we think and respond to WIC video; c. Tip Sheets in PDF; d. Power point slides of all 12 lessons, reminder and general tip lesson in PDF; e. Summary of key points in each video lesson in PDF; f. Instructions for use of the videos in PDF. ACR2017-00453 8 OSU A2017-1172 TFIC2016-0179 Schedule 8 Materials Modification Guide Except as provided in Section 1.1, modification of Physical Materials is not permitted. AOR2017-00453 9 OSU A2017. TEC201"178 1172 FIRST AMENDMENT TO DISSEMINATION LICENSE AGREEMENT FOR "MOTHERS IN MOTION" THIS FIRST AMENDMENT to the Dissemination License Agreement for "Mothers In Motion" (the "First Amendment") is entered into by and between Michigan State University, an educational institution organized under the laws of the State of Michigan, having an office at 325 E. Grand River, Suite 350, East Lansing MI48823 ("Licensor") and State of Michigan Department of Health and Human Services Women, Infants and Children, having an office at 320 S. Walnut, Lansing, MI 48913 ("Licensee"). WHEREAS, Licensor and Licensee entered into Dissemination License Agreement for "Mothers In Motion", effective October 16, 2015, (Licensor reference AGR2015-01146) (the "Original Agreement"); and WHEREAS, the term of the Original Agreement has expired and Licensee desires to continue the Original Agreement and Licensor is amenable to doing so; and WHEREAS, Licensor and Licensee desire to amend certain terms and conditions in the Original Agreement. NOW, THEREFORE, Licensor and Licensee agree to amend the Original Agreement as follows: 1. Section 4 shall be deleted in its entirety and replaced with the following: "4. Consideration In consideration of the rights granted herein, Licensee will provide Licensor effectiveness and utilization data reports based on the use of the Physical Materials. The data report shall include: a) number of clients who access the Physical Materials lessons; b) number of times specific lessons are completed; c) number of unique users; d) client perceptions for usefulness and helpfulness of lessons; and e) client beliefs in relation to ability to make changes based on lesson completion. Data reports shall be due to Licensor in accordance with the following schedule: (1) Two (2) years from the Effective Date; (2) Five (5) years from the Effective Date; and (3) October 1, 2022, and every two (2) years thereafter through the term of the Agreement. Reports shall be sent to Licensor at msutagr c@r msu.edu." AGR2015-01146 Pg I of 2 MI DHHS TEC2015-0036 Mothers In Motion 2. Section 6.1 shall be deleted in its entirety and replaced with the following: "6.1 This Agreement shall commence on the Effective Date and shall extend indefinitely, unless terminated by Licensee on written notice to Licensor in accordance with Section 16 or earlier terminated in accordance with paragraph 6.2 hereof." 3. Section 6.3.2 shall be deleted in its entirety and replaced with the following: "Upon termination, the following provisions shall survive and remain in effect: 2.1; 4 (with respect to a final data report which shall be due thirty (30) days following the effective date of termination); 6.3; and 8." 4. All other provisions of the Original Agreement remain unchanged and in effect. If there is any conflict between this First Amendment and the Original Agreement, this First Amendment will take precedence, 5. All terms capitalized herein and not otherwise defined in this First Amendment shall have the meaning ascribed to them in the Original Agreement. This First Amendment may be signed in one or more counterparts, each of which shall be treated as an original, and together the counterparts shall constitute one complete document. 7. This First Amendment is effective as of October 16, 2020. IN WITNESS WHEREOF, the patties hereto have caused this First Amendment to be executed by their respective duly authorized officers or representatives on the date indicated below. MICHIGAN STATE UNIVERSITY Richard W, Digitally signed by Richard W. Chylla, PhD, Chylla, PhD, CIP, RTTP CLP RTTP Data: 2021.11.0915;29:22 By: ' .05-R0. Name: Richard W. Chylla, Ph.D., CLP, RTTP Title: Executive Director Date: 11/9/21 STATE OF MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES WOMEN, INFANTS AND CHILDREN By: l'1 Name: Christina Herring -Johnson Title: WIC Director Date: 11/18/21 AGR2015-01146 Pg 2 of 2 MI DHHS TEC2015-0036 Mothers In Motion iO Acknowledgement of Receipt of the MDHHS Home Visiting Guidance Manual I acknowledge the receipt of the Michigan Department of Health and Human Services' (MDHHS) FY23 Home Visiting Guidance Manual which describes the policies, procedures and deliverables to which will adhere while implementing home visiting (name of your organization) programs funded by the MDHHS Home Visiting Unit (HVU). I acknowledge that the information described within is subject to change. I understand that the revised information may supersede, modify, or eliminate existing policies and procedures. All changes will be communicated to grantees by the HVU. I understand it is my responsibility and the responsibility of the home visiting staff within my organization to comply with the MDHHS-HVU policies and procedures and any revisions made subsequent to this acknowledgement. I acknowledge that I have read a copy of the MDHHS Home Visiting Guidance Manual. Upon signature of this Acknowledgement of Receipt, I will retain a copy for the organization identified above and will forward this document to the MDHHS-HVU by November 4, 2022. Printed name of HV Supervisor/LLG Coordinator Signature of HV Supervisor/LLG Coordinator Date Printed name of Home Visiting Program Administrator Date Signature of Home Visiting Program Administrator 2 # # # The Michigan Department of Health and Human Services' (MDHHS) Home Visiting Unit seeks to work as part of the Michigan Home Visiting Initiative (MHVI) toward a common vision for home visiting through engaging partners in a collaborative process to develop and implement policies, procedures, standards, measures and funding mechanisms that support common goals. MDHHS funds a continuum of evidence -based, prevention -focused home visiting programs that support families who are living in communities that have environments that inhibit positive maternal and child health, economic stability, educational attainment, and child safety throughout Michigan. These programs are working to ensure that families are connected to the home visiting program that best fits their identified needs. We anticipate that working as partners with our funded grantees, will lead to positive outcomes for children and families. By clearly stating our expectations and requirements, grantees will understand their roles in helping to ensure Michigan families receive high -quality home visiting services that are delivered in compliance with state and federal regulations. MDHHS utilizes an interdepartmental structure and team process to address early childhood systems and services integration and coordination. Primary partners include the Michigan Department of Education (MDE), the Early Childhood Investment Corporation (ECIC), and the Michigan Public Health Institute (MPHI) as well as additional programs within MDHHS. This manual contains policies and procedures for the implementation of programs funded through the Michigan Department of Health and Human Services. The purposes of this document are: To provide transparency regarding implementation of evidence -based home visiting to meet federal (Maternal, Infant and Early Childhood Home Visiting (MIECHV)) and State of Michigan (Public Act 291 of 2012) requirements. 2. To provide clear guidelines and expectations for local home visiting programs or Local Leadership Group implementation. The manual is organized into sections that correlate with expected or required administrative, fiscal and programmatic activities. Compliance with policies listed in this manual will be assessed during programmatic or fiscal site visits. Community: A community may be an entire county, particular cities, zip codes or other specifically defined criteria. Concentrated Disadvantage Index (CDI): The CDI is a statistical analysis that provides an understanding of the history of disinvestment in geographic areas. The CDI utilizes the American Community Survey dataset to understand different socio-economic experiences of families by looking at: percentage of population living below poverty level; percentage of households with a female head -of -household, no spouse present; percentage of population who receives public assistance income; percentage of population under 18; percentage of civilian population over 16 who are unemployed. The CDI is used to create maps that show areas of disinvestment in communities that can be used to understand outreach opportunities within a community. Continuous Quality Improvement (CQI): Quality improvement is a systematic approach to specifying the processes and outcomes of a program through regular data collection and the application of changes that may lead to improvements in performance or program outcomes. Early Childhood Investment Corporation (ECIC): A public/private entity created to be a statewide leader in early childhood. MDHHS contracts with ECIC to continuously improve Michigan's comprehensive early childhood system. ECIC provides system level support, acting as a fiduciary to ensure parent leaders are compensated for their time in an appropriate and timely manner. EGrAMS: The Electronic Grants Administration and Management System utilized by MDHHS to implement an electronic grants program. It is the system used for managing and monitoring progress of awarded grant agreements. Evidence -Based Home Visiting Model (EBHV): A clear, consistent model implemented with fidelity, which is research -based with a rigorous research design and grounded in relevant, empirically -based knowledge. The model must meet federal, DHHS-defined criteria to be listed as an Evidence -Based Home Visiting Model (www.homvee.acf.hhs.gov). (As an additional reference, see the definition of a Promising Program as stated in Appendix A, Public Act 291 of 2012.) 5 Exploration and Planning Tool (E&PT): A comprehensive process tool which was created to support communities who are considering implementing an EBHV Model. Communities convene a wide range of partners, parents, and community leaders and use this tool to examine their readiness for implementation, examine community risk, and identify the home visiting model that best fits the needs and gaps identified through the assessment. Health Equity: Health Equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. (Robert Wood Johnson Foundation) Implementation Plan Review (IPR): A monthly meeting attended by members of the MDHHS- HVU, staff from various agencies, and interested parties. Discussion includes the review of data submitted from the Local Implementing Agencies (LIA) against goals and benchmarks, the notation of trends and strategies for supporting successful local efforts. Kitagawa Analysis: The Kitagawa Analysis is a statistical analysis that calculates disparities for specific population groups based on the difference between the observed preterm birth rate and what is expected based on standard, statewide populations. The Kitagawa helps to define the proportion of disparities experienced by populations, highlighting inequities in Michigan communities including Social Determinants of Health and systemic racism, and focusing resources in communities based on these disparities. Local Implementing Agency (LIA): A local agency (e.g. health department, school, non-profit, etc.) implementing an EBHV model. Local Leadership Group (LLG): A local agency that supports the development of a local home visiting system ensuring a strong connection between home visiting programs and the greater early childhood system. Michigan Department of Health and Human Services Home Visiting Unit (MDHHS-HVU): a unit within state government that funds and supports the continuum of evidence -based home visiting programming in local communities. Michigan Home Visiting Initiative (MHVI): A multi -departmental, multi -agency consortium focused on efforts to build and align the statewide prevention -focused home visiting system. It transcends across funding streams, outcomes, and agencies. Maternal, Infant and Early Childhood Home Visiting Program (MIECHV): A federal funding stream provided through the Health Resources and Services Administration that is helping Michigan to build the infrastructure of a comprehensive home visiting system and expand evidence -based services to the highest risk populations. A Michigan Public Health Institute (MPHI): The agency MDHHS contracts with to provide data collection, evaluation, and Continuous Quality Improvement services and support for the Michigan Home Visiting Initiative. Procedure: A series of steps to guide the implementation of home visiting services based on the requirements identified by the Michigan Home Visiting Initiative. Professional Development: Continuous advancement of knowledge in the Michigan Home Visiting Core Knowledge Framework through reputable webinars, in -person meetings, conferences, books, peer -reviewed journal articles, and other coursework. Referral: Appendix E provides a statewide definition of 'referral' that was written by an intra- agency group of home visiting partners and providers and was adopted in 2017. SMART goal: A SMART goal is Specific, Measurable, Achievable, Relevant and Time -bound. SMARTIE goal: A SMARTIE goal is Specific, Measurable, Achievable, Relevant, Time -bound, Inclusive, and Equitable. VA Acknowledgement of Receipt of the MDHHS Home Visiting Guidance Manual.............2 Introduction..................................................................................................................... 3 Organizational Information.............................................................................................. 3 Howto Use this Manual..................................................................................................4 Glossary.......................................................................................................................... 5 Administration............................................................................................................... 10 Policy Al-13: Exploration and Planning Tool..........................................................................11 Policy A2-13: MDHHS Grant Agreements...............................................................................13 PolicyA3-13: EGrAMS............................................................................................................14 Policy A4-13: Subrecipient Monitoring(SRM).........................................................................18 Fiscal............................................................................................................................. 22 Policy F1-14: Allowable Costs... .............................................................................................. 23 Policy F2-14: Allowable Cost Exception Request...................................................................25 Program Implementation... ..................... ....................................................... .......... 27 Policy PI1-16: Fidelity to a Home Visiting Service Model (revised April 2022)........................28 Policy PI1 b-18: Michigan Home Visiting Quality Assurance System (MHVQAS)....................30 Policy PHc-21: Virtual Home Visitation...................................................................................31 PolicyPI2-16: PA 291.............................................................................................................32 Policy PI3-16: Staff Recruitment (formally Staffing) (revised April 2022)................................34 Policy P14-16: Data -Informed Outreach (revised April 2022)..................................................36 Policy P15-21: Family Retention and Completion of Program (formerly Parent Retention and Completion of Program) (revised April 2022)................................................ .......................... 39 Policy PI6-16: Professional Development (revised April 2022)...............................................41 Policy PI7-16: Reflective Supervision......................................................................................43 Policy PI8-16: Engage and Coordinate with Community Members, Partners, and Parents .... 44 Policy Pl8b-21: Assemble and Engage a Community Advisory Board...................................45 PolicyP19-16: Data Collection.................................................................................................47 Policy Pl9b-22: Performance Measure Improvement (new April 2022)..................................48 Policy P110-13: Quality Improvement (QI) (formerly Continuous Quality Improvement (CQI) (revised April 2022).................................................................................................................50 8 Policy PH Ob-20: Parent Engagement in Quality Improvement (QI) (formerly Parent Engagement in Continuous Quality Improvement) (revised April 2022).................................56 Policy PI11-16: Work Plan (revised April 2022)....................... ............................................ ...57 Policy PI12-16: Promotional Materials....................................................................................60 Policy PI14-16: Developmental and Behavioral Screening (formerly Developmental Screening) (revised April 2022)...............................................................................................61 Policy P114b-20: Screening (revised April 2022).....................................................................63 Policy PI15-16: Community Coordination (formerly Dual Enrollment) (revised April 2022).....65 Policy PI16-16: Re-enrollment.................................................................................................67 Policy P117-16: Health Insurance Outreach and Enrollment...................................................68 Policy PI18-17: Family Stories (retracted April 2022).................................................. ............ 70 Policy PI19-22: Infant Safe Sleep (new April 2022)................................................................71 Policy P120-22: Social Determinants of Health (new April 2022)................... ............. ............ 73 Policy P121-22: Family First Prevention Services Act (new April 2022)..................................74 Local Leadership Groups..............................................................................................76 Policy LLG1-17: Local Leadership Group (LLG) Funding.......................................................77 Policy LLG2-17: LLG Support and TA (formerly Coordination with MDHHS Contractors) (revised April 2022).................. ........... .... .......... ............. ___ ............. ............. .................. ....... 78 Policy LLG3-17: Continuation of Effort (revised April 2022)....................................................79 Policy LLG4-17: Sustainability Plan........................................................................................82 Policy LLG5-19: LLG Impact Report.......................................................................................83 Appendices................................................................................................................... 85 AppendixA: PA 291 of 2012...................................................................................................86 Appendix B: Allowable Costs Guide for MDHHS Home Visiting Grantees..............................89 Appendix C: FY23 Deliverables and Contact Chart (revised April 2022)............ .................. 104 Appendix D: Monitoring Activities Menu................................................................................112 Appendix E: Michigan Home Visiting Initiative (MHVI) Definition of Referral ........................114 Appendix F: Parent Leader Financial Support Policy............................................................116 Appendix G: Programmatic Contract Monitoring Template (retracted April 2021) .... ........... 121 Appendix H: Family Story Release Form (retracted April 2022)....................... .................... 122 Appendix 1: Resources (new April 2022)....... .................... ........... .......................... ............... 123 Policy Al-13: Exploration and Planning Tool Eligible communities (pre -determined through a statewide Needs Assessment) must complete the Exploration and Planning Tool in its entirety and submit it to the MDHHS Home Visiting Unit (MDHHS-HVU) in order to be considered for potential funding. This is utilized when a change in funding or new funding is available. Supplemental Information: The Exploration and Planning Tool (E&PT) was created to support communities who are in the exploration phase of implementation of an Evidence -Based Home Visiting (EBHV) Model. Communities will use this tool to examine their readiness for implementation, examine community risk, and to identify the home visiting model that best fits the needs and gaps identified through the assessment. The tool is meant to be used with a wide range of partners, parents, and community leaders. Procedure Exploration and Planninq Tool: 1. Communities that are experiencing a high level of risk, as determined by a statewide Needs Assessment, will be approached about the possibility of implementing or expanding EBHV in the community. 2. Communities that are interested will be invited to join a webinar that will explain the development of the E&PT and provide information on how the tool should be completed. 3. The E&PT, Phase 1, will be provided to the respective communities. 4. The communities will engage representatives from the MDHHS-HVU required partners: Public Health, Substance Abuse, Child Abuse and Neglect, Head Start and Early Head Start. Partners from the Early Childhood community, Michigan Department of Education (MDE), parents, and others should also be included. 5. The MDHHS-HVU will provide technical assistance (TA) to the communities during this exploration phase. 6. The communities will submit their respective E&PT, Phase 1, to the MDHHS-HVU. 7. The MDHHS-HVU will schedule follow-up calls and meetings with the communities to discuss implications of Phase 1. 11 8. The MDHHS-HVU will provide E&PT, Phase 2, to communities. 9. Communities will complete, with required partners, Phase 2. 10.The MDHHS-HVU will review Phase 2 and make a final decision about the EBHV Model to be implemented by the community and the associated funding to be awarded. Timelines: E&PT1 MDHHS E&PT2 MDHHS Responsibilities Responsibilities *Timelines may change depending on the requirements of the funding opportunity. 12 Policy A2-13: MDHHS Grant Agreements Each agency that agrees to receive funding from the MDHHS-HVU is required to sign a grant agreement with MDHHS. Procedure Grant Agreements: 1. MDHHS will conduct pre -award monitoring activities of the agency accepting the funding in order to determine the appropriateness to receive funding. 2. The agency will work with the Home Visiting Program Analyst and the MDHHS Grants and Purchasing Bureau to initiate a grant agreement. 3. The agency will be added to the MDHHS Electronic Grants Administration and Management System (EGrAMS), if not already included. (See Policy A3-13) 4. The agency must follow the requirements outlined within the agreement. The grant agreement may be renewed each fiscal year based on satisfactory performance. 5. The agency is responsible for reviewing the grant agreement each year and identifying changes in the agreement language, although the MDHHS-HVU will share communication outlining any major changes in expectations. 6. The grant agreement will consist of the following components: a. Standard MDHHS boilerplate language outlining departmental expectations. b. Attachment E, Program Requirements, outlining MDHHS Home Visiting programmatic expectations. c. Attachment C, Reporting Requirements, outlining MDHHS Home Visiting reporting expectations. d. If the agreement is held with a health department, Program Requirements and Reporting Requirements will be included in Attachment III. 7. For any grant agreement questions, agencies may contact the MDHHS Home Visiting Program Analyst or their respective Model Consultant. See Appendix C for contact information. 13 fdministration Policy A3-13: EGrAMS All recipients of state or federal funds are required to utilize EGrAMS, the grant management software used to implement programs funded through MDHHS. EGrAMS can be used for the submission of grant agreements and amendments, payment processing, and program reporting. EGrAMS: 1. Each agency that accepts funding from the MDHHS-HVU is required to utilize the EGrAMS system. 2. In -person training opportunities for EGrAMS are provided by the MDHHS Grants and Purchasing Bureau on a regular basis or training can be accessed on-line via webinars and training manuals. Upon initiation of the grant agreement, training must be taken by all agency personnel who will use EGrAMS. 3. Technical assistance (TA) regarding EGrAMS is available from the Home Visiting Program Analyst. In addition, the MDHHS Grants and Purchasing Bureau has an EGrAMS help desk that is accessible by calling 517-335-3359 or sending an e-mail to MDHHS-EGrAMS-HELPn-michioan.gov. 4. All grant agreement requirements are uploaded into EGrAMS: a. Grant Agreement language (see Policy A2-13) b. Budget c. Work Plan (see Work Plan section of this policy) d. Financial Status Reports (FSRs) e. Work Plan Reports (WPRs) (see Work Plan Report section of this policy) f. Any additional requirements 5. Should the agency require changes to be made to the grant agreement, the Home Visiting Program Analyst or respective Model Consultant should be contacted in order to obtain prior approval. MDHHS-HVU staff will review the amendment request and notify the agency in writing or via telephone as to whether the request is approved or denied. Approved requests will be submitted to the Grants and Purchasing Bureau in order to have the grant agreement opened in EGrAMS for changes to be made by the agency. The agency will be notified via EGrAMS once the grant agreement is ready to be amended. After modifications have been made, the amended agreement should be submitted via 14 EGrAMS at which time MDHHS-HVU staff will approve the amendment(s) electronically so the grant agreement is officially updated. Upon initiation of the grant agreement, the agency must submit an appropriate budget. The budget must include all reasonable expenditures necessary for the agency to carry out the agreement objectives. The budget should also reflect all funding sources associated with the program, including fees and collections, as well as local, state and federal funding sources. All agencies (including health departments) must submit their budgets via EGrAMS. 3. Categories that should be included in every budget are as follows: a. Salary and Wages: only includes employees of the agency working directly on the program. b. Fringe Benefits: only includes employees of the agency working directly on the program. c. Travel: only includes employees of the agency working directly on the program. d. Supplies and Materials: must be divided into office, educational, and medical supplies. e. Contractual: only includes subcontractors of the agency and all associated expenditures related to the subcontract. Subcontractors identified here should be agencies vs. individual consultants. f. Equipment: for equipment purchases over $5,000 only and must receive prior approval. g. Other Expenses: any expenditures not indicated above. Individual (i.e. self-employed) consultants should be identified here. h. Indirect: must be an indirect cost rate approved by a federal cognizant agency or MDE. A 10% de minimis rate or a cost allocation plan (for health departments only) are also acceptable. 4. For questions about the budget, agencies may contact the Home Visiting Program Analyst, 5. See Appendix B for additional budget information. Work Plan: By June 30, 2022, all agencies must submit a Work Plan to the MDHHS Home Visiting mailbox (MDHHS-HVlnitiative(d)..michiaan.00v) for preapprovai. A form will be provided for this submission. Notice of approval or the need for revision will be 15 sent to appropriate agency staff. For those agencies that are not health departments, approved Work Plans must be submitted via EGrAMS at the time of application. Approval must be received before the Work Plan is put into EGrAMS. 2. Because agencies that are health departments cannot submit Work Plans via EGrAMS, once the Work Plan is received in the Home Visiting mailbox, a response acknowledging receipt will be sent. Notice of approval or the need for revision will be sent to appropriate health department staff. Once the Work Plan is approved, no further action needs to be taken by the health department regarding Work Plans at the time of application. 3. Every Work Plan should include the following: a. Objectives: goals intended to be achieved by the program (may enter as many objectives as necessary); b. Activities: activities that will be conducted by the program in order to achieve the objective (enter each activity individually under its specified objective); i. LIA objectives and activities must include SMART (Specific, Measurable, Achievable, Relevant, and Time -bound) plans for outreach and retention of families. ii. LIA objectives and activities must include plans to increase health equity outcomes in the community. c. Date Range: the timeframe associated with completing the activity; d. Responsible Staff: person responsible for making sure the activity is completed; e. Expected Outcome: what you anticipate will happen as a result of the activity's completion; f. Measurement: how the program will measure progress towards the achievement of the outcome; g. Target Audience: the group that will be impacted by the activity. 4. For more detailed information about entering Work Plans, please see the "About EGrAMS" link on the left side of the EGrAMS home page. 5. For suggested Objectives and Work Plan content, see Policy PI11-16. 6. For questions related to Work Plans, agencies may contact their respective MDHHS-HVU Model Consultant for LIAs or the State LLG Coordinator for LLGs. Financial Status Reports: 1. Financial Status Reports (FSRs) are required of all agencies. For health departments, these reports are due quarterly (within 30 days of the end of the quarter). For all other agencies, these reports are due monthly (within 30 days of the end of the month). 16 2. All agencies (including health departments) must submit their FSRs via EGrAMS. 3. FSR requirements can be found in the grant agreement boilerplate language. 4. FSRs must reflect actual expenditures that occurred within the reporting period by source and budget line item. 5. Once expenses have been approved by the MDHHS-HVU, they cannot be changed on that specific FSR. However, corrections can be made on future FSRs. 7. For additional information about FSR submissions, please see the "About EGrAMS" link on the left side of the EGrAMS home page. 8. For questions about FSRs, agencies may contact the Home Visiting Program Analyst. Work Plan Reports: 1. Work Plan Reports (WPRs) are required of all agencies. For all agencies (including health departments) these reports are due quarterly by the 30th of the month following the end of the quarter. (See Policy PI11-16) 2. Agencies that are health departments do not submit WPRs via EGrAMS. Instead, their WPRs should be submitted to the Home Visiting mailbox at MDHHS-HVlnitiativee-michician.00v on the form provided. An e-mail will be sent in response indicating that the WPR was received and subsequently it will be distributed to the appropriate MDHHS Home Visiting staff member(s). All other agencies must submit their WPRs via EGrAMS. 3. WPRs must be narrative in nature and include updates on progress made for all activities during that quarter. Sufficient detail about all activities should be included so that MDHHS Home Visiting staff are able to ascertain how an agency is progressing toward its objectives. 4. All WPRs should include: a. A Period Summary: a detailed account of activities that took place during the quarter; b. Evaluation Results: any data that should be included to demonstrate progress toward the objective; c. A Completion Date: only to be filled in if an activity is 100% completed. Once a completion date is entered in EGrAMS and the Complete box is checked, this activity will not be able to be reported on again within the fiscal year. 5. For additional information about WPR submissions, please see the "About EGrAMS" link on the left side of the EGrAMS home page. 6. For questions about WPRs, agencies may contact their respective MDHHS-HVU Model Consultant for LIAs or the State LLG Coordinator for LLGs. 17 Policy A4-13: Subrecipient Monitoring (SRM) SRM will occur for all programs receiving state and federal monies to implement MDHHS Home Visiting activities. MDHHS is required to monitor the activities of subrecipients as necessary to ensure that state and federal funding is used for authorized purposes in compliance with laws, regulations, and the provisions of the grant agreements that govern each home visiting award. SRM activities include an annual risk assessment of each subrecipient agency, review of financial and performance reports, follow-up to ensure timely and appropriate action on all deficiencies, the issuance of a management decision for audit findings, training and TA on program and fiscally -related matters, and on -site reviews of agency operations. Supplemental Information: Each of the EBHV models supported have program monitoring, assessment, support and technical assistance available through the model national offices. For LIAs/LLGs who receive funding through MDHHS, additional program development supports specific to the requirements of MIECHV and PA 291, will be provided by MDHHS and the Michigan Public Health Institute (MPHI). LIAs and LLGs shall fully participate in these monitoring, assessment, support, and technical assistance activities. Procedure SRM Activities: SRM activities include: 1. Review of financial and programmatic reports required by MDHHS. 2. Follow-up to ensure that the grantee takes timely and appropriate action on all deficiencies. 3. Performing monitoring specifically required by statute, regulation, and/or award requirements. 4. Performing pre -award monitoring to determine the fitness of the grantee during the selection process. 5. Obtaining and reviewing a completed Fiscal Questionnaire from the grantee. 6. Performing desk reviews of the grantee's records. 7. Performing on -site reviews of the grantee's records and/or operations. 8. Providing the grantee with training and technical assistance. 9. Arranging for agreed -upon procedure engagements for grantees. See Appendix D for further information on SRM. iu Risk Assessment: 1. Annually, the Home Visiting Program Analyst will conduct Risk Assessments for every subrecipient agency who holds a grant agreement with the MDHHS-HVU. 2. The Risk Assessment will take into consideration an agency's performance related to both programmatic and fiscal components. 3. Each agency will receive a Risk Assessment score, which will determine the level of sub -recipient monitoring they will receive that fiscal year, up to and including a possible site visit. A sub -recipient Monitoring Plan for the MDHHS-HVU will be developed by the Program Analyst. 4. MDHHS Home Visiting grant requirements include: a. Annual programmatic site visits of all LIAs regardless of Risk Assessment scores; b. Fiscal site visits for grantees based upon Risk Assessment scores. Once a fiscal site visit is conducted, subsequent visits will occur every three years after the initial visit. If a fiscal site visit is warranted, the agency will be notified with adequate time to prepare; and c. LLG programmatic site visits occurring, at a minimum, every three years. 5. Programmatic and fiscal site visits may occur separately, but every effort will be made to combine the site visits when possible. Prooram Monitoring, Assessment. Support and TA: 1. Each LIA shall fully participate with their model's national office and/or state office with regards to program monitoring, assessment, support and technical assistance services. 2. LIAs/LLGs shall participate in Learning Collaborative/Grantee Meetings, webinars, Community of Practice calls, the annual Michigan Home Visiting Conference, and other opportunities as provided by MDHHS and MPHI. (See Policy P16-16 for more details.) 3. LIAs/LLGs shall contact support staff at MPHI and/or MDHHS as needed for specific questions. (See Appendix C for contact information.) 4. The LIA shall participate in the annual programmatic site visit with MDHHS Home Visiting staff and provide all required documentation. Quality Assessment (MHVQAS) site visits will occur every four years during a time that will not coincide with national model site visits. The Quality Assessment visit will take the place of an annual site visit for that year. (See Policy PI1 b-18 for more details regarding MHVQAS.) 19 5. For specific programmatic monitoring expectations, see the MDHHS-HVU Programmatic Site Visit Tool posted on the Michigan Home Visiting Initiative Groupsite at httos://mhvi.orour)site.com. Site Visits: Prior to Site Visit 1. By the end of the first quarter of the fiscal year, the programmatic site visit schedule for the LIAs and LLGs funded by the MDHHS-HVU will be developed. 2. All LIAs and LLGs funded by the MDHHS-HVU will be notified with the projected dates of the review. If necessary, to accommodate the needs of the agency, review date changes can be made with consideration of the availability of the review team. 3. Agencies who are determined to require a fiscal site visit based on their Risk Assessment score, will be notified that they will be receiving a fiscal review during the current fiscal year. Every effort will be made to conduct the fiscal review at the same time as the programmatic site visit. If unable to combine the fiscal review with the programmatic site visit, the MDHHS-HVU Program Analyst will work with the agency to schedule a mutually beneficial time. The agency will typically receive a one -month advance notice for the fiscal review. 4. Prior to the review date, the LIA Program Manager or LLG Coordinator will receive: a. A confirmation email of the review dates/times; b. An explanation of the review including the tentative agenda; c. Notification as to whether a fiscal review is required; d. A description of what materials need to be sent to the MDHHS-HVU in advance of the review and by what date; e. A description of what materials need to be available on site during the review; f. A listing of who will be conducting the review, and g. In the event that external conditions require a virtual site visit, the Program Manager/LLG Coordinator and other staff to be interviewed will receive virtual meeting appointments in alignment with the site visit agenda. The agenda may be modified to accommodate a virtual format. KE During Site Visit 1. The day of the review, the MDHHS Home Visiting team will meet in the morning with the agency staff. The morning meeting must include at a minimum the agency Program Manager and Fiscal Manager (if a fiscal review is being conducted at the same time). Agency staff should be available to reviewers during the entire visit. 2. During the morning meeting, the review team will explain the process and the proposed agenda. 3. During the morning session, the MDHHS Home Visiting team will review the documents that were requested. These will include both programmatic documentation as well as fiscal documentation if the reviews are being conducted at the same time. Questions may be asked of the agency and additional documentation may need to be provided. 4. The afternoon session will consist of the presentation of program strengths as well as any significant findings. 5. Time will be allowed for agency staff to ask questions or share concerns. 6. Any recommendations may be shared at this time or the agency may be told that they will be provided in a follow-up phone call or written communication. 7. At the time of the closing session, if the agency is significantly out of compliance, an additional review must be taken with the MDHHS Home Visiting Unit Program Manager prior to any next steps. 8. Each agency will receive a written report summarizing the review results. 9. If an agency is found to be out of compliance, the report may include a Site Improvement Plan. 10.Any agency that receives a Site Improvement Plan will need to take steps that must be completed no later than one year following the date of the review with the understanding that some steps may need to be completed sooner. 11.TA will be provided to the agency by MDHHS Home Visiting staff as needed to ensure all corrective actions have been completed. 21 22 Fiscal Policy F1-14: Allowable Costs Federal funds received by the MDHHS-HVU and passed through to subrecipient agencies are required to be spent according to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (see federal regulation 2 CFR, part 200). Additional allowable cost requirements are identified in the HHS Grants Policy Statement as well as MDHHS policies. Supplemental Information: It is expected that each subrecipient agency, in its normal course of operation, will abide by the basic Generally Accepted Accounting Principles (GAAP). In addition, the MDHHS-HVU has taken several steps to ensure that all spending is in compliance with the above regulations. As a result, the MDHHS-HVU has developed an Allowable Costs Guide which includes an easy -to -understand breakdown of the regulations along with specific examples of how both MIECHV and state funds can be spent. The intent is to assist in clarifying all of the regulations which govern MDHHS-HVU spending. All spending of state and federal funds must follow these guidelines. Some exceptions may be requested as per Policy F2-14. Procedure Allowable Costs Guide: 1. Upon approval to receive state and/or federal Home Visiting funding, each agency will receive a copy of the MDHHS Allowable Costs Guide (see Appendix B). 2. The agency's fiscal and program staff should familiarize themselves with this document so that they are aware of which program costs are allowable as well as those that are subject to exception. 3. If an agency has a question about whether an expenditure is allowable, the question should be directed to the MDHHS Home Visiting Program Analyst prior to making the purchase. Usually, the question can be answered rather quickly, however there may be times when the question may require clarification from our HRSA project staff. MDHHS takes all fiscal questions seriously and wants to ensure each is answered in a thoughtful and consistent manner. 4. If an expenditure is subject to an exception, the agency must follow Policy F2-14 — Allowable Cost Exception Request. 23 5. If an agency incurs an unallowable expenditure or has not followed the Allowable Cost Exception Request policy, it may result in a corrective action up to and including a pull -back of MDHHS-HVU funds. 6. All spending of state and federal funds must be reflected in the agency's current budget. Any requests that may necessitate a change in the budget, may be subject to a budget amendment. Notify the MDHHS Home Visiting Program Analyst if an amendment is deemed necessary. 7. All expenditures must be documented in the Financial Status Reports (FSRs) that are required to be submitted in EGrAMS by each agency. 24 Fiscal Policy F2-14: Allowable Cost Exception Request Requests for any exception to the Allowable Costs guidelines must be sent to the MDHHS- HVU. Funds under consideration as being an exception, should not be spent or allocated without prior approval by the Home Visiting Unit. Procedure Allowable Cost Exception Request: All agencies that utilize state or federal funding through the MDHHS-HVU must follow the Allowable Costs guidelines (Policy F1-14) that have been developed by the MDHHS-HVU. These guidelines follow the Uniform Administrative Requirements, Cost Principles, and Audit Requirements as well as the HHS Grants Policy Statement and MDHHS policies. However, any agency that wishes to request an exception to the guidelines must submit an exception request in writing prior to the expenditure of funds. 1. Any agency that wishes to request an exception to the Allowable Costs guidelines must submit the request in writing. Note: Any budgetary changes will need to align with the MDHHS amendment dates that are provided to each agency. 2. The written request must include the following: a. Agency name b. Program name c. Date of the request d. Name of the fiscal manager and program manager e. Amount of the request f. Short summary explaining why the exception is necessary and why it is being requested. g. Statement indicating the potential positive impact on the families served by the program. h. Statement indicating why other funds could not be used for the request. i. Statement indicating whether the program has requested an exception previously. 3. The written request must be submitted to the MDHHS-HVU with sufficient time to allow for a 2- to 4-week review period. 4. HVU staff will review the request. If the request is clearly not allowable under federal policy, the request will be denied, and the agency will be notified in writing. 5. If the request is an unusual funding request, but is not specifically denied by state or federal policy, the request will be considered. 25 6. MDHHS will notify the agency, by telephone, followed by written communication, within 2 to 4 weeks of the written request. 7. If the request requires an amendment to either the program budget or Work Plan, the agency will be notified of the changes and asked to incorporate the changes during the next amendment cycle. 26 27 Policy PI1-16: Fidelity to a Home Visiting Service Model (revised April 2022) LIAs that utilize MDHHS Home Visiting funding must ensure fidelity to a home visiting service model. LIAs shall: 1. Implement one of the following models: Early Head Start, Healthy Families America, Nurse -Family Partnership, or Parents as Teachers. 2. Adhere to the program standards established by the model. 3. Operate the program with fidelity as required by the model. 4. Provide documentation from accreditation and/or model site visits. 5. Provide documentation that home visitors are trained in the model's approach and that procedures are used to ensure home visitors implement the program with fidelity. Deliverables: Deliverables Due Date Documentation from accreditation and/or model site visits As visits occur Documentation that all home visitors attend training related to model fidelity At annual site visit Monitorina and Evaluation: MDHHS monitors for fidelity in several ways. 1. Monthly Implementation Plan Review (IPR) Meetings: The state Home Visiting team (including MPHI) meets on a monthly basis to review data from the LIAs. This review includes: enrollment, attrition, service duration, capacity filled, caseloads, staff retention, and other metrics as needed. 2. Annual Site Visits: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 3. Ongoing Partnerships with National and State Model Offices: MDHHS works closely with each of the national and state model offices to ensure fidelity. IE 4. Quality Assessment Tool: Michigan utilizes the Michigan Home Visiting Quality Assurance System (MHVQAS) to assess quality of implementation. The tool will be utilized with MDHHS-HVU funded programs every four years, adjusted so it does not fall in the same year as a full accreditation visit for HFA, EHS, or PAT. The tool results will be shared with the LIA, state office of the model and with the national model representatives as appropriate. (See Policy Pl1b-18 for further information about MHVQAS). 29 • • • Policy P11b-18: Michigan Home Visiting Quality Assurance System (MHVQAS) All LIAs receiving MDHHS Home Visiting funding will participate in a quality assessment using the MHVQAS tool, The tool is used to assess the quality of home visiting programs implemented in Michigan to meet the requirements of both Public Act 291 of 2012 and MIECHV funding. Procedure 1. Each LIA shall participate in a Quality Assessment site visit every four years, at a schedule that complements, not competes, with national model site visits. 2. The Quality Assessment visit will take the place of an annual site visit for that year. 3. Home Visiting staff will provide orientation and training regarding use of the tool through a recorded webinar and one-on-one training as necessary. 4. Home Visiting staff will provide the materials for the MHVQAS visit at least three months prior to the visit. 5. The MHVQAS reviewer will hold, upon request, an individual TA call with the site to discuss the tool and answer initial questions. 6. LIAs will send the required documents to the reviewer at least two weeks prior to the on -site visit. 7. The LIAs will pull all required materials to be reviewed on site. 8. The MHVQAS report of the assessment visit will be provided to the sites within one month of the visit. 9. All sites will have individual recommendations about quality improvement provided to them in the report. The report will be discussed as a team. The MHVQAS tool will be used to identify areas of quality, best practices, and opportunities to improve practices. It is not anticipated that as a site prepares for the review, practices should be changed during the preparation process for the review. The intent of the review is to identify opportunities for future improvement. It is not anticipated nor expected that LIAs will receive a score of "fully met' for each domain and standard. It is also not expected that a LIA will work on every domain that is identified as "partially met' or "unmet'. We instead recommend that sites select one or two standards they wish to improve and focus on those before moving on to additional items. The MHVQAS tool will allow MDHHS Home Visiting staff to identify practices that could be improved upon across all models, to be addressed as part of the statewide system of quality improvement. 30 Policy P11c-21: Virtual Home Visitation LIAs that receive MDHHS Home Visiting Unit funding must develop and implement policies and procedures to ensure that they are able to complete virtual or telehealth visits in accordance with model fidelity. Procedure 1. LIAs will compose a written policy that addresses the needs of the program and families in the event a virtual visit is required due to public health law or preference of the family, 2. LIAs will inform MDHHS if there are technology concerns to being able to implement virtual home visits. 3. LIAs will write policy to include: a. National model expectations around what constitutes a virtual home visit (e.g., duration, technology medium, etc.); b. Screenings that can and will be completed virtually; c. Plans for any portions of the model that need adaptation to be completed virtually (e.g., parent child interaction observations, etc.); d. Commitment to documenting virtual/telehealth home visits using existing data system expectations. 4. A portion of the policy can be that the LIA will update and adapt the policy if model expectations shift, or national best practice indicates a shift across the system (e.g., IPV screenings are no longer considered safe in a virtual environment and all LIAs are asked to utilize universal IPV education in lieu of a screening). Deliverables: Deliverables Due Date Virtual Home Visit Policy At annual site visit Monitorina and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 31 Policy PI2-16: PA 291 LIAs shall comply with the provisions of Public Act 291 of 2012. Procedure 1. LIAs shall provide documentation that the program has policies and procedures that align with the requirements of PA 291 (see Appendix A). a. Per PA 291, LIAs shall deliver face-to-face home visits using an approved EBHV model. b. All services are offered on a voluntary basis. c. Regular home visits will be planned to improve the health, well-being, and self-sufficiency of parents and children. These visits will be documented in case files. d. LIAs shall ensure that home visiting staff meet the professional criteria and training requirements of the implemented model. e. Home visiting programs will provide case file documentation of services that do one or more of the following: i. Work to improve maternal, infant, or child health outcomes including reducing pre -term births. ii. Promote positive parenting practices. iii. Build healthy parent and child relationships. iv. Enhance social -emotional development. v. Support cognitive development of children. vi. Improve the health of the family. vii. Empower families to be self-sufficient. viii. Reduce child maltreatment and injury. ix. Increase school readiness. f. LIAs shall maintain and provide documentation of strong links with other community -based services 32 Deliverables: Deliverables Written policy stating that services will be provided on a voluntary basis Model Site Visit reports will be reviewed to ensure the EBHV model is implemented with fidelity Case files that document home visit planning, home visit completion, and parent goals Documentation of initial and ongoing home visitor training (training logs) Documentation of a-f of this policy that supports model fidelity and compliance with PA 291 Documentation of links with other community -based services Monitorina and Evaluation: Due Date At annual site visit At annual site visit At annual site visit At annual site visit At annual site visit At annual site visit During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met, 33 Policy PI3-16: Staff Recruitment (formally Staffing) (revised April 2022) LIAs shall provide opportunities for and maintain home visiting staff who reflect the population served which is a key component to increasing health equity, decreasing racial and ethnic disparities, and supporting family retention. If unable to recruit eligible candidates to maintain staff who reflect the population served, the agency must document their good faith, due diligent efforts to comply with this requirement. Procedure i. Each LIA shall have a written staff recruitment policy that includes developing, in accordance with agency policy, a written staff recruitment plan that includes actions to support recruitment and hiring of staff who are reflective of the population served. The staff recruitment plan should demonstrate the agency's commitment to best practices within equal opportunity hiring. 2. Staff recruitment activities should support identifying potential candidates who reflect the data -informed outreach population identified in the Outreach Toolkit as approved by MDHHS. 3. The LIA will maintain documentation of actions taken to support broad and diverse staff recruitment. These include, but are not limited to: a. A list of locations where the posting was placed b. Use of a variety of media for posting c. Use of internships or relationships with area institutions of higher learning to generate interest d. Use of relationships with area hospitals, health care providers, public and private schools and/or social workers to generate interest e. Use of sororities, associations, or social networks, etc. f. Ensuring a diverse interview panel g. Expressing commitment to health equity and the ability to work effectively with diverse groups in job descriptions h. Including questions related to diversity or health equity in the job posting if questions for candidates are required 4. If the LIA conducts exit interviews with departing staff to help improve future staff retention efforts, the HVU requests that you share learnings from those interviews to inform future potential statewide improvement opportunities. This is not a requirement. a. If interested, submit exit interview information to your Model Consultant at the annual site visit to support understanding trends within the home visiting workforce. 34 5. The LIA shall post and re -hire a position within 180 days of the position being vacated. Extenuating or challenging circumstances need to be shared with MDHHS-HVU to discuss exceptions to the hiring deadline. Deliverables: Deliverables Due Date Written policy requiring staff recruitment plan At annual site visit Written staff recruitment plan At annual site visit Documentation of actions taken for staff recruitment and hiring At annual site visit Documentation of posting and hire within 180 days At annual site visit Monitorinq and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 35 Policy PI4-16: Data -Informed Outreach (revised April 2022) Home Visiting models funded by the MDHHS-HVU shall use their Outreach Toolkit. This toolkit includes their County Profile of Disparate Pre -Term births, MIECHV Needs Assessment County Profiles, and Concentrated Disadvantage Maps provided by MDHHS to determine the population to whom they should conduct outreach. LIAs shall conduct outreach efforts to engage and enroll families living in communities that contribute to inequities and disadvantage as a key strategy to increase health equity and decrease racial and ethnic disparities. Procedure Data-lnformed Outreach; 1. Updated County Disparate Pre -term birth reports are distributed biannually by MDHHS. The LIA can use this information along with the entire Outreach Toolkit to guide outreach efforts if the model/program serves pregnant people 2. The outreach population/geographic region identified by the Outreach Toolkit may not be changed without express permission from the MDHHS-HVU after additional justification is provided and reviewed. a. Additional justification must include completion of the data portion of Phase 1 of the MDHHS Exploration and Planning Tool. (See Policy A1- 13) b. The Exploration and Planning Tool is available upon request from the Model Consultant. c. Additional data pertinent to the request may be included. If the LIA needs the assistance of the Home Visiting epidemiologist during this process, contact the appropriate Home Visiting Model Consultant who will connect the LIA with the epidemiologist. d. The justification to add or change the outreach population must be submitted to the MDHHS-HVU in writing. e. MDHHS will make a determination on approving the justification within 14 days of receipt. The justification must then be submitted to HRSA (for MIECHV grantees) for approval. LIAs who receive state funding are not required to obtain HRSA approval. 3. LIAs shall provide documentation of policies and procedures which facilitate targeted outreach efforts. 4. LIAs shall document an Outreach Objective and related activities as a component of their annual Work Plan and regularly report progress within their quarterly Work Plan Reports. 36 R 0 rA LIAs must keep a record of all outreach efforts including: the name of the entity to whom the outreach occurred, staff assigned, the activity performed, and time spent. This document will be reviewed by the Model Consultant at annual site visits and upon request. a. Printed materials, media materials and social media materials for outreach activities shall be vetted through the Model Consultant at MDHHS-HVU. LIAs shall refer clients not eligible for their model or not able to be served by their model, to another evidence -based Home Visiting Program. The LIA should consider parent choice, parent need, and available programs when discussing other options with a family. LIAs shall ensure full caseloads within the established timeframe based on model guidance for new staff. Consideration for the ramping up period of a new hire should be made in alignment with model guidelines. A full caseload, per MDHHS, is no less than 10 families per full time (1.0 FTE) home visitor for Early Head Start; no less than 15 families per full time (1.0 FTE) home visitor with 3 years or more experience for Healthy Families America (exceptions are if a HV serves two counties the caseload is 14; if they serve more than two counties the caseload is 12), with case weight not to exceed 30; and no less than 25 families per full time (1.0 FTE) home visitor for Nurse -Family Partnership. Parents as Teachers shall follow the requirements of the model and utilize the points system to determine caseload size, approximately 15-20 families per 1.0 FTE. Caseload capacity is subject to change if the home visitor is funded under the Families First Prevention Services Act or the Substance Use expansion. a. For agencies that receive MIECHV funding, keep in mind that a family can only be counted as a MIECHV family if 25% of the home visitor's salary and fringe are funded with MIECHV funds. MDHHS-HVU encourages all MIECHV-funded LIAs to designate as many staff as possible as MIECHV. As part of doing this, the braiding of MIECHV funding with other agency home visiting funds will need to occur, allowing for better program consistency and sustainability. If you do not have braided funding currently and are interested in establishing braided funding, please reach out to the MDHHS-HVU Program Analyst or Program Manager. This change must be approved by the MDHHS- HVU and HRSA if it takes place mid -grant cycle as it will impact the expected number of MIECHV families to be served. 37 Deliverables: Deliverables Policies and procedures that facilitate data -informed outreach activities Outreach Efforts Tracking Log Monitoring and Evaluation: Due Date At Annual Site Visit At Annual Site Visit During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. W. Policy PI5-21: Family Retention and Completion of Program (formerly Parent Retention and Completion of Program) (revised April 2022) LIAs funded by the MDHHS-HVU shall employ strategies that foster family retention with home visitinq services and completion of program as defined by the model. 1. Home Visiting programs will achieve and maintain a minimum of 85% caseload capacity per month. 2. LIAs shall provide a copy of an agency -specific written policy addressing family retention, and appropriate procedures to support the policy. Procedures should include strategies that facilitate family engagement to support retention and program completion. 3. Policies and procedures should include the definition of program completion per model standards, the inclusion of family retention -focused objectives and activities in the annual Work Plan, and activities to monitor family exit reasons. a. LIA shall monitor family exit reasons quarterly using the LIA database. If information is not easily accessible, the HVU can provide this data. Documentation that the review occurred includes a data system generated report of family exit reasons, other documentation that indicate the LIA monitors family exit reasons. LIA shall include Objective(s) and Activities to strengthen retention and minimize attrition in the annual Work Plan. Progress on those Activities must be included in quarterly Work Plan Reports. b. Activities should reflect review of family exit reasons and/or retention rates. Sample Policy: ABC Model will employ strategies that foster family engagement and retention with home visiting services and completion of the [Model] program. c. Procedures may include CQI strategies, pursuing technical assistance, family satisfaction surveys, parent -to -parent interaction, etc. (e.g., Previous PDSA cycles are available for reference on Groupsite). 39 Deliverables: Deliverables Sentinel Item - Documentation of 85% monthly caseload capacity Written policies and procedures that facilitate family engagement Work Plan and Work Plan Reports Documentation supervisor/team reviewed family retention rates at a minimum of four times per year and that activities in Work Plan align with status of family retention rates Documentation supervisor/team reviewed family completion/graduation rates at a minimum of four times per year and that activities in Work Plan align with the status of family program completion rates Monitorina and Evaluation: Due Date By the 5th business day of each month in REDCap At annual site visit June 30 and at the end of each quarter respectively At annual site visit At annual site visit During each LTA's annual site visit, a Model Consultant will confirm that all requirements are met. m Policy P16-16: Professional Development (revised April 2022) All LIA staff associated with MDHHS Home Visiting funding shall participate in professional development as required by their model and MDHHS-HVU. Procedure Professional Development and Trainina: 1. The LIA budget and annual Work Plan shall reflect time and resources for team and/or individual attendance at model -specific trainings or meetings. 2. The LIA budget and annual Work Plan shall reflect time and resources for team attendance at required Grantee meetings. 3. The LIA budget and annual Work Plan shall reflect time and resources for professional development. Professional development must include provision for a minimum of five MDHHS-funded staff to attend the annual Michigan Home Visiting Conference --full staff if fewer than five including all home visitors and supervisor. 4. The LIA shall develop a policy and procedure for tracking the professional development activities and hours for each member of the staff including supervisors and program administrators. 5. Supervisors and home visitors are expected to: a. Review the Michigan Core Knowledge Framework webinar (posted on Groupsite). This can be done as a group or individually. Documentation that staff have reviewed the webinar should be included in training logs. Effective FY23, the training log should include the core knowledge area addressed in each training. b. Effective FY23, supervisors and home visitors will create a professional development plan for each staff member to address topics considered to be opportunities for growth. 6. LIAs shall have a written plan in place that includes the provision of training to all staff to assure that they: a. Complete annual training on child maltreatment, mandatory reporting, safe sleep, health equity, implicit bias, and systemic racism. b. Know how to assess and address social determinants of health for their families in preparation for future use of SDOH screening tools. Resources for SDOH can be found in Appendix I. 41 Are knowledgeable of the most recent American Academy of Pediatrics (AAP) safe sleep recommendations. Training should be completed within 60 days of employment and be updated annually. Training should include both the basics of safe sleep and advanced training on how to have effective conversations with families. i. Free training on the basics of safe sleep and advanced topics found online at www.michioan.00v/safesleeD, Information for Professionals Online Trainings. ii. Basic: "Infant Safe Sleep for Professionals Working with Families" iii. Advanced: "Helping Families Practice Safe Sleep." iv. Group trainings (including virtual) arranged by contacting the MDHHS Infant Safe Sleep Program at www.MDHHSInfantSafeSleeDe.Michiaan.00v. d. Are trained in the utilization of all screening protocols Links to free trainings relating to the knowledge areas are located on the MHVI Groupsite at httDs://mhvi.arouDsite.com. Deliverables: Deliverables Due Date Policies and procedures that ensure ongoing professional development At annual site visit Team attendance at Grantee Meetings Meeting 3x/year Training logs and professional development plans At annual site visit an - Documentation of the review of the Michigan Core Knowledge At annual site visit Framework Monitorina and Evaluation: Attendance rosters will be used to monitor attendance at MDHHS/MPHI-required events. Work Plan Reports will be reviewed quarterly. During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 42 Policy P17-16: Reflective Supervision LIAs that utilize MDHHS Home Visiting funding must develop and implement policies and procedures that ensure the effective provision of reflective program -wide supervision with fidelity to the model(s) implemented. Procedure LIAs shall: 1. Write a policy and procedure for providing effective reflective supervision per model and state requirements. 2. Document the number of hours of reflective supervision per month per home visitor in the appropriate data system. 3. Make sure written reflective supervision practices match model -specific requirements listed in the grant agreement. (Within the grant agreement, see Attachment E or Attachment III for health departments.) Deliverables: Deliverables Due Date Policies and procedures that ensure implementation of reflective Annually supervision practices Comply with grant agreement provisions regarding reflective Annually supervision expectations Submit required data Monthly Documentation of training in reflective supervision for all supervisors One Time Monitoring and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. Monthly data requirement may be reviewed at monthly IPR meetings. 43 Policy PI8-16: Engage and Coordinate with Community Members, Partners, and Parents The LIA shall ensure that there is a broad -based community advisory committee that is contributing to system building and the home visiting continuum in the community. This may occur collaboratively with the Local Leadership Group established to work with the MIECHV oroaram or other early childhood committees and/or advisory bodies. Procedure Enaaae and Coordinate with Community Members. Partners. and Parents:. 1. One or more representatives of the LIA shall maintain an active role with the Local Leadership Group (LLG). 2. If a LLG does not exist in the community, one or more representatives of the LIA shall maintain an active role with the Great Start Collaborative (GSC). 3. The LIA shall use the local early childhood advisory groups, LLG and GSC to build collaboration and support with and for data -informed outreach populations within the community. 4. LIA shall maintain awareness of Regional Perinatal Quality Collaboratives' (RPQC) activities within their community. Participation is required by at least one member of the LIA (the participant does not have to be a supervisor). The LIA is encouraged to participate with other appropriate collaborative bodies that support quality program implementation. Monitorina and Evaluation: Attendance rosters and meeting minutes will be used to monitor attendance at advisory group events. During each LTA's annual site visit, a Model Consultant will confirm that all requirements are met. 01 Policy PI8b-21: Assemble and Engage a Community Advisory Board The LIA shall ensure that they have identified a broad -based community advisory board (CAB) that provides program -specific input to increase quality program implementation, improve access to community resources for families, and raise awareness of the program within the community it serves. Procedure Assemble and Engage a Communitv Advisory Board: 1. The LIA must engage a broad -based community advisory board that consists of two parents, at a minimum, and multiple community partners that could include representation from the following systems: healthcare, public health, child welfare, substance use, behavioral health, and education. 2. If there is an LLG in the community, the LLG can function as the CAB as long as: a. This partnership is mutually agreed upon. b. There is a MOU in place to describe the expectations and responsibilities of both agencies that includes: i. The frequency in which the CAB meets which should be based on model requirements or, at a minimum, on a quarterly basis. ii. A reference that meeting minutes from the CAB will capture the issues brought forward from the model and how those issues were addressed. 3. The LIA shall provide a written policy that establishes a CAB following model requirements, comprised of community partners including the requirement of two parents. a. One of the parents must be a recipient of home visiting services from the LIA whose enrolled child is currently age five or younger. It is the expectation that the parents who are attending the CAB meetings and any activities attached to that work will be supported financially according to MDHHS-HVU expectations (see the Parent Leader Financial Support Policy, Appendix F). 45 Deliverables: Deliverables _ Policy that establishes the creation and role of a CAB based on model requirements MOU between LIA and LLG if applicable Minutes from CAB meetings Monitoring and Evaluation: _ Due Date_ Annually Annually Annually Attendance rosters and meeting minutes will be used to monitor attendance at advisory group events. During each LIA's/LLG's site visit, a Model Consultant or MDHHS contractor will confirm that all requirements are met. m Policy P19-16: Data Collection Each LIA shall ensure timely, complete, and accurate data collection and submission to maintain model fidelity and to meet MDHHS/MPHI requirements. Procedure Data Collection: 1. The LIA shall comply with all model and MDHHS data collection requirements, including use of all appropriate data systems (e.g., REDCap). 2. The LIA shall authorize MDHHS and MPHI to receive information from the national model data system as applicable. a. Early Head Start: REDCap b. Healthy Families America: Home Visiting Online (HVOL), REDCap c. Nurse -Family Partnership: Flo and REDCap d. Parents as Teachers: Penelope Case Management (or alternate system implemented), REDCap 3. The LIA shall work with MPHI to collect and report additional data beyond that required for the model, but required by MIECHV and PA 291. 4. The LIA must have a written policy regarding data collection timelines and expectations. The policy will align with the data collection timelines located in the Deliverables and Contact Chart (Appendix C). Deliverables: Deliverables Performance Measure (PM) Data Program Level Data Due Date As visits occur, the recommendation is that family data will be submitted within five_ business days of each home visit. All data must be complete prior to the next MPHI PM report extraction. 5th business day of the month for previous month's data Written policy regarding data collection At annual site visit Monitoring and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. MDHHS and MPHI will review data per required submission dates and at monthly IPR meetings. 47 Policy Pl9b-22: Performance Measure Improvement (new April 2022) LIAs that receive MDHHS Home Visiting Unit (HVU) funding, must demonstrate commitment to improvement in the HVU performance measures. Procedure 1. LIAs will receive and review Performance Measure (PM) Reports three times per year. Supplemental Information: Performance Measure Reports highlight rates of completion on key quality markers which are required of MDHHS-funded LIAs. Sites are expected to use the data demonstrated by these reports both to maintain excellence and to foster growth. 2. LIAs will review the state level PM Reports and identified annual Opportunity for Improvement (OFI). 3. Using a team approach, the MDHHS-HVU PM Reflection Document will support LIAs to organize plans for improvement of two self-selected indicators upon receipt of PM Report Q1 - Q4. LIAs may choose to adopt the state level OFI as one of the self- selected indicators if it applies to the LIA. The term "improvement' includes decreasing missing data and/or increasing the level of performance within a given indicator. Improvement can include, but is not limited to: a. ensuring data are entered in the correct place b. revising forms c. documenting processes/procedures and training staff d. supporting staff development e. engaging in a PDSA cycle f. gathering input from families g. accessing model resources 4. The PM Reflection Document will be updated following PM Report Q1 — Q2 and PM Report Q1 — Q3. 5. The completed PM Reflection Document will be submitted to the MDHHS-HVU Model Consultant within 30 days of receipt of each PM Report. 6. LIAs are encouraged to reach out to the MDHHS-HVU Model Consultant, MPHI Data Consultant, and/or MPHI QI coach to access available supports. Accessing these support mechanisms can be offered as evidence of a strategy for performance measure improvement. 48 7. LIAs should be aware that the state will be focused on the state level OR which may result in additional improvement strategies that will occur for the state level OFI including, but not limited to, data system updates, PDSA cycles, and direct intervention with an LIA. Deliverables: Deliverables PM Reflection Document updated Reflection Document Monitorina and Evaluation: Due Date 30 days after receipt of PM Report Q1 - Q4 30 days after receipt of PM Report Q1 — Q2 and PM Report Q1 - Q3 During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 49 Policy PI10-13: Quality Improvement (QI) (formerly Continuous Quality Improvement (CQI) (revised April 2022) Each LIA that receives funds from the MDHHS-HVU is required to participate in activities that support fostering and nurturing a culture of quality within local agencies/programs and across the home visiting system. Supplemental Information: Quality improvement is a systematic approach to specifying the processes and outcomes of a program through regular data collection and the application of changes that may lead to improvements in performance or program outcomes. The HVU has embraced the use of quality improvement methods and tools to support improvement in processes at the state, local, and systems levels. Additionally, the HVU has been committed to building a culture of quality at every level of the home visiting system since the inception of the Michigan Home Visiting Initiative. The components of a culture of quality include: - Leadership Commitment - QI Infrastructure - Employee Empowerment - Customer Focus - Teamwork and Collaboration - Continuous Quality Improvement Ultimately, a culture of quality is realized when all staff use quality improvement methods, tools, and techniques on an everyday basis to better serve their customers. Note Changes for FY23: There will be no Learning Collaborative that begins in FY23; nor is there a set number of expected PDSA cycles. Expectations remain for attendance at Grantee Meetings, Communities of Learning, and bimonthly meetings with QI Coaches. 50 Procedure: Foundational Quality Improvement Each LIA is expected to have a diverse QI team who engages with their designated MPHI QI coach no less than bimonthly, but can be as often as monthly. Documentation of the QI team shall be submitted with the quarterly Work Plan Report. LIA QI teams shall be well-rounded and composed of the following types of roles within and outside of your agency: • Program Director/Manager/Coordinator • Supervisors • Home Visitors • Data Clerk • Program/Administrative Assistant • Parents (See Policy PI10b-20) • Partners • Other roles not captured that are relevant to your program/the improvement efforts in which you are engaged b. At a minimum, all QI teams are required to include the following roles and should have around 5-7 members if possible (we do recognize that LIAs vary in size): • At least one Supervisor • At least one Home Visitor • At least one Parent • Support roles (data clerk, program/administrative assistant, etc.) 2. LIAs shall work with their MPHI QI coach to identify improvement opportunities that exist within their program and then use the appropriate QI methods, tools, and techniques to work towards improvement. LIAs are required to engage their MPHI QI coach at least bimonthly in a regular team meeting. Coaching allows for one-on-one specialized support tailored to each LIA's needs and where they are in their development of knowledge, skills, and abilities with respect to quality improvement. While opportunities for shared learning are provided, MDHHS-HVU recognizes that these opportunities are geared toward the broader group of grantees who are in various phases of development and don't offer individualized support. MDHHS-HVU sees individualized support through coaching as a critical component for furthering learning and skill building. MPHI QI coaches provide specialized support that may not be available internally to LIAs and is essential to supporting growth. 51 a. Coaches should be included in a QI team meeting at least bimonthly. LIAs shall connect with their MPHI QI Coach at the start of the fiscal year, no later than October 30th, to plan which meetings the coach will join and get them on calendars. MPHI QI Coaches are available to join additional QI team meetings, as needed. MPHI QI Coaches can: • Provide coaching support in nurturing and enhancing a culture of quality • Help your team identify areas for improvement including Performance Measures, Work Plan activities, Implementation Challenges, Process challenges, etc. • Support your team in working through the stages and steps of a PDSA cycle. • Support your team in identifying and using QI tools that would be helpful. • Support your team in developing a measurement plan and using, displaying, and interpreting data. • Simply be available to support your team with whatever arises during your meetings and improvement efforts as needed. b. Documentation of support (e.g., notes from the coach, minutes from a meeting, etc.) from a QI coach will be submitted by MPH] to the HVU on a quarterly basis. LIAs do not need to submit this documentation. 3. LIAs are expected to use QI methods, including the PDSA cycle and QI tools, as a routine part of their work, and to describe their efforts to MDHHS on a quarterly basis. An LIA must submit documentation to the Model Consultant at the time of the LIA quarterly Work Plan Report as part of activities to meet the Q] Objective. This documentation could include any or all of the following: a. Team charter b. PDSA cycle tools c. Process map/standard operating procedures d. Root cause analysis (fishbone diagram, five whys, tree diagram, etc.) e. Brainstorm of potential solutions (affinity diagram, prioritization matrix, tree diagram, etc.) f. Plan for spread, scale, and retention of learnings (Implementation Checklist for Sustaining Successful Changes) g. Notes from team meetings when your MPHI QI coach was present. 4. By February 15 of each year, an LIA must submit a summary of the QI activities that have taken place over the previous year. A summary template is available for LIAs. 52 Culture of Qualitv Efforts LIAs are expected to focus on building their culture of quality during FY23. Precise plans for this effort will take shape based on the outcomes of the state improvement effort underway in FY22 focused on culture of quality. This may involve using an assessment tool to identify the strengths and opportunities for improvement each LIA has for each component of a culture of quality. HV ColIN QI Efforts This section is applicable for the years in which Michigan participates in improvement efforts led by the National HV ColIN. As opportunities become available through the HV ColIN, they will be shared with LIAs to gather interest. 1. LIAs will provide all information required for HV WIN applications for those who have expressed interest in participating in the CollN. 2. LIAs must agree to and fulfill all HV ColIN expectations of participation including, but not limited to: a. Assembling participants to form diverse, cross -sector improvement teams, including parents with lived experience. b. Support active participation of team members for the entire duration of the HV WIN effort. c. Commit to a common aim and set of measures. d. Engage in HV WIN activities, including: • Learning sessions • Monthly action period calls • Monthly coaching calls • Monthly data and PDSA submissions e. Using the online HV ColIN database to communicate regularly and share information with other teams and faculty. 2. LIAs should also remain in close connection with their MPHI QI Coach as MPHI will be supporting LIA participation in the HV CollN. Qualitv Planninq Efforts for New LIAs New LIAs that do not have experience with QI, will be required to participate in quality planning efforts in preparation for QI efforts that will take place in the timeframe specific to that new LIA. Participation in quality planning efforts includes: 1. An initial assessment of need to inform development of an Action Plan to guide quality planning work for the year (initial and follow-up coaching sessions). 53 2. Small group coaching from MPHI during MHVI Grantee meetings during which time participants will learn from one another, problem solve, share ideas, and work on next steps. 3. Once per quarter QI coaching sessions with MPHI to check in on progress with LTA's action plan and creation of deliverables (polices, procedures, etc.), celebrate successes, work through challenges encountered and plan next steps. 4. Support with mapping processes/writing procedures pertaining to individualized needs related to model fidelity to support LIA in carrying out processes in a standardized way as needed. 5. Support with reviewing data/determining measures that could be easily tracked to understand how the implementation of processes is unfolding as needed. 6. Review of quality planning required as part of the Action Plan with agreed upon deliverables and Summary documentation. Summary presentation of progress is to be presented at the final MHVI Grantee meeting of the fiscal year, 7. Other coaching/support for quality planning as agreed upon by MDHHS, MPHI, and the LIA. Overall QI Support 1. Virtual QI Community of Learning (CoL) gatherings will bring agencies together to engage in peer -to -peer learning and to provide just -in -time training on CQI methodology and tools. Agencies will share Ql effort materials with other agencies. QI CoLs will typically occur in November, March, and July of each fiscal year. 2. Ongoing coaching support (and related CQI supports) will be provided by MPHI. 54 Deliverables: Deliverables Establish and maintain a QI team that includes all required members. Documentation of QI activities Summary of QI efforts Monitoring and Evaluation: Due Date Submit with quarterly Work Plan Report Submit with quarterly Work Plan Report February 15 During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. Attendance rosters and sign -in sheets will be used to understand which grantees attend QI Community of Learning (CoL) gatherings, trainings, virtual learning opportunities, etc. QI coaching interactions are shared monthly with the HVU Model Consultants. For questions regarding CQI, please contact your MPHI QI Coach. See Appendix C for CQI contact information. 55 Policy P110b-20: Parent Engagement in Quality Improvement (Ql) (formerly Parent Engagement in Continuous Quality Improvement) (revised April 2022) Each LIA that receives funds from the MDHHS-HVU is required to include a minimum of one parent who has received home visiting services, and has a child aged 0-5 years old who received home visiting services, as a full member of the QI team for the fiscal year. Supplemental Information: Work in Michigan and other states has demonstrated that QI efforts are more meaningful and more effective when the parent voice is incorporated into QI activities. The most significant impact of this voice occurs when parents are fully integrated into the QI team. For parents to become engaged in this work they must have both training and financial support. MDHHS-HVU can provide support to grantees in the areas of parent engagement and financial compensation. Procedure 1. LIAs will ensure that a minimum of one parent who has received home visitation services is a full, engaged participant on the QI team. 2. All parents who are members of the QI team must be recipients of home visiting services from the LIA whose enrolled child is currently age five or younger. An LIA may request to include a parent whose child was a recent graduate (within two years) if no other current parents wish to participate. If a parent graduates in the middle of a fiscal year and wishes to stay on the team, that is allowable and encouraged. 3. All parents who are members of the QI team will be given the opportunity to receive QI training from MPHI through parent -specific scheduled trainings. 4. All parents who are members of the QI team will be financially supported per the statewide Parent Leader Financial Support Policy (see Appendix F). Monitorina and Evaluation: During each LTA's annual site visit, a Model Consultant will confirm that all requirements are met. For questions regarding parent engagement in QI, please contact your Model Consultant. 56 a • • - 11 Al • • Policy PH 1-16: Work Plan (revised April 2022) IAll grantees must develop an annual Work Plan that will guide program implementation. Supplemental Information: By June 30, all LIAs/LLGs must submit a Work Plan outlining program activities to the MDHHS Home Visiting mailbox (MDHHS-HVlnitiative(d)..michigan.gov) for preapproval using the Work Plan template provided. For health departments, once the Work Plan is approved, nothing further needs to be done regarding Work Plans when submitting an application via EGrAMS. For those LIAs/LLGs that are not health departments, the approved Work Plan must be submitted via EGrAMS at the time of application. For health departments, the template mentioned above can be used for each Work Plan Report and the reports can be submitted to the same mailbox (MDHHS- HVlnitiativear7michioan.00v). For those LIAs/LLGs that are not health departments, Work Plan Reports can be completed in EGrAMS. Please refer to the Deliverables chart below for due dates for submission for both the Annual Work Plan and Quarterly Work Plan Report. Procedure Work Plan: 1. The annual Work Plan should be based on contractual elements found in Attachments C and E or Attachment III for health departments. 2. The Work Plan objectives must be written as SMART or SMARTIE goals. Activities may be written as SMART or SMARTIE goals, but do not have to be in that format. 3. The Work Plan must include an Outreach objective designed to reach the data - informed outreach population(s) as identified through the MDHHS-HVU provided Outreach Toolkit which includes the Kitagawa Analysis, MIECHV Needs Assessment County Profiles and Concentrated Disadvantage Maps. (This is not a requirement for LLG Work Plans.) 4. The Work Plan must include a Retention Plan (see Policy P15-21) for minimizing attrition rates for program participants. 57 5. The Work Plan must include a Health Equity (HE) objective written as a SMARTIE goal. Following are examples on how to move from SMART to SMARTIE Goals for your HE objective: a. SMART: By December 2022, we will increase the percentage of children enrolled in home visiting who receive timely services following a positive screen for developmental delays from 73% to 85%. b. SMARTIE: By December 2022, we will increase the percentage of Hispanic children enrolled in home visiting who receive timely services following a positive screen for developmental delays from 41 % to 68%. c. SMART: By September 30, 2023, we will decrease the number of families who disengage from the program prior to completion by 10%. d. SMARTIE: By September 30, 2023 we will decrease the number of African -American families who disengage from the program prior to completion by 10%. e. SMART: By December 30, 2022 we will have 100% of all staff vacancies filled with qualified individuals. f. SMARTIE: By December 30, 2022 we will have 100% of staff vacancies filled with qualified individuals who reflect the community in which we are serving. Additional information to help develop the objectives can be found in Appendix I. 6. The Work Plan must include a Quality Improvement objective. Documentation of activities to meet the objective must be submitted quarterly as part of the quarterly Work Plan Report. 7. The Work Plan must include the LTA's strategies to maintain program quality and fidelity. 8. Work Plan Reports must be submitted quarterly as of the 301h of the month following each quarter. 9. LLGs will work with the State LLG Coordinator for individual instructions on annual Work Plans and Work Plan Report content. m Deliverables: Deliverables Annual Work Plan Quarterly Work Plan Report Monitoring and Evaluation: Due Date June 30, 2022 Q1: January 30, 2023 Q2: April 30, 2023 Q3: July 30, 2023 Q4: October 30,2023 As each plan or report is due, the respective Model Consultant or State LLG Coordinator will read each submission and either approve the submission or send it back to the LIA/LLG with suggestions for improvement. During each LIA's/LLG's site visit, the Model Consultant or State LLG Coordinator will confirm that all requirements are met. 59 Policy P112-16: Promotional Materials All promotional materials using MDHHS funds, whether print, mixed media or social media, must be vetted and approved through MDHHS before being published. Appropriate logos and federal grant disclaimers must be incorporated. Procedure Promotional Materials: 1. Send draft materials to the MDHHS Home Visiting mailbox at MDHHS- HVlnitiative ab..michigan.gov. 2. Materials using MDHHS funds must be approved by MDHHS with a written approval received by the LIA and/or LLG. 3. All materials must include the MHVI logo, which can be obtained from MDHHS once approval is granted. 4. All materials must include the HRSA federal grant disclaimer and grant number, which can be obtained from MDHHS once approval is granted. 5. Separate approval must be obtained for each item an agency wishes to print or publish to social media or traditional media. 6. Promotional materials must meet allowable cost standards (see Appendix B). Monitorinq and Evaluation: During each LTA's/LLG's site visit, a Model Consultant or a MDHHS contractor will confirm that all requirements are met. Policy PI14-16: Developmental and Behavioral Screening (formerly Developmental Screening) (revised April 2022) LIAs that utilize MDHHS Home Visiting funding must ensure that home visitors conduct appropriate developmental and behavioral screening for all enrolled children and take appropriate action as required by the screening results. Note: ASQ-3 and the ASQ-SE are the preferred screening tools. If a new LIA is using an alternate, validated, screening tool, approval for use of the tool must be obtained from the HVU to ensure consistent data collection for state reporting. Procedure LIAs shall have written procedures regarding their developmental and behavioral screening practices and all appropriate follow up actions, including subsequent referrals or parent activities. These procedures must include the following topics: 1. Screening frequency: LIAs must require that home visitors conduct developmental screenings according to model requirements, but no less than at 9, 18, and 24 or 30 months. LIAs must require that home visitors conduct behavioral screenings according to model requirements. 2. Training: LIAs must have a written plan in place to ensure that home visitors have the appropriate tools for screening and are trained in screening protocols. 3. Referral* requirements: LIAs must require home visitors to refer children that do not pass the screening. These written procedures must include: a. If a child does not pass the screening, and scores in the "refer" or black area of the ASQ-3 or ASQ-SE, the home visitor will discuss the results with the family and ensure a referral to the local Early On program is made with parental consent. If a parent indicates any concerns in the "overall" narrative section, including vision and hearing, discuss concerns with the family and ensure a referral to the local Early On program or the child's doctor is made. b. A release of protected health information must be signed by the parent to make the referral due to needing to share the screening results which are considered protected information. The home visiting program should obtain written consent from the parent for Early On or the child's physician to share information back with the home visiting program (e.g., was the child found eligible and is receiving services). c. If a child scores in the black area and a referral is not made, a written justification must be included in the child's chart/record. d. If a child falls into the "monitor" or gray area of the ASQ, the results must be shared with the parents. 61 i. At this point, if the parent and/or home visitor determines it is necessary, a referral to Early On can be made. ii. If it is determined that sharing developmental guidance and activities with the parent is appropriate, the child must be re- screened within the timeframe set according to guidance within the ASQ manual, to ensure the child is progressing and there are no additional concerns. iii. A child who scores in the gray area for the second time, after developmental activities have been provided, should be referred to Early On for evaluation. It is not recommended that the child be re- screened continuously. All referral requirements listed above apply in this circumstance. e. Referral requirements (e.g., black, gray areas) are listed for the ASQ system. The scoring may be different for other approved screening tools. Referral expectations will be discussed on an as needed basis with an LIA not using the ASQ system and must also be included in a written policy. f. Referral requirements (e.g., black, gray areas) are listed for the ASQ system. The scoring may be different for other approved screening tools. Referral expectations will be discussed on an as needed basis with an LIA not using the ASQ system and must also be included in a written policy. 4. Collaboration with referral agencies: Written procedures should include how and when a copy of the developmental screening tool will be shared with other agencies (Early On, CMH), and how the home visitor will follow up on their referral to ensure continuity of care. *See Appendix E for the Michigan Home Visiting Initiative (MHVI) definition of "Referral". Deliverables: Deliverables Due Date Written procedures that address each of the developmental and Annually behavioral; screening requirements Monitoring and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. Policy PI14b-20: Screening (revised April 2022) LIAs that utilize MDHHS Home Visiting funding must ensure that home visitors conduct appropriate screening for all enrolled families and take appropriate action as required by the screening results. Procedure LIAs shall have written procedures regarding their screening practices and all appropriate follow up actions, including subsequent referrals. These procedures must include the following topics: Required Screening: LIAs must require that home visitors conduct: a. Maternal Depression Screening using a validated tool per model requirements. If there are no model requirements, the screening should occur within three months of enrollment for those not enrolled prenatally or within three months of delivery if the caregiver enrolled during pregnancy. b. Interpersonal Violence Screening using a validated tool per model requirements and within six months of enrollment if there are no specific model requirements. Additional screens may be used throughout enrollment as needed. c. Substance Use Screening: Screening tool: If the model does not already provide guidance on the substance use screening tool, the LIA must utilize validated tools identified by MDHHS-HVU which include the 5Ps for pregnant people and the UNCOPE for the postpartum period and beyond. ii. Screening frequency: If the model does not already provide guidance on frequency of screening, the LIA must implement SUD screening utilizing a validated tool within six months of enrollment and annually thereafter. d. Tobacco Screening using the model developed tool per model requirements. If model has no model developed tool, the LIA should use a tool available for the purpose. Screenings should occur within three months of enrollment. e. Parent Child Interaction screening using the model developed tool per model requirements. If the model does not have a tool, the LIA should utilize the PICCOLO. 63 2. Training: LiAs must have a written plan in place to ensure that home visitors have the appropriate tools for the screening, are trained in screening protocols, are able to identify when there is a need for a referral, and are knowledgeable of the community resources that are available for families in need of mental health, domestic violence, substance use, or smoking cessation services. See Appendix I for Michigan -specific resources. 3. Referral requirements: LiAs must require home visitors to refer families to the appropriate services for any positive screen. Please see definition of referral in Appendix E for clarification on what constitutes a referral. Deliverables Deliverables Written policy and procedures that address each of the screening requirements Documentation of completed screenings Monitorinq and Evaluation: Due Date Annually - - ------ --- - --- - Per model or MDHHS Requirements Performance Measure Reports will be used to confirm completed screens according to model or MDHHS-HVU requirements. During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. NO Policy PI15-16: Community Coordination (formerly Dual Enrollment) (revised April 2022) LIAs supported by MDHHS-HVU funding shall participate in activities that support enhanced community coordination for home visiting systems. LIAs will also develop and implement policies and procedures to ensure that home visiting participants are enrolled in only one evidenced -based home visiting program at a time. Procedure 1. LIAs shall provide documentation (e.g. RPQC/LLG meeting minutes, local MOUs, referral reports, etc.) of coordination with opportunities for integrated access within their community including: a. Existing centralized access points for home visiting such as MI Bridges and regional HUBs. b. Referrals from the local child welfare system. c. Referrals from Peer Navigators housed within medical systems to support families impacted by substance use. 2. LIAs are required to list and update program information in the MHVI HV Program Finder. 3. LIAs are required to become a referral partner within the MI Bridges system. 4. LIAs shall write policies and procedures regarding how the program will avoid dual enrollment of participants in more than one evidence -based home visiting model. These written policies and procedures must include: a. Documentation of how the LIA will confirm that participants are not currently enrolled in another EBHV program. (Exceptions are made for families who are enrolled in Infant Mental Health at the same time as another model. That is not considered to be dual enrollment.) b. Documentation that if a family is noted to be in two programs, the LIA will work with the family and the other program to identify which home visiting program will best fit the family's needs and is the option selected by the family. c. Documentation of how the LIA will transfer enrolled families to alternative home visiting models if it best meets the interests and needs of the family and considers risks to disrupting an existing positive relationship between a home visitor and family. 5. LIAs who have exceptional circumstances and would like to request a waiver to allow for dual enrollment must contact the appropriate MDHHS-HVU Model Consultant and provide in writing the following: a. Documentation of why a family must be enrolled in two programs 65 b. A listing of the two programs c. Documentation of the benefit to the family d. Documentation that the same outcomes for the family cannot be achieved with enrollment in a single evidence -based program. Deliverables: Deliverables Documentation of coordination with existing coordinated access; enrollment in Ml Bridges; and participation in the HV Program Finder. Written policies and procedures to avoid dual enrollment Policies and procedures to transfer families to other home visiting programs Monitorinq and Evaluation: Due Date Annually Annually Annually During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. M. Policy P116-16: Re -enrollment LIAs that utilize MDHHS Home Visiting funding must, with fidelity to the model(s), develop and implement policies and procedures to re -enroll eligible participants seeking home visiting services. Procedure LIAs shall: 1. Write policies and procedures to re -enroll eligible individuals with fidelity to the model. 2. These written policies and procedures must include how to re -enroll participants after: a. Disengagement b. Program completion and subsequent pregnancy c. Relocation to/from another community with a MDHHS-supported home visiting program 3. Policies and procedures should address continuity of services and the continuation or transfer of data. 4. Provide documentation to the MDHHS on an annual basis. Deliverables: Deliverables Due Date Written policies and procedures to re -enroll eligible participants under Annually the circumstances described above (with fidelity to the model). Monitorina and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 67 Policy PI17-16: Health Insurance Outreach and Enrollment LIAs that utilize MDHHS Home Visiting funding must ensure that home visitors: (1) assist families in accessing health insurance coverage, primary health care, and clinical preventative services and (2) provide information to families regarding consumer protections, including those identified in the Affordable Care Act. Procedure 1. LIAs must have written policies and procedures that identify how they are ensuring that home visitors assist families in accessing health insurance coverage, primary health care, and clinical preventative services. Supplemental Information: • For assistance locating Navigations or Certified Application Counselors, in your community visit: httos://IocaIheID.health care. aov/#intro.. • To learn more about insurance options available to children and families, visit: Michigan's Consumer Guide: httD://www.michiaan.aov/som/0,4669,7-192- 29942 32326-263900--,00.html. • For a list of consumer protections offered under the federal health care law, visit httos://www. healthca re.aov/hea lth-care-law-protections/ria hts-and- Drotections/. 2. LIAs must have written policies and procedures that identify how they are ensuring that home visitors provide information to families about consumer protections for public and private insurance. 3. LIAs should establish procedures to ensure that there is documentation of how the home visitor assisted the family in case notes. 4. Home visitors may connect families with other personnel (such as Navigators or Certified Application Counselors) to assist them in completing paperwork to establish eligibility for insurance affordability programs such as tax credits, Medicaid, or CHIP. W. Deliverables: Deliverables Due Date Documentation that home visitors assist families in accessing health Annually insurance coverage, primary health care, and clinical preventative services to all families Documentation that home visitors provide information to families Annually regarding consumer protections Monitorinq and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 70 Policy Pill 9-22: Infant Safe Sleep (new April 2022) LIAs that utilize MDHHS Home Visiting Unit funding shall ensure that home visitors assess infant safe sleep for all enrolled children under age 1 and provide education and referral for resources and support as needed. Procedure LIAs shall have a written policy and procedures regarding their agency's practices to assess infant safe sleep, and requirements for follow-up. The policy and procedures must include the following steps: 1. Assessing Safe Sleep: a. Assess the level of knowledge of safe sleep and intent to practice safe sleep for every expectant family within the third trimester of pregnancy as permitted by status of pregnancy at enrollment. Assess a family's safe sleep practices for every infant under 1 year of age at the initial visit, or as soon as the relationship allows, if the program begins after birth. b. Regularly assess a family's infant safe sleep practices, for every infant under 1 year of age. 2. Education: a. Provide education on the State of Michigan Safe Sleep Guidelines. b. Utilize motivational interviewing techniques to support families in practicing safe sleep as well as addressing any challenges to practicing safe sleep. 3. Referral to Resources: If the family is assessed to have an unsafe sleep environment and the family has a stage of readiness, the HV program will assist with providing or locating safe sleep resources (e.g., Consumer Product Safety Commission approved crib, portable crib, etc.) See Appendix I for Michigan - specific resources. 71 Deliverables: Deliverables Due Date Written policy and procedures that address each of the infant safe Annually sleep assessment, training, and family support requirements Monitoring and Evaluation: During each LTA's annual site visit, a Model Consultant will confirm that all requirements are met. 72 � • • 1. / ,.. Policy P120-22: Social Determinants of Health (new April 2022) LIAs that utilize MDHHS Home Visiting funding must ensure that home visitors are assessing and addressing social determinants of health (SDOH) for their families. LIAs shall have written policy and procedures regarding family SDOH assessments, any indicated referrals, and follow-up. These procedures must include the following topics: 1. Screening: Assessing for SDOH should be an ongoing conversation with families. Beginning in FY24 (October 1, 2023), LIAs must require that home visitors formally screen the family for SDOH, using a tool to be determined, during the enrollment period and then annually thereafter. 2. Referral to Resources: Every LIA must have a process in place that ensures that home visitors are aware of the resources available in each community so that when a family has an identified SDOH need, the home visitor can refer the family to available community resources at the same visit the need is identified. This resource list should include community specific resources and state resources. Appendix I includes additional resources for programs and families. Deliverables: Deliverables Due Date Written policy and procedures that address each of the SDOH Annually requirements Monitorinq and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 73 Policy PI21-22: Family First Prevention Services Act (new April 2022) Local Implementing Agencies that receive Family First Prevention Services Act (FFPSA) funding are expected to follow federal reporting guidelines, coordinate with local Department of Health and Human Services (DHHS) offices and provide quality home visiting services to support families involved with the Child Welfare system, Procedure 1. LIAs are required to work with MDHHS to complete a Memorandum of Understanding with MDHHS to establish expectations for the relationship that is being built between child welfare and the home visiting program. 2. Healthy Families America (HFA) LIAs will need to submit the HFA's Child Welfare Protocol application to HFA National. They will also need to work with their assigned Child Welfare Service Analyst to obtain the signature of their local DHHS office on a letter of support. Both need to be completed before an HFA LIA can enroll any families under FFPSA or the Child Welfare Protocol. 3. In addition to other data mentioned in this Guidance Manual, LIAs are required to record and submit monthly FFPSA billable reporting through REDCap. This data includes: a. Family demographic information (including MiSACWIS IDs) b. The number of children in the family and corresponding MiSACWIS IDs (per DHHS referral form) c. Enrollment date d. Eligible/ineligible status e. FFPSA eligibility change dates f. Closure date if family has exited home visiting services 4. LIAs will need to send their program level consent forms to MDHHS-HVU for review. Consent forms need to ensure families understand what information will be shared with funders as required under FFPSA federal reporting. 5. The state FFPSA team is required to conduct CQI strategies on FFPSA implementation and outcomes. LIAs will be expected to participate in this process and collect data as needed. 6. LIAs are expected to inform the DHHS worker for their assigned FFPSA families of the following: a. Enrollment date b. If family chooses to not enroll c. If home visitor is struggling to contact a family for two weeks d. Closure date e. Notice of 11-month anniversary of initial referral to start annual review process 74 7. By the end of the second year of FFPSA implementation LIAs must have an FFPSA policy in place that includes, but is not limited to: a. How FFPSA eligible families will be referred if FFPSA home visitors and/or programs have reached their caseload capacity. The policy must include that the LIA will work with their local DHHS office to determine how families that are referred will be connected with other home visiting programs if the FFPSA LIA is not able to accept the referral. b. How to serve FFPSA eligible families that live outside of the MDHHS-HVU outreach population service area. Families referred by DHHS may be served by a DHHS office in the LIA service area, but live outside of area (especially youth in foster care). LIA can consult with Model Consultant on a case -by - case basis. c. How to maintain funding requirements regarding geographic regions, cities, or populations to whom your program should conduct outreach for non-FFPSA funded staff (e.g., MDHHS-HVU requirements, pregnant parents). Non- FFPSA home visitors should try to maintain enrollment from those outreach populations unless there is clear overlap with the families referred as FFPSA families. Deliverables: Deliverables Due Date FFPSA Billable Report submitted through REDCap 51h business day of each month Written FFPSA Coordination Policy At annual site visit Monitoring and Evaluation: During each LIA's annual site visit, a Model Consultant will confirm that all requirements are met. 75 BMW - MUM ii s+ . LLGs, See the title page of each Guidance Manual section to identify which 76 Policy LLG1-17: Local Leadership Group (LLG) Funding The purpose of the LLG is to support the development of a local home visiting system that leads to improvement and coordination of home visiting programs at the community or regional level, The LLG also provides a governance structure for a coordinated system of planning and ensures a strong connection between home visiting programs and the greater early childhood system. Procedure 1. LLG funding may be used to pay for staff who support the functioning of the LLG. Examples include an LLG coordinator and administrative support. 2. LLG funding must be used to support parent leaders for their work with the LLG which can include financial support to attend the annual Michigan Home Visiting Conference. 3. LLG funding must be used to primarily support the LLG Coordinator's staff time and to financially support parent leaders. Additional support of LLG members to participate in LLG trainings or to have support to attend the annual Home Visiting Conference is permitted if the budget allows and the following is understood: a. Those members that are supported are regular attendees at LLG meetings. b. First consideration is given to members who do not currently receive MDHHS Home Visiting Unit funding. c. Priority is given to those that have never attended the conference or other opportunities. d. A fair selection process is implemented subsequent to the above qualifiers being met, e.g., a lottery system, first -come, first -served, etc. 4. LLG funding may be used to carry out MDHHS home visiting activities as specified in the grant agreement. Examples include recruitment of required and encouraged LLG representatives, implementation of the Home Visiting Continuum of Models Project Plan, participation in the LLG Quality Improvement activities, or the implementation of a Sustainability Plan. 77 Policy LLG2-17: LLG Support and TA (formerly Coordination with MDHHS Contractors) (revised April 2022) The LLG will receive support from MDHHS staff, including the Parent Coordinator and the State LLG Coordinator, as well the Michigan Public Health Institute (MPHI) to implement the work of the LLG. Procedure The Parent Coordinator and State LLG Coordinator: The MDHHS-HVU Parent Coordinator and State LLG Coordinator will provide consultation, coaching and technical assistance to the LLG as they seek to carry out the activities related to local home visiting system building, engaging parent leaders, developing a continuum of models, sustainability planning, and the project Impact Reports. New LLGs will receive consultation, coaching and technical assistance from both the MDHHS-HVU Parent Coordinator and State LLG Coordinator to learn and understand contract requirements and deliverables for the activities listed in the paragraph above. LLGs will participate in program monitoring visits with the State LLG Coordinator every three years unless otherwise indicated or necessary. Note: Fiscal site visits will occur on a three-year schedule with the MDHHS-HVU Program Analyst which will be coordinated with the program monitoring visits when possible. The Role of MPHI: MPHI will provide Quality Improvement (QI) consultation, coaching and technical assistance to the LLG QI teams as they plan and implement QI efforts. In Policy LLG3-17: Continuation of Effort (revised April 2022) The LLG will continue efforts started in previous years. Note: New LLGs will be expected to follow an established series of steps to build opportunities for system building within communities. This includes recruitment of required and recommended partners, development of a local Home Visiting Continuum of Models Project Plan, and a Sustainability Plan. All LLGs are expected to be trained in the methods of Continuous Quality Improvement (see below). All LLGs are expected to be part of the Great Start Collaboratives within their communities. Consultation, coaching and technical assistance will be provided to all new LLGs by the MDHHS-HVU Parent Coordinator and State LLG Coordinator. Procedure 1. Ensure recruitment and participation of both required and strongly encouraged LLG representatives. a. The LLG must include representatives from Public Health, Mental Health/Substance Abuse, DNS/CAN Council, MDHHS-funded local home visiting programs, and Head Start. The LLG must also include two parents, at a minimum, who 1) are or have been recipients of evidence - based home visiting services from the following programs: Maternal Infant Health Program, Nurse -Family Partnership, Healthy Families America, Early Head Start, Parents as Teachers, Infant Mental Health, Play and Learning Strategies, or Family Spirit and 2) have a child with whom they participated in the home visiting program that is currently age five or younger. A parent who has participated only in Early On does not meet this criterion. If a parent has participated in Early On and one of the eight EBHV models identified above, they meet the criteria. b. Other LLG representatives that are strongly encouraged, but not limited to, are: education, local home visiting programs not funded through the MDHHS-HVU, health system partners, and representatives from the Great Start Collaborative/Great Start Parent Coalition, Regional Perinatal Quality Collaboratives, WIC and Medicaid Health Plans. Local groups should include members of tribal nations whose service areas overlap the community and members of community service agencies that represent populations that frequently experience health disparities. c. LLGs may utilize the Partnership Survey on a voluntary basis to understand the engagement and commitment of LLG members. 79 2. Implement one strategy from the respective community's Local Home Visiting Continuum of Models Project Plan. a. An existing LLG must continue to implement at least one strategy from the respective community's Local Home Visiting Continuum of Models Project Plan each fiscal year. i. Continuum strategies must be included in the quarterly Work Plan Reports. b. New LLGs will be supported to develop a Continuum of Models Project Plan within the first two years. 3. Participate in the LLG Quality Improvement activities. a. An existing LLG must participate in the yearly LLG Quality Improvement activities which may have a different focus each year. 4. The LLG must participate in three LLG Grantee meetings. A parent leader must be part of the QI team participating in both the local CQI meetings and LLG Grantee meetings. Qualitv Improvement 1. LLGs need to complete at least two PDSA cycles per fiscal year. a. At least one should be completed by March and the other by September. b. A team charter is required for each PDSA cycle and should be shared via Groupsite at httDs://mhvi.orour)site.com. The team charter template is located on Groupsite. The following iterations of the team charter must be uploaded/shared via Groupsite for each cycle: i. An initial team charter with the Plan stage complete (needs to be shared prior to moving into the Do stage for feedback). ii. An updated team charter that includes feedback from the Plan stage and with Do, Study, and Act complete. iii. A final version of the team charter that includes all components and feedback. c. LLG CQI teams are required to receive and incorporate feedback on their QI team charters from the team's MPHI QI Coach for each PDSA cycle. MPHI QI Coaches will stay attune to new uploads on Groupsite and provide feedback within two weeks of team charters being shared. Feedback will be provided on the Plan stage (prior to the team moving to the Do stage) and at the conclusion of the cycle (once the Do, Study, and Act stages are completed). Feedback should be incorporated on an ongoing basis. 2. LLG CQI efforts should occur on an ongoing basis throughout the fiscal year. :o 3. LLGs are required to engage in QI coaching. QI coaching involves two components. First, the LLG Coordinator must connect with their MPHI QI coach and the State LLG Coordinator for an initial coaching call prior to the start of each PDSA cycle to help identify an opportunity on which to focus. Second, each LLG QI team is required to engage with their MPH[ QI coach during at least one CQI team meeting for each PDSA cycle. LLGs should connect with their MPHI QI Coach to plan for which meetings the coach will join at the start of each fiscal year. MPHI QI Coaches are available to join more than one CQI team meeting per PDSA cycle as needed. During meetings where your team's MPHI QI coach is present, they can: o Help your team identify areas for improvement o Support your team in working through the stages and steps of a PDSA cycle o Support your team in using QI tools o Support your team in developing a measurement plan and using, displaying and interpreting data o Walk through feedback on a recently reviewed team charter, answering questions and supporting the team with revisions o Simply be available to support your team with whatever arises during your meeting as needed 4. LLGs may be asked to present PDSA cycles at the annual Michigan Home Visiting Conference. Deliverables: Deliverables Content Team Charters Documentation of PDSA cycles to date Story Boards Documentation of completed PDSA cycles 91 Due Date Initial: 15th of February and June Final: 15th of May and September Template for Story Boards will be provided by MPHI. Teams will develop Story Boards for May and September Grantee meetings with PDSA cycle(s) completed using template or another electronic format of their choosing. Policy LLG4-17: Sustainability Plan The LLG will implement their Sustainability Plan. • -. LLGs are designed to support collaboration and coordination of a local evidence -based home visiting system within their respective communities. LLGs should implement a minimum of one SMART goal as part of their Action Plan work with the Sustainability Plan. The Sustainability Plan should include: 1. Strategies for how to continue the home visiting infrastructure and system - building work within the community; 2. A budget to support the proposed future activities, which will allow the LLG to pursue adequate and appropriate funding; and 3. An emphasis on maintaining a continued connection between the LLG and key partners in an effort to perpetuate the importance of home visiting programs within the greater, local early childhood system. Questions regarding the Action Plan implementation should be sent to the State LLG Coordinator. [a Policy LLG5-19: LLG Impact Report The LLG will submit a summary of the impact of the LLG. Procedure 1. LLGs will write and submit a summary of the impact of the LLG which shall include the following information: a. What has been the benefit of the LLG to your community? b. Describe the impact the LLG has had in the community including successes and challenges regarding: i. Parent Leadership --involving families in local efforts. Be sure to include details as to what you are doing differently as a result of these efforts. ii. Involving required and recommended partners iii. Building a home visiting continuum iv. Building relationships among home visiting models v. Bringing all home visiting models to the table vi. Connecting families to the home visiting model that best fits their needs vii. Other projects/workforce development c. Describe how the LLG has impacted outreach, enrollment and the engagement of families in evidence -based home visiting in the community. 2. The report will be due September 1 every third year (e.g., 2023, 2026, 2029 etc.). LLG CQI Update 1. List the SMART aim statements and results of each of the LLG CQI projects for the last three years. a. The LLG may reach out to the MPHI QI Coach for access to the LLG QI Tracker to be able to include that information in this report. Or, the LLG Coordinator may locate this information on Groupsite (htti)s://mhvi.cirouDsite.com) if it is not readily available through their agency. 2. Of the strategies that have been tested, which have been adopted? 3. Of the strategies that have been adopted, how has their success/impact continued to be monitored? 4. Is there anything the LLG would change regarding the LLG CQI projects? 5. Are there any additional supports the LLG needs pertaining to CQI? M. LLG Communitv Please describe updates about the home visiting system provided to the community? Is there a communication strategy? Would that be a helpful component of the LLG? Other Are there any other specific successes or challenges to include? Questions regarding the Impact Report should be sent to the State LLG Coordinator. Deliverables: Deliverables LLG Impact Report Content Content will include discussion of items listed above unless otherwise noted by MDHHS. Due Date September 1, 2023 m Act No. 291 Public Acts of 2012 Approved by the Governor August 1, 2012 Filed with the Secretary of State August 1, 2012 EFFECTIVE DATE: 91st day after final adjournment of 2012 Regular Session STATE OF MICHIGAN 96TH LEGISLATURE REGULAR SESSION OF 2012 Introduced by Reps. Lyons, Haveman, Townsend, Ananich, Liss, Price, Hobbs, MacGregor, Shaughnessy, Jacobsen, Wayne Schmidt, Roy Schmidt, Kandrevas, Tlaib, Lane, Forlini and Walsh • • • AN ACT to support voluntary home visitation programs; to authorize the promulgation of rules regarding home visitation programs; and to prescribe the powers and duties of certain state departments and agencies. The People of the State of Michigan enact: Sec. 1. As used in this act: (a) "Departments" means the department of community health, the department of human services, and the department of education. (b) "Evidence -based program" means a home visitation program described in section 3. W "Home visitation" means a voluntary service delivery strategy that is carried out in relevant settings, primarily in the homes of families with children ages 0 to 5 years and pregnant women. (d) "Home visiting system" means the infrastructure and programs that support and provide home visitation. (e) 'Promising program" means a home visitation program described in section 3. Sec. 2. (1) The departments shall only support home visitation programs that include periodic home visits to improve the health, well-being, and self-sufficiency of parents and their children. (2) Home visitation programs supported under this act shall provide face-to-face visits by nurses, social workers, and other early childhood and health professionals or trained and supervised lay workers (3) Home visitation programs supported under this act shall do 1 or more of the following: (a) Work to improve maternal, infant, or child health outcomes including reducing preterm births. (b) Promote positive parenting practices. (c) Build healthy parent and child relationships. (d) Enhance social -emotional development. (e) Support cognitive development of children. (fi Improve the health of the family. (g) Empower families to be self-sufficient.(h) Reduce child maltreatment and injury. (i) Increase school readiness. Sec. 3. The departments shall only support home visitation programs that are either of the following: (a) Evidence -based programs that are based on a clear, consistent program or model that are or do all of the following: (i) Research -based and grounded in relevant, empirically based knowledge. Evidence -based programs are linked to program -determined outcomes and are associated with a national organization, institution of higher education, or national or state public health institute. Evidence -based programs have comprehensive home visitation standards that ensure high -quality service delivery and continuous quality improvement, have demonstrated significant, sustained positive outcomes, and either have been evaluated using rigorous randomized controlled research designs and the evaluation results have been published in a peer -reviewed journal or are based on quasi -experimental research using 2 or more separate, comparable client samples. (ii) Follow a program manual or design that specifies the purpose, outcomes, duration, and frequency of service that constitute the program. (iii) Employ well -trained and competent staff and provide continual professional development relevant to the specific program model being delivered. (iv) Demonstrate strong links to other community -based services. (V) Operate within an organization that ensures compliance with home visitation standards. (vi) Operate with fidelity to the program or model. (b) Promising programs that do not meet the criteria of evidenced -based programs but are or do all of the following: (i) Have data or evidence demonstrating effectiveness at achieving positive outcomes for pregnant women, infants, children, or their families. There must be an active evaluation of each promising program, or there must be a demonstration of a plan and timeline for that evaluation. The timeline shall include a projected time frame for transition from a promising program to an evidence -based program. Follow a manual or design that specifies the program's purpose, outcomes, duration, and frequency of service. (iii) Employ well -trained and competent staff and provide continual professional development relevant to the specific program model being delivered. (iv) Demonstrate strong links to other community -based services. (v) Operate within an organization that ensures compliance with home visitation standards. (vi) Operate with fidelity to the program or model. Sec. 4. This act does not apply to either of the following: (a) A program that provides early intervention services under part C of the individuals with disabilities education act, 20 USC 1431 to 1444. (b) A program that provides a 1-time home visitor infrequent home visits, such as a home visit for a newborn child or a child in preschool. 87 Sec. 5. The departments shall develop internal processes that provide for a greater ability to collaborate and share relevant home visiting data and information. The processes may include a uniform format for the collection of data relevant to each home visiting model and the development of common contract or grant language related to voluntary home visiting programs. Sec. 6. Each state agency that authorizes funds through payments, contracts, or grants that are used for home visitation shall include language regarding home visitation in its contract or funding agreement that is consistent with the provisions of this act. Sec. 7. The departments may promulgate rules under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, as necessary to implement this act. Sec. 8. Not later than December 1, 2013 and December 1 of each fiscal year after that, the departments shall provide a collaborative report on home visitation to the house and senate appropriations subcommittees on the department of community health, state school aid, and the department of human services, to the state budget director, and to the house and senate fiscal agencies. The report provided under this section shall include, but not be limited to, the goals and achieved outcomes of the home visiting system with data on cost per family served, number of families served, and demographic data on families served; the number of evidence -based programs that shall include the total as well as a percentage of overall funding for home visiting; and the number of promising programs that shall include the total as well as a percentage of overall funding for home visiting. The report shall include model descriptions and model -specific outcomes. Clerk of the House of Representatives Secretary of the Senate Approved Fedeca\Dei133tandpn\ °�m No. P•g� pdmtn\sttaYNts ut�emen Kem Req moata an` OWN abxe co p\\oWabxe P OWNR �admmcstca1-11 tNe CO" and \ 'es, newsP a\. , Bee EXc pdm bon cdu mnYa\s, tonS e comP`nectrans tfie (tke. na\Fede�a\G\a1 n vNI-X0 Pddt6o is ment of goods staff', Pcpeuce iot tai awacdt a of aged other SPactfic � h, et � kc, �Watd. ssa a a _,s of the FQ Gr ntees jsat\e19 pApNNs Rn\e pdyclollo, amP\es C\atiiolo Yes Ao4 {ot ta en verY�stn9-nio\ goods e g iPm a\e6weI5m9\Stot meat sS 0 SYo optam gp0o meetth hNo tmd`s^asntants Pa eds0{goo, menuoithe �ans>reusa co9tams am ouiteaa, home AsNng P :Yc, to Pcoto <he commupa`1 outcea� to �' SILO9Iton Des iptYOn iawlmeeUn 5 ,P ficai\� � etc. aceevo Y ;dsPaG bons, �s, conv°`a es °i ce any °�. sPaamhas� of Sedt°hm�S m advecGs°a9afol\ow Mcoceduces �e pHHS, ,tn Sid aPP�O be 20 ..p ea bn each et°1 Exception to Exception Description the Federal Additional MDHHS Rule ClarificationiExamples Federal Definition Circular Allowable Additional Federal Clarification oval. g7, a-i33 and Uniform under HRSA Yes Minor Alteration and Renovation +No. A- allowable ONLY with prior Item Administrative Requirements Major Alteration and Renovation not McAlterati°n and Renovation Yes & No DefiriffioM configuration Minor Alteration and Renovation costs es the aliowable. es +n facility Work that Chang h sical fabrication, modification, will be considered m relation to the Alteration and arrangements or other p Y Minor Alteration and Renovation oval. nclud ng proportion of MIECl-"J amS funds Renovation characteristics of an existing allowable ONLY with prior 1 removal, or installation to-WISnterior for the staff memberiprog facility or installed equipment structure of the building. includes (but is not limited to) so that it can it used more changes to wails, partitions, doors, effectively for its current and windows, designated purpose. Y include work referred to as Minor Alteration and Renovation conversion, DefiP+tom et or other mprovements, Replacement of carp rehabilitation, remodeling, or floor finish material, including modernization. baseboard Painting of walls, doors, • ceilings, and other paintable surfaces General interior decorating wires prior approval and improvements or upg Yes MDHHS req roan tslwas things as Motion ,jr, Usion of disclaimer. This project product May include such gas live or suppo fed by the Health Rassp,cof the Us films, videotapes, Yes "Audiovisuali means any p or pictures, ge vices Administration {HRSA product containing visual imagery, sound, recorded radio of television Depa tment of Health and Human Services production of any p r° rams or public service (HHS) under Grant No. C ppod Home Audiovisual Activities containing visual imagery both. "Production' refers to the slide shows, If step announcements, Maternal, Infanta for (ant amount �— andlor sound, s and techniques used to create P g audio recordings, VtsiSng program, 9 a finished audiovisual product, sign, filmstrips, audio recations, or Th±s information or content and audiovisual is intended general public, including, but not limited to, multimedia p members of the g filming or conclusions are those of the author and the pilots °r layout, sari . filitort should not be construed as the official oduct taping, fabrication, sound recording, exhibitsow both are an integral part. jposNon or policy of, nor should any tapes of the finished p sound, HRSA, HHS and editing. endorsements be inferred by must be submitted to MDHHS or the US- Government. to be submitted with the The Annual Report to HRSA. costs of such prints or tapes are allowable. 90 Rem Costs ExcePt`p° to ExOeptiwn DeSor�Ptron the FOdera\ DNHS RU\e pdd\t10nat M NI A tionlExamPtes Clanfioa NO atFedera\GarihCaCon beforaF`nan dla\ 0\ar pt\O,vab\e pdd\ti�on hosts maY t Def`nitlon CUnform be treated as ae \s Re\aced nand�a\ Statemeh�ot met ovi FedP a 133 and under HRSp No. 8y�dmrnistra6ve Yos the °��ostWhentheNS9ant•oP S;dg\epud�tthr{sh0\dsace ents en . ROq;aem arte° a sing\e or Program, as by subrec P utired to be costs of audred \nq trs PP°ded PC45 C;ORi 4.261d o'r°e end, the Srn9 specified in 45es Wrote than e erfot�` \e by cOrdan°e r rth, ether audd when tt'mc\Ue costs can b ac ct �A-1331 \f'mctuded Pco\ect, but `60xted h ect 01 {\ or cientuse mand Aid areal\owab\e sPecfrcad to,ea0 d t cost rate an llocated s\s, an th`s b for sta to s afi an indrrec wdh, d ortrOna\ ba S�stent\y Y ateria\s roPOd10a a� fica\\y HS fund nT n \ Or it sP m on a prof wed con es Yes Purchas HVIM9H a Prova\. for POPo°v dbl %ec cask pan Practice\seO� Othe �t$e'cas d\rec NIA c\\entA re4urres P t the cr treated CQsts over $50D agency as a re P ou\d be awardl audds sh costs. NIA yes \s necessaN for the has a6brarY' e ct r\dare n acfiv\6es tf th a trctPate e\ acwkkes and n °r9anrZa6on tO contain Y es parentto P me direct\y re\ated t suit\n mee0n9 a and JOur a\s la P\ace set aPeadm9, v`ewk g that r NS benchmark sf0 m91bp0 NIP acb4y es urraddu° materra Or study M\scN �H w, are\nc \stemng ovldad as �hddcare costs MHv\ actr dt X Faof and ou\d be P d NIA to Pah'c �a as pad °f pPPen \oumaa\library geo\res an address u ent. norm as indrtect cosh e of yes this do treated rf w\t rn the SLOP p\\owable r osts a Program t10 r ceNe health or `C ddcare ndrv\dua\s Q Federal Definition Circular Exception to Item No. A-87, a-133 and Uniform Allowable Additional Federal Clarification Additional MDHHS the Federal Exception Description Administrative under HRSA Clarification/Examples Rule Requirements Client -specific Assistance Services/funds made available to a No N/A Clients who need specific individual No N/A specific client that are not generally assistance should be referred to resources available to the standard program within the community. population. Communications Costs incurred for telephone Yes N/A N/A No N/A services, local and long distance telephone calls, telegrams, postage, messenger, electronic or computer transmittal services and the like are allowable. Construction Construction activities may include No N/A HRSA has notified MDHHS that submitted No N/A construction of a new facility or requests for articles such as: Playground projects in an existing building that equipment, a tricycle path, air conditioning are considered to be construction, units for the building, etc., are considered such as relocation of exterior walls, construction and are not allowable. roofs, and floors; attachment of fire escapes; or completion of unfinished shell space to make it suitable for occupancy. 92 Item parFid�pation dlon Circular Aable FederalD 133andjjnlform llow undera,) 87Adminia,,,,, I ReQuirements as as lets of rovfder boards amerip for: be comPensated actual Reasonable and outer{.pocket costa result incurred solely as eduled o{ attending a sch meeting, mcludinmeals, transporta[ron, childcare, and to c als 01 -The reasonable necessaryb the recipient furnished er or proglder to coP,a uring par{�drpants d s'if not chedu sled meeting c pang eimbur$a top° fiery fse o as per diem AddiHonai Federal CTarrfrcation ° vable for p0696on as part omeVfsittnglocalLeadershfp 1 �r°up actual costs �LLG)- In°lodes as a result of fncunad solely mewing -a uding transP° meals, childcare andwa9 Additional MDNHS C1301cationiExamples agan°Y established rent reimbursement p°IlC1es of U DOHS ksee APPend%Fl unless e agency has a P6clTsed r tha roi 'Ants supersede 93 Exception 19 the Federal I Rule No Exception Descript on NIA Federal Definition Circular No. p,.87 a•133 and Uniform item Administrative Requirements Depreciation and use apowanceS are a means of Depr�iafion the cost of fixed allocating assets to Periods benefiting from ,,at use. NIA Direct Services `DueslMembershlpEees Exception to Exception Description the Federal 1 Additional MDHHS _ Rule GlarificationlExamptes --NIA Allowable Additional Federal Clarification No under NRSA —are as ,The value of an assetwili deciine Such costs usually over its useful Ilfe. This annual "loss Yes De reciation or uses n value 10 the asset is called indirect costs. p 'and can be charged charges on equipment or building acquired under a federally suPpohed "depreciation as an "expense" by your e not allowable organization to retect the loss. project a No lJ sited direct services only to the ay be it As Pa t of MDHHS-MU funding1, No costs of direct se vmentalrhem h, (a g • health care, etc. legal services, dental care, etc')' may be paid for using funding, costs of a non-federal enf0s memberships in aland business, technic, professional organizations are allowable. federal Costs of a non- to an ity's subscfiefsrip business, professional, and technical periodicals are allowable. provided to the lam Y to an extent required in fidelity evidence -based model ( n sefvices maternal and O oft eaNu 5e provided asp modelr Family Parnershlp to the home Consultation oogram (not speciftic \kiting P be Paid for uf0izing families) may MDHHS-HVU funding NIA payment of dues or membership Yes embershlp fees for an individual'' m in a professional or technica l organization is alloWa mebit cost as n employee develop NIA costs of membership In or, Co gaill Yes en aged In lobby ie Cost of e u substantialllygallowable. advocacy under allowabie the membership l be vaned based circumstance�Erlthat is funded wilh ho is on the % of F someone w MDHHS funds (e g'will have 25% of a 25 MDHHS FTE bershlp pa d for the cost of the Them with these funds) Kem EXoeptionto ExcePtwnDescttpGon Op fedeta\ pWS Ra\e NIP pddfiona\�` amPtes C\atidca'kronlEX No Federal WIT licaUp° u\ar b\e pdditiwna\ NIP rr\tc rNAOI HRSP \De�nd�ri\EOtm oeta IN 1xv N3�sttame NIP Pdm . end No Reamtem No to a scnl n9e �s\on �ontirbu.0ns S\m\1at P or any be NIP to ad qor even wh h cannot m sts area\\owable occorrense otce tarty as io co torero\d wig or wlth a ed\n9, ensa6on ttheY ate 0me,lnte e of the\t haPp des Coe extenttha for e t° the ude en<s°stsin° sutans e tea °nab\e, c0o \cY °E e aPPUed amm as \owat� ude s ate ul ent costs e onnet establish P cons\stenCe of rands, P\\owab\e ecto isthatheve g Emp sat on tot P ot9an\za °E the sour Y actootnorethanthe es on\y tnO se se st mu ,osts cue We d\n9 a\\ d of re9atd\ess devoted pto9tam ctua\\y m�bepdti\pslshe bet of H seN'�nera on, Pa\d surrendered and ru e of 6me a NIP �eadSta °r�ont°thed� etMON rem ed,t0rser \set r Percenta9 ram be\nPmwh°atefunde a�nngthe Penedd r Federa\ to the pto9 s\\ents �\s\6n9 tund\n0 omance butnot N°me Ped s tnc\udm0 to, lag* NIP award '_A, Fn ted No amusement, \, and soGa�sts s an � atedwitto h sash � uG as ti\ckat dts, orts eve vs or sP tenta\s, a1s,\°dg\n9' d9talu\6esl ottat\Oap`e.lsee hsP 95 Federal Definition Circular No, A-87, aA33 and Uniform Item Administrative Requirements Allowable under HRSA Equipment Tangible personal property Equip having a useful life of more than one year and a per -unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the non -Federal entity for financial statement purposes, or$5000. MowBenefits provided nces and to s to their Fringeices provided by employers employees as pensation Ir salaries anc addition to regular lude wages. Fringe benefits costs but are not limed to, the Costs of leave, employeeto men, pensions, and unemployment benefit plans. Fundraising Costs Costs of organized fund raising, including finnial .itata ncof gifts campaigns, and bequests, and similar expenses incurred to raise capital or obtain contributions are unallowable. Yes Additional Federal Clarification Exception to Additional MDHHS the Federal ClarificationlExamples Rule Tangible property (other than land or NIA buildings) that is used in the Examples operations of a business. of equipment include devices, machines, tools, and vehicles. Yes As part of an employee's compensation, In proportion to the amount of time an employee grant-supported devotes to the program. Tuition is not an allowable cost for Programs funded under the MDHHS Home visiting Unit. No Cost of staff time to pursue funding opportunities outside the grant and the costs of supplieslmatsdals used to fundraise (e.g. brochures) are unallowed. 92 NIA Yes No No Exception Description prior approval must be sought and provided by the MDHHS-HVU. NIA NIA Federal Definition Circular No. A-67, a-133 and Uniform Allowable Item Additional Federal Clarification Additional MDHHS Administrative under HRSA Clarification/Examples Requirements Honoraria Costs of meetings and Yes A payment for services rendered, NIA conferences, the primary such as a speaker's fee under a purpose of which is the conference grant is allowable. dissemination of technical information, are allowable. This includes costs of meals, local transportation, rental of facilities, speakers' fees, and other items incidental to such meetings or conferences. Incentive Costs No Federal Definition Yes Incentive payments to volunteers or Incentive Costs are not the same as patients participating in a grant- parent financial reimbursement for the supported project or program are work of parent leaders engaged in QI or allowable. Incentive payments to other partnership activities. Incentives individuals to motivate them to take are an acknowledgement of advantage of grant -supported health accomplishments provided to all care or other services are allowable participants enrolled in a program in if within the scope of an approved alignment with model standards (e.g., retention, graduation, other milestones) project, and are equitable for all enrolled families Incentive costs or gifts to referral to receive. Parents who are partnering sources are not allowable expenses. with grantees as parent leaders are to receive reimbursement and compensation per the MDHHS Parent Leader Financial Support Policy which exclusively prohibits gift cards as compensation in accordance with a Multi -State Department agreement to comply with that prohibition for parent leaders. 97 Exception to the Federal Exception Description Rule Yes Unallowable when the primary intent is to confer distinction on, or to symbolize respect, esteem, or admiration for, the recipient of the honorarium. Yes Gift cards are allowable as incentives as long as they do not become income for recipients or are used to purchase items that do not fall within health priorities under HRSA such as alcohol, tobacco, or weapons. If an LIA chooses to offer gift cards as an incentive, the LIA must have a procedure in place that requires the recipient to sign a document acknowledging they will not use the gift card to exchange for cash, or for the purchase of alcohol, tobacco, or weapons. This documentation will be reviewed during annual site visits. Incentives must be available for all families, notjust some. Incentives may not be purchased for future use and held on to for an extended length of time. Federal Definition Circular Exception to Item No. A-87, a-133 and Uniform Allowable Additional Federal Clarification Additional MDHHS the Federal Administrative under HRSA Clarification/Examples Rule Requirements Insurance No Federal Definition Yes N/A Cost associated with guarding No against property loss or damage by making payments in the form of premiums to an insurance company which pays an agreed -upon sum to the insured in the event of loss. Lobbying The cost of certain influencing No Includes activities to influence the N/A No activities associated with introduction, enactment, or obtaining grants, contracts, modification of legislation by the cooperative agreements or U.S. loans are an unallowable cost. Congress or State legislature. Exception Description NO N/A Federal Definition Circular Item No. A-87, a-133 and Uniform Administrative Requirements Meals Travel costs are the expenses for transportation, lodging, subsistence (including meals) and related items incurred by employees who are in travel status on official business of the governmental unit. Allowable Additional MDHHS Exception to under HRSA Additional Federal Clarification Clarification/Examples the Federal Exception Description Rule Yes Additional allowable meal expenses Guest meals are not allowable. Cost include: Subjects and patients under study Where specifically approved as part of the project or program activity, e.g., in programs providing children's services When an organization customarily provides meals to employees working beyond the normal workday, as a part of a formal compensation arrangement • As part of a per diem or subsistence allowance provided in conjunction with allowable travel • Under a conference grant, when meals are a necessary and integral part of a conference, provided that meal costs are not duplicated in participant's per diem or subsistence allowances. V• of alcoholic beverages are unallowable. Yes Costs of meals, in addition to staff meals while in travel status, can be covered for specific programmatic activities that are a well-defined component of model implementation (e.g., Early Head Start provides snacks as part of their curriculum). Federal Definition Circular Item No. A-87, a-133 and Uniform Administrative Requirements Public Relations Costs— Community relations that are (Also see Advertising) dedicated to maintaining the image of the non -Federal entity or maintaining or promoting understanding and favorable relations with the community or public at large, or any segment of the public. Registration Fees Costs of meetings and conferences, the primary purpose of which is the dissemination of technical information are allowable. This includes costs of meals, transportation, rental of facilities, speakers' fees, and other items incidental to such meetings or conferences. Allowable Additional Federal Clarification under HRSA Yes Includes only costs specifically required by the grant or for costs of communicating with the public about specific activities or accomplishments under the grant. Unallowable costs include costs of displays, demonstrations, exhibits, meeting rooms or other special facilities used in conjunction with special events, salaries and wages of employees engaged in setting up and displaying exhibits, cost of promotional items and memorabilia including models, gifts and souvenirs, cost of advertising and PR designed solely to promote the non -Federal entity. Promotional items as part of a community event is considered advertising and is unallowable. Yes Are allowable for attendance at conferences, symposiums, or seminars if necessary to accomplish project or program objectives. 100 Additional MDHHS Exception to the Federal Clarification/Examples Rule NIA No Guest fees are not allowable. No Exception Description NIA NIA Federal Deflrrition Circular No. A-871 a-133 and Uniform Item Administrative Requirements ppowable Additional Federal Clarification underliRSA Rental costs are allowable to Yes Rentalll.ease of the extent that th„fro such Facilities & Equipment reasonable in light factors as� rental costs comParabfe Property, i4 any; market conditions in the r the alternatives ae� ncly, type, life e,, condition, and value of the Property leasedRental . arrangements should be reviewed periodically to determine Iteia dSttheeS have char, options are available. Salary & wages include 9 Salaries & Wages compensation for personnel services includes ail rrently or emune ation,P aid accrued.ior services rendered during the period of performance under Federal 1 awards. NIA Additional MDHHS ClarificationlExampies Salary & wageS are allowable the Yes are reasonablee , extent that they of conform to the established Policy lied the organization consistently applied regardless of the pie rce of funds, and reflect no m devoted percentage of time actually to the Program, ioi NIA NIA Exception to Exception Description the Federat Rule NIA No No NIA Item Sub-awardslContracts Under Grants Supplies Federal Be1i33 and Unition rniioam rcul No. A-g7, a" Administrative Requirements Allowable Additional Federal Clarification under HRSA ^Subaward" is a Portion of an award that is distributed 10 the} third party (subrecip h) by entitYi I recipient (pass-throug dd of the originai award to cOnduw0fWin a portion of the project compilance with the sponsor s terms and conditions. Yes Allowabie to carry out a portion of the programmatic effo gods oor jor the acquisition of routine goods services under the grant, °Contract" means a mutually binding legal relationship obligating the seller to furnish the supplies or se vices and the buyer to pay for the_— All tangible proPe other than those described in equipment. A computing device Is a supply f the acquisition cost is less than the lesser of the capitatizaGon level established by the non -Federal entity ores or financial statement p P $5,000, regardless of the length of its useful l �e �� Exception to the Federal Additional MDHHS Rule Clariticationlexamples No MDHHS requires agencies who subcontract to submit 000 of the subcontractor budgets to the MDHHS Home Visiting Program are ubject Analyst. subcontractors to monitoring Y tne MDHHS subrecipient agency. ost Yes Acquisition ding the cost to mead, the asset Including asset for its intended , or as modtficafionsa , chargeS, such; accessories. Annslu ante, freight an as taxes, duty, be included or installation may Inane with SOM excluded in acco accounting practices 102 NIA Exception Description NIA Yes Items such as diaper bags, items to promote parent engagement, early are allowable if they are literacy etc., consistent with the curriculum of the HV model. Uniforms are considered allowable. Federa\De\133rand\yr dorm Rio•PA IIS' .ksttafkVe ReJoeman ks \te n nd Nge a4Pr0Pr\atateryas Educafrona\ educe{wna\ m .\oys & oyees rave\-Emo not ne(rnrdon GarWIOAon able pddlErona\�edera\ NA01 under NRsp e aPProPnate, m p\\oI 5 o Protects seNing as ..«,Dram Yes costs60,13\ em\ ssP°d d ro\ated 'ad by emP\0seo1 &\r a\ rn traa \ e 9°vemmenta\ pdd\CroaCronlEDan P\es C\anf\c ay be 9tveno canons\Memoure'rsPad `r\m�e Se prt`a� o a\°odmes. the Federa\ Rule No ou\d ch Crave\COO 'Mcunedas4 testhataleaum Os�s entcare,\ncWd drracthe�th0r P gu'amPat\otthdstedt\Cu°\cu Pa6 elp,or oche roved a Early Hea PaCient remres are ap suPP°heo soe\a\ se oC the gran costs SOdra\r acGurne ramU crh0e Pntoaspotrn9or Prdov\sddeedtam nthe 9 9e as ale WhbbCrgP ere co of P \NOV4 sts b\e nc\udrn9 a8on, are e o t Zatron s trio slstaned have\ Po\9cy�"e s a Yas estabUsh WorWn9° ram may emP\Da ted Pro1�t ° Pr�drem °r at c\ude suPP assoeratetl Pe es asd h s nallow epsas' sby subsistence exP es \t travai travel- A NIP, No Ex.., Descnpt` O INNS for quas�ons �ontacttheM stems ac{thatV-11v aw,ak5 a�rfiG \tres d\sPersed re\atedito the m°del 1e.9, �sPega\e\5\y9I?,Taaslieedn9 etcl No Nip NIp MDHHS Home Visiting Local Implementing Agencies and Local Leadership Groups FY 2023 Deliverables and Meeting Schedule Program &Evaluation Reports Submit To Report Content Due Date EHS PAT HFA NFP Visit Tracker Visit Tracker HVOL Flo Performa nce Measure Data MHVI Monthly Program Level Data Work Plan Reports Medicaid Outreach Reports Data entered into home visiting model - specific system Caseloads, all FTE, and FFPSA for previous month Work Plan form Quarterly updates include period summary and evaluation results for each activity and QI documentation (coaching notes, QI documentation) Medicaid Report Form (Berrien, Calhoun, Kalamazoo, Kent NFP only) Family data needs to be entered within 5 business days of the home visit 5th business day of the month for the previous month's data Q1: Jan 30, 2023 Q2: April 30, 2023 03: July 30, 2023 Q4: October 30, 2023 Q1: Jan 30, 2023 Q2: April 30, 2023 Q3: July 30, 2023 Q4: October 30, 2023 Lead Staff Lead Staff MPHI: Carrie MPHI: Carrie Seroka Seroka REDCap REDCap Lead Staff Lead Staff MDHHS: MDHHS: EHS: TBD PAT: Kate Rood Lead Staff MPHI: Carrie Seroka and Aubrey Stechschulte REDCap Lead Staff MDHHS: TBD Lead Staff MPHI: Monal Shroff and Nick Thompson REDCap Lead Staff MDHHS: Annie Heit MPHI MPHI MPHI Technical MPHI Technical Technical Technical Support: Support: Support: Support: Carrie Seroka and Monal Shroff and Carrie Seroka Carrie Seroka Aubrey Stechschulte Nick Thompson EGrAMS Home Visiting Mailbox: MDHHS- (Exception - Health HVlnitiative(amichiq Departments submit an.gov EGrAMS EGrAMS to Home Visiting Mailbox: MDHHS- (Exception - HVlnitiative o),michiga Genesee Detroit NFP submit to n.qov EGrAMS) Home Visiting Mailbox: MDHHS- N/A N/A NIA HVlnitiativenmichiq an.gov 104 QI Deliverables; LIAs Deliverable Content Due Date Submit To Each LIA is expected Submit as documentation with Quarterly Work Plan to have a diverse QI Q1: Jan 30, 2023 Reports. QI Team team. See guidance in QI policy included Q2: April 30, 2023 Q3: July 30, 2023 Documentation should include Team member's names in this manual for Q4: October 30, 2023 and positions. required members. LIAs shall connect with their MPHI QI Coach at the start of the fiscal year, no later than October 30th, to plan which meetings the coach will join and get them on calendars. LIAs will maintain notes from team meetings and submit Coaches should be quarterly. Bimonthly Coaching included in a QI team Bimonthly October 2022 — meeting at least September 2023 MPHI will maintain a QI Coaching Tracker and share with bimonthly MDHHS-HVU monthly. MPH(QI Coaches: EHS: Grace Weatherbee HFA: Brenda Dietrich and Michelle Datema NFP: TBD PAT: TBD Documentation of QI Q1: Jan 30, 2023 Submit as appropriate in response to QI Work Plan Methods, including the PDSA cycle and Documentation of QI Q2: April 30, 2023 objective in Quarterly Work Plan Reports, QI tools, as a routine efforts to date Q3: July 30, 2023 part of their work Q4: October 30, 2023 Documentation of QI Submit to: Model Consultant Annual Summary of efforts for QI Plan QI Efforts year. By February 15, 2023 Template will be provided. 105 QI Deliverables: LLGs Deliverable Content Due Date Submit To Coaching Each Fall (October- Arrange with MPHI QI Coach and State LLG Coordinator-- call/session to December 2022) and Brenda Dietrich and TBD. support kicking off Spring (dependent on Coaching each PDSA cycle; when team is ready to MPHI QI Coach and State LLG Coordinator should be Calls/Sessions done in conjunction begin second cycle, invited to QI team meetings that fall in this timeframe. MPHI with State LLG typically March -May QI Coach is able to attend additional meetings if needed. Coordinator 2023) Feel free to reach out and request. Initial: 151h of February Submit to: Groupsite and June. Final: 151h of May and MPHI QI Coach: Brenda Dietrich Documentation of QI September. Team Charter efforts to date Q1: Jan 30, 2023 Q2: April 30, 2023 03: July 30, 2023 Q4: October 30, 2023 PDSA Summary Tool Submit to: Groupsite must be completed in Documentation of advance of Grantee MPHI QI Coach: Brenda Dietrich PDSA Summary Tool completed PID meetings where they cycle will be shared (May and September). Grant Agreement Establishment Submit To Report Content Due Date EHS PAT HFA NFP Annually within two Initial Budget Proposed weeks of notification EGrAMS EGrAMS EGrAMS EGrAMS Budget of application in EGrAMS Annually by June 30 for MDHHS- HVU/State LLG Coordinator EGrAMS Home Visiting Mailbox: MDHHS- Work Plan preapproval using (including HVlnitiative(7a,michigan.gov Work Plan form form provided by EGrAMS EGrAMS Genesee & (Includes health departments MDHHS-HVU. Detroit administering other HV models). Approved versions NFP) should be submitted based on columns to the right. Within two weeks of Grant Agreement Proposed notification of EGrAMS EGrAMS EGrAMS EGrAMS Amendment amendment in Amendment EGrAMS 106 Financial Status Reports (FSR): All LIAs and LLGs Submit To Report Content Due Date Health Departments Non -Health Departments (HD) Actual 30 days after Monthly FSR: expenditures for the end of the Non -HD only the month month Quarterly Actual 30 days after FSR: expenditures for the end of the HD sites only the quarter quarter Within 2 Anticipated weeks of Obligation expenditures notification of Report through end of Obligation the fiscal year Report in EGrAMS Actual expenditures HD sites: See through the end contract Final FSR of the fiscal year. language Possible to Non -HD sites: submit up to See contract three --one must language be marked Final. NIA EGrAMS EGrAMS NIA EGrAMS EGrAMS EGrAMS EGrAMS 107 Event LIA QI Community of Learning (CoL) Gathering MHVI Grantee Meeting (LIAs) LIA Check -In LLG Coordinator Check -In LLG Grantee Meeting HFA Community of Practice Meetings PAT Community of Practice Meetings EHS Learning Community Meetings NFP Supervisor Meetings Meetings & Gatherings Requirement Date Time & Place Documented attendance and participation for as many team members as possible Documented attendance and participation for as many team members as possible Recommended attendance, not required. Recommended attendance, not required. Documented attendance and participation for the team Recommended, but not required by MDHHS Recommended, but not required by MDHHS Recommended, but not required by MDHHS Recommended but not required by MDHHS November2022 March 2023 July 2023 January2023 May 2023 September 2023 Fourth Tuesday of the month Every Other Month All gatherings will be held in accordance with times that work best for most teams. Meeting time and locations are TBD. It is likely there will be a mix of virtual and in -person meetings in FY23 if it is safe to gather in person. 1:00 pm —1:30 pm, Zoom 10 Meeting time and locations are TBD. It is likely there will be January 2023 a mix of virtual and in -person meetings in FY23 if it is safe May 2023 to gather in person. Meetings that are in person will be held September 2023 at same location as LIA Grantee meetings. If meetings will be held in person, the participants will be Monthly notified. If meetings will be held in person, the participants will be Monthly notified. Quarterly All meetings will be held virtually. Monthly If meetings are held in person, the participants will be notified W. Role Early Childhood Consultant EHS/ HFA Model Consultant Support Contacts Contact For Questions regarding the EC system, other early childhood partners, developmental and behavioral screening. Questions regarding programmatic compliance, IPR data, outreach and retention, Early Literacy, and MHVQAS. Synthia Britton 517-5824431 brittons a().michioan.aov W-N Questions regarding State of Michigan Carlotta Allievi Epidemiologist data, Kitagawa, Outreach Toolkit, other 248-961-3373 system data questions. AllieviC(v)michiaan.aov Families First Prevention services Act Coordinator questions about implementation of (FFPSA) FFPSA Questions regarding implementation of HFA/PAT State Office the HFA and PAT models including accreditation, fidelity, and other requirements. Questions regarding funding, project Manager —Home Visiting Unit implementation, and program/staff related concerns. Questions regarding programmatic NFP Model Consultant compliance, IPR data, outreach and retention, breastfeeding, substance use, and Safe Sleep. Parent Coordinator Questions regarding parent enqaqement/leadership, payment, etc. Questions regarding meeting MDHHS PAT Model Consultant contract expectations, programmatic compliance, outreach and retention, MHVQAS, etc. Professional Development and Questions regarding reflective Training Coordinator supervision and training or Community of Practice for HFA and PAT. Program Analyst State LLG Coordinator Substance Use Consultant Questions regarding EGrAMS, grant agreements/amendments, and fiscal compliance. Questions regarding LLGs. For questions regarding parent engagement/leadership, contact Autumn Baqley Substance Use training; Substance Use funding implementation; General questions. Contact Kate Rood 517-643-2378 Roodk a(7michiqan.gov Cynthia Zagar — Center for Quality Family Support Manager 248-892-8555 czagarftmphi.orq Tiffany Kostelec 517-242-7905 kostelect &michiaan.gov Annie Heit 517-930-6754 heital no michiaan.aov Autumn Bagley BagleyA1 (o,michigan.gov Kate Rood 517-643-2378 Rood kta@michiaan.gov Tricia Drenth — HFA Training, Specialist 517-230-7448 tdrenthla.mohi.ora Charisse Sanders 517-282-8418 sandersc2 onmichiaan.aov "20 WX TA, and Quality Assurance 109 Submission and Question Contacts Submit To Submit What Contact FSR: All LIAs and LLGs http://egrams-mi.com/dch Work Plan: All EHS/HFA/PAT httn:llegrams-mi.com/dch EGrAMS except Health Departments; httD:I/earams-mi.com/dch Genesee and Detroit NFP; and LLGs that are not Health Departments. Carrie Seroka EHS/PAT Program Level Data 517-324-8360 (technical support with REDCap) cseroka@mphil.org Carrie Seroka 517-324-8360 cseroka(a.mohil.orq HFA Program Level Data (technical or REDCap support with REDCap) Aubrey Stechschulte httos://redcav,mphi.orq 517-324-7332 astechsc(a mphj�oom Monal Shroff 517-324-8355 mshroffemphi.orq NFP Program Level Data (technical or support with REDCap) Nick Thompson 517-324-6056 nthompsolamphi.org Mona[ Shroff 517-324-8355 mshroffamphi.orq Flo NFP Performance Measure Data or Nick Thompson 517-324-6056 nthomgso5mphi.om Carrie Seroka 517.324-8360 cseroka@mphil.ora HVOL HFA Performance Measure Data or Aubrey Stechschulte 517-324-7332 astechsc@,mphi.orq Carrie Seroka Visit Tracker EHS and PAT Performance 517-324-8360 Measure Data cseroka@mphil.oro 110 MPHI MDHHS MDHHS-HVlnitiative anmichioan.gov EHS QlCoach HFA QI Coach NFP QI Coach LLG QlCoach Work Plans: LLG Health Departments Work Plans: All HFA Health Departments Work Plans: NFP Health Departments Medicaid Outreach Report: Select NFPs Grace Weatherbee 517-324-7370 oweather5mohi.ora Brenda Dietrich 517-324-8316 bdietrichna mohi.orq or Michelle Datema 517-709-8282 mdatemana.mohi.orq wo Brenda Dietrich 517-324-8316 bdietrich(u)mohi.orq UN WE Annie Heit 517-930-6754 heita1 an,michioan.00v Annie Heit 517-930-6754 heita1oq michigan.gov 111 Appendix D: Monitoring Activities Menu Michigan Department of Health and Human Services Monitoring Activities Menu Monitoring Activitv Guidance 1.* Review financial and programmatic reports required by 1a. Ensure all required reports were obtained when due. MDHHS. ' Required for all grantees regardless of the assessed level of risk. 1 b. Review programmatic reports to determine if performance goals were achieved. 1c. Review financial reports for budgetary compliance, unusual items to be further evaluated, compliance with requirements (matching, maintenance of effort, limitations, etc.), and proper certifications. 1 d. Follow up on deficiencies noted from the review of the programmatic and/or financial reports, and take action to ensure correction when warranted. 1e. Document follow-up actions, and evidence the reviews with a sign -off. 2.' Follow-up and ensure that the grantee takes timely and 2a. Follow up on identified deficiencies from audits, on -site appropriate action on all deficiencies pertaining to the reviews, and other means; and ensure the grantee takes timely grant award detected through audits, on -site reviews, and other means. ' Required for all grantees regardless of the assessed level of risk. 3. * Perform monitoring that is specifically required by statute, regulation, and/or award requirements. ' Required for all grantees regardless of the assessed level of risk and appropriate corrective action. The Bureau of Audit, Reimbursement, and Quality Assurance will notify Program Offices of deficiencies detected through audits via the management decision process. 2b. Document follow-up actions. 3a. Ensure program specific monitoring that is required by statute, regulation, and/or award requirements is completed. 3b. Document monitoring actions. 4. Perform pre -award monitoring to determine the fitness 4a. Gather and evaluate information to determine the fitness of of the grantee during the selection process. the grantee in fulfilling the grant agreement obligations. Information could include past evaluation or audit results, and financial statements. 5.Obtain and review a completed "Subrecipient Questionnaire" from the subrecipient. 6. Perform desk reviews of the grantee's records. 41b. Document pre -award monitoring activities. 5a. Obtain and review the completed "Subrecipient Questionnaire" from the Subrecipient. Evaluate responses for issues needing follow up. 5b. Follow up on items identified from the review of the completed "Subrecipient Questionnaire" that may be issues of non-compliance, and take action to ensure correction when warranted. 5c. Document the review, and any follow-up actions. 6a. Request and review a sample of detail (i.e. general ledger detail, vendor invoices, time and attendance records, allocation 112 7. Perform on -site reviews of the grantee's records and/or operations. 8. Provide the grantee with training and technical assistance. detail, programmatic information, etc.) that supports information provided on programmatic and/or financial reports. Reported costs should be supported by an accounting system that tracks programs separately, supported by documentation (invoices), and are reasonable and allowable. 6b. Follow up on deficiencies noted from the desk review, and take action to ensure correction when warranted. 6c. Document the desk review work, and follow-up actions. 7a. Go on -site to the grantee's location and review a sample of detail (i.e. general ledger detail, vendor invoices, time and attendance records, allocation detail, programmatic information, etc.) that supports information provided on programmatic and/or financial reports; and/or evaluate operations for programmatic compliance. Reported costs should be supported by an accounting system that tracks programs separately, supported by documentation (invoices), and are reasonable and allowable. 7b. Follow up on deficiencies noted from the on -site review, and take action to ensure correction when warranted. 7c. Document the on -site review work, and follow-up actions. 8a. When deemed necessary and/or requested by the grantee, provide training and technical assistance to ensure the grantee has the necessary information and skills to carry out the grant award. 8b. Document the training and technical assistance. 9. Arrange for agreed -upon procedures engagements for 9a. This monitoring option is limited to subrecipients who are subrecipients as described in 2 CFR 200A25. exempted from Single Audit; and the cost is allowable only if conducted in accordance with Generally Accepted Governmental Auditing Attestation Standards, paid for and arranged by MDHHS, and limited in scope to certain compliance requirements. This option, if chosen, should be coordinated through the Bureau of Audit, Reimbursement, and Quality Assurance. 113 A referral is considered to have occurred when program staff have identified a need and provided appropriate information to the client for additional services outside the home visitation program. Recommended steps include: 1. Discuss the particular resource(s) with the client, so he/she clearly knows what to expect. 2. Encourage the client to seek services from the resource(s). 3. Determine whether the client wishes to seek services from the resource(s). The client may indicate they have an alternate resource they would like to access. 4. Provide specific information in writing about contacting the resource(s) unless contraindicated (e.g., leaving written material for a client at risk of or experiencing Interpersonal violence, which may not be safe). 5. Determine if the client needs assistance to contact the resource(s) due to limited English proficiency, low literacy, comprehension difficulties, immobilization stemming from depression, fear or stigma related to using certain services (e.g., Early On®, mental health services, substance abuse services, domestic violence services, etc.), or other concerns. 6. Provide assistance in contacting the resource(s), if needed. 7. If the client doesn't wish to seek services, ask about his/her reasons, and if appropriate, gently encourage him/her to continue to think about it, explaining the potential benefits. Ensure that you revisit the referral at the next appropriate juncture. Some referrals may need to be revisited sooner rather than later. 8. Document that a referral was made even if the client didn't accept the referral or take action. 9. Ensure the appropriate release of information forms have been signed by the parents if specific health information pertaining to the client (e.g., screening results, etc.) is shared. Referral Scenario (embedded with numbered referral steps) Over the course of several weeks of visits with a single mom with a one month old baby, the home visitor notices a pattern of mom being a bit disheveled, less talkative, and seeming tired. She also notes that the house is more cluttered and that the curtains are closed, making it look very dark inside. The home visitor starts to explore her observations and during the course of the conversation, mom shares that she is feeling tired, irritable, and has been feeling overwhelmed. She didn't think having a baby would make her feel that way and she sometimes feels very guilty and isn't sure she likes her baby and sometimes doesn't want to interact with the baby. Based on the information shared, the home visitor asks the mom how long she has felt that way and to share a little bit more about what she had just stated. The home visitor tells the mom that she is concerned that the mom may be experiencing post-partum depression and shares some information that normalizes this experience. She indicates that, if the mom is agreeable, the home visitor can ask a few questions to screen for maternal depression so the two of them can decide what some next steps would be. The screening is positive, leading the home visitor to again normalize her experience and to share that depression after having a baby is very common, but that the home visitor expresses concern that mom's symptoms are significant enough to discuss a referral to a professional in the community who can help this mom address these feelings. (2) The home visitor shares a list of resources that accept 114 her insurance and are in the mom's community and explains that she can help the mom to choose someone to see and assist her if she needs help setting up an appointment. She then tells the mom that at the first visit the professional would talk with mom to understand what has been happening and then formulate a plan of care from there. (1) The home visitor asks the mom if she is interested in seeking this service in the community. (3) Mom admits it is probably a good idea but she is just not able to think about getting out into the community to see a professional and she is sure she will feel better if she can get some sleep. The home visitor asks the mom if she can leave the list of resources with her to consider, and asks if she can call back in two days just to check to see if mom feels differently. (4, 7) The home visitor then explores what other concerns mom has and how they might identify ways to help mom get more sleep — something all new moms need. The home visitor would return to the office to note in the case notes and/or data system that a referral to address maternal depression was made but that the mom did not act on the referral at this time. (8) The home visitor calls two days later and checks back in with the mom a week or so after that. Mom reports that she is not feeling better and that she thinks she would like to seek some help. The home visitor asks the mom if she is comfortable calling one of the resources herself or if she would like the home visitor to be there for support when she calls. (6) Mom states she is ok calling herself. The home visitor lets mom know she is happy to support her however she needs and that she is glad the mom is taking this step to get some additional support in the community. She reminds her about how her baby will also benefit from her taking care of this important need. Mom calls back a day later to say that the therapist in the community would like to have some records from the home visitor to understand how her pregnancy and birth went, and the screening results for the first appointment which is scheduled for the following week. The home visitor brings a release of information to the mom to sign to be able to send the requested records. (9) The home visitor updates the case notes to indicate that mom accepted the referral and that a first appointment has been sent. The home visitor documents the signed release of information. 115 State of Michigan Procedures and Guidelines for Financial Support of Parents in the Michigan Home Visiting Initiative at the State or Local Level The intent of these procedures and guidelines is to support the provision of financial support to parents participating in Michigan Home Visiting Initiative (MHVI) activities or Home Visiting related business and/or activities, while maintaining user- friendly financial procedures and accountability leaving clear paper trails for evaluation and audit purposes. Note: If the procedures and guidelines in this document do not adequately support a parent to participate, MDHHS will discuss other options and ideas for how to best provide the needed support. Parents are provided standard reimbursement of expenses incurred (e.g., travel, childcare, etc.) to participate in activities related to the Michigan Home Visiting Initiative. Parents are provided compensation for their time in recognition of the value the MHVI places on the parent voice as part of a comprehensive system. Parent participation is central to the implementation of home visiting and financial support is based on the following principles: • Parents are considered essential allies and partners in planning, implementation, improvement, and training related to home visiting. • The experience and expertise that parents bring is of great value. Therefore, parents will be compensated for their time and efforts in the same way that participating professionals are compensated for their work. • Agencies that act on behalf of the Home Visiting Initiative will make essential parent participation a reality, learning what is needed for parents to fully participate. • Family diversity is respected and encouraged. Parents with diverse perspectives and experiences should be welcomed. Procedures for Parent Leader Financial Support Agency Agencies need to have procedures in place to provide and track the income Responsibilities paid to parents for their activities. • Gift Cards are not allowable forms of compensation for parents engaged in this work as parent leaders. • If a parent receives income of $600 or more, they must receive a 1099- MISC tax form at the end of the calendar year to allow them to report that as income. • An agency will need to ensure that parents who are receiving income complete a W-9 at the beginning of each calendar year, as this will be required to have on file should a parent reach $600 in income and need to receive a 1099-MISC tax form for reporting purposes. • Any agency providing financial support to a parent will provide notification to parents in writing that their earned income (excluding reimbursements) is taxable and they will receive a 1099-MISC tax form 116 per agency procedures if a family receives $600 or more in income from the agency. Payments for parents should be processed by the agency within two weeks of receipt of the Parent Leader Financial Support Request Form. Generally, payment should be received by the parent approximately fourteen business days after the form is submitted. If this is not possible for your agency, you must submit notification to the parent, in writing, of the expected timeline for payment. Agencies may wish to include language similar to the following in documents to parents for their awareness: "The recipient of the compensation shall not be entitled to participate in any plans, arrangements, or distributions by the agency pertaining to or in the connection with any fringe, pension, bonus, or similar benefits for agency regular employees. The agency will not withhold or pay any sums, state, federal or local taxes, social security (FICA), or worker's compensation insurance and the recipient of the honorarium reimbursement agrees to hold the agency harmless for the payment of such sum, interest, penalties, or costs in the collection of the same." Agencies are encouraged to reach out to their Local Leadership Group (LLG) for advice on developing forms and reimbursement of parents. If an agency does not have an LLG within their community, the Early Childhood Investment Corporation (ECIC) is an alternative for guidance. If an agency prefers, they may request a Parent Leader Financial Support Request Form from MDHHS which is customizable for any agency. Any form utilized for this purpose must include the name of the staff person to whom the parent will submit the form for payment. Parent Parents who receive financial support for their work as parent leaders are Responsibilities required to: Complete the MDHHS Parent Leader Financial Support Request Form or comparable agency form and submit it to the appropriate, identified staff for processing with supporting documentation (e.g., receipts). MHVI financial compensation earnings are taxable. Reimbursements (e.g., travel and childcare) are generally not taxable when a receipt or other documentation is submitted. See Travel and Childcare sections for more information. Parents will need to report these earnings on their income taxes. If a parent has concerns about how payment received for the Michigan Home Visiting related work will affect their family, it is recommended that they seek advice from a tax professional. Most communities have locations for free tax advice. It is recommended for a family to call 2-1-1 or visit https://www.mi2l 1.org/ if they would like assistance locating free tax support. Additionally, if a parent is receiving services from government programs that are based on income eligibility, parents need to report this amount to their caseworker within ten days of receipt of the income. 117 Completing Forms for a parent to receive financial compensation, childcare, and/or Forms travel reimbursement are available from the MDHHS Home Visiting Unit and should be available at all events in which the parent is participating. If an agency wishes to develop a form specific to their agency, that is allowable. *Note — Social Security Numbers should not be requested on the form. ** Forms should include all information necessary to maintain acceptable documentation for agency accounting purposes. Forms should also identify who the parent should submit the form to for payment. PARENT TIME FINANCIAL SUPPORT Financial support is available to parent leaders for attending Home Visiting Initiative administrative meetings, Home Visiting Initiative subcommittee meetings, local home visiting quality improvement activities, Local Leadership Group meetings and activities, and, with prior approval by MDHHS or the local implementing agency, other Home Visiting Initiative related business and/or activities. Rates Parent leaders are paid at a rate of $18.00/hour for up to eight hours for their time conducting activities related to home visiting, with total time calculated based upon meeting preparation time, actual meeting time, and travel time to and from the activity. This rate is an agreed upon amount for parent financial support between state agencies and is subject to change in future years. REIMBURSEMENT FOR TRAVELITRAVEL-RELATED EXPENSES - I Travel reimbursement is available to parent leaders who use their own vehicles or pay for other transportation to attend Home Visiting administrative meetings, Home Visiting subcommittee meetings, local Home Visiting continuous quality improvement activities, other Home Visiting related business/activities, and Local Leadership Group meetings and activities (special meetings and events must have prior approval by MDHHS). See the Rates chart for further information. Rates Expenses will be reimbursed at approved State or agency rates for mileage, hotel, and meals. Other transportation, parking, registration fees, tolls, etc. are reimbursed based on actual costs (with receipt provided). Any other costs would require prior authorization from the agency. 118 Type of Expense Mileage Hotel Rates Current State of Michigan Premium Rate -Approved Private Vehicle. As of January 1, 2022, $0.585 per mile. Please see Internal Revenue Service Website (wwwJrs.aov). Notes • Adjusted periodically. • Only available if a parent drives to the meeting. If a parent carpools, both parents may not request mileage reimbursement. • Driving directions to and from location must be provided with request for reimbursement. Per State rates — $85.00/night • Must have a receipt. Meals Per diem State rates — $8.50 breakfast $8.50 lunch $19.00 dinner Parking fees Tolls Other Transportation (cabs, Uber, etc.) IRegistration fees for special events/meetings Actual fees Actual cost Actual cost • Excludes meals available at meetings. • Excludes alcohol and entertainment. • Must have a receipt • Must have a receipt. • Must have a receipt. • Must have a receipt. Actual fees • Must have a receipt. • Prior approval by agency required. CHILD CARE -REIMBURSEMENT - Childcare reimbursement is generally available to parent leaders for Home Visiting Initiative administrative meetings, Home Visiting Initiative subcommittee meetings, local home visiting quality improvement activities, Local Leadership Group meetings and activities, and with prior approval by MDHHS or the local implementing agency, other Home Visiting Initiative related business and/or activities. Parents requesting childcare reimbursement are responsible to: choose their own childcare providers provide the needed training • assume any liability • make payment to the childcare provider • collect the signature of the childcare provider 119 Rates Actual childcare expenses, up to a maximum of $60/day, will be reimbursed by MDHHS or the local agency. If childcare expenses will exceed the $60/day limit, a parent must notify the agency prior to the event to request an exception. If expenses are less than $60, parents will claim actual amounts. To be counted as a reimbursement, a receipt for the childcare signed by the provider must be provided to the reimbursing agency. If a receipt is not provided, the parent may still request the amount, however, this will be considered income and is therefore taxable and would be listed as income if the parent reached the $600 threshold to receive a 1099-MISC tax form. Processing requests Checks for childcare Davment are issued in the name of the parent. Parents are responsible for issuing payment for childcare to the caretaker. If the agency has a question about a request for childcare reimbursement, they should contact the parent directly to discuss the question. 120 Appendix G: Programmatic Contract Monitoring Template (retracted April 121 +' 1 122 mom Resources that are available to communities in Michigan include, but are not limited to: 1. Substance Use Treatment: a. MDHHS (httos://www.michiaan.(iov/mdhhs/0,5885,7-339- 71550 2941 4871 4877---,00.html) b. MDHHS For County Specific Resources: htti)s://www.michiaan.qov/mdhhs/0,5885.7-339-71550 2941 4871 29887- 151431--,00. html) c. SAMHSA's National Helpline (1-800-662-HELP (4357)) which is a confidential, free, 24-hr per day information service in English and Spanish. This service provides referrals to local treatment facilities, support groups, and community organizations. 2. Safe Sleep: a. Consulting the resource map on the MDHHS Safe Sleep website (www.michigan.gov/safesleeD, Safe Sleep Resources by County) to determine agencies in your county that provide safe sleep education and resources. b. Contacting MDHHS Infant Safe Sleep Program staff at MDHHSInfantSafeSleep(a)michiaan.gov. c. Consulting with leadership of your local Regional Perinatal Quality Collaborative (RPQC). Contact Emily Goerge Perinatal Nurse Coordinator, at GoergeE@michigan.gov for RPQC contacts. 3. Social Determinants of Health a. HRSA's Social Determinants of Health Academy (htti)s://sdohacademv.com/) b. A Short Course on the Social Determinants of Health (httr)s://Dublichealth.uams.edu/social-determinants-of-health/) c. Social Determinants of Health Academy Foundational Trainings fhttr)s://sdohacademv.com/foundational) 4. Implicit Bias a. MDHHS and MPHI i. Session 1 - Unconscious Bias: One Part of a Biooer Problem ii. Session 2 -Unconscious Bias: One Part of a Biaaer Problem, 5. Tobacco Cessation a. MDHHS (httr)s://www.michiaan.00vlmdhhs/0,5885,7-339-71550 2955 2973--- ,00.html) b. Michigan Tobacco Quitline 1-800-784-8669 c. CDC (httos://www.odc.aov/tobacco/campaign/tips/quit- smokina/auitline/index.html) 6. Intimate Partner Violence a. MDHHS (httos://www.michlaan.aov/mdhhs/0,5885.7-339-71548 7261--- ,00.html) 123 b. Centers for Disease Control httos://www.cdc.aov/violencei)revention/intimatelDartnerviolence/index.htmi c. National Domestic Violence Hotline (httDs://www.thehotline.ora/) 7. Mental Health a. Michigan Chapter of Postpartum Support International (htti3s://t)sichai)ters.com/mi/) b. MDHHS (httos://www.michioan.aov/mdhhs/0,5885.7-339- 71550 2941 4868 4899---.00.html) 8. Child Development a. Early On (httos://www,1800earlvon.orq) 9. State Resources a. MI Bridges(https://newmibridges.michiaan.gov) b. MiKidsMatter (httDs://www.michioan.00v/mikidsmatter/) c. 211 (httr)s://www.mi2ll.ora/) 10. Health/Racial Equity Resources a. Racial Equity Impact Assessment httos://www.raceforward.orci/sites/default/files/RacialJusticeimiDactAssessment v 5.pdf b. Centers for Disease Control Guide -Promoting Health Equity A Resource to Help Communities Address Social Determinants of Health httos://www.cdc.aov/nccdr)hD/dch/prop rams/healthvcommunitiesoroaram/tools/pd. f/SDOH-workbook.pdf c. Racial Equity Tools httos://www.racialeau itvtools.ora/resources/evaluate/defininq-the-work 124 12/22/21 MDHHS Children's Special Health Care Services (CSHCS) FY21/22 Percentage of Eligible Enrolled in CSHCS by Local Health Department Jurisdiction Local Health Department Percentage of Medicaid Eligible ALLEGAN 70.48% BARRY-EATON 74.61% BAY 78.97% BENZIE-LEELANAU 68.07% BERRIEN 79.87% BRNCH/HLLSDL/ST.JO 70.75% 1 I CALHOUN 83.70% 1 CENTRAL MICH 82.54% CHIPPEWA 83.86% Detroit 91.30% DELTA-MENOMINEE 87.11% DICKINSON-IRON 86.21% DISTRICT #2 82.07% DISTRICT#4 81.77% DISTRICT# 10 84.28% GENESEE 88.43% GRANDTRAVERSE 68.91%] 74.13% rHURON INGHAM 88.15% IONIA 74.64% JACKSON 78.56% KALAMAZOO 73.28% KENT 78.25% LAPEER 76.97% LENAWEE 79.20% LIVINGSTON 67.13% ] I L.M.A.S. 88.14% rI MACOMB 80.41% 1 I MARQUETTE 80.92% MIDLAND 74.13% MID-MICHIGAN 80.84% MONROE 77.51% I MUSKEGON 85.10% HD NORTHWEST 72.77% OAKLAND 75.69% I OTTAWA 60.77% SAGINAW 83.98% ST. CLAIR 79.43% SANILAC 76.55% SHIAWASSEE 85.73% 1 TUSCOLA 81.67% VANBUREN-CASS 77.15%] I WASHTENAW 80.73% WAYNE 91.30% WESTERN U.P. 84.77% FY 22/23 COMPREHENSIVE AGREEMENT APPLICABLE LAWS, RULES, REGULATIONS, POLICIES, PROCEDURES, AND MANUALS Drogram/Element Laws/Administrative Rules Federal Regulations/Circulars Policies General - (Law)Annual State - 2CFR Part 200 Uniform Administrative Requirements, - Waiver PolicyBCS- AdministrationAppropriation Bills* Cost Principles, and Audit Requirements for Federal 2007* - (Law) Public Health Awards; Final Rule - MDCH Funding Code P.A. 368 of 1978 - 2CFR Part 225 (OMB Circular A-87) (Revised) Cost Allocation Policy* (as amended)* Principles for State, Local and Indian Tribal - Minimum Program - (Law) Single Audit Act- Governments Requirements - Amended*1996 - Federal OMB Circular A-102 (Revised) Implemented Department Policy - (Law) Federal MCH through "Common Rules -Grants Management* 8000* Block Grants-P.L. 97-35 - PHS Grants Management Handbook* - Capital Outlay Prior of 1981 (as Block Grant Regulations (1) Approval Policy -BCS- amended)(1) - 45 CFR Part 96 014* - (Law) Subcontract - 45 CFR Part 74 Administration of Grants (3) or; Requirements, Civil 45 CFR Part 92, Uniform Administrative Rights Laws/Special Requirements for Grants and Cooperative Assurances as specified Agreements to State and Local Governments, as in the agreements* applicable* - (Law) Local Uniform - Federal OMB Circular A-133Audits of States, Local Budgeting Act P.A. 621 Governments and Non -Profit Organizations* of 1978 (as amended)* - Federal OMB Circular A-133 Compliance - (Law) Local Uniform Supplement Accounting Act P.A. 71 of 1919 (as amended)* _ 2 CFR Part 180 Guidelines to Agencies on Government wide Debarment and Suspension - (Law) Section 1352 of _ 45 CFR Part 93 Lobbying* P.L. 101-16t(re: Lobbying) ((��)) - 45 CFR Part 6, Inventions and Patents* - (Law) Management and - 42 CFR Parts 432 and 433 (Title XIX Funded Budget Act* Programs) - (Law) OBRA 89 P.L. - 45 CFR, Part 46, Protection of Human Subjects 101-239(amendmentto - Catalog of Federal Domestic Assistance(CFDA)* Title V)* FOR SUBGRANTEES. - (Law) 1968 P.A. 317 and _ 2 C.F.R. Part 220 (OMB Circular A-21) Cost 1973 P.A. 196 as Principles for Educational Institutions* amended regarding conflict of interest* - 2 CFR Part 215 (OMB Circular A-110) Uniform - (Law)P.L. 103-227 Administrative Requirements for Grants and Other Agreements with Institutions of Higher Education, Part C Environmental Hospitals and Other Non-profit Organizations* Tobacco Smoke* - 2C.F.R. Part 230(OMB Circular A-122)Cost - (Law) PA 533 of 2004 Principles for Non-profit Organizations* - (Rules) 325.13053 - Federal OMB Circular A-133 Audit Requirements for States, Local Governments and Non -Profit Organizations* - Federal OMB Circular A-133 Compliance Supplement - Americans With Disabilities Act of 1990* Procedures - Waiver Procedure BCS-2007.1* - Capital Outlay Prior Approval Procedure BCS-014.1* State/Federal Manuals - (State) Local FMIS Manual* - (State) Treasury LHD Accounting Procedures Manual* - (State) MDCH Reporting Requirements Notebook (H-284)* - (State) Minimum Program Requirements - (Fed) PHS Grants Policy Statement* - (Fed)PHS Grants Administration Manual* - (Fed) HHS Grants Administration Manual* - (State) Annual Budget, FSR & Indirect Instructions* ES PND m040 S StatalFadelatManuate G EpUR uaYlonv eesWeh \�E F pROG �dutes Ev? e{ $e vlc orlon E�\S ES, Pso (dsiot Pan HN?fove and Y 22123 GOMPR�NS pO`\ potiGes QuaitHN,Jpre y�tloni�bsecU nNeeu or Ms- III bo"G3u vZP�evan8on Rv�ES, REC' 2pp3 Hs�ha onlAee 9 y5ti41 OCN CoUdto �se\, 9Quaoe % PsSuMa ch Ppp\,\Gp`8\-E`Pwd �atP.e9uta<wnsiclicutats �av+sl Pdlnuusttativa Rues proBlatYdElemant li-aWl9 as 0 dadsY \Ck%30f H\� prevention as a9 an3t51 31 Secv\ces 0gg4lMGi-As9 of 19g8 . �i'aW'p3 .5t44 f 19 2 \MC�3 g6 0 9 . ltaw�p P ions me Pto9tan'sletemants `aW ale n°t�otedeats. tha rain e\ern sections °f other P�o9 �o9ramsl Ru1e. acifi° pest° oted iundadP isttafive uyt Fotno. o tom �o9e�etaebmPpes<onb�ta45fiesaW,�Rael\Fed1s9"tdeiaFedetatM,an tes ua Pndet ties IRAs, idlstta sl9nd�e to ppan '�yPia\\Y noted and er Gene�ai co u n'. l� s 9nifles a Sta l�l \d�fia\\9 dund Ries„ (Statal \ciitl�Pa��ist�aaJea\S„ co\un'n. StatelFadefa\ M boc HN P 14�aPd R1a5 pid N\v1Pot H{eQSWl`\ PCRsMa p6v\thDePae a\ND$go, no estln9 e\m . 4 C NC ST Guld es.t I to ra f'�nfidentiaUty ovinchh him \ntt Jlv� cdc.ata Sacun m�nieccai�oND Agency Name: Click or tap here to enter text. Fiscal Year: Click or tap hereto enter text. NOTE: Any question answered N/A must have an explanation in the comments column. A.1. Are grant funds only used on allowable activities and ❑ Yes not on items prohibited by the laws, regulations, and ❑ No provisions of each MDHHS contract and program? A. 2. Are staff aware of the applicable cost principles in Title ❑ Yes 2 CFR 200, Subpart E? ❑ No A.3. Are staff aware of unallowable charges (e.g., alcoholic ❑ Yes beverages, bad debts, contingency reserves, ❑ No contributions and donations, fund raising, use allowances, etc.)? A.4. If costs are allocated to multiple funding sources, are ❑ Yes they allocated in accordance with the benefits received ❑ No in accordance with the cost principles and a documented process? A.S. Does the Agency have written accounting policies and ❑ Yes procedures for the receipt and disbursement of funds, ❑ No purchasinq, and pavment of expenses? A.6. Does the Agency have a financial management system ❑ Yes that provides for the identification of all Federal awards ❑ No received and expended, and the Federal programs under which they were received? [Title 2 CFR 200.302(b)(1)1 A.7 Does the financial management system provide a clear ❑ Yes and accurate record of the receipt and disbursement of ❑ No grant funds with a separate revenue and expense accounts for each separate program and agreement? A.8 Is the financial management system capable of tracking ❑ Yes revenues and expenses by the MDHHS grant period ❑ No when it differs from the Agency's fiscal year? A.9 Does the Agency have written procedures for ❑ Yes determining the reasonableness, allocability, and ❑ No allowability of costs in accordance with Title 2 CFR Part 2 and the conditions of the Federal award? [Title 2 CFR 200.302(b)(7)1 A.10 Does the Agency have an effective internal control ❑ Yes system over Federal awards that provides reasonable ❑ No assurance that the Agency manages Federal awards in compliance with Federal statutes, regulations, and the terms and conditions of the Federal awards; and the internal controls are in compliance with guidance issued by the Comptroller General of the United States and the Committee of Sponsoring Organization (COSO) of the Treadway Commission? [Title 2 CFR 200.303(a)l A.11 Does the Agency evaluate and monitor its compliance ❑ Yes with statutes, regulations, and the terms and conditions ❑ No of Federal awards? [Title 2 CFR 200.303(c)] A.12 Does the automated accounting system have controls in ❑ Yes place to limit access to authorized personnel only (e.g., ❑ No access is limited by secure user ID and password, are roles based on least privilege? A.13 Does the Agency maintain a complete set of books that ❑ Yes include a cash receipts journal, a cash disbursements ❑ No journal or transaction/voucher listing, and general ledger? A.14 Does the general ledger include account titles, posting ❑ Yes dates, descriptions of transactions, posting references, ❑ No debit and credit amounts and balances? A.15 Does the Agency have a chart of accounts that is used ❑ Yes by all programs/activities of the Agency? ❑ No A.16 Does the accounting line detail enable reporting ❑ Yes MDHHS grant expenditures comparable to the MDHHS ❑ No grant budget line items? AA7 Do the general ledger revenue and expense accounts ❑ Yes for the MDHHS grants agree with the reports (e.g., ❑ No Financial Status Report or Statement of Expenditures, etc.)? A.18 Does the Agency follow Generally Accepted Accounting ❑ Yes Principles (GAAP) to record financial information? ❑ No AA 9 Is the modified accrual (government) or accrual ❑ Yes (nonprofit) basis if accounting used to record revenues ❑ No and expenses? A.20 Are there clearly defined responsibilities for the ❑ Yes following duties, including consideration for access and ❑ No use within the automated accounting system? Indicate all that apply and identify the position title(s) responsible. a. Reconciliation of bank accounts b. Approving invoices for payment c. Approving time records d. Payroll preparation e. Approving payroll for payment f. Mailing or delivering payroll checks g. Opening mail h. Preparing bank deposit slips i. Making bank deposit j. Posting receipts to the accounting system k. Posting expenses to the accounting system A.21 Is the person that approves invoices for payment (a) ❑ Yes other than someone that requesting payment, and (b) ❑ No knowledgeable about allowable and unallowable costs? A.22 Does that person authorizing invoices for payment ❑ Yes review original invoices and other supporting ❑ No documentation? A.23 Are all expenditure payments supported by ❑ Yes documentation include (a) type of purpose of expense, ❑ No (b) amount, (c) date service was provided, (e) date of invoice, and (f) programs to be charged? A.24 Are original invoices marked paid to prevent a duplicate ❑ Yes payment? ❑ No A.25 Do only persons authorized to prepare or supervise the ❑ Yes preparation of checks has access to blank checks? ❑ No A.26 Are all checks pre -numbered? ❑ Yes ❑ No A.27 Are all voided checks retained? ❑ Yes a. Click or tap here to enter text. b. Click or tap here to enter text. C. Click or tap here to enter text. d. Click or tap here to enter text. e. Click or tap here to enter text. f. Click or tap here to enter text. g. Click or tap here to enter text. h. Click or tap here to enter text. L Clink or tap here to enter text. j. Click or tap here to enter text. k. Click or tap here to enter text. 2 ❑ No A.28 Are all voided checks clearly marked as void? ❑ Yes ❑ No A.29 Do all checks require two signatures? ❑ Yes ❑ No A.30 Are there dollar threshold limitations when checks ❑ Yes require only one signature? ❑ No A.31 Do the Agency's policies and procedures prohibit ❑ Yes signing blank checks? ❑ No A.32 Do the Agency's policies and procedures prohibit ❑ Yes checks to be made out to Cash? ❑ No A.33 Are individuals (a) who sign checks, (b) have ❑ Yes disbursement responsibilities, or (c) receipting ❑ No responsibilities, properly bonded? A.34 Do the Agency's policies and procedures describe when ❑ Yes petty cash may be used, the dollar threshold, and ❑ No documentation required, and a process to account for ❑ N/A the petty cash fund? A.35 Are the accounting records current and balanced ❑ Yes regularly? ❑ No A.36 Are the Agency's bank accounts reconciled on a ❑ Yes monthly basis by someone who does not authorize ❑ No transactions and/or are the reconciliations reviewed by management? AX Is the Agency current with filing payroll, unemployment, ❑ Yes and filings with the Internal Revenue Service? ❑ No A.38 Are the accounting records and confidential client ❑ Yes records adequately protected in accordance with laws ❑ No regarding privacy and confidentiality, and protected from fire and damage? [Title 2 CFR 200.303(e)) A.39 Is source documentation (e.g., vouchers and original ❑ Yes invoices, etc.) readily available to support amounts ❑ No entered into IT systems and charged to MDHHS grants? A.40 When the accrual basis if accounting is used, are all ❑ Yes costs reported to MDHHS actually incurred during the ❑ No funding period and paid within the time period specified (i.e„ reported in the proper grant year)? A.41 Do the record retention policies comply with the contract ❑ Yes provisions and Title 2 CFR 200.334? ❑ No A.42 Does the Agency have back up policies and procedures ❑ Yes to ensure that data can be retrieved in the event of ❑ No system failure? A.43 Does the accounting system have budgetary controls, ❑ Yes by line item and total, to prevent excess expenses from ❑ No being charged to funding sources? A.44 Does the Agency have written policies and procedures ❑ Yes for management and the governing board to document ❑ No its review of a functional budget compared to actual expenses by funding source and program? [Title 2 CFR 200.302(b)(5)] A.45 Does the Agency have policies and procedures for ❑ Yes management and the governing board to follow-up on ❑ No budget variances when they occur? A.46 Does the governing board have an Audit and/or Finance ❑ Yes Committee that convenes and communicates regularly ❑ No with the governing board to assist in understanding and responding to adverse financial developments? Click or tap here to enter text. I A.47 Does the Agency have adequate controls over the ❑ Yes financial management system to ensure complete and ❑ No accurate data processing (e.g., sequence checks, referential integrity checks, control/hash totals, range checks, nun totals, reconciliations, etc.)? AA8 Does the Agency have procedures to identify and ❑ Yes correct processing errors? ❑ No A.49 Does the financial management system produce logs or ❑ Yes audit trails for all user activity, including system ❑ No administrators and transaction processing? A.50 Can users modify the financial management system ❑ Yes logs or audit trails? ❑ No A.51 Are third party contractors used to provide accounting ❑ Yes systems, processing, or functions? ❑ No A.52 Are third party contracts or service level agreements in ❑ Yes place? ❑ No ❑ N/A A.53 Are external audits performed of third party contractors ❑ Yes that provide accounting systems, processing, or ❑ No functions? ❑ N/A A.54 Are SSAE 18 reports of the third party contractors ❑ Yes required and reviewed? ❑ No ❑ N/A A.55 Does the Agency have policies and procedures ❑ Yes regarding updating or changing the automated financial ❑ No management system? A.56 Does the Agency have a formal change management ❑ Yes process in place to ensure data integrity? ❑ No BA Does the Agency have a documented process for ❑ Yes allocating staff time among all programs and activities to ❑ No ensure personnel costs are reported for each beneftting grant? B.2 Are personnel records supported by a system of internal ❑ Yes control which provides reasonable assurance that ❑ No personnel expenses are accurate, allowable, and properly allocated? [Title 2 CFR, 200.430(i)(1)(viii)] B.3 Do personnel expense records reasonably reflect the ❑ Yes TOTAL activity (i.e., time worked and paid time off) for ❑ No which the employee is compensated by the Agency, not exceed 100% of compensated activities? [Title 2 CFR 200.430(i)(1)(iii)l B.4 Do personnel expense records support the distribution ❑ Yes of the employee's salary and wages among specific ❑ No activities or cost objectives if the employee works on more than one Federal award; a Federal award and a non -Federal award; an indirect cost activity and a direct cost activity; two or more indirect cost categories which are allocated using different allocation bases; or an unallowable activity and a direct or indirect cost activity? [Title 2 CFR 200.430(i)(1)(vii)] B.5 If budget estimates (determined before services are ❑ Yes performed) are used for interim accounting purposes for ❑ No allocating and reporting personnel costs, are the ❑ N/A following in place: Click or tap here to enter text. a. A system for establishing the estimates produces reasonable approximations of the activity actually performed? b. Significant changes in the corresponding work activity are identified and entered into the records in a timely manner? c. The system of internal controls includes processes to review after -the -fact activity in comparison to the budget estimates, with adjustments to ensure the final amount charged to the Federal award is accurate, allowable, and properly allocated? [Title 2 CFR 200.430(i)(1)(viii)j B.6 For local governments and Indian Tribes using ❑ Yes substitute processes or systems (other than those ❑ No described in Title 2 CFR 200.430(i)(1) for allocating salaries and wages to Federal awards, such as but not limited to, random moment sampling, rolling time studies, case counts, or other quantifiable measures of work performed, is the substitute system approved by the cognizant agency for indirect costs? [Title 2 CFR 200.430(i)(5)1 B.7 Do the personnel positions charged to the grant ❑ Yes generally conform to the positions in the MDHHS ❑ No budqet? B.8 Are attendance records maintained to monitor leave ❑ Yes usage? ❑ No B.9 Do supervisors approve leave time taken? ❑ Yes ❑ No 8,10 Does the Agency have a written Personnel Policy? ❑ Yes ❑ No B.11 Are fringe benefits, in the form of employer expenses for ❑ Yes employee health, life, unemployment, and workers ❑ No compensation insurance, charged based on actual costs incurred, and supported by invoices? 6,12 Are fringe benefits, in the form of regular compensation ❑ Yes paid to employees during periods of authorized ❑ No absences from the job, and employer contributions for social security, insurance, and pension costs, allocated equitably to all related activities? 6.13 Are fringe benefit costs allocated on a per person basis ❑ Yes based on hours worked in the program? ❑ No ❑ N/A Click or tap here to enter text. BA4 Are total fringe benefit costs allocated based on the ❑ Yes percentage of total salaries and wages attributable to ❑ No the program? ❑ N/A Click or tap here to enter text. B.15 Does the Agency have a documented fringe benefit ❑ Yes policy which includes all fringe benefits? [Title 2 CFR ❑ No 200.430(c ] CA Does the Agency have written travel policies and ❑ Yes procedures defining reasonable limits for hotel and meal ❑ No reimbursements, mileage rates, unallowable costs, and documentation requirements? _ C.2 Is travel charged to MDHHS grants supported by ❑ Yes employee travel vouchers that include the purpose of ❑ No travel, the period covered, destination, departure and arrival times, with appropriate documentation? [Title 2 5 CFR 200.475(b)(1) requires documentation that justifies that participation of the individual is necessary to the Federal award] D.1 Agency Owned Buildings — Is space based on 1 ❑ Yes depreciation plus actual operating and maintenance ❑ No costs with NO use allowance? D.2 Agency Rented Buildings — Is the space cost supported ❑ Yes by a current signed lease agreement? ❑ No D.3 Is space cost allocated to all benefitting programs by ❑ Yes square footage used by each program or another ❑ No consistently applied allocation base? DA Does the Agency have a documented written space ❑ Yes cost policy and procedure? ❑ No m < E.1 Does the Agency have a current executed contract for ❑ Yes each contractor? ❑ No E.2 Do the contracts contain the applicable provisions ❑ Yes described in Title 2 CFR Appendix II? ❑ No E.3 Are contractor charges supported by detailed billings as ❑ Yes to the type and amount of services/goods provided ❑ No rather than only stating For Services Rendered? EA Are contract billings reviewed prior to payment to ❑ Yes ensure consistency with the contract terms and ❑ No objectives? a F.1 Are indirect costs charged to MDHHS programs (e.g., ❑ Yes agency -wide administration, division level ❑ No administration, county/city central services, nursing supervision, general nursing, etc.)? F.2 If charging indirect costs to the MDHHS, is the ❑ Yes methodology being consistently used for all grant ❑ No awards (MDHHS and other funding sources) in accordance with Title 2 CFR Part 200? F.3 Select the indirect methodology used: a. A DeMinimis rate of 10% of modified total direct ❑ costs. b. A Federally approved indirect cost rate ❑ negotiated between the Agency and the Federal government. C. A rate negotiated between MDHHS and the ❑ Agency. d. A rate approved by another Department of the ❑ State of Michigan and accepted via contract by MDHHS. e, Actual indirect costs allocated in accordance ❑ with the Agency's documented cost allocation plan which complies with the provisions of 2 CFR Part 200 (e.g., based on a pro rate share of personnel costs, total direct costs of the benefitting programs, etc.). f. Indirect costs not consistently applied to all ❑ awards and benefitting activities using one methodology. Explain in the comments column. FA Does the Agency comply with the indirect cost rate/cost ❑ Yes allocation plan documentation that provides a fair and ❑ No equitable distribution of indirect costs to aff Agency Click or tap here to enter text. programs and activities that benefit from the indirect expenses in accordance with 2 CFR Part 200 (e.g., based on a pro rate share of personnel costs, total direct costs of the bene_fittinq programs, etc.)? F.5 Does the Agency comply with the indirect cost rate/cost ❑ Yes allocation plan documentation and certification ❑ No requirements in accordance with the appropriate appendix of 2 CFR Part 200? ® Appendix III — Institutions of Higher Education ® Appendix IV — Nonprofit Organizations Appendix V — Local Governments and Indian Tribe - Wide Central Services Cost Allocation Plan Appendix VI — Local Government and Indian Tribe Indirect Cost Proposals F.6 Which of the costs are included in the Agency -wide - administration cost pool and allocated as indirect costs. a. Salaries/Wages/Fringe Benefit of Adm Staff ❑ b, Data Management ❑ c. Space Costs ❑ d. Communication Costs ❑ e. Equipment Depreciation q f. Central Service Cost Allocation Plan (County/City) ❑ g. Other (describe) ❑ Click or tap here to enter text. F.7 Describe the Indirect rate computation and methodology ❑ N/A Click or tap here to enter text. for allocating Agency -wide costs. F.8 Are any other indirect costs (e.g., nursing supervision, ❑ Yes Click or tap here to enter text, general nursing, other) charged to MDHHS grants. If ❑ No yes, please describe the cost and the how they are allocated to the benefitting MDHHS grants and other benefittinq Agency programs and activities. G.1 For programs funded by MDHHS on a reimbursement ❑ Yes basis, are the costs paid for by the Agency before ❑ No reimbursements are requested from MDHHS? ❑ N/A Click or tap here to entef text. G.2 For programs funded by MDHHS on a reimbursement ❑ Yes basis, does the Agency have provisions in place for ❑ No timely submission of requests for reimbursement? ❑ N/A Click or tap here to enter text. G.3 If MDHHS advances funds to the Agency for any ❑ Yes programs, does the Agency have procedures to ensure ❑ No that the time elapsed between the pre -payment ❑ N/A Click or tap here to enter text. (advance) and disbursements are minimized? f2 CFR 200.305(b)I HA !f MDHHS grant funds were used to purchase ❑ Yes equipment, were the items purchased specifically ❑ No approved in the MDHHS original or amended budget? H.2 Are the equipment purchases supported by approved ❑ Yes invoices? ❑ No H.3 Do the Agency's procedures designate the person(s) ❑ Yes Click or tap here to enter text. authorized to approve equipment purchases? ❑ No Identify the position title(s) in the comments column. HA Does the Agency maintain inventory records (for ❑ Yes equipment costing over $5,000), as well as adequate ❑ No safeguards over government -financed property and equipment including an inventory every two years? (2 CFR 200.313(d)(1),(2),(3)) H.5 ' Does the Agency maintain equipment inventory records ❑ Yes that provide the following detail in accordance with 2 ❑ No CFR 200.313(d)(1)(3) requirements? Check all that apply to your Agency. a. Item Description ❑ b. Serial Number ❑ C. Cost ❑ d. Acquisition and Disposal Dates ❑ e. Location/Responsible Program ❑ f. Funding Source ❑ g. Tag Number ❑ H.6 Are MDHHS grant -funded supplies maintained in a ❑ Yes secure location with access limited to applicable ❑ No program staff? H.7 Are there controls in place to prevent unauthorized ❑ Yes consumption of MDHHS grant -funded supplies? ❑ No H.8 Does the Agency maintain a perpetual inventory of ❑ Yes MDHHS grant -funded supplies, and perform periodic ❑ No physical inventories of qrant supplies? H.9 If yes, how often are the physical inventories A Do the Agency's financial report to MDHHS include the ❑ Yes required match? ❑ No ❑ N/A 1.2 Is the reported match from allowable sources and ❑ Yes comply with the requirements specified in 2 CFR ❑ No 200.306(b)? ❑ N/A 1.3 Does the Agency have procedures in place to ensure ❑ Yes required levels of effort are maintained? ❑ No ❑ N/A L4 Were required levels of effort maintained? ❑ Yes If no, explain in the comments column. ❑ No ❑ N/A 1.5 Has the Agency adhered to all earmarks established by ❑ Yes MDHHS grants? (e.g. Women's Specialty Services ❑ No target; maximum amount or percentage for program ❑ N/A development and coordination activities; a minimum amount or percentage for services related to access, in - home services, and legal assistance; etc.) If no, explain in the comments column. J.1 Does the Agency comply with the General Procurement Standards contained in 2 CFR 200.318, which include, but are not limited to the following? a. The non -Federal entity must have and use ❑ Yes documented procurement procedures, ❑ No consistent with State, local, and tribal laws and regulations and the standards of this section, for the acquisition of property or services required under a Federal award or subaward. The non - Federal entity's documented procedures must conform to the procurement standards identified in 2 CFR 200.317 through 200.327. In, Maintaining oversight to ensure that contractors ❑ Yes perform in accordance with the terms, ❑ No Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter' text. I conditions, and specifications of their contracts or purchase orders? C. Maintaining written standards of conduct covering conflicts of interest and governing the performance of its employees engaged in the selection, award and administration of contracts? d. Awarding contracts only to responsible contractors possessing the ability to perform successfully under the terms and conditions of a proposed procurement? e. Maintaining records sufficient to detail the history of procurement including the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price? J.2 Does the Agency conduct all procurement transactions in a manner providing full and open competition consistent with the standards of 2 CFR 200.319? 13 Does the Agency have written procedures for procurement transactions ensuring that all solicitations incorporate a clear and accurate description of the technical requirements for the material, product, or service to be procured; aft requirements which the offerors must fulfill; and all other factors to be used in evaluatinq bids or proposals? f2 CFR 200.319(d)j JA Does the Agency comply with the following allowed methods of procurement and the requirements for each (including establishing appropriate thresholds) as specified in 2 CFR 200.320'? a. Micro -purchases (generally less than or equal to $10,000 without quotes if price is reasonable) b. Small purchase procedures (generally less than $250,000 with quotes from adequate sources) C. Sealed bids d. Competitive proposals e. Non-competitive procurement K.1 Did the Agency verify that subcontractors and subrecipients under covered transactions (procurement contracts for goods and services under a grant or cooperative agreement that are expected to equal or exceed $25,000, and all subawards to subrecipients irrespective of award amount) are not suspended or debarred or otherwise excluded? Note: Verification may be accomplished by checking the System for Award Management for excluded parties maintained by the General Services Administration at www.sam.aov, collecting a certification from the entity, or adding a clause or condition to the covered transaction with that entitv per 2 CFR 180.300. LA Does the Agency have program income (fees and collections)? L.2 Is program income (fees and collections) billed on a sliding fee scale? L.3 Does the fee scale conform to applicable poverty guidelines? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Click or tap here to enter text. Glick or tap here to enter text. If no, proceed to Section M, Reporting. 0 LA Are duplicate receipt slips prepared for every receipt, and a copy given to the client? L.5 Are all receipts recorded promptly and deposited daily or at appropriate intervals? L.B If receipts must be kept overnight, are they adequately safeguarded? L.7 Is all MDHHS grant program income revenue posted to separate program revenue accounts? L.7 Are duplicate deposit slips prepared? L.8 Are deposit slips stamped by the bank or treasurer's office and checked against records of receipt? L.9 Does the Agency use program income for current costs, and deduct program income from total allowable costs to determine the net allowable costs [2 CFR MA Are financial reports (e.g. Financial Status Reports, Statement of Expenditures) submitted timely to MDHHS? M.2 Do financial reports to MDHHS include actual costs, and not budgeted amounts? M.3 Do financial reports to MDHHS include costs in the appropriate line item categories? NA Does the Agency act as a pass -through entity and enter into subaward agreements related to the subawards passed through from MDHHS to the Agency? N.2 Does the Agency identify every subaward to subrecipients as a subaward and include the following required information [2 CFR 200.332(a)(1)1? Check those that the Agency includes in its subaward agreement(s). a. Subrecipient's unique identifier b. Federal award identification number G. Federal award date d. Subaward period of performance start and end dates e. Subaward budget period start and end dates f. Total amount of Federal award g. Federal award project description h. Name of Federal awarding agency, pass - through entity, and contract information for awarding official i. Assistance Listing number and name j. Whether the award is research and development k. Indirect cost rate N.3 Does the Agency communicate all requirements imposed on the subrecipient, including requirements imposed by MDHHS, so that the Federal award is used in accordance with Federal statutes, regulations and the terms and conditions of the Federal award? [2 CFR 200.332(a)(2)) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 0 I ❑ Yes ❑ No If no, proceed to Section O, Policies and Procedures. 10 NA Do the Agency subawards with subrecipients include a ❑ Yes requirement that the subrecipient permit the pass- ❑ No through entity and auditors to have access to the subrecipient's records and financial statements as necessary? f2 CFR 200.332(a)(5)] N.5 Does the Agency evaluate each subrecipient's risk of ❑ Yes noncompliance with Federal statutes, regulations, and ❑ No the terms and conditions of the subaward for purposes of determining the appropriate subrecipient monitoring? t2 CFR 200.332(b)] N.6 Does the Agency monitor the activities of subrecipients ❑ Yes to ensure that the subawards are used for authorized ❑ No purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subawards; and that subaward performance goals are achieved? (2 CFR 200.332(d)] N.7 Does the Agency monitor the subrecipients with on -site ❑ Yes reviews? ❑ No N.8 Does the Agency monitor the subrecipients with a ❑ Yes financial review checklist? ❑ No N.9 Does the Agency monitor the subrecipients with any ❑ Yes other checklists or procedures? ❑ No N.10 Does the Agency review financial and programmatic ❑ Yes reports of the subrecipients? t2 CFR 200.332(d)(1)] ❑ No N.11 Are subrecipient's financial reports or billing reports ❑ Yes reviewed by the Agency for budgetary compliance and ❑ No allowable costs before reimbursinq the subrecipients? N.12 Does the Agency verify that each subrecipient's ❑ Yes financial reports or billings report actual expenses and ❑ No revenues, and not budgeted amounts? N.13 Does the Agency verify that each subrecipient's time ❑ Yes documentation for volunteer services used to match ❑ No requirements. ❑ N/A No volunteer time used for match. NA4 Does the Agency test program income reported by ❑ Yes subrecipients for accuracy and completeness? ❑ No N.15 Does the Agency verify that its subrecipients are ❑ Yes audited as required by Title 2 CFR 200, Subpart F, ❑ No when it is expected that the subrecipient's Federal awards from all funding sources during the subrecipient's fiscal year exceed the $750,000 threshold that requires a Single Audit? (Title 2 CFR, 200.332(d)(2)] N.16 Does the Agency receive and review its subrecipients' ❑ Yes Single Audit reports, if applicablO ❑ No ❑ N/A Subrecipients do not meet the threshold for a single audit. Proceed to Section O, Policies and Procedures. N.17 Does the Agency follow-up to ensure its subrecipients ❑ Yes take timely and appropriate action on all deficiencies ❑ No pertaining to the Federal awards provided by the Agency that are detected through audits, on -site reviews, and receive written confirmation from the subrecipient, highlighting the status of corrective actions to address the deficiencies? t2 CFR 200.332(d)(3)] 11 N.18 Does the Agency issue management decisions ❑ Yes pertaining to the deficiencies provided by the Agency to ❑ No the subrecipient? [2 CFR 200.332(d)(3)] N.19 Does the Agency issue its management decisions within ❑ Yes six months of receiving the subrecipient's audit report? ❑ No 0.1 Does the Agency have a documented Confidentiality ❑ Yes Policy? [Title 2 CFR 200.303(e)] ❑ No 0.2 Does the Agency maintain written standards of conduct ❑ Yes covering conflicts of interest for the action of its ❑ No employees engaged in the selection, award, and administration of contracts if there is a real or apparent conflict of interest? [Title 2 CFR, 200.318(c)(1) and (2)1 6.3 Does the Agency have a written procedure to disclose, ❑ Yes in writing, any potential conflict of interest to MDHHS? ❑ No ITitle 2 CFR 200.1121 0.4. Does the Agency have written procedures for ❑ Yes determining the allowability of costs in accordance with ❑ No Title 2 CFR Subpart E and the terms and conditions of the Federal award? [Title 2 CFR 200.302(b)(7)] 0.5 Does the Agency have written procedures for managing ❑ Yes equipment (including replacement), whether acquired in ❑ No whole or in part under a Federal award, until disposition takes place? [Title 2 CFR 200 313(d)] 0.6 Does the Agency have written policies which include ❑ Yes fringe benefits offered to employees to ensure expenses ❑ No are allowed9 [Title 2 CFR 200.431(a)] 0.7 Does the Agency have a written travel policy that ❑ Yes includes all types of expenses (e.g., lodging, meals, ❑ No mileage, modes of transportation, etc.) that are reimbursable by the Agency when an employee is traveling for the benefit of the Federal program? [Title 2 CFR 200.474(a)] 0.8 Does the Agency have a written Whistleblower policy ❑ Yes and procedure? [41 U.S.C. 47121 ❑ No 0.9 Does the Agency have a written procedure to notify ❑ Yes MDHHS within one business day after discovering any ❑ No unauthorized use or disclosure of confidential information? [MDHHS Agreement, Section Il, P.41 0.10 Does the Agency have a written HIPAA policy and ❑ Yes procedure? [MDHHS Agreement, Section II, M.4] ❑ No ❑ N/A 0.11 Does the Agency have a written policy and procedure to ❑ Yes immediately report breaches of protected health data to ❑ No MDHHS? tMDHHS Agreement, Section II, M.51 ❑ N/A Name and Title of Authorized Representative Click or tap here to enter text. Email Address Click or tap here to enter text. Date Click or tap here to enter text. Signature 12 FOR MDHHS USE ONLY Evaluator Name Click or tap here to enter text. Evaluator Title Click or tap here to enter text. Date Click or tap here to enter text. 13 IN MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES DeMinimis 10% Indirect Rate Calculator Fiscal Year 2023 Grant Agreements NOTE: The Grantee will complete the blue shaded cells. The yellow cells will be automatically calculated. (GRANTEE NAME: GRANT PROGRAM NAME: GRANT PROJECT (if applicable): A. TOTAL BUDGETED PROGRAM EXPENSES 1 Salaries and Wages 2 Fringe Benefits 3 Employee Travel and Training/Conferences 4 Supplies and Materials 5 Subawards/Subrecipient Services 6 Contractual - Professional Services 7 Communications 8 Grantee Rent Expense 9 Space Expenses 10 Capital Expenditures - Equipment and Other 11 Client Assistance - Rent 12 Client Assistance - All Other 13 Other Expenses 14 Volunteer Salaries and Wages 15 Volunteer Fringe Benefits 16 volunteer Travel and Training ITotal Program Expenses B. EXCLUDED EXPENSES IRent Expense Capital Expenditures - Equipment and Facilities Client Assistance -Rent Tuition Remission Scholarships and Fellowships (Participant Support Costs Charges for Patient Care Portion of Subaward in Excess of $25,000 Subrecipient Name 1 1) 1 2) 1 3) C. 4) ' I s) 16) I 7) I 8) 9) 10) I 11) I 12) 13) 1� 14) 1 I 15) 16) I 17) I 18) I 19) 20) 21) 22) 23) 24) 25) ITota Excluded Expenses TOTAL BUDGETED MODIFIED DIRECT COSTS D. CALCULATED BUDGETED DeMINIMIS EXPENSES ATTACHMENT B.4 ,dated March 2022 EXCLUDED EXPENSES (See Definitions Tab) Title 2 CFR 200 states the Modified Total Direct Costs Rental Costs Capital Expenditures Equipment Tuition Remission Scholarships and Fellowships Participant Support Costs Charges for Patient Care Portion of Subaward in Excess of $25,000 (MDTC) excludes: FY 2023 ATTACHMENT B.3 MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES BUREAU OF GRANTS AND PURCHASING EQUIPMENT INVENTORY SCHEDULE Please list equipment items that were purchased during the grant agreement period as specified in the grant agreement budget's cost detail schedule - Attachment B.2. Provide as much information about each piece as possible, including quantity, item name, item specifications: make, model, etc. Equipment is defined to be an article of non -expendable tangible personal property having a useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. Please complete and forward this form to the MDHHS contract manager with the final progress report. Grantee Name: Contract #: Date: Grantee's Signature: Date: DCH-0665 FY2023 ATTACHMENT MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Local Health Department Agreement October 1, 202- September 30, 2023 Fiscal Year 2023 INSTRUCTIONS FOR THE ANNUAL BUDGET INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES TABLE OF CONTENTS Pape I. INTRODUCTION............................................................................................................2 II. MINIMUM BUDGETING REQUIREMENTS................................................................... 2 III. REIMBURSEMENT CHART........................................................................................... 3 IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES.............................................................................................................. 4 V. FORM PREPARATION - GENERAL.............................................................................. 4 VI. FORM PREPARATION - EXPENDITURE CATEGORIES ............................................. 4 VII. FORM PREPARATION - SOURCE OF FUNDS............................................................. 7 VIII. SPECIAL BUDGET INSTRUCTIONS A. Public Health Emergency Preparedness(PHEP).................................................. 10 B. WIC........................................................................................................................ 10 C. Family Planning..................................................................................................... 12 D. Breast and Cervical Cancer.................................................................................. 13 E. CSHCS Outreach and Advocacy........................................................................... 15 F. Program Budget Detail- Cost Detail Schedule Preparation .................................... 16 G. Medicaid Outreach Activities Reimbursement Procedures .................................... 21 I. Immunization 317 and VFC Allowable Expenditures ............................................. 26 1 ANNUAL BUDGET FOR LOCAL HEALTH SERVICES TFUMSTDITIGIM The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs' funding and Essential Local Public Health Services (ELPHS) (formerly known as the local public health operation's funding) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. MINIMUM BUDGETING REQUIREMENTS A. Cost Principles - Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. B. Federal Block Grant Funds - Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (other than minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. C. Expenditure and Funding 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 Budget Requirements for Certain Categorical Proqram Elements - The Annual Budget for Local Health Services is completed in the MI E-Grants System through the application budget to include details for all program elements (excluding Administration and Grantee Support). E. Local MCH - Local MCH funds can be used to support the health of women, children, and families in communities across Michigan. Funding addresses one or more Title V Maternal and Child Health Block Grant national and state priority areas and/or a local MCH priority need identified through a needs assessment process. Priority areas are developed into Local MCH Work Plans which are described in the Annual Local MCH Plan. These funds are to be budgeted as a funding source in two project categories. The Local MCH projects need to be budgeted separately. Please note only two LMCH project titles can be used: MCH — Children MCH —All Other These funding sources cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of expenditures, and evidence is provided that the expenditures satisfy all funding requirements. Local health departments are encouraged to select only one to two performance measures and delve deeper into the strategies in an effort to "move the needle." III. REIMBURSEMENT CHART A. Proqram 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. Tvne of Proiect The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Research and development (R&D) means all research activities, both basic and applied, and all development activities that are performed by non -Federal entities. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. C. Reimbursement Chart The Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures for each program/element having a performance reimbursement option. In addition, the chart also provides the subrecipient, contractor, or recipient designations, as in prior years: IV. LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION_ PROCEDURES As in past years, no additional accounting system detail is being required beyond local uniform accounting procedures prescribed by the Michigan Department of Treasury, Local Financial Management System requirements, documentation requirements of categorical program funding sources and any local requirements. Some agencies may already have separate cost centers in their accounting system to directly identify costs and related funding of required services, but such breakdowns are not essential to being able to meet minimum reporting requirements if proper allocation procedures are used and adequate documentation is maintained. All allocations must have clearly measurable bases that directly apply to the amounts being allocated, must be documented with work papers that will provide an adequate audit trail and must result in a representative reporting of costs and funding for affected programs. More specific guidance can be found in Title 2 CFR, Part 200 Appendix V State/Local Government and Indian Tribe -Wide Central Service Cost Allocation Plans and the brochure published by the Department of Health and Human Services entitled "A Guide for State, Local and Indian Tribal Governments: Cost Principles and Procedures for Developing Cost Allocation Plans and Indirect Cost Rates for Agreements with the Federal Government. V. FORM PREPARATION - GENERAL The MI E-Grants System on-line application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Grantee. The system is designed to accommodate any number of local program elements including those unique to a particular local Grantee. Applications, including budgetforms, 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. Budqeted expenditures are to be entered for each program element, project or group of services by applicable major category. A. Salaries and Waqes- 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. Fringe 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 Exp for Equip & 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/Subrecipient) - 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 5 budgeting indirect costs: 1. Local Health Departments receiving more than $35 million in direct Federal awards are required to have an approved indirect cost rate from a Federal Cognizant Agency. If your Local Health Department has received an approved indirect rate from a Federal Cognizant agency, attach the Federal approval letter to your MI E-Grants Grantee Profile. 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 Ml E-Grants Grantee Profile. 4. Local Health Departments with cost allocation plans should reflect these allocations in the Other Cost Distributions budget category. See Section M. Other Cost Distribution for budgeting guidance. 5. As a Subrecipient of federal funds from MDHHS, a Local Health Department that has never received a negotiated indirect cost rate, your Local Health Department may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) based on Title 2 CFR part 200 requirements. MTDC includes all direct salaries and wages, fringe benefits, supplies and materials, travel, services, and contractual expenses up to the first $25,000 of each contract. MTDC excludes all equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs, and portions subcontractual/subaward expenses in excess of $25,000 per contract. Attach a current copy of the letter stating the applicable indirect costs rate or calculation information justifying the de minimis rate calculation to you MI E-Grants Grantee profile. Detail on how the indirect costs was calculated must be shown on the Budaet Detail Schedule. The amount of Indirect Cost should be allocated to all appropriate program elements with the total equivalent amount reflected as a credit or minus in the Administration projects. M. Other Cost Distributions — Use to distribute various contributing activity costs to appropriate program areas based upon activity counts, time study supporting data or other reasonable and equitable means. An example of Other Cost Distributions is nursing supervision. The distribution process permits costs reflected in a single program element to be subsequently distributed, perhaps only in part, to other programs or projects as appropriate. If an allocation is made, the charges must be reflected in the appropriate program element and the offsetting credit reflected in the program element being distributed. There must be a documented, well-defined rationale and 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 6 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. Vll. 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 1st & 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. iii. Any Other Collections B. Fees & Collections - 3rd Party — 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 Fundinq (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 V Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) H. Local Non-ELPHS - Local funds budgeted for the following expenditures: 1. Expenditures for services not designated as required and allowable for ELPHS funding (e.g., medical examiner and inpatient maternity services); expenditures determined not to 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 forthe 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. n 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 Hearinq — 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 must equal the ELPHS Food allocation. P. ELPHS — Drinking Water - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS Drinking Water program and must equal the ELPHS Drinking Water allocation. Q. ELPHS — On -site Sewaqe - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS On -site Sewage program and must equal the ELPHS On -site Sewage allocation. R. MCH Fundinq -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. E •61 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 Fundinc Contractor Public Health Emergency U.S. Department of Health & Human Services, Centers for Disease Control Preparedness WIC U.S. Department of Agriculture, Food & Nutrition Service Family Planning U.S. Department of Health & Human Services, Public Health Service Breast and Cervical Cancer U.S. Department of Health & Human Services, Centers for Disease Control CSHCS Outreach & Advocacy Michigan Department of Health & Human Services Medicaid Outreach Activities Centers for Medicare and Medicaid Services 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 Emerciencv Preparedness (PHEP) Special Budqet Requirements Local Health Departments will receive the initial FY 22/23 allocation of the CDC Public Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period October 1, 2022 through June 30, 2023. LHDs must submit a nine -month budget and a quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE Local Health Department program elements: 1. Public Health Emergency Preparedness (PHEP) (October 1 —June 30) 2. Public Health Emergency Preparedness (PHEP)— Cities of Readiness (October 1 — June 30) 3. Laboratory Services - Bioterrorism (October 1 — September 30) B. WIC Special Budqet Requirements Cost/Funding Cateqories - The following local budget breakdowns are required to fulfill WIC grant application budget requirements each fiscal year: Salaries & Fringe Benefits Automated Management Systems Space Utilization Costs Equipment 10 Supplies Communications & Travel All Other Direct Costs Indirect Costs All Funding Sources by Type The WIC cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget form in the MI E-Grants System. General instructions for these forms are contained at the end of this section. Agencies receiving WIC -USDA Infrastructure grants must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. Agencies receiving WIC -USDA Breastfeeding Peer Counselor funds must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. And comply with special reporting requirements. 2. Costs Allowable Only With Prior Approval -The following costs are allowable only with prior review/approval of the Michigan Department of Health & Human Services as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR Part 246, and USDA -WIC Administrative Cost Handbook 3/86). Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Automated Information Svstems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental -purchase agreement or other method of acquisition. B. Capital Expenditures of $2,500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C. 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. Accountinq and Auditino Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1. Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Grantee level. F. Traininq 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. Buildinq Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. 11 H. Non -Fringe Insurance and Indemnification Costs. All charges to WIC must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. C. Family Planninq Special Budget Requirements, Cost/Funding Categories - The following local budget breakdowns are required to fulfill Family Planning grant application budget requirements each fiscal year: Salaries & Wages Fringe Benefits Travel Equipment Supplies Contractual Construction All Other Direct Costs Indirect Costs All Funding Sources by Type The Family Planning cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget in the MI E-Grants System. General instructions for these forms are contained at the end of this section. Costs Allowable Only With Prior Approval -The following costs are allowable only with prior review/approval of MDHHS. Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Alterations and Renovations - to change the interior arrangements or other physical characteristics of existing facilities or installed equipment, to the extent that such changes cost more than $1,000 each. B. Audiovisual Materials and Activities - acquired, produced, presented, or disseminated to the general public. C. Consultant Contracts for General Support Services - including equipment and supplies, that will cost in excess of $25,000 or 10% of the total direct cost budget (whichever is greater). D. Equipment - including general purpose and special equipment (e.g., air conditioning) costing $5,000 or more per unit. E. Insurance - contributions to a reserve for a self-insurance program. F. Public Information Service Costs — for the cost of providing public information services. G. Publication and Printing Costs - for the cost of publications. H. Capital Expenditures - for land or buildings. Indemnification Aqainst Third Parties Costs - insurance against potential liabilities. Mass Severance Pav - involving grant -supported personnel. 12 K. Organization/Reorganization Costs - allocable to the program. L. Overtime Premium - involving grant -supported personnel. M. Patient Care Costs — re -budgeting out of or reduction in patient care costs (considered a change in scope). N. Professional Services - in connection with Patent/Copyright Infringement Litigation. O. Trailers or Modular Units — for costs of trailers and modular units. P. Transfers Between Construction and Non -construction, - for approved construction funds. Q. Transfers Between Indirect and Direct Costs - for amounts awarded for indirect costs to absorb increases in direct costs. R. Transfers for Substantive Proarammatic Work -to a third party, by contracting, or any other means used for the actual performance of substantive programmatic work. All charges to Family Planning must be necessary, reasonable, allowable, and allocable, for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule and 2 CFR, Part 215 (OMB Circular A-110) D. Breast and Cervical Cancer Control Coordination Program Special Budaet Requirements The Breast and Cervical Cancer Control Navigation Program (BC3NP) budget is to be developed based on specific responsibilities of Local Health Departments (LHDs) participating in the Breast and Cervical Cancer Control Navigation Program. LHDs agreeing to participate in the program fall into two categories: LHDs agreeing to participate as Local Coordinating Agencies (LCAs) and LHDs agreeing to participate as Local Community Partners (LCPs). LHDs agreeing to participate as Local Coordinating Agencies (LCAs) — LCAs are responsible in assuring implementation of all program requirements and policies and procedures. This includes client outreach and recruitment into BC3NP to achieve yearly targeted caseload allocations, financial monitoring of program expenses and claims for provision of client clinical services, obtaining results of client services and entry of client data into the program's secure statewide database to monitor timeliness and completeness of care delivery and authorize payment for services, and assuring appropriate providers are contracted with the program to provide screening and diagnostic services to enrolled clients. Only coordination expenses will be reimbursed through the Comprehensive Agreement. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCA and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing clinical services claims to the MDHHS Cancer Prevention and Control Section. The Coordination amount 13 of $205-$210 per woman is based on achievement of a target caseload established for each LCA by MDHHS. Requirements. Each LCAs target caseload is evaluated yearly based on the BC3NP Tiered Program Performance requirements. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. b. LHDs agreeing to participate as Community Partners (LCPs) — LCPs are responsible for implementing strategies to identify and recruit clients eligible for the BC3NP, enroll clients into the program, and arrange for provision of screening and diagnostic clinical services through contracted providers. LCPs will obtain results of all clinical services provided to BC3NP clients and send this information to MDHHS for data entry into the secure program's statewide database. Information entered into the database will be reviewed by MDHHS staff to evaluate timeliness and completeness of care delivery and authorize payment for services. MDHHS staff will oversee financial monitoring of program expenses and claims for provision of client clinical services. LCPs will be awarded a base award (to be determined yearly by MDHHS) that is to be used to implement strategies to recruit a minimum target caseload of BC3NP women established for these agencies by MDHHS. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCP and/or direct service providers with contracts or letters of agreement with the LCP will be responsible for billing clinical service claims to the MDHHS Cancer Prevention and Control Section. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. For specific billing requirements refer to the most recent BC3NP Participation Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates refer to the current fiscal year Unit Cost Reimbursement Rate Schedule for the BC3NP issued in August of each fiscal year. The above referenced documents are available at https://michigan.gov/BC3NP E. The Well -Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) budget is to be developed in the following way: 1. WISEWOMAN Coordination and Screening should be used to budget costs associated with coordination of the program and delivery of the initial screening and risk reduction counseling to WISEWOMAN participants. This includes collecting answers to health intake questions, WISEWOMAN screening services (height, weight, body mass index, 2 blood pressure readings, total cholesterol, HDL cholesterol, and fasting glucose or Al C), and delivery of risk reduction counseling. 2. All Direct Service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreements with the LCA will be responsible for billing Direct Service claims to the MDHHS Cancer Prevention and 14 Control Section. This includes follow-up fasting lipid panel, fasting glucose, Al c, and one diagnostic exam. No Direct Services expenses will be reimbursed through the Comprehensive Agreement. The Coordination and Screening amount is $150 per woman based on a target caseload established by MDHHS. 3. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 95% caseload performance requirement for this project. For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and other Program instructions for the WISEWOMAN Program issued in August of each fiscal year. The above referenced documents are available at www.michiaan.00v/ wisewoman. F. Children's Special Health Care Services (CSHCSI Outreach and Advocacv - The program element, titled CSHCS Outreach and Advocacy should be used to budget costs associated with this program. I. Proqram Budqet - Online Detail Budget Application Entry Complete the appropriate budget forms contained within the MI E-Grants System for each program element. An example of this form is attached (see Attachment l for reference). 1. Salary and Waqes - a. Position Description - 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 Required - Enter the number of positions required for the program corresponding to the specific position title or description. This entry may be expressed as a decimal (e.g., Full -Time Equivalent — FTE) when necessary. If other than a full-time position is budgeted, it is necessary to have a basis in terms of time reports to support time charged to the program. c. Amount —The MI E-Grants System calculates the salary for the position required and records it on the Budget Detail. Enter this amount in the Amount column. d. Total Salary —The MI E-Grants System totals the amount of all positions required and records it on the Budget Summary. e. Notes - Enter any explanatory information that is necessary for the position description. Include an explanation of the computation of Total Salary in those instances when the computation is not straightforward (i.e., if the employee is limited term and/or does not receive fringe benefits). 2. Fringe Benefits — Select from the expenditure row look -up applicable fringe benefits for staff working in this program. Enter the percentage for each. The MI E-Grants 15 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. Equipment - 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, G. Program Budget -Cost Detail Schedule Preparation B1 Attachment 131-Program Budqet Summary �Agenry ABC Health Department Program Comprehensive Agreement -FY 20V ADg&apgn: FamAJ Planning Semces SAMPLE .hnw Domments Facesheel C.M.n na i 9mlyei Mlatelianewv hnd.� k Clvse 16 B'mD't Summary 1 MRECTEX FHSES Program EXpebses Salary &'Nage, 82,41900 83,419001 0.0011 i a00] 19 Fnngt Benefits 34,20200 2420200 Goal 000: [3 Cap Eap Por E9w,8Fc Contractual I _ . Su ies and Matenal PG' _ _ „ 23,27500, 23,2I°001 ', � � _ _ 000, _ 000 Travel 3340 Do,! 3,340 DW _00U+ ODo! rcmmumcatfon 7,26200!1 7,262-001i 0001 000� CoenlyLrty Central Services Space Costs ''_ 10,1310ll i 10,131 G0, 000 aDo All Others(ADP, Can Employees. MGl,l 3,894001 389400 DOD aDO Total Pro9am Expenses 16552300 1 165,523 oo; 000 000 _ TOTAL URDU EXPENSES , 165,52300 � 155,523001 1 0Do 000 INt31RECT EXPENSES 1 la�fittttC95t9 ,chrcd Coats 29,405.60 __29,40500 000 000 Ob+=r Costs D,,toboions 1,685 Go 1,68500, _ 000E 000 Tots)lnca cl Costs 31,09000 31,090001 000 00P TOTAL INDIRECT EXPENSES 31,090001 31,09000i b90 090 TOTAL EXPENOQURES 196.013 GD', 196,61300; aGo 000 17 Source of Funds Fawshcet Certficnhons Budget I Manllrbnews i index r® d ValiAata OPPDF Copy Saurceot Funds TOTALEXPERMURES t96,01300: Soured of FueMs ' Fees and Collections- tstaOd2rd Par/ X Fees and CDlleNOna-Did Party Federal or State elon MDCH) > Federal Cost Based Relmhursement ' Federally Pmdtled Vamnes Federal Mad ... d Outreach Required Match -Local Local Non-ELPHS Local llcn-ELPHS Other NOa£LPH9 MDCH Non Comprehendee X IdDCH C omprehenarre ELPHS—MDCH Heanng ELPHS—MDCH VISIde " ELPHS—MDCH Other ELPHS—FUod ELPHS— Daildrig Water .ELPHS—no-one So Nage '61CH Funding X Local Funds -Other Intact Match MUCH Fixed Unit Rate Comprehended Agreement- FY 2M n Cinxe, � SM1ow free (�; :) a DO' 196,613.00'I 0,00 DOD _ 000 -----0.0oi 0 0110 — 66,0000U� - -- -0.0o', _ 66,000001 ' coo ---- - 000�� - - 000 L] 000 19,000001 DOD 1900p 00' 0 � 0 00 DOD Gm DOD 000 oDo boa a00', 0 I o as a 00„ 000 o.00 aDo 0,00 -- -ooe - 000, _ 600 000 1, 000 -----Doe 000 000 0.001 ___ a.bo, � Doc _ 0 00 0.00 aDo C3 - 56,01300 0001 000; 66.913.00' 0 a 001 aDo 6001 DOD 0 Ob' a0a. OOD� 0001 000 Doe ---- o-ob -; 000 000I 000 0 000 000 000; 000' 00u, 0.00 000. _ 000' [A 00a1 000 000, 0Do1 Do'I 44,90006 Dan 44,80000 0.00 o.00 . _ _ D00�,� and: ! 0 D oo;j one _ 000,! 000 18 B2 Attachment B2-Program Budget Cost Detail Agency ABG Health Depannre0t Pmgram COn1P.ehensl'd4 agreement -FY 20M Application Family Planning 2eroces SAMPLE F.Iihnit Cenlptanona findget lAtamll.mgrS I Index ®save ®Saver F3 Validate u;�pDF �Copg Budget Detag Category Pmgram Emenses-Salap'8_Wages - Tempe EzpendAure Classificailon Beq.. 1 - Sub TrFe Dlred Instructions- ;;mledaiilnuloadeuoptmn Bannry Neguanfry as FTEs IaenM1fy the rate as avereg: cast per FlE Shi 0 %Close 1 Y: 5hv.r hea C, lJ -- NPrrative; 0 % 1Juren PradNoner - - rl O1g91000000-FTE Ff 11,T90 OW 17,290 D0 000 OUO �J El%;Public Health Hurse_ '�❑, p40 ?4932430IFLE ,❑, 16 069 00 �. 16,064 DD', 0.00 BOB ,.1 ❑ %LCoordmator _ �B 0.41�_ 51036660 FTE �'I_'I 20,92500 20.92500 _ _ 000 _ 000 �1 � ❑>"�lerP - 'El, 1,04 25729240'FTE '� 29,135,00- 29,6500 - 060 - 000 L-1 e sa.e B.sa.e< ©v�l,aate � -fie puF [ �„pr r sha>r i�� (!T t Budget Detail Category Pmgram ExpensEs- Cap Evp for EgmpdFac Type Expenditure ClassNcabon Seq.: 1 Suh Typa. Dved IJMabre' 0 I nstNtllans. �E9ulonlenl hazGnedaslre cae(ofssmgk Hem �eWe]etS`.,nAO ar more anaHMeuSeful lde s(rcmre tAen ore year Cpsts tnoep hcLde toe cery end apy applirabk expanaet such av lnabllelwn cods. memtensn¢e ieea, ale ttemscosM1nB kaa:M1ert$�o]0shvub be+ -Dusted mlo lbe suppleae�M rtwte(mis 0're, El ®sii 0001 v_e_a, LE vaDdate liHt_-_�+ POF [{j cupY �r5fwn tree Budget Detali Category I Provram0 ensos- _ p - Conlradual Ape Expenditure _ _ C8,541mbon Seq 1 Suh TIpe Dlrad IJarrabee JI nslmeGnnS]ConLndual2tem to secontlery reuF+'rtl orgemvhans pnl�Flease enleahe maletllniormafron �Cennuieu(a aw suosotlmg szrvire subcsntreo4 aOouM ee bulgekd ender Me ofber exP'nse tree LJ E sate Bsame� L�vahaa mJ i0 POF ISO eopr Budget Satan i Categoy Program Erpens.e- Supplles..0 Mahm.a Claaant.tlim Seg I LeJal C-Llnallem CCategory 'InstNRlons ',Xzms lFefow_t waSmer. s5,poo I PT Type: ExpennMre -- ---- - SubType: Diced Namum: ❑ k IPnnGng INSD 0 iGOO6- 0,00 BOB G.7 Elk Pgsla9e - - � - - -- ['^] - 900 00 000OD0 ®5 BSaree [� Va idah: PDE Lj Copy J: Show Tree' 00 Budget Daunt Categoy Pmgram &pensEs-Traoel - Jpe Expenddura ClasslUcum, Seq J LevelLt.. llem f}C.Punw Sub Type: Dlmd NanaUve Instructions ❑ T'bhleage _ _ --'� :,OD0,00� 3p0000;' - --000 000 ElY;Conte..Doer --_- - 0,00 19 0 sore 03 of 2Yalldate �'_ -1 Ivor- t copy Budget Detad Calegoh Program 6pense5-Communieabon C{a391finetmn SPq 1 Lo,ol L:IJne lem �l Gahgol� j tnsfiuc40ns ,pe Expeadtlul, Sub Type Died Narrative' G9 ❑ T CIDer _ -- -- -- - - - - - - ❑ 7,26200 7,26200' D.Oo D00 rA phones and FT lines_ e Save 18Saveo I[$Valmll IF jPPOF lice" Show Tree 61}(v) Budget Dead Category' Program Expenses-CounhLlp CenVal Services_ ,pe Expenditure Classl0catiDn Seq 1 Level C, Upe Item L'Coupon, Sub Type Dlred - Narra➢ve e Sala nsa•ax r Validat I:"PDFCOYyj Budget Called Category Program Expenses -Space Costs Clasupcaflon Bee 1 Level GLmellem {)Cnlegbry In bacu.ns' ❑ % Rant- ❑ X Cb1er- U91111es ',� nie ��,�� � � l e sai B Seve-0 Yolidt . �'i POP Q_j Copy Budget Delon Category. _Program Expenses-nl{ONen, Y Dp. Con Employees. M16sc Classlflallon seq. t Lavel. ';.+7, Llne Item CJ Category JnelNdfans 1. r ❑ Y Suppauing Services _ ❑ Y '.Lab Fees n X 'rimer e sa.a e6a.eC UV,lidee. L'-JJWPDF PylCPPY Budget Deta Category: Indued Coam Indned Costs Gaesl6ca➢on Soot 3 Instrud.mi Type: 'Bxpeapill re Sub TypeOimd ICJ 6,9230n, 6,923 Q 2.60909 2,600 Type EmendOme Sub Type' Dined f; Sir.. Tree Plnr.tbe. 000 0Do @5 Coo 0un shiny Tree Narrative 0 B 2.279 DO 2,2]90P 000 DOD C) .Q 30o Do'I m m D 00- DOD P,l bd znn nn' inn nn nnn. nnn Pl k show Tree Tlpe E+pentllWre x Sub Type: ,Intlrzed Narrabve' � All ❑ X,Rscal Voar Rale E];,250o0'1II5210 29,405.00 294i O• L ""` e5avoo L7 Validate,P�PDFI �j Copy Budget Mall _ �Calegory. Indued Costs- ONer Costs OlsfnbuAons Ape [Expenditure Classificabon Seq. 3- Sol detract I X Gursmaktlm ❑ _ Olslnbuhan IQ 166590' 1,6El 18-1 D.00 Ooo F7 snPyr r.aa r) C) Ninny e 20 H. Medicaid Outreach Activities Reimbursement Procedures Medicaid Outreach Activities that are funded by local dollars and meet federal requirements are eligible for reimbursement at a 50% federal administrative match rate. Local Health Departments must maintain proper documentation of the activities performed and those activities must conform with the activities outlined in MSA Bulletin 05-29. Medicaid Outreach Activities funding is a subrecipient relationship. Budget Preparation A. Medicaid Outreach Activities Complete the MI E-Grants application and budget forms for the application Medicaid Outreach Activities that occur during the fiscal year: 10/1/xx-09/30/xx. Reimbursable activities included in the budget must conform to the requirements as specified in the MSA Bulletin 05-29. Complete the MI E-Grants application and budget forms for this program. 1. Expenditure Category Tab Enter the expenditures budgeted for the fiscal year: 10/01/xx-09/30/xx. Expenses budgeted for each of the listed expenditure categories are allowable and must be specific to the Medicaid program as described in MSA Bulletin 05-29. Outreach activities must not be part of direct service. Expenditures must be reflected in the cost allocation plan. 2. Source of Funds Tab Budget the amount expected from the federal government for allowable Medicaid Outreach Activities. Federal Medicaid Outreach represents the anticipated 50% federal administrative match of local contributions. Budget the local contribution. Required Match - Local represents the 50% matching local contribution for Medicaid Outreach activities. These two amounts must match. 3. Sources of Local Funds Tvpes Local Health Departments may utilize their county appropriation, any earned income, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the Health Department as a source for matching funds. Other state and/or federal grant awards for Medicaid Outreach must be recorded on the appropriate line as indicated in the Comprehensive Budget Instructions -Attachment I. B. Nurse -Family Partnership Outreach (applicable only for Berrien, Calhoun, Ingham, Kalamazoo, Kent, Oakland, and Saginaw) Complete the MI E-Grants application and budget forms for the application titled Nurse -Family Partnership Medicaid Outreach for the timeframe: 10/01/xx-09/30/xx. Complete the MI E- Grants application and budget forms for this program. 21 Expenditures related to Nurse -Family Partnership Medicaid Outreach should be reflected under one program element and adhere to Section VIII, Special Budget Instructions section found in the Comprehensive Budget Instructions - Attachment 1. The budget should reflect the entire fiscal year period: 10/1/xx-09/30/xx. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD Nurse -Family Partnership program has been applied. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Reauired Match - Local Represents the 50% match of local contributions. Budget the local match contribution in Required Match — Local. Federal Medicaid Outreach and Required Match — Local must equal each other. Additional local contribution related to service provision for non - Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds — Other. 3. Sources of Local Fund Tvoes 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. C. CSHCS Medicaid Outreach Complete the MI E-Grants application and budget forms for the application titled CSHCS Medicaid Outreach for the timeframe: 10/01/xx-09/30/xx. Expenditures related to CSHCS Medicaid Outreach should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1 /xx-09/30/xx. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD CSHCS program has been applied. A table containing each health jurisdiction Medicaid Participation Rate is located in the MI E-Grants site. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Required Match - Local 22 Represents the 50% match of local contributions. Budget the local match contribution. Federal Medicaid Outreach and Required Match — Local must equal each other. Additional local contribution that is not eligible for the 50% federal match should be reported on the Local Funds — Other line. 3. Sources of Local Fund Types Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non-state/non- federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the health department as a source for matching funds to be used at the discretion of the health department as a source for matching funds. 4. Comprehensive CSHCS Outreach and Advocacv and Case Management/Care Coordination Funds Should be reported in a separate program element. D. Indirect Costs There are three (3) options for indirect costs. They are: 1. an approved federal or state indirect rate; 2. a 10% de minimis rate; or 3. a cost allocation/distribution plan Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go to VI. Form Preparation, L. Indirect Cost, on page 5 of this document. E. Cost Allocation Certification The Cost Allocation Certification remains on file with the Department until there is a change in the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS- Medicaid-Outreach), the local health department must: 1) submit a copy of the revised cost allocation plan with the budget request; and 2) complete a revised cost allocation methodology certification. Both documents are to be attached to a Detailed Budget line in EGrAMS. 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. Federal Medicaid Outreach Should be used to request the 50% federal administrative match for Medicaid Outreach. 23 2. Required Match - Local Should be used to report the local match for Medicaid Outreach. Both the federal and local amounts must match. Source of Funds Category Other source of funds that are non -reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds — Other). Total Source of Funds must equal Total Expenditures. B. Nurse -Family Partnership Medicaid Outreach — Quarterly and Final FSRs For Quarters 1-3, LHDs must reflect the actual Medicaid Outreach expenses incurred in a separate program element titled Medicaid Outreach. Actual expenses incurred for each of the listed expenditure categories are allowable but must be specific to Medicaid Outreach as defined by MSA Bulletin 05-29 and not part of a direct service. Expenses should be supported by a time study or other federally approved methodology. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Both lines should equal. Additional local contribution related to service provision for non -Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Cateqory Other source of funds that are non -reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds — Other). C. CSHCS Medicaid Outreach — Final FSR CSHCS Medicaid Outreach billing may occur before the final FSR through the MI E-Grants system after Comprehensive Agreement CSHCS Outreach and Advocacy funds have been 24 fully expended. Local contributions eligible for the Medicaid Outreach match should be cost distributed to the CSHCS Medicaid Outreach program element from the CSHCS Outreach and Advocacy program element and reported as indicated below. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Reouired Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Additional local contribution that is not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds 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 appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I. 4. Comprehensive CSHCS Outreach and Advocacv and Care Coordination Should be billed as separate program element. Ill. 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. Note: CSHCS Outreach and Advocacy and CSHCS Care Coordination activities funded through the Comprehensive Agreement are recorded as separate program element. 25 Object Class Cateprglftpenses VFC-only site visits ,FIX -only site visit, Combined (AFIX &. VFC site visits) Perinatal hospital record reviews Equipment* Fax machines for vaccine ordering Vaccine storage equipment for WC vaccine Copy machines 4Egrup ent_ an articles oftangiNe nonexpenrtable Personal property having acquisitfan cost raf $5,000 or rmxre per unit. If Bost is below this threshold amount, item mom, he mciudet7 in supplies. Supplies Vaccine administration supplies (including, but not limitedtn, nasal pharyngeal swabs, syringes for emergency vaccination clinics) Dffce supplies -computers, general office (pans, paper, paper clip& etc.). ink cartridges, calculators Personal computers I Laptops i Tables Pink Books, Red Books, Yellow Books Printers 'Allowable Allowable iAlowwable. Allowable :-Allowable i Allowablewitlt Allowable with 317 with"VFC with ' W with with Pan ; VIiC Distribution : with PPEF operations operatlon ordering VFC/AMX Flu funds j' foods fund funds '.: s funds funds funds J (where appitcIWO) ✓ ✓ w ✓ v'� '%' (fur w`7Yr.`Futir;n {�silRyj d J ✓ i i i i ✓ V, a ✓ ✓ i I ✓ ✓ ✓ ✓ ✓ V ✓ 910016 Section I —The Basics p.22 IPOM 2017 Object Class Categoriyxpenses - Allowable Allowable Allowable Allowable Allowable A,llowablo with Allowable . with 3l' with Y C with VFC v�h with Pan VFC Aisteihution with P'FIF operations operation' ordering .NB�YAFi7i, PTn funds . funds iuitds ', [nods` sfunds .',fuutls', im&i (whareap�licnbt}.. Laboratory supplies (influenza cultures and PC12s, cultures and molecular, lab Y` media seMq-Ping) -_ Digital data iogger With valid certificate � f 4'f C2lJbrat3©n/vSl IdtitttU'te3ting report Vaccine1, s tti ties (stars e V s T11 6 pF g eontafiicrs, ice packs, bubbic Wrap, etc,) Contractual State/total corderencts cxpcoscs (conference site, materials printing, hotel accommodations expeenscs, spcaicer fees) Food cost is no? a lowable. RegionallLocal meetings Generat contractual smriccs (e o.. IAN local health departments, contractual staff, advisory committee media, provider trainings) GSA Contractual services (CDC j managed) — Other US contractual agreements (support enbancern-M upgrades) j Financial Assistanee (Ft J 'pion -CDC Contract vacchies ;17 vaccine funds musty mqucstcd in funding aumliraaon (eG[ATTS ) w&r 317 FA vaccines V d ✓ Y ✓ ( ✓ ✓ ✓ i k _ C � I /fY�-PFfQ7R� P•raiLlc(�J 4.1612016 Section I —Tire Basics p.2:; N IP[)M 2017 J N` Object Class C:ategoq/F penses , Allowable. 'Allowable. jAnowable. - Allowable - Allowable[ Allowable with Allowable with 317 unit! i'FC 'trB' with with. with Pan: VK DWrihution: with PPHF operations " operation ordering VFC/,4PLX ' Flu funds funds funds toads sfnada_' funds funds- (whrreirpiicabd) Indirect Id; m J ✓ J J ✓ ✓ ✓ n ire cf casts f4iseellaneous Accounting services ✓ ✓ - Advertising (restricted to recruitment of staff or trainees, procurement of goods and services, disposal of scraip or surplus materials) Audit Fees ✓ BRFSS Suns ey 4 ✓ Committee meetings (room rental. equipment rental, ctc.) ✓ ✓ J Communication (electroniCcomputer transmittal, messenger, postage, local and : ✓ ✓ ✓ ✓ J long distance telephone) T Consumer information activities � ''� ^� 'r � f Consumer / provider board participatir n (travel reimbursement) '� ✓ Data processing ✓ f ✓ ✓ ✓ ✓ Laboratory services (tests conducted for } immunization pr„eraser® ✓ a,. I..ocalset-Vice delivery attivities ✓ f Maintenance operatiotvn'rtpairs ✓ Malpractice insurance far volunteers ✓ Membcrships.`subsctiptions ✓ '� NIS Ovcrsampling ✓ Pager,,Vcetl phones ✓ �" J ✓ ✓ Printing ofvaccincaccountability forms ✓ 9,'l6/201 fs I Section i—The Basies p14 IPOM 2011 Allowable with 317 operations Professional service costs direct!v related to immunization activities (limited term staff), Attorney Geiietal Office services Public relations Public I-toniprinting costs (all other immunization related publication and printing, expenses) Rent (rvAjuircs rxplanatiQn of why these costs are not inchided in the indirect rest rate agreement or cost allocation plan) Shipping for materials (other than ✓ Vaccine) Software I icensv'Rencivals, (ORACLIE, etc.) Stipend keitnburstments ✓ Toil -tree phone lines for vaccine V oT-dcfinl- Training costs - Statewide, staff, providers rranslations (transia materials) Vehicle lease {restricted To awzrdees with policies that prohibit local travel ✓ reimbursement) VFC. enrollment materials VFC provider feedback surveys ✓ YIS camera-ready copies 9116(2016 Allowable ;:Allowable Allowable.` Allowable with,'' yc 1*ith VTC" with with FAtI Opem-ton brdrrfng VFC /AFIX Fil)filitils 3 funds funds funds A110able with Allowable VFCDistribution with PPITF I funds fonds (Where applicable} N V Section I —The Basics p:25 MOM 2017 Non -Allowable' ImmunizationFunds Expense Honoraria Advertising costs jit g., caravr:Mtirivs, dixf,141ts, �xhih+tx, ru �tiiagi, merrxarnhiFiu, gi}3x, .wank rrirs� Alcoholic beverages Building Imrchases, comrruction, capitol improvements Land pumhaases LeRislativealobbying activities i oading Depreciation on w-e charges Research � l'unedraiain� lnterust on loans for thty acquisition andlor moderniz.atirM Of an existing building Clinical cm,mvicesr Entertainment Payment of"bad debt Dry cleaning Vehicle Purdiuse Promotional and/or Inrrntive Materials (e,g., plaques, cipt7airig .uad 4orrr.raeurr+rntivr-iicans su.Ir usperu', rrattgv`iaaVs, Joid�n'.x+fuliru-, d:a+t}un'_Gs, CUXt/iv'a'rn:c bat�5;! Purchaasa of icy_)d (imlexs,cv4 arf,.�q+rind trme! yv'' dx'�an c vt_r) NOT allowcmbW with federal immunirattlon funds V.. . Other mstrictlons Imbiah must be taken uato accotutt while writing the budget - ✓ J Funds may be spent only foraactivities aaml personnel costs than( acre directly related to the linanunixation and Vaecines fear Children C &L)perative Agreement. Funding "t a~sts not directly related to immunization activities are outside the scope of this cooperative agreement ptogram and will tint be funded. . Pre -award casts will not be reimbursed. )/ t 6,02016 Section 1-7he Basics p.26 IPaINt 2017 30 Version Comprehensive MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES FY 22/23 AGREEMENT ADDENDUM A This addendum adds the following section to Part I and Renumbers existing 11 Special Certification to 12 and existing 12 Signature Section to 13: Part I 11. Agreement Exceptions and Limitations Notwithstanding any other term or condition in this Agreement including, but not limited to, any provisions related to any services as described in the Annual Action Plan, any Contractor (Oakland County) services provided pursuant to this Agreement, or any limitations upon any Department funding obligations herein, the Parties specifically intend and agree that the Contractor may discontinue, without any penalty or liability whatsoever, any Contractor services or performance obligations under this Agreement when and if it becomes apparent that State or Department funds for any such services will be no longer available. Notwithstanding any other term or condition in this Agreement, the Parties specifically understand and agree that no provision in this Agreement shall operate as a waiver, bar or limitation of any kind, on any legal claim or right the Contractor may have at any time under any Michigan constitutional provision or other legal basis (e.g„ any Headlee Amendment limitations) to challenge any State or Department program funding obligations; and, the parties further agree that no term or condition in this Agreement is intended and no such provision shall be argued to state or imply that the Contractor voluntarily assumed or undertook to provide any services as described in the Annual Action Plan, and thereby, waived any rights the Contractor may have had under any legal theory, in law or equity, without regard to whether or not the Contractor continued to perform any services herein after any State or Department funding ends. 2. This addendum modifies the following sections of Part II, General Provisions: Part II Responsibilities -Grantee Software Compliance. This section will be deleted in its entirety and replaced with the following language: Version: Comprehensive The Michigan Department of Health and Human Services and the County of Oakland will work together to identify and overcome potential data incompatibility problems. III. Assurances A. Compliance with Applicable Laws. This first sentence of this paragraph will be stricken in its entirety and replace with the following language: The Contractor will comply with applicable Federal and State laws, and lawfully enacted administrative rules or regulations, in carrying out the terms of this agreement. M. Health Insurance Portabilitv and Accountability Act. The provisions in this section shall be deleted in their entirety and replaced with the following language: The Grantee agrees that it will comply with the Health Insurance Portability and Accountability Act of 1996, and the lawfully enacted and applicable Regulations promulgated there under. X. Liability. Paragraph A. will be deleted in its entirety and replaced with the following language. A. Except as otherwise provided by law neither Party shall be obligated to the other, or indemnify the other for any third party claims, demands, costs, or judgments arising out of activities to be carried out pursuant to the obligations of either party under this Contract, nothing herein shall be construed as a waiver of any governmental immunity for either party or its agencies, or officers and employees as provided by statute or modified by court decisions. `a r eXP\ar'at�on of a4pf�Cabildy 3 f\n\f\oos• Struot�o�s PaGka9e for fu�he F� 2p2212� eworkfor e\eR`e�t dogram and budget `o tuber mere ava\abfs etNtotal stake U a\fo�lQb e °Ost, P00�NA and Budget F<anr agreetne�t and Pr to years a°tua\ nu do o{ the eats Wi\\ be `maa e, sta \n9). �lo al Re{er to P\aaster °omPee� methods' e Past kN °omP\e °oium� b�u aW ° , V%e ased \.E., fixed u „ Go\u�`n. r tom ` ursern e °{ th ExPeOta7) PT\or to ° Ormance b „Percent these bl o these re�mb {ron the averag ormance t ne 1�l-ent not Pert \umn by the n regardm9 d sta `n9 „ {ota\ P?rpG\A g" re�mbursem man°e, co r exP\anatro Negotiate \y\ngthe ndltures pNNS etPed°r forfurthe and t cdl e 24) to by � °aP unas State F nded �{emendg t�afg struofiions Pa6ka9e �41 ent{u the S eau`Pm u\t p y\ng °u\ated by �' \ eensNe agreement and b el Gal r to master °Omer segkng f� tles gpat,dare Copra\natiiorx t d {ape to_a°e `n the home 1. CS�Case Management 61 services eesee . e Provide P 1. MaX\ \A seine t $201 5a p u res the Gale Goord`nato< fie. m a{ rea C0CRpiNP�\ON RE or e ke sett�n9 th GA OF GP e h°m 2' P L\ Pt P an o{ Gate p s Leh �e Phone $1�0 N 1 t taUaPPian °f Gare °v\NPTtGt, atel vIle $3�'p0 Pyear`�U\be re+mbursed 2 Pn \\ GPRE COp(�p ton s re`r {burse u ary Per e\ e a\ \\ Gare o 15a`nas per gene 1 • P maX�mum 2• (2) Reimbursement Chart for Fixed Rates AIDS/HIV Prevention Non- Categorical Body Art CSHCS-Medicaid Elevated Blood Lead Case Management Fetal Infant Mortality Review (FIMR) Case Abstractions Immunization Assessment Feedback Incentive Exchange (AFIX) Follow-up Immunization Nurse Education Immunization VFC (only) Provider Site Visits Immunization VFC/AFIX Combined Provider Site Visits Informed Consent SIDS (FIMR Interviews) $11.00 per blood draw for non -categorical health departments. Limited annually to $2,000 $288.98 / appl. annual license prior to July1 $144.49 / appl. annual license after July 1 $130.03 / appl. temporary license $288.98 / appl. renewal prior to December $433.47 / appl. renewal after December/1 $28.89 / duplicate license $201.58 per home visit, for up to 6 home visits $270.00 per case, not to exceed the maximum set for each Grantee $100 per personal visit or $50 for a phone call (with information mailed afterward) to the provider office, not to exceed the maximum set for each individual contractor. $200 per session except Vaccines Across the Lifespan, which is to be reimbursed at $250 per session, upon completion and submission of Provider Contracts and Report Forms. Reimbursement can only be made for one in-service module session per physician clinic site per year. $150 per site visit, not to exceed the maximum set for each individual Grantee $350 per site visit, not to exceed the maximum set for each individual Grantee $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services. $125 for each family support visit. A maximum of six (6) visits per infant death is reimbursable (3) Allocation to be reflected in individual programs during budgeting process. (4) Funding Source (not a single element). Hearing and Vision are single elements. (5) Subject to Statewide Maintenance of Effort requirement for Title X. (6) State funding is first source (after fees and other earmarked sources). (7) Fixed unit rate subject to actual costs. (8) The performance reimbursement target will be the base target caseload established by MDHHS. (9) Subject to a match requirement (hard or in -kind) of $1 for each $3 of MDHHS agreement funding for Coordination. (10) Fixed rate limited to contract amount. (11) Up to six (6) visits per family. (12) Non -categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum of $2,000 annually. (13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Semi-annual FPAR data will be used to determine total Title X users. (14) Public Health Emergency Preparedness (PREP) funding BPI must be expended by June 30 and is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a nine -month budget and a quarterly Financial Status Report (FSR) column for this program element. (15) Public Health Emergency Preparedness (PHEP) funding for October 1—June 30, and July 1—September 30, is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a three-month budget and a quarterly Financial Status Report (FSR) column for this program element. (16) Project meets the Research and Development criteria as defined by Title 2 CFR, Section 200.87. (17) Not Applicable (18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements. NOTE: Some footnotes may not apply to this agency. ATTACHMENT III MICHIGAN DEPARTMENT OF HEALTHSERVICES LOCAL ♦ HEALTH DEPARTMENT • r... Fiscal Year 2023 PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Grantee and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on -site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Many program specific assurances and other requirements are defined within the referenced documents including Minimum Program Requirements established for the following program elements as of October 1, 2006: 1. Breast and Cervical Cancer Control 2. Clinical Laboratory 3. CSHCS 4. EGLE Drinking Water and Onsite Wastewater Management 5. Family Planning 6. Food ELPHS 7. Hearing ELPHS 8. HIV/STD Prevention Treatment 9. MDHHS Essential Local Public Health Services (ELPHS) 10.Michigan Care Improvement Registry 11.Vision ELPHS 12.WIC For Fiscal Year 2023, special requirements are applicable for the remaining 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. A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. 111111:1'1 A reimbursement method by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required Essential Local Public Health Services (ELPHS), as noted in the current Appropriations Act. Grant Reimbursement A reimbursement method by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total state allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable and a source before any local funding requirements unless a special local match condition exists. The Performance Level column specifies the minimum state funded performance target percentage for all program elements/funding sources utilizing the performance reimbursement method (see above). If the program elements/funding source utilizes a reimbursement method other than performance or if a target is not specified, N/A (not available) appears in the space provided. Performance Target Output Measures Performance Target Output Measure column specifies the output indicator that is applicable for the program elements/ funding source utilizing the performance reimbursement method. Output measures are based upon counts of services delivered. Relationship Designation The Subrecipient, Contractor, or Recipient Designation column identifies the type of relationship that exists between the Department and grantee on a program -by -program basis. Federal awards expended as a subrecipient are subject to audit or other requirements of Title 2 Code of Federal Regulations (CFR). Payments made to or received as a Contractor are not considered Federal awards and are, therefore, not subject to such requirements. Subrecipient A subrecipient is a non -Federal entity that expends Federal awards received from a pass - through entity to carry out a Federal program, but does not include an individual that is a beneficiary of such a program; or is a recipient of other Federal awards directly from a Federal Awarding agency. Therefore, a pass -through entity must make case -by -case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. Subrecipient characteristics include: • Determines who is eligible to receive what Federal assistance; • Has its performance measured in relation to whether the objectives of a Federal program were met; • Has responsibility for programmatic decision making; • Is responsibility for adherence to applicable Federal program requirements specified in the Federal award; and • In accordance with its agreements uses the Federal funds to carry out a program for a public purpose specified in authorizing status as opposed to providing goods or services for the benefit of the pass -through entity. Contractor A Contractor is for the purpose of obtaining goods and services for the non -Federal entity's own user and creates a procurement relationship with the Grantee. Contractor characteristics include: • Provides the goods and services within normal business operations; • Provides similar goods or services to many different purchasers; • 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 will be provided in amendment #1. Project Title Name EMAIL Admjnistranon Projects _ - Laura de Is Rambelie _ delarambellel@michl9an gov Adolescent STIScreening_ Chrstopher Stickney _sbckneyc@mmh'j�an q_ov Asthma Laus, de la Ramer delmambelel michj an.gav _ Body Atl.Fixed Fee Seth Eckel eckelsl micM an oov Breast$ Cervical Cancer Central(BCCCP) Coordination Polly Hager hager michi an.o_gv IKidsNow K id Kgvalchick kovAeh ckk@- hgaa gpv �CAHC ild and Adolescent Health Center Pm.Imn Ex e� Wm Kovalchickkoalchlckk michj anov ildhood Leas Paramus Prevention _ Michelle Twjchi _ _ wel'islm mjchi ag n pov Chlldren's Steciel Hfth Care Seivlees(CSHCS) Care Coordination Keliv Schoenhen-Gram Gainscommichlems oov Chlldren's Special Him Care Services (CSHCS) Outreach R Ademoury Kelly Schoenherr-Gram Gmmk21mmIchlaimbov ICLPP Lead Expansion Cann Smudel ssedelc[amlchloan rev CCommuniN Blood Lead Teetmq Garin Speidel speldelc michj an.00v CSHCS Medicaid Elevated Blood Lead Case Mqm[ Thomas Large _larooudirmehiaan aov SHCS Medicaid Outreach K-11y Schoanheir-Gram Gramk2Smlchigan aov CSHCS Vaccine Initlalrve __ Kell Seen -Gram _ Gmmk2 michj an.ilov Eastern Eouine Pnceoheitis Virus Surveillance Proiact _ �e Stobiercd steel kim@michigan gov Eat Safe Fish _ Chnstooher Finch finchc2@michlgan.gov EEEH-AII Locations _ Tagged Doll dollt@michloan.gov EGL ddkinQ Water and Cote Wastewater Management Jeremv Hoeh _ _himcdhomoduse..00v Emergency Response Planninq Gerald Tiernan tiernanq@mlchlgan qov Ending the HIV Ep demic Implemema( n Christopher 5ttckney _ skd:neycraldo Wag n0, Envlromenlal Health Data in Michigan Thomas Largo lar of michigan oov Fetal Alcohol Sisecimm Disarders Community Pro ects Aufea Booncharoen bognch omma@mjchi ag n goy Fetal Infant Modal, Review(FIMR Case Xbobacon Nicholas Ducal _ d¢aln on it FFPSA TV Expansion - Chansse Sanders sandersc2amichiaan oov FIMR Interviews Nicholas Ducal drzaln@michloan oov Food ELPHS Adam Christenson chnatensona michl2w. v Sonocacvel isolate Surveillance Prolecr CMlsto er Stickney shckne c michigan Harm Reduction Subbed Services Seth Eckel Es,kelsl michiaan aov Hearmq ELPHS Jerrie, Cedars dakersko7mlabgagem, HIV& STI Tested Prai _ Christopher Sticknev shckne mlchlgan Aov HIV I STI Partner Services Christopher Sticknev silckneyc a�mlchl_gan g_ HIV Care Coardlnatlon Chnskjold Sticknev stye@michjgan.gav HIV Data to Care Christopher Sticknev shckneycCaimmhiq_ HIV Housing Assistance _ Christopher Stickney_ _stickneyc@michigangov HIV Linkage to Care _ Chnsm hermSUckne� stclmmichlaan.aov HIV PrEP Clinic Chrstopher Stckney at�c(dmChigan HIV Preventlon _ Christ_ opher Stickney shckne c mlchlgan. oy v _ HOPWA Plus Lvnn Handles HendgesL2@mlchigangov Housing Oppodumties far People Living win HIVIAIDS Jessica Altenbemt aAenbmuslardeaieanalty fmmdrr,mAon AZom Plan IAP Teen Adams atlion0dolahigans. Immunization Action Plan -Pilot Tend Atlams atlamsl2@michiaan gov ImmuNEatfon Field Services has - Tern Ad ems edamst2@nAchlaan aov Immunization Fixed Fees _ Tenl Adams _ odamsQ(glmichigardi Immunization Mlrh an Ca_ relmp_rovement Reastry MCtR Re Ions Rvan de is Rambege dmmimbdis michfGan qov Immunlzatlon Vaccine Dual, Assurance Tern Adams adamst2@michigan qov Infant Safe Sleep _ Nicholas Drzal drzaln michigan qov Informed Consent _ Laura de la Ramberye delarambellel@michj ag n9ov Laboratory Servces Bw Marty Soehnleo _ehnlenm mlchlgan gov_ Lactation Consultem _ Deanna Chateau _ charestd@michigan qov Lead Hazard Control Courtney Wlsmski wlsnskicadmichmen.aov Local Health Department LLHEH Shanng Sum o) d_ Laura de la Rambelie dolarembellel@michigan qav Maternal Infant Erly Chd Home Visiting Initiatle Rural Local Home Mating Gto3 Charose Sanders saadersc2@michloan qav Maternal Infant Env Childhood Home Visiting Initiative Local Home Visiting Grp Chi Sanders saadersc2@mjcamen qov CH - All Other _ Trudy Each EechT michigan i IMCH-Children Trudy Esch EschT@michigan qov Local Public HeaI1M1 Servces ELPHS Laura de la Ramele delarzmbellelid �MDHHS-Esaerfial Outreach Came Tanv tirvq@michiaan qov lescent Problem v B Parenting Program Hilary Brennan brandonh(mmichmansms 6 Health and Wellness 4x4 Plan -Implementation Scott Beil bellsl @michiquabov MI Home Vstinq In dobve Rural Expansion Grant _ _ Chansse Sanders_ saudercc2ramichlgan av MIECHVP Healthy Families America Ex ap nslq= Chansse Sander= _ sandersc2 mwhi ao n gov Mmgri Health Community Qepacity BUAdin Ig ndiaNe ._ Brenda Jegede __Je eg Oeb, mwhi aq ngov_ __ Nurse Patrol, PartnMerin, aitl Outreach Chansse Sanders__ sandersc2@michloangW ____ Norse FamiW Partnership Services Che=sse Sanders sandersc2 mlchgan Soy _ Oral Health Kinder9aden Assessment Carne Trryahrryc@michEan,gov Pudik Health Emerrcy Pre0aredrress(PHEP)70/f=6130 Mary Mawueen maoqueenm@mlchgan gov Public Health Ememencv Preparedness (PHEP)➢I LAM Mary Mawueen mayvaenm(na-mlchwan gov Public Health Emergency Preparedness (PHEP�CR170/f=6130 Mary Marqueen marqueenm mwhi a2n gov __ Pub lc Health Emargencv Preoaredness(PHEPI CRI 7l1-9130 Mary Macguee, macolueenm@mlchlquiran, Regional Perinatai Care Svstem Deanna Charei charestdpmlchltlan we SEAL' Whiten Dental Sealant Chnsdne Farrell (arrellc(almlchlon qov ISBxual Violence Prevention Jennifer DelaCmz delacmz'Co7mlchrgan qov Sexually Transmltled lnfeotion CSTll Control Christopher S9ckney __stickneyc@m'chlap_n gov_ Stat.da Lead Case Manogment - Fried Fee Cann Speldel ___ speldelc@m'ch'gan gov_____ _ STI�ty Services Christopher St'ckney stickneyc(olmichlgan. og v _ Taking Pnde'n PravenM1on andarsonk10 m'chl ag n as Tobacco Control Grant Program Julia Hllchniham hltchinghaml@mlch'gan,dos Transformmq Youth Sulfide Preveni Jennifer DeLaCruz delaco.Aidmmhlgan are TubercWosrs Ta7conlout Peler Davidson davidsono(dlmlchman.cov Vector=Rome Survedlance B Prevention__ Mary Gmge Stob'erskl slobiersklmCommh'gan gnv VlSmn ELPHS Rachel Schumann schumennr@nHhhId ov West Nile Virus CommumN Surveillance Mary Grace Stob'e_ atob'erskim@mlchlgan,ggv _ _ _ _ WIC BreasBeedmg Cecdla Hofsgn hulscucl@_—ti'gangov WIC Migrant Cedl'a Hutson hutnilamlch'gan.gev WIC Resident Services_ Cecilia Hutson_ hulsrursl ichinn qov ___ _ Wlsewoman _PRIlyPage_r h o mru_L9—v—.— -- PROJECT TITLE: Adolescent Sexually Transmitted Infection (STI) Screening Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health care cost. Adolescents and young adults experience elevated rates of infection in Michigan and across the country. Individuals 15-24 years of age will be screened for chlamydia and gonorrhea at the following Oakland County sites: 1. Oakland County Main Jail 2. Oakland County Work Release 3. Oakland County Community Sites where Priority Population Gathers Reporting Requirements (if different than agreement language): Report Period Quarterly report of screening Quarterly and treatment activity GRANTEE SPECIFIC REQUIREMENTS Utilizing the identified project sites: Due Date(s) 15 days after the end of the quarter How to Submit Report Email to MDHHS contract liaison 1. Test at least 100 adolescents and young adults per month, using NAAT tests for gonorrhea and chlamydia. 2. Collect race, gender, age, test result, and treatment date for all tests. 3. Refer clients for further health evaluation if indicated. 4. Provide client centered risk reduction plan, promoting abstinence. 5. Treat all positives on site if possible. 6. Contact positive clients that are released prior to treatment with treatment options in community. 7. Promote self -notification of partners. 8. Develop one annual slide set highlighting year end data by demographic variable including trend data. 9. Continue to promote awareness of prevalence of STIs within adolescent and young adult populations. Participate in MDHHS convened meetings regarding chlamydia and gonorrhea screening as requested. Technical Assistance 1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https:Hbit.ly/3HS7xdG Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS- SUPPORT(abmichiclamov PROJECT: Asthma Demonstration Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Provide evidence -based asthma management education to families and providers in an attempt to decrease hospitalizations and emergency room utilization for individuals with asthma. Reporting Requirements (if different than contract language) Progress report updates are required twice per year per CDC reporting requirements. Any additional requirements (if applicable) PROJECT: Body Art Fixed Fee Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis This agreement is intended to establish a payment schedule to the Grantee, following notification of a completed inspection and recommendation for issuance of license. The intent is to help offset costs related to the licensing of a body art facility, when fees are collected from the respective Grantee's jurisdiction in accordance with Section 13101-13111 of the Public Health Code, Public Act 149 of 2007, which was updated on December 22, 2010 and is now Public Act 375. Reporting Requirements (if different than contract language) The Department will reimburse the Grantee on a quarterly basis according to the following criteria: 1. Initial annual license for a Body Art Facility prior to July 1 ® $288.98 (50% of state fee) 2. Initial annual license for a Body Art Facility after to July 1 O $144.49 (50% of state fee) 3. Issue a temporary license for a Body Art Facility t $130.03 (75% of state fee) 4. License renewal prior to December 1 ® $288.98 (50% of state fee) 5. License renewal after to December 1 ® $433.47 (50% of state fee + 50% late fee penalty) 6. Duplicate license 0 $28.89 Payment will be made for those body art facilities that have applied and paid in full to the Department, following notification of a completed inspection and recommendation for issuance of license. Please note that the fees in the list above are based on FY2022 reimbursement rates and are subject to change with the Consumer Price Index. Any additional requirements (if applicable) The Grantee is authorized to enforce PA 375 and conduct an inspection of all body art facilities under its jurisdiction, investigate complaints, and enforce licensing regulations and requirements. The Grantee must complete a Body Art Facility Inspection Report [DCH-1468 (07-09)], as provided by the Department, or other report form approved by the Department that meets, at minimum, all standards of the state inspection report. Only body art facilities that have applied for licensure should be inspected. All body art facilities must be inspected annually. Licenses will only be released from the Department following notification of a completed inspection and upon recommendation by the Grantee. Completed inspection reports should be signed by the facility owner and recommendation for licensure should be forwarded to the Department within two to four weeks following the inspection. Reports should be entered via the online interface or can be sent to: HIV/STD and Body Art Section Division of Communicable Diseases 333 S. Grand Ave, 3rd Floor Lansing, Michigan 48933 PROJECT: Breast and Cervical Cancer Control Navigation Program Beginning Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The BC3NP (Breast and Cervical Cancer Control Navigation Program) provides individualized assistance to low-income women, < 250% FPL, in overcoming barriers that may impede their access to receiving breast and cervical cancer services. Services are provided to uninsured, underinsured, and insured women both within and outside the program. Women identified for priority enrollment in the program are those women in hard -to -reach populations, such as minorities, particularly African American, Hispanic, Asian American, Arab American, and Native American women as well as women who have insurance but do not know how to access the healthcare system to receive breast or cervical cancer services. Breast and/or cervical screening and diagnostic services are reimbursed for uninsured and underinsured low-income women enrolled through the program that meet the following criteria: • Age 21-64; self -referred, referred from a BC3NP provider or a non-BC3NP provider and requires cervical cancer screening and/or diagnostic services for an identified cervical screening abnormality. • Age 40-64; self -referred, referred from a BC3NP provider or a non-BC3NP provider and requires breast cancer screening and/or diagnostic services for an identified abnormality. • Age 21-39; referred from either a BC3NP or non-BC3NP provider with an breast finding requiring diagnostic follow-up to rule out or confirm a breast cancerdiagnosis. The BC3NP provides navigation services to low-income insured women, not enrolled in the program, to assist them in accessing the healthcare system so they can receive breast and/orcervical cancer screening, diagnostic, and/or treatment services through their insurance provider. Reporting Requirements (if different than contract language) Instructions for use of MBCIS, a statewide database, will be provided to agencies that contribute data to this database. The CPCS will exchange relevant program reports with appropriate contractors through encrypted email or a secure file transfer system. Any additional requirements (if applicable) For specific BC3NP requirements, refer to the most current BC3NP Policies and Procedures or visit www.michigan.gov/BC3NP. PROJECT: CAHC MI Kids Now (All Locations) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: A major role of the CAHC program is to provide a safe and caring place for children and adolescents to receive needed medical care and support, learn positive health behaviors, and prevent diseases, resulting in healthy youth who are ready and able to learn and become educated, productive adults. CAHCs assist eligible children and adolescents with enrollment in Medicaid and provide access to Medicaid preventive services. Reporting Requirements (if different than contract language) A. The Grantee shall submit the following reports on the following dates: Quarterly Program Data Report: Due 30 days after the end of the reported quarter Annual Program Narrative: Due 30 days after the end of the grant period B. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Contract Manager. C. Reports and information shall be submitted to the Contract Manager as follows: Quarterly Program Data Report: via the Child and Adolescent Health Center Clinical Reporting Tool located at Clinical Reporting Tool (knack.com) Annual Program Narrative: email D. The Contract Manager shall evaluate the reports submitted as described in Attachment C, Items A. and B. for their completeness and adequacy. E. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. Any additional requirements (if applicable) Funding Eligibility To be eligible for funding, all applicants must provide signed assurance that referrals for abortion services or assistance in obtaining an abortion will not be provided as part of the services (MCL §388.1766). For programs providing services on school property, signed assurance is required that family planning drugs and/or devices will not be prescribed, dispensed or otherwise distributed on school property as mandated in the Michigan School Code (MCL §380.1507). Applicants must assure compliance with all federal and state laws and regulations prohibiting discrimination and with all requirements and regulations of MDE and MDHHS, Target Populations to be Served Proposals should focus on the delivery of health services to ages 5-21 years at school - based sites, and 10-21 years at school -linked sites, in geographic areas where it can be documented that health care services that are accessible and acceptable to children and adolescents require enhancement or do not currently exist. The children (birth and up) of the adolescent target population may also be served where appropriate. Funding may be used to provide clinical services to students receiving special education services up to 26 years of age, Technology Successful applicants are required to have an accessible electronic mail account (email) to facilitate ongoing communication. All successful applicants will be added to a CAHC program list serve, which is the primary vehicle for communication from the State. Successful applicants must have the necessary technology and equipment to support billing and reimbursement from third party payers. Referto Reference A, Minimum Program Requirements which describes the billing and reimbursement requirements for all grantees. Training At least one staff member is required to attend a yearly Michigan Department of Health and Human Services CAHC Annual Meeting in the fall, as announced by the MDHHS team. Unallowable Expenses The following costs are not allowed with this funding: • The purchase or improvement of land • Fundraising activities • Political education or lobbying, including membership costs for advocacy or lobbying organizations • Indirect costs The following restrictions are in effect for this funding: Funds may not be used to refer a student for an abortion or assist a student in obtaining an abortion (MCL §388.1766). • Funds may not be used to prescribe, dispense or otherwise distribute a family planning drug or device in a public school or on public school property (MCL §380.1507). ® Funding may not be used to serve the adult population (ages 22 years and older), with the exception of students up to 26 years of age who are receiving special education services. Funds may not be used to supplant or replace an existing program supported with another source of funds or for ongoing or usual activities of any organization involved in the project. Minimum Program Requirements The Minimum Program Requirements document is considered to be part of Attachment III. PROJECT: Child and Adolescent Health Center Program Expansion Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: A major role of the CAHC program is to provide a safe and caring place for children and adolescents to receive needed medical care and support, learn positive health behaviors, and prevent diseases, resulting in healthy youth who are ready and able to learn and become educated, productive adults. CAHCs assist eligible children and adolescents with enrollment in Medicaid and provide access to Medicaid preventive services. Reporting Requirements (if different than contract language) A. The Grantee shall submit the following reports on the following dates: Quarterly Program Data Report: Due 30 days after the end of the reported quarter Annual Program Narrative: Due 30 days after the end of the grant period B. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Contract Manager. C. Reports and information shall be submitted to the Contract Manager as follows: Quarterly Program Data Report: via the Child and Adolescent Health Center Clinical Reporting Tool located at Clinical Reporting Tool (knack.com) Annual Program Narrative: email D. The Contract Manager shall evaluate the reports submitted as described in Attachment C, Items A. and B. for their completeness and adequacy. E. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. Any additional requirements (if applicable) Funding Eligibility To be eligible for funding, all applicants must provide signed assurance that referrals for abortion services or assistance in obtaining an abortion will not be provided as part of the services (MCL §388.1766). For programs providing services on school property, signed assurance is required that family planning drugs and/or devices will not be prescribed, dispensed or otherwise distributed on school property as mandated in the Michigan School Code (MCL §380.1507). Applicants must assure compliance with all federal and state laws and regulations prohibiting discrimination and with all requirements and regulations of MDE and MDHHS. Target Populations to be Served Proposals should focus on the delivery of health services to ages 5-21 years at school - based sites, and 10-21 years at school -linked sites, in geographic areas where it can be documented that health care services that are accessible and acceptable to children and adolescents require enhancement or do not currently exist. The children (birth and up) of the adolescent target population may also be served where appropriate. Funding may be used to provide clinical services to students receiving special education services up to 26 years of age. Technology Successful applicants are required to have an accessible electronic mail account (email) to facilitate ongoing communication. All successful applicants will be added to a CAHC program list serve, which is the primary vehicle for communication from the State. Successful applicants must have the necessary technology and equipment to support billing and reimbursement from third party payers. Refer to Reference A, Minimum Program Requirements which describes the billing and reimbursement requirements for all grantees. Training At least one staff member is required to attend a yearly Michigan Department of Health and Human Services CAHC Annual Meeting in the fall, as announced by the MDHHS team. Unallowable Expenses The following costs are not allowed with this funding: • The purchase or improvement of land • Fundraising activities • Political education or lobbying, including membership costs for advocacy or lobbying organizations • Indirect costs The following restrictions are in effect for this funding: • Funds may not be used to refer a student for an abortion or assist a student in obtaining an abortion (MCL §388.1766). • Funds may not be used to prescribe, dispense or otherwise distribute a family planning drug or device in a public school or on public school property (MCL §380.1507). • Funding may not be used to serve the adult population (ages 22 years and older), with the exception of students up to 26 years of age who are receiving special education services. • Funds may not be used to supplant or replace an existing program supported with another source of funds or for ongoing or usual activities of any organization involved in the project. Minimum Program Requirements The Minimum Program Requirements document is considered to be part of Attachment III. PROJECT: Childhood Lead Poisoning Prevention Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis MDHHS CLPPP's mission is "to prevent childhood lead poisoning across the state through surveillance, outreach and health services". This grant provides local health departments the opportunity to prevent and address lead poisoning within their communities, with support of CLPPP. The overall goal of the grant is to increase testing for children under the age of 6, specifically capillary to venous testing rates. Reporting Requirements (if different than contract language) 1. Workplan — submitted according to due dates set by CLPPP 2. Quarterly Reports — submitted no later than thirty (30) days after the close of the quarter. Grantee Specific Requirements Grantees shall: Identify target areas with lower testing rates, with the assistance of CLPPP and quarterly data reports provided to the LHDs. Provide a workplan with a detailed overview of how your LHD plans to increase testing rates within the grantee focus area, and explanation of target audience/locations. Metrics for success should be strategic, measurable, ambitious, realistic, time -bound, inclusive, and equitable. Planning for the workplan should be done in coordination with CLPPP. CLPPP will provide recommended activities to the grantees. Conduct a quarterly review of the workplan and grant activity progress. Submit a quarterly report to CLPPP with progress made, as well as revisions needed for the workplan. Attend meetings with CLPPP and other grantees as scheduled. Ensure all communication materials that are developed and distributed by the grantee are approved by CLPPP if MDHHS funds are used. PROJECT: CLPP Lead Expansion Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis MDHHS CLPPP's mission is "to prevent childhood lead poisoning across the state through surveillance, outreach and health services". The goal of this pilot is to maximize the number of children less than six years of age protected from lead poisoning and the number of City of Detroit childcare facilities where lead hazards are controlled. This goal should be accomplished through targeted lead testing and hazard controls efforts, expanded education and outreach, and enhancing nursing and environmental services to children with an EBLL 3.5-19 mcg/dL, residing in the 6 high risk zip codes in the City of Detroit. Grantees could achieve this goal through: 1) Targeted lead testing and hazard controls efforts, this can include: • Lead education in early childhood care centers (daycares, Early Head Start, Head Start) • Lead inspection risk assessments in licensed childcare centers 2) Expanded education and outreach, this can include: • Providing lead testing on site at early childcare centers • Providing referrals to other essential health services (WIC, IMMS, Vision/Hearing screening) 3) Enhancing nursing and environmental services to children with an EBLL 3.5- 19mcg/dL, residing in the 6 high risk zip codes in the City of Detroit, this can include: • Non -Medicaid children — providing nursing case management home visits • Coordinate lead inspection risk assessments for children with an EBLL, residing in this zip code Reporting Requirements (if different than contract language) • Provide a workplan with a detailed overview of how your LHD plans to expand education, NCM and linkage to care within the grantee focus area, and explanation of target audience/locations • Submit quarterly reports Any additional requirements (if applicable) • Attend quarterly call/in-person meetings • Ensure all communication materials that are developed and distributed by the grantee are approved by CLPPP if MDHHS funds are used. PROJECT: Community Blood Lead Testing Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis In response to the decrease in blood lead testing due to COVID-19 and the impact on pediatric visits and WIC agency closure, there is a necessity to support local health departments to facilitate innovative strategies in their jurisdictions to ensure access to and completion of blood lead testing for children to identify lead exposure. It is imperative that there is a community -based approach to blood lead testing. This pilot funding is to support local health departments in planning for implementation of strategies to increased blood lead testing of children <6 years old within their jurisdiction. This planning will follow the ABC Building Blocks for Community Blood Lead Testing, comprised of assessing, bolstering, and coordinating. Grantees could achieve this goal through: 1) Assess current state of blood lead testing in the jurisdiction, this can include • Survey community partners and local health department to determine where blood lead testing is taking place • Identify gaps in blood lead testing availability • Identify barriers to accessing blood lead testing • Identify Medicaid Health Plans (MHPs) serving the community • Identify Partners for promotion of lead testing 2) Bolster current testing efforts, this can include: • Conduct provider education regarding recommendations for blood lead testing at existing access points • Conduct public education about existing testing options, targeting children less than 6 years old • Enhance access to existing local access points for blood lead testing by reducing identified barriers to testing 3) Coordinate a testing plan, this can include: • Work with Medicaid Health Plans to identify children due for screening and perform targeted outreach • Identify a plan for a "safety net' option for free testing for uninsured, those whose insurance will not cover testing, those falling outside our target groups, or communities needing timely access to testing • Reporting Requirements (if different than contract language) • Provide a workplan with a detailed overview of how your LHD will demonstrate functional "safety net' option and ability to increase access to testing as needed • Submit quarterly reports Any additional requirements (if applicable) • Attend quarterly call/in-person meetings • Ensure all communication materials that are developed and distributed by the grantee are approved by CLPPP if MDHHS funds are used. PROJECT: CSHCS Care Coordination Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis Beneficiaries enrolled in CSHCS with identified needs may be eligible to receive Care Coordination Services as provided by the local health department. In addition, beneficiaries with either CSHCS, CSHCS and Medicaid, or Medicaid only (no CSHCS) may be eligible to receive Case Management services if they have a CSHCS medically eligible diagnosis, complex medical care needs and/or complex psychosocial situations which require that intervention and direction be provided by the local health department. LHD staff includes registered nurses (RNs), social workers, or paraprofessionals under the direction and supervision of RNs. Services are reimbursed on a fee for services basis, as specified in Attachment IV Notes. Reporting Requirements (if different than contract language) See Attachment I for specific budget and financial requirements. Case Management and Care Coordination services within a specific Case Management role cannot be billed during the same LHD billing period, which is usually a fiscal quarter. Care Coordination and Case Management Logs are submitted electronically via the Children's Healthcare Automated Support Services (CHASS) Billing Module to the Contract Manager. Quarterly logs must be submitted with the financial status report. Annual Narrative Progress Report A brief annual narrative report is due by November 15 following the end of the fiscal year. The reporting period is October 1 — September 30. The annual report will be submitted to the Department and shall include: Summary of successes and challenges Technical assistance needs the Grantee is requesting the Department to address Brief description of how any local MCH funds allocated to CSHCS were used (e.g. CSHCS salaries, outreach materials, mailing costs, etc.), if applicable The unduplicated number of CSHCS eligible clients assisted with CSHCS enrollment. • The unduplicated number of CSHCS clients assisted in the CSHCS renewal process. Definitions Unduplicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment is defined as: Number of CSHCS eligible clients the Grantee provided one-on-one (in person or via telephone) substantial assistance to complete the CSHCS enrollment process during the fiscal year. This assistance includes, but is not limited to, helping the family obtain necessary medical reports to determine clinical eligibility, completing the CSHCS Application for Services, completing the CSHCS financial assessment forms, etc. Assistance does not include mailed letters to the family. Unduplicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process is defined as: Number of CSHCS enrollees the Grantee provided one-on-one (in person or via telephone) substantial assistance to complete and/or submit documents required for the Department to make a determination whether to continue/renew CSHCS coverage during the fiscal year. "Assisted" may also include collaboration with the client's Medicaid Health Plan. Assistance does not include mailed letters to the family. Any additional requirements (if applicable) Case Management services address complex needs and services and include an initial face-to-face encounter with the beneficiary/family. Case Management requires that services be provided in the home setting or other non -office setting based on family preference. Beneficiaries are eligible for a maximum of six billing units per eligibility year. Services above the maximum of six require prior approval by MDHHS. To request approval, the LHD must submit an exception request, including the rationale for additional services, to MDHHS. Limitations on the need for and number of Case Management service units are set by MDHHS and must be provided by a specific Case Management role, in accordance with training and certification requirements. Staff must be trained in the service needs of the CSHCS population and demonstrate skill and sensitivity in communicating with children with special needs and their families. Care Coordination is not reimbursable for beneficiaries also receiving Case Management services during the same LHD billing period, which is usually a calendar quarter. In the event Care Coordination services are no longer appropriate and Case Management services are needed, the change in services may only be made at the beginning of the next billing period. PROJECT: CSHCS Medicaid Elevated Blood Lead Case Management Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The local health department will complete in -home elevated blood lead (EBL) case management (CM) services, with parental consent, for children less than age 6 in their jurisdiction enrolled in Medicaid with a blood lead level equal to or greater than 3.5 pg/dL as determined by a venous test. EBL CM will be conducted according to the "Case Management Guide for Children with Elevated Blood Lead Levels" that is provided by the Childhood Lead Poisoning Prevention Program (CLPPP), Michigan Department of Health and Human Services (MDHHS). For each child eligible for EBL CM, efforts to contact the family to provide CM services and specific services provided must be documented in the child's electronic record in the Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPSS) database. Reporting Requirements (if different than contract language) Quarterly FSR and FSR Supplemental Attachment Submit request for reimbursement through EGrAMS based on the "fixed unit rate" method. The fixed rate for case management services is $201.58 per home visit, for up to 6 home visits. Additionally, a FSR supplemental attachment form is required to be uploaded in EGrAMS that specifies the number of children and home visits for which reimbursement is being requested on. The FSR and the FSR supplemental attachment form must be submitted no later than thirty (30) days after the close of the quarter. Quarterly Case Management Logs A complete spreadsheet of CM activities is due quarterly, submitted electronically through the CLPPP's secure DCH-File Transfer Site available through MiLogin, using a template provided by CLPPP. The quarterly spreadsheet must be submitted no later than thirty (30) days after the close of the quarter. Annual Report An annual report is required covering the reporting period for FY23 is October 1 — September 30. The format and due date for the submission will be determined by CLPPP, and communicated to the local health departments. Reporting Time Period October 1 — December 31 January 1 — March 31 April 1 — June 30 July 1 —September 30 Due dates for quarterly spreadsheet, FSR, and supplemental form January 31 April 30 July 30 October 20 Any additional requirements (if applicable) The local health department shall: • Have CM conducted by a registered nurse trained by MDHHS CLPPP. To be reimbursed for a home visit, the visit must be completed by a registered nurse. • Sign up for the DCH-File Transfer Site available through MiLogin. This site will be used for data sharing of confidential information. • Have an agreement with all Medicaid Health Plans in their jurisdiction that allows for sharing of Personal Health Information. • Identify and initiate contact with families of all Medicaid -enrolled children with EBLLs. Complete case management activities according to the MDHHS CLPPP Case Management Guide. Document all required case management activities in the child's electronic file in the HHLPPS database. Required documentation includes an initial home visit form, follow-up visit forms, dates of chelation therapy, and plan of care. PROJECT: CSHCS Medicaid Outreach Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis Local Health Departments may perform Medicaid Outreach activities for CSHCS/Medicaid dually enrolled clients and receive reimbursement at a 50% federal administrative match rate based upon their CSHCS Medicaid dually enrolled caseload percentage and local matching funds. Reporting Requirements (if different than contract language) See Attachment I for specific budget and financial requirements. Annual Narrative Progress Report N/A Any additional requirements (if applicable) N/A PROJECT TITLE: CSHCS Outreach and Advocacy Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Local Health Departments (LHDs) throughout the state serve children with special health care needs in the community. The LHD acts as an agent of the CSHCS program at the community level. It is through the LHD that CSHCS succeeds in achieving its charge to be community -based. The LHD serves as a vital link between the CSHCS program, the family, the local community and the Medicaid Health Plan (as applicable) to assure that children with special health care needs receive the services they require covering every county in Michigan. LHD is required to provide the following specific outreach and advocacy services • Program representation and advocacy • Application and renewal assistance • Link families to support services (e.g. The Family Center, CSHCS Family Phone Line, the CSHCS Family Support Network (FSN), transportation assistance, etc.) • Implement any additional MPR requirements • Care coordination • Budget and Agreement Requirement and Grantee • Submission of all documents via the document management portal, as required Reporting Requirements (if different than agreement language): Annual Narrative Progress Report A brief annual narrative report is due by November 15 following the end of the fiscal year. The reporting period is October 1 — September 30. The annual report will be submitted to the Department and shall include: • Summary of successes and challenges • Technical assistance needs the Grantee is requesting the Department to address • Brief description of how any local MCH funds allocated to CSHCS were used (e.g. CSHCS salaries, outreach materials, mailing costs, etc.), if applicable • The unduplicated number of CSHCS eligible clients assisted with CSHCS enrollment. • The unduplicated number of CSHCS clients assisted in the CSHCS renewal process. Definitions Unduplicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment is defined as: Number of CSHCS eligible clients the Grantee provided one-on-one (in person or via telephone) substantial assistance to complete the CSHCS enrollment process during the fiscal year. This assistance includes, but is not limited to, helping the family obtain necessary medical reports to determine clinical eligibility, completing the CSHCS Application for Services, completing the CSHCS financial assessment forms, etc. Assistance does not include mailed letters to the family. Unduplicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process is defined as: Number of CSHCS enrollees the Grantee provided one-on-one (in person or via telephone) substantial assistance to complete and/or submit documents required for the Department to make a determination whether to continue/renew CSHCS coverage during the fiscal year. "Assisted" may also include collaboration with the client's Medicaid Health Plan. Assistance does not include mailed letters to the family. Any additional requirements (if applicable): Relationship between Grantees and Medicaid Health Plans: The Grantee must establish and maintain care coordination agreements with all Medicaid Health Plans for CSHCS enrollees in the Grantees service area. Grantees and the Medicaid Health Plans may share enrollee information to facilitate coordination of care without specific, signed authorization from the enrollee. The enrollee has given consent to share information for purposes of payment, treatment and operations as part of the Medicaid Beneficiary Application. Care coordination agreements between Grantees and the Medicaid Health Plans will be available for review upon request from the Department. The agreement must address all the following topics • Data sharing • Communication on development of Care Coordination Plan • Reporting requirements • Quality assurance coordination • Grievance and appeal resolution • Dispute resolution • Transition planning for youth PROJECT: CSHCS Vaccine Initiative Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis Local Health Departments are eligible to receive funding to support efforts to increase vaccination rates among children with disabilities and special health care needs, along with parents and family members of children with special health care needs. Eligible activities include incorporating the promotion of adherence to MDHHS vaccination guidelines into existing interactions and communications with CSHCS families, accommodations for serving children with special needs into existing or established community vaccination efforts, and additional vaccination outreach and promotion efforts focused on child populations with special needs. Eligible activities should include a focus on vaccinations for COVID-19 but can also include a broader focus on adherence to recommended pediatric vaccination schedules. Children with disabilities and special health care needs includes children enrolled in CSHCS but can also include children with special health care needs that are not enrolled in or medically eligible for CSHCS. Reporting Requirements (if different than contract language) Annual Narrative Progress Report With Final FSR, please submit a brief narrative with the following information 1. Describe how these funds have been used to promote vaccinations among children with special needs and their family members. When feasible, include a list of events or activities that have been supported with these funds, a total for the number of events or activities, and an estimate of the number of families reached through these activities. 2. Describe any local partnerships or collaborations used to reach families for vaccinations, including partnerships with health care providers and/or provider organizations. Please note any challenges or successes. 3. Describe any innovative or unique methods used to reach families with a child with special health care needs to promote or encourage adherence to recommended vaccination guidelines. Any additional requirements (if applicable) N/A PROJECT: Eat Safe Fish Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The Grantee will collaborate with the Department and the EPA Region V Saginaw Community Information Office to deliver a uniform message for the Saginaw River and connected waters regarding the fish and wild game consumption advisories within the tri- county area (Midland, Saginaw, and Bay). Reporting Requirements (if different than contract language) Track and report output measures. Write and Submit quarterly reports and an annual report to the Department. • Submit draft quarterly reports within 15 days after the end of each quarter. • Annual reports upon request. Any additional requirements (if applicable) The grantee will develop a plan to distribute that message using existing health department programs, the medical community, special events, and community service providers to communicate with the at -risk population. 2. The grantee will get approval from the Department program manager and for any changes to the Saginaw and Bay County Cooperative Agreement Scope of Work including budget and budget narratives. 3. The grantee will provide appropriate staff to fulfill the following objectives and outputs as detailed: • Comply with the Saginaw and Bay County Cooperative Agreement budget and budget narratives as describe in the scopes of work provided to the BCHD program manager as applicable from October 1 to September 30. • Provide 30 hours of health education and community outreach per week. • Conduct health education and community outreach in Saginaw, Midland, and Bay Counties. Activities will include, but not be limited to, internal BCHD distribution, health care provider outreach, and key event participation. • Track hours to comply with cost recovery requirements. • Development, Printing, and Distribution of Outreach Materials and implementation of Display Booth. • Identify, track, and record of materials distributed at additional locations within Midland, Bay, and Saginaw Counties. • Make payment for the replacement of signage on the Tittabawasse and Saginaw Rivers. • Conduct Capacity Building in Saginaw, Midland and Bay Counties • Actively seek out new community partners in Saginaw, Midland and Bay Counties. • Participate in monthly SBCA teleconference. • Provide Presentation of display booth at select community events in coordination with EPA Region V Saginaw Community information Office. *Conduct Outreach though existing BCHD Programs such as WIC, Immunizations, programs for young mothers, or other programs reaching the target population. •Assist the EPA Region V Saginaw Community Information Office with community outreach. .Outreach to Health Care Providers. PROJECT: EGLE Drinking Water and Onsite Wastewater Management Start Date: 10/1/2022 End Date: 09/30/2023 Project Synopsis State funding for ELPHS shall support, and the Grantee shall provide for, all of the following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act No. 336, of 1998 Section 909: • Infectious/Communicable Disease Control • Sexually Transmitted Disease • Immunization • On -Site Wastewater Treatment Management • Drinking Water Supply • Food Service Sanitation • Hearing • Vision • State funding for ELPHS can support administrative cost for the eight required services including allowable indirect cost, or a Grantee's cost allocation plan. ® ELPHS funding can also be used to fund other core health functions including: Community Health Assessment and Improvement, Public Policy Development, Health Services Administration, Quality Assurance, Creating and Maintaining a Competent Work Force and Local Public Health Accreditation. These services may be budgeted separately as part of the Administrative Budget element. • Net allowable expenditures are the authorized actual/allowable expenditures (total costs less specified exclusions). Available funding is also limited by state appropriations. • First and second party fees earned in each required service program may be used only in that required service program. • State ELPHS funding is subject to local maintenance of effort compliance. Distribution of state ELPHS funds shall only be made to agencies with total local general fund public health services spending in fiscal year (FY) 2023 of at least the amount expended in FY 92/93. To be eligible for any of the State funding increases from FY 94/95 through FY 2023, the FY 92/93 Local Maintenance of Effort Level must be met. Reporting Requirements (if different than contract language) All final amendment ELPHS funding shift request memos need to be submitted no later than May 1. Please send the official memo to request ELPHS funding shifts by email to Laura de la Rambelje (DelaRambeljeL@michigan.gov) and copy Carissa Reece (ReeceC@Michigan.gov). Any Additional Requirements (if applicable) ® Assure the availability and accessibility of services for the following basic health services: Prenatal Care; Immunizations; Communicable Disease Control; Sexually Transmitted Disease (STD) Control; Tuberculosis Control; Health/Medical Annex of Emergency Preparedness Plan. ® Fully comply with the Minimum Program Requirements for each of the required services. Grantee will be held to accreditation standards and follow the accreditation process and schedule established by the Department for the required services to achieve full accreditation status. Grantees designated as "not accredited" may have their Department allocations reduced for Departmental costs incurred in the assurance of service delivery. The accreditation process is based upon the Minimum Program Standards and scheduled on a three-year cycle. The Minimum Program Standards include the majority of the required Department reviews. Some additional reviews, as mandated by the funding agency, may not be included in the Program Standards and may need to be scheduled at other times. Onsite Wastewater Management The Grantee shall perform the following services for private single -and two-family homes and other establishments that generate less than 10,000 gallons per day of sanitary sewage: ® Maintain an up-to-date regulation for on -site wastewater treatment systems (Systems). The regulation shall be supplemented by established internal policies and procedures. Technical guidance for staff that defines site suitability requirements, the basis for permit approval and/or denial, and issues not specifically addressed by the regulation shall be provided. ® Evaluate all parcels to determine the suitability of the site for the installation of initial and replacement Systems in accordance with applicable regulation(s). These evaluations shall be conducted by a trained sanitarian or equivalent and shall consist of a review of the permit application for the installation of a System and a physical evaluation of the site to determine suitability. ® Accurately record on the permit to install the initial or replacement System or on an attachment to the permit the site conditions for each parcel evaluated including soil profile data, seasonal high-water table, topography, isolation distances, and the available area and location for initial and replacement Systems. The requirement for identifying a replacement System applies to issuance of new construction permits only. • Issue a permit, prior to construction, in accord with applicable regulation(s) for those sites that meet the criteria for the installation of a System. The permit shall include a detailed plan and/or specification that accurately define the location of the initial or replacement System, System size, other pertinent construction details, and any documented variances. • Provide and keep on file formal written denials, stating the reason for denial, for those applications where site conditions are found to be unsuitable. ® Conduct a construction inspection prior to covering each System to confirm that the completed System complies with the requirements of the permit that has been issued. Maintain, on file, an accurate individual record of each inspection conducted during construction of each system. In limited circumstances where constraints prohibit staff from completing the required construction inspection in a timely manner, an effective alternate method to confirm the adequacy of the completed System shall be established. The effective alternative method shall be utilized for no more than ten (10) percent of the total number of final inspections unless specific authorization has been granted by the State for other percentage. The results of all such inspections or an alternate method shall be clearly documented. ® Maintain an organized filing system with retrievable information that includes documentation regarding all site evaluations, permits issued or denied, final inspection documentation, and the results of any appeals. ® Conduct review and approval or rejection of proposed subdivisions, condominiums and also land divisions under one acre in size for site suitability according to the statutes and Administrative Rules for Onsite Water Supply and Sewage Disposal for Land Divisions and Subdivisions. ® Utilize the State's "Michigan Criteria for Subsurface Sewage Disposal" (Criteria) for Systems other than private single- and two-family homes that generate less than 10,000 gallons per day. Systems treating less than 1,000 gallons per day may be approved in accordance with the Grantee's regulation. Advise the State prior to issuance of a variance from the Criteria. Variances are only to be issued by the Director of Environmental Health of the Grantee after consultation with the State. Appeals of any decision of the Grantee pursuant to the Criteria including systems treating less than 1,000 gallons evaluated in accordance with the Grantee's regulation shall only be made to the State. Maintain quarterly reports that summarize the total number of parcels evaluated, permits issued, alternative or engineered plans reviewed, and number of appeals, number of inspections during construction, number of failed systems evaluated, and number of sewage complaints received and investigated for each residential (single and two-family homes) and non-residential properties. The report forms EQP2057a.1 (Non -Residential) and EQP2057b.1 (Residential) are available on the EGLE website. All quarterly reports are to be submitted directly to EGLE, to the address noted on the form, within fifteen (15) days following the end of each quarter. • Review all engineered or alternative System plans. Conduct adequate inspections during the various phases of construction to ensure proper installation. ® Collect data at the time of permit issuance when a System has failed to document the System age, design, site conditions, and other pertinent factors that may have contributed to the failure of the original System. Evaluations shall record information indicated on the EGLE Onsite Wastewater Program Residential and Non -Residential Information forms. The results for all failed Systems evaluated shall be maintained in a retrievable file or database and summarized in an annual calendar year data report. Annual summaries of failed system data shall be provided to EGLE for input into the state-wide failed system database. The EGLE Onsite Wastewater Program Residential and Non -Residential Information forms shall be provided to the State no later than February 1 st of the year following the calendar year for which the data has been collected. ® Provide training for staff involved in the Program as necessary to maintain knowledge of current regulations and internal policies and procedures and to keep staff informed of technological improvements and advancements in Systems. Establish and maintain an enforcement process that is utilized to resolve violations of the Local Entity and/or State's rules and regulations. Maintain complaint forms and a filing system containing results of complaint investigations and documentation of final resolution. Investigate and respond to all complaints related to onsite wastewater in a timely manner. Drinking Water: The Grantee shall perform the following services including but not limited to: ® Perform water well permitting activities, pre -drilling site reviews, random construction inspections, and water supply system inspections for code compliance purposes with qualified individuals classified as sanitarians or equivalent. ® Assign one individual to be responsible for quarterly reporting of the data and to coordinate communication with the assigned State staff. Reports shall be submitted no later than fifteen (15) days following the end of the quarter on forms provided by the State. The report form EQP2057 (07/2019) is available on the EGLE website. All quarterly reports are submitted directly to the EGLE address noted on the form. Perform Minimum Program Requirements (MPRs) activities and associated performance indicators. These are available on the EGLE website. Guidance regarding the MPRs and indicators is available in the "Local Health Department Guidance Manual for the Private and Type III Drinking Water Supply Systems." The guidance manual is available online at Michigan.qov/WaterWellConstruction. PROJECT: Food Service Sanitation (FOOD ELPHS) Start Date: 10/1/2022 End Date: 09/30/2023 Project Synopsis State funding for ELPHS shall support and the Grantee shall provide for all the following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act No. 336, of 1998 Section 909: • Infectious/Communicable Disease Control • Sexually Transmitted Disease • Immunization • On -Site Wastewater Treatment Management • Drinking Water Supply • Food Service Sanitation • Hearing • Vision ® State funding for ELPHS can support administrative cost for the eight required services including allowable indirect cost, or a Grantee's cost allocation plan. • ELPHS funding can also be used to fund other core health functions including: Community Health Assessment & Improvement, Public Policy Development, Health Services Administration, Quality Assurance, Creating & Maintaining a Competent Work Force and Local Public Health Accreditation. These services may be budgeted separately as part of the Administrative Budget element. ® Net allowable expenditures are the authorized actual/allowable expenditures (total costs less specified exclusions). Available funding is also limited by state appropriations. ® First- and second -party fees earned in each required service program may be used only in that required service program. Reporting Requirements (if different than contract language) All final amendment ELPHS funding shift request memos need to be submitted no later than May 1s'. Please send the memo to Laura de la Rambelje (DelaRambeljeL@michigan.gov) and copy Carissa Reece (ReeceC(&michioan.aov) Food Service Establishment Licensing = Provide updates to MDARD on the 1 st and 15th of each month, as necessary to: • Provide a list of food service establishments approved for licensure/license issued. = Provide a list of food service establishment licenses that have not been approved for licensure and are considered voided or deleted. • Return the actual licenses to MDARD that are to be voided or deleted. = Return renewal license applications and licenses that require correction. Mark the corrections on the renewal application. Temporary Food Establishment Licensing Provide updates to MDARD on the 1st and 15th of each month, as necessary, to provide: • A copy of each temporary food establishment license issued. • A list of lost or voided licenses by license number. Any additional requirements (if applicable) Food Service Establishment Licensing • Accept responsibility for all licenses specified in the "Record of Licenses Received." ® Issue licenses in accordance with the Michigan Food Law 2000, as amended. Temporary Food Establishment Licensina Upon receipt, sign and return the "Record of Licenses Received" to MDARD. Issue licenses in accordance with the Michigan Food Law 2000, as amended. Make every effort to issue temporary food establishment licenses in numerical order. Food Service Establishment Licensinq Furnish pre-printed food service establishment license applications and pre- printed licenses to the Grantee for each licensing year (May 1 through April 30) using previous year active license data. Provide a count of all licenses sent to the Grantee titled 'Record of Licenses Received." ® Reprint any licenses requiring correction and send corrected copies to the Grantee. ® Bill the local health department for state fees upon notification by Grantee that the license has been approved and issued. Temoorary Food Service Establishment Licensina Furnish blank temporary food service license application forms (forms FI-231, FI- 231A) and blank Combined License/Inspection forms (FI-229) upon request from the local health department. Furnish a "Record of Licenses Received" with each order of Combined Licenses/Inspection forms. Periodically reconcile temporary food service establishment licenses sent to the Grantee with the licenses that have been issued (copy returned to MDARD). ® Bill the local health department for state fees upon notification by the Grantee that the license has been approved and issued. PROJECT TITLE: ELPHS Hearing and Vision Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Hearing and Vision Programs screen over one million preschool and school -age children each year. Screening services are conducted in schools, Head Starts, and other preschool centers by local health department (LHD) hearing and vision technicians. Children who fail their vision screening are referred to a licensed eye doctor (Ophthalmologist or Optometrist) for an exam and treatment. Follow-up is conducted by the LHD to confirm that the child gets the care that they need. Children who do not pass their hearing screening are referred to their primary care physician, audiologist, or Ear, Nose, and Throat physician for diagnosis, treatment, and recommendations. Reporting Requirements (if different than agreement language): Upon completion of the FY23 grant agreement, grantees must submit a School -Based Hearing and Vision Program Annual Narrative Progress Report to MDHHS-Hearinq- and-Vision(amichiaan.gov and cc: respective Program Consultants (Jennifer Dakers, dakersie-michiaan.gov and Dr. Rachel Schumann, schumannr(0.michigan.gov The report must include: 1. Successes -accomplishments of the program/technician(s) 2. Challenges- issues that created difficulty in managing the program and/or performing screening services. 3. Technical Assistance Needs- request support from the Hearing and/or Vision Consultant. 4. Additional Feedback -questions in this section will change annually based on relevant/current program topics/issues. Each Local Health Department (coordinators and technicians) should keep an ongoing log of Successes and Challenges to compile and share at the end of the fiscal year. Final reports are submitted by the grantee to MDHHS. The reports are due 30 days after the end of the fiscal year. For questions regarding these reports, please contact: Jennifer Dakers, MDHHS Hearing Consultant, dakersi(cDmichigan.ciov Dr. Rachel Schumann, MDHHS Vision Consultant, schumannr(a)michloan.gov Any additional requirements (if applicable): Grantees must adhere to established Minimum Program Requirements for School - Based Hearing & Vision Services as outlined in the Michigan Local Public Health Accreditation Program 2019 MPR Indicator Guide. PROJECT: MDHHS Essential Local Public Health Services (ELPHS) Beginning Date: 10/1/2022 End Date: 09/30/2023 Project Synopsis State funding for ELPHS shall support and the Grantee shall provide for all of the following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended, Part 24 and Act No. 336, of 1998 Section 909: • Infectious/Communicable Disease Control • Sexually Transmitted Disease • Immunization • EGLE Drinking Water and Onsite Wastewater Management ■ Food Service Sanitation • Hearing • Vision State funding for ELPHS can support administrative cost for the eight required services including allowable indirect cost, or a Grantee's cost allocation plan. ELPHS funding can also be used to fund other core health functions including Community Health Assessment & Improvement, Public Policy Development, Health Services Administration, Quality Assurance, Creating & Maintaining a Competent Work Force and Local Public Health Accreditation. These services may be budgeted separately as part of the Administrative Budget element. Net allowable expenditures are the authorized actual/allowable expenditures (total costs less specified exclusions). Available funding is also limited by state appropriations. First and second party fees earned in each required service program may be used only in that required service program. • State ELPHS funding is subject to local maintenance of effort compliance. Distribution of state ELPHS funds shall only be made to agencies with total local general fund public health services spending in FY23 of at least the amount expended in FY 92/93. To be eligible for any of the State funding increases from FY 94/95 through FY23, the FY 92/93 Local Maintenance of Effort Level must be met. Reporting Requirements (if different than contract language) Local maintenance of effort reports are due: 1. Projected Current Fiscal Year— October 30 2. Prior Fiscal Year Actual — March 31 A final statewide cost settlement will be performed to assure that all available ELPHS funds are fully distributed and applied for required services. All final amendment ELPHS funding shift request memos need to be submitted no later than May 1 s'. Please send the memo to Laura de la Rambelje (DelaRambelieL(a.michioan.00v) and copy Carissa Reece (ReeceC(a).michiaan.gov) • Each LHD will be required to complete the MDHHS ELPHS Detail report at the end of Quarter 2 and Quarter 4. Any additional requirements (if applicable) • Assure the availability and accessibility of services for the following basic health services: Prenatal Care; Immunizations; Communicable Disease Control; Sexually Transmitted Disease (STD) Control; Tuberculosis Control; Health/Medical Annex of Emergency Preparedness Plan. • Fully comply with the Minimum Program Requirements for each of the required services. = Grantee will be held to accreditation standards and follow the accreditation process and schedule established by the Department for the required services to achieve full accreditation status. Grantees designated as "not accredited" may have their department allocations reduced for Departmental costs incurred in the assurance of service delivery. The accreditation process is based upon the Minimum Program Standards and scheduled on a three-year cycle. The Minimum Program Standards include the majority of the required Department reviews. Some additional reviews, as mandated by the funding agency, may not be included in the Program Standards and may need to be scheduled at other times. PROJECT: Emerging Threats — Hepatitis C Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis Funds are provided to grantees to increase local capacity to make improvements in hepatitis C virus (HCV) testing, case follow-up, and linkage to care. Progress will be tracked by monitoring case completion rates and HCV linkage to care within the MDSS and evaluating HCV testing volumes submitted by grantees through STARLIMS. Reporting Requirements (if different than contract language) • Grantees will keep a log of MDSS IDs on client interactions and linkage to care progress for submission to the MDHHS Viral Hepatitis Unit on a quarterly basis. Grantees will participate on semi -routine group conference calls and/or 1:1 technical assistance check in calls to discuss best practices and identify barriers. • Grantees will collect and submit specimens to the MDHHS Bureau of Laboratories for HCV testing through their public health clinics. Target Requirements Grantees will meet the following objectives for Hepatitis C, Chronic follow-up: Target 1: Interview attempted on 90% of Hepatitis C, Chronic cases within 30 days of referral date. Target 2: Interview completed on 50% of Hepatitis C, Chronic cases within 60 days of referral date. Target 3: Hepatitis C RNA test result on 50% of Probable Hepatitis C, Chronic cases within 90 days of referral date. Violation Monitoring: The inability to meet the metrics will elicit the following response from MDHHS related to this funding: • Technical assistance • Corrective action/performance improvement plans with MDHHS • Reallocation of funds. Any additional requirements (if applicable) • Grantees will document process for carrying out the HCV project during the current pandemic • Grantees will document best practices or protocols for HCV case investigation and linkage to care Grantees will document pathways to link patients to medical care • Grantees may collaborate with the State Viral Hepatitis Unit for assistance • Grantees can submit HCV specimens to the MDHHS Bureau of Laboratories at no cost to them or the client PROJECT TITLE: Ending the HIV Epidemic Implementation Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The purpose of this project is to implement activities to support the objectives of the CDC PS20-2010 Ending the HIV Epidemic in Wayne County. The purpose of these objectives is to reduce the incidence of HIV in and improve the overall health and well- being of residents of Wayne County. Reporting Requirements: 1. The Grantee will clean-up missing data by the 10th day after the end of each calendar month. Grantee must report required variables as outlined by National HIV Monitoring and Evaluation (NHM&E) and MDHHS. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Division of HIV and STI Programs (DHSP). 3. The Quality Control and Daily Client Logs may be sent to the Contract Manager via: Email — Mary Roach (roachm anmichioan.aov) and Safina Thomas (thomass56CcDmichigan.gov) Fax - (517) 241-5922 Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727, Lansing, MI 48909 4. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by the Division of HIV and STI Programs (DHSP). Grantee Report Submission Schedule R .ort. Pe - Counseling, Testing, and referrals iot►."; Quality Control Monthly 10th of the following Department Staff Reports month Daily Client Logs Monthly 10th of the following Department Staff month HIV Testing Annually Reviewed during Department Staff Proficiencies site visits HIV Testing Sent to MDHHS Competencies Annually before the end of Department Staff the fiscal year Non -Reactive Results As needed Within 7 days of test APHIRM PrEP Cascade Data Monthly 101h of the following APHIRM month Reactive Results As needed Within 24 hours of APHIRM test Case Report Forms As needed in the event a Adult Case Report LMS reactive result Form Directions MDHHS Surveillance Partner Services & Linkage to Care (as applicable) Linkage to Care and Partner Services As needed Within 30 days of APHIRM Interview*** service Internet Partner Services (IPS) and Ongoing Within 30 days of APHIRM Partner Services service Interview**** Disposition on Partners of HIV Ongoing Within 30 days of APHIRM Cases service Evidence Based Risk Reduction Activities (as applicable) SSP Data Report, Quarterly 10rh of the following Syringe Utilization month Platform (SUP) 340b PrEP Prescription Log Billing Revenue Report STI 340B Utilization/Inventory Report, Clinical HIV/STI services (as applicable) Weekly Quarterly Every Friday by the close of business DCH File Transfer — MDHHS-340B PrEP PT ADT***** 10th of the following month Department Staff Within 10 days after Quarterly the end of the quarter Log into SGRX340BFIex.com website, generate a quarterly report on the reporting tab, and it will be transferred automatically to ScriptGuide/DHSP *CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social Marketing data; Evidence based intervention data; other prevention services and activities, if applicable ** Aggregated testing data ***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was interviewed by Partner Services within 30 days of diagnosis) ****(e.g. client identify dating apps used to meet partners), if applicable *****https://milogintp.michigan.qov Any additional Requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal fund, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal funds. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. 4. The Grantee will submit all educational materials (e.g., brochures, posters, pamphlets, and videos) used in conjunction with program activities to DHSP for review and approval prior to their use, regardless of the source of funding used to purchase these materials. Materials may be emailed to: MDHHS- HIVSTIoperations(o michiaan.gov. Grant Program Operation 1. The Grantee will participate in DHSP needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities, network detection response and interventions in collaboration with DHSP opportunities provided by DHSP. 3. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for funds must match the percentage claimed on the FSR for the same period. Submit a budget modification to DHSP in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. e. If there are any changes in staff or agency operations, please email MDHHS Operations MDHHS-HIVSTIooerations(a.michigan.gov. 4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with guidelines and standards issued by DHSP and: a. Provide medical oversight letter/agreement signed by a licensed physician is necessary to collect specimens and order HIV antibody/antigen, HIV genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C testing. According to Part 15 of the Public Health Code MCL 333.17001 Q), 'practice of medicine' is defined as "the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these act". Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." • Ensure provision of Clinical Laboratory Improvement Amendments (CLIA) certificate. • Report discordant test results to DHSP Email — Mary Roach roach m(o)michigan.gov and Safina Thomas (thomass56(oD.michiaan.Qov) Fax - (517) 241-5922 • Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course or Information Based Training (as applicable), test device training, and annual proficiency testing. 4 If conducting blood draws, the grantee must conduct the packaging and shipping training via Bureau of Laboratories. BashoreM(a).michiaan.gov ® Ensure that all staff and site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training and reviewed annually. • Develop, implement, and monitor protocol and procedures to ensure that patients receive confirmatory test results. To maintain active test counselor certification, each HIV test counselor must submit one competency per year to the appropriate departmental staff. If conducting SSP, the grantee will develop programs using MDHHS guidance documents and will address issues such as identification and registration of clients, exchange protocols, education, and trainings for staff, and referrals. a. Grantees will participate on monthly or quarterly conference calls to discuss best practices and identify barriers. 6. If conducting PS, the Grantee will comply with guidelines and standards issued by the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." The Grantee must: a. Provide Confidential PS follow-up to infected clients and their at -risk partners to ensure disease management and education is offered to reduce transmission. b. Effectively link infected clients and/or at -risk partners to HIV care and other support services. c. Work with Early Intervention Specialist to ensure infected clients are retained in HIV care. d. If applicable, • Procure TLO or a TLO-like search engine. • Ensure staff that are utilizing TLO or TLO-search engine complete the TLO training to maintain and understand the confidential use of the system. • Effectively utilize the Internet Partner Services (IPS) Guidance to provide confidential PS follow-up to at -risk partners named by infected clients who were identified to have been met through the use of dating apps. • Ensure staff and site supervisors successfully complete the Internet Partner Services Training. Ensure staff conducting Internet Partner Services participant in monthly, bi-monthly meetings, webinars or calls to discuss best practices and identify barriers. 7. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with guidelines and standards issued by DHSP and: 8. Funds generated by this program must be utilized to support the program, including to hire a Mid -level provider, supporting staff, and program materials to provide Pre -Exposure Prophylaxis (PrEP) services. Any funds included in this agreement above must be re -invested in HIV/STI PrEP services. This could mean improving, enhancing, and/or expanding your current HIV/STI services or adding new services to improve patient health outcomes for HIV/STI. 10.Any revenue or income generated via billing from this agreement must be reinvested into this project. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. Software Compliance The Grantee and its subcontractors are required to use APHIRM (formerly Evaluation Web) to enter HIV client and service data into the centrally managed database on a secure server. The Grantee and its subcontractors are required to use APHIRM to enter PrEP Cascade Data into the centrally managed database on a secure server. 3. The Grantee and its subcontractors are required to use APHIRM to enter EBI Data into the centrally managed database on a secure server. 4. The Grantee and its subcontractors are required to use APHIRM (formerly Partner Services Web) to enter Partner Services interview, linkage to care data, and identified dating apps through the use of Internet Partner Services (IPS) where appropriate. 5. The Grantee and its subcontractors are required to use SHOARS to request amendments, supplies, data, technical assistance and to register for trainings. 6. New staff needing access to APHIRM are required to submit the APHIRM user request form through SHOARS. 7. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations@michigan.gov of APHIRM users who are separated from the agency for deactivation. Mandatory Disclosures The Grantee will provide immediate notification to DHSP, in writing, including but not limited to the following events: 2. Any formal grievance initiated by a client and subsequent resolution of that grievance. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. 4. Any staff vacancies funded for this project that exceed 30 days. a. All notifications should be made to DHSP by MDHHS- H IVSTlogerations(d)m ichioan.gov. Technical Assistance 1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https://bit.ly/3HS7xdG Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS- SUPPORT(a).michiaan.gov. . 3. You may request TA on the implementation of the HIV Prevention program. This may include issues related to: APHIRM, Intervention Database, Programs, Budget/Fiscal, Grants and Contracts, Risk Reduction Activities, Training, or other activities related to carrying out HIV prevention activities. Compliance with Applicable Laws 1. The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. PROJECT: Environmental Health Data in Michigan Start Date: 10/1/ 2022 End Date: 9/30/2023 Project Synopsis The purpose of this project is to fund the Western Upper Peninsula Health Department (WUPHD) to build on its existing June 2018 Flood After Action Report and Improvement Plan. Reporting Requirements (if different than contract language) Grantee will attend bi-weekly virtual meetings to disucss project activities and progress of the detailed year 1 workplan as submitted to and accepted by the CDC. Changes to the workplan by WUPHD will be discussed and approved by MDHHS DEH CO-Pls and reported to CDC prior to implementation. The WUPHD staff will provide written progress reports at the time of the bi-weekly project team meetings. Western Upper District Health Department staff will work with MDHHS DEH staff to develop a detailed evaluation plan within six months of the grant award from CDC. WUPHD staff will be required to collect and report on performance evaluation measures to MDHHS DEH staff for inclusion in the Annual Performance Report and in the CDC performance measures and evaluation results portal. A final project report is due from WUPHD to MDHHS DEH within 30 days from the date of termination or final expenditure. The report will include: • Intro & Scope Why was this project initiated? What did we hope to accomplish? • Goals & objectives What were our intended outputs (tangible deliverables from the year 1 workplan to CDC)? What were the intended outcomes (changes in: behavior, departmental capacity, processes, partnerships, resource allocation, etc.)? Process 1. Who was involved and what was their role (project team, steering committee, other agencies/stakeholders)? 2. What were the key steps in the project and when did they occur (outreach and engagement, stakeholder meetings, drafts, etc.)? 3. What was accomplished (tangible outputs and outcomes)? Successes & challenges 1. Compare the intended outputs and outcomes to the actual (did they change, if so, why and how?) 2. What was successful about the project? 3. What were the challenges? Next steps 1. How will the results be used? 2. Will this project encourage future activity in this area? Attach any of the final documents or notes on final processes that were developed as a result of this funding Any additional requirements (if applicable) PROJECT: Expanding, Enhancing Emotional Health (All Locations) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The E3 program funds mental health staff in schools to provide one on one therapy and small group therapy. Reporting Requirements (if different than contract language) Work plans will be submitted annually, attached to the original grant application at the beginning of the year. Quarterly work plan reports will be submitted, attached to the FSR, within 30 days of the end of the quarter. Work plans and work plan reports can also be submitted via e-mail to your appropriate E3 consultant: Gina Zerka: zerkaaCa)michigan.aov or Mario Wilcox: wilcoxm7Ca michiaan.gov All data previously reported will be submitted quarterly. The due dates are as follows: a. Q1: Due January 315t, b. Q2: Due April 30tn c. Q3: Due July 315i and d. Q4: Due September 30t" All data shall continue to be entered into the Clinical Reporting Tool (CRT). See below for data definitions. The grantee shall permit the Department or its designee to visit and make an evaluation of the project as determined by the Contract Manager. Number of Unduplicated Users (clients) by Demographic Designation per quarter Definition of an Unduplicated User: An unduplicated user is an individual who has presented themselves to the E3 Program for service with the mental health provider (minimum Master's prepared and licensed mental health provider), and for whom a record has been opened. Opening a record includes documenting an assessment, diagnosis and treatment plan. Once per year, the user is counted to generate the number of unduplicated clients utilizing the E3 services for that year. Aoe Range Female Male Total 0-4 5-9 10-17 18-21 Number of Unduplicated Users (clients) by Race per quarter White Black/African-American Asian Native Hawaiian or Pacific Islander American Indian or Alaskan Native More than One Race Number of Unduplicated Users (clients) by Ethnicity per quarter Arab/Chaldean Hispanic or Latino Definition of a Visit: A visit is a significant encounter between an E3 provider and a new (unduplicated) user or established (duplicated) user. Each visit should be documented as appropriate to the visit and provider (i.e., visits include an assessment, diagnosis and treatment plan documented in the medical record and/or other documentation appropriate to the visit). A user will likely have multiple visits per year. Total Visits by Provider Type per quarter "Mental Health Provider must be minimum Master's prepared and licensed. Mental Health Provider visits are counted as "face to face" contacts. "Telehealth Visits can be tele-conferencing and tele-phonic. Telehealth visits should be counted when using this mechanism during visit. Note: Telehealth visits should be counted only once, as a Telehealth visit. Do not count as a visit with BOTH the mental health provider AND a Telehealth visit. Visits by Type per quarter Count the visit by type of session provided. If the client was seen individually, count as an individual visit. If the client was seen in a therapeutic group, count as a group visit. If a client receives both individual and therapeutic group services, count both visit types. QUALITY INDICATORS REPORT DEFINITIONS For each of the following Quality Measures, report the YTD NUMBER each quarter. Each quarter, your data will likely be equal to or greater than, the previous quarter. Note that this is different than the quarterly reporting elements, where data is reported by quarter for that specific quarter only. Number of Unduplicated Clients Ages 10-21 Years with an Up -to -Date Depression Screen Report the number of unduplicated clients up-to-date with depression screening. This information could come directly from a behavioral health screener or risk assessment, so the number screened (flagged) for depression may equal or be very close to the number of behavioral health screeners and/or risk assessments completed. (Note this is not the same as a depression assessment conducted by a provider.) Do not double count clients who were screened (flagged) for depression using behavioral health screen or risk assessment and who also completed a specific depression screening tool (e.g., Beck's, PHQ-9, etc). Number of Clients Age 12 and Up with a Positive Depression Assessment (Diagnosis of Depression) Report the number of clients (age 12 and older) with a diagnosis of depression according to the score on the depression screening tool and psychosocial assessment by the provider. Exclude the following: a) those who are already receiving documented care elsewhere, and b) those who are referred out of the E3 site for treatment. Number of Clients Age 12 and Up with a Diagnosis of Depression who have Documented, Appropriate Follow -Up Report the number of clients from the denominator who receive treatment at the E3 site who have all of elements of an appropriate follow-up plan: a) had a psycho -social assessment completed by 3rd visit (includes suicide risk assessment/safety plan), b) had a treatment plan developed by 3rd visit, c) treatment plan reviewed @ 90 days (for those on caseload for 90+ days), and d) screener re -administered at appropriate interval to determine change in score. For the following two quality measures, please note that you are NOT expected to administer BOTH a behavioral health screen AND a risk assessment to each client. You only need to administer one tool or the other as appropriate for age, developmental level and need. Please report the number of behavioral health screens and/or risk assessments provided to your clients: Number of Unduplicated Clients Ages 5-21 Years with at least one Behavioral Health Screen in the annual year. Report the number of clients that receive a Behavioral Health Screen as appropriate for age and developmental level. Examples of appropriate screening tools (to use) include but are not limited to Pediatric Symptoms Checklist (17 or 34), Strength and Difficulties Questionnaire. Number of Unduplicated Clients with an Up -to -Date Risk Assessment / Anticipatory Guidance Report the number of clients that are complete with an annual risk assessment or anticipatory guidance, as appropriate for age and developmental level. This may include clients that are UTD because they completed the risk assess ment/anticipatory guidance in a previous fiscal year but are being seen in the E3 site in the current fiscal year. Reported on annual basis only, as requested: Enter the dollar amount in claims submitted for services provided during the current fiscal year (October 1- September 30), regardless of whether or not the claims were paid during the fiscal year. Enter the dollar amount received in revenue during the current fiscal year (October 1- September 30), regardless of whether or not revenue resulted from claims filed during the fiscal year. For each of these entries, you will be entering data by: Medicaid Health Plan/Medicaid (from a drop -down menu) Commercial Self -Pay Other Note that the Estimated Percent of Claims Paid and Unpaid (based on dollar amount, not on number of claims) and Payor Mix will be auto totaled. 5 Most Common Reasons for Rejection of Submitted Claims Select the five most common reasons for rejection of submitted claims from the dropdown menu according to best -fit category. DIAGNOSES AND PROCEDURE CODES AND FREQUENCY Reported on annual basis only, as requested: Mental Health Problem Diagnoses — Top 5 diagnoses from the mental health provider CPT codes — Top 5 CPT codes - both the code and the name of procedure End of the Year/ Fall Narrative In addition to the quarterly data reporting. All E3 sites are required to submit an End of Year/Fall Narrative Report. This report will focus on the Continues Quality Improvement requirement as indicated in the Minimum Program Requirements document. The report template will be given to E3 program sites by their assigned Program Consultant. Completed Fall Narratives will be emailed to the assigned Program Consultant. 6 Due on October 30 each year MINIMUM PROGRAM REQUIREMENTS October 1, 2022 - September 30, 2023 The E3 program shall be open and provide a full-time or full time equivalent mental health provider (i.e., 40 hours) in one school building year-round. Services shall: a) fall within the current, recognized scope of mental health practice in Michigan and b) meet the current, recognized standards of care for children and/or adolescents. Services provided by the mental health provider are designed specifically for children and adolescents ages 5 through 21 years and are aimed at achieving the best possible social and emotional health status. Services 1. A minimum caseload of 50 clients (users) must be maintained annually. 2. In addition to maintaining a client caseload, the following services may be provided and must be reflective of the needs of the school: a. treatment groups using evidence -based curricula and interventions; b. school staff training and professional development relevant to mental health; c. building level promotion, such as school climate initiatives, bullying prevention, suicide prevention programs, etc d. classroom education related to mental health topics e. case management to and partnerships with other private/public social service agencies 3. A Behavioral Health Screen and/or Risk Assessment will be completed for unduplicated users at least once in the current fiscal year. 4. The use of an Electronic Medical Records system is required. Assurances 5. These services shall not supplant existing school services. This program is not meant to replace current special education or general education related social work activities provided by school districts. This program shall not take on responsibilities outside of the scope of these Minimum Program Requirements (Individualized Educational Plans, etc.). 6. Services provided shall not breach the confidentiality of the client. 7. The E3 program shall not provide abortion counseling, services, or make referrals for abortion services. 8. The E3 program, if on school property, shall not prescribe, dispense, or otherwise distribute family planning drugs and/or devices. Staffing/Clinical Care 9. The mental health provider shall hold a minimum master's level degree in an appropriate discipline and shall be licensed to practice in Michigan. Clinical supervision must be available for all licensed providers. For those providers that hold a limited license working towards full licensure, supervision must be in accordance to licensure laws/mandates and be provided by a fully licensed provider of the same degree. 10. The E3 program shall be open during hours accessible to its target population. Provisions must be in place for the same services to be delivered during times when school is not in session. Not in session refers to times of the year when schools are closed for extended periods such as holidays, spring breaks, and summer vacation. These provisions shall be posted and explained to clients. The mental health provider shall have a written plan for after-hours and weekend care, which shall be posted in the center including external doors and explained to clients. An after-hours answering service and/or answering machine with instructions on accessing after-hours mental health care is required. If services are not able to continue during periods of not in session, a written plan must be communicated to MDHHS for approval. Administrative 11. Written approval by the school administration (ex: Superintendent, Principal, School Board) exists for the following: a. location of the E3 program within the school building; b. parental and/or minor consent policy; and c. services rendered through the E3 program. A current signed interagency agreement or MOU must be established between the local school district and mental health organization/fiduciary that defines the roles and responsibilities of the mental health provider and of any other mental health staff working within the school. This agreement must state a plan will be in place for transferring clients and/or caseloads if the agreement is discontinued or expires. 12. The mental health provider or contracting agency must bill third party payors for services rendered. Any revenue generated must be used to sustain the E3 program and its services. E3 shall establish and implement a sliding fee scale, which is not a barrier to health care for adolescents. No student will be denied services because of inability to pay. E3 program funding must be used to offset any outstanding balances (including copays) to avoid collection notices and/or referrals to collection agencies for payment. 13. Policies and procedures shall be implemented regarding proper notification of parents, school officials, and/or other health care providers when additional care is needed or when further evaluation is recommended. Policies and procedures regarding notification and exchange of information shall comply with all applicable laws e.g., HIPAA, FERPA and Michigan statutes governing minors' rights to access care. 14. Implement a quality assurance plan. Components of the plan shall include, at a minimum: a. ongoing record reviews by peers (at least semi-annually) to determine that conformity exists with current standards of practice. A system shall be in place to implement corrective actions when deficiencies are noted; b. conducting a client satisfaction survey/assessment at least once annually. 15. The E3 program must have the following policies as a part of overall policies and procedures: a. parental and/or minor consent; b. custody of individual records, requests for records, and release of information that include the role of the non -custodial parent and parents with joint custody; c, confidential services; and d. disclosure by clients or evidence of child physical or sexual abuse, and/or neglect. Physical Environment 16. The E3 program shall have space and equipment adequate for private counseling, secured storage for supplies and equipment, and secure paper and electronic client records. The physical facility must be youth -friendly, barrier -free, clean and safe. PROJECT TITLE: Fetal Alcohol Spectrum Disorder Community Project Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Grantees will collaborate with the Department to assist local communities with evidence - based activities, to implement alcohol screening and prevent prenatal alcohol exposure among women of reproductive age and to refer affected children, birth to 18 years of age, and their families to an FASD Diagnostic Center for evaluation and intervention for the purpose of improving care and services for women, infants and families. Reporting Requirements (if different than agreement language): The Grantee will collect data using the project evaluation/data tracking forms to monitor the FASD community program effectiveness and report service numbers. The Grantee will collect data using the FASD Workplan Narrative Report (A) and the Data Evaluation Report (B) provided, to monitor the FASD community program effectiveness. The Grantee shall submit FASD Workplan report and the Data Evaluation Report electronically to the MDHHS FASD Program Contact Person on dates specified below. a. Grantee must provide documentation that FASD services are tracked for all direct and enabling services provided, including individuals screened, and referred through the FASD community project. Any such other information as specified in the Statement of Work shall be developed and submitted by the Grantee as required by the Contract Manager. c. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the projects as determined. FASD Report Guidance Report Time Period A I, FASD October 1 - December 31 Work Plan January 1 - March 31 Narrative April 1 - June 30 Report July 1 - September 30 B FASD October 1 - March 31 Data Evaluation April 1 — September 30 Report FASD Quarterly Meetings Due Date January 15 April 15 Julv 15 October 15 April 15 October 15 Submit To Email to IuftalO)michigan.gov Email to IuftalC�michioan.gov The Grantee will participate in quarterly Technical Assistance calls with MDHHS FASD Program staff according to the schedule below. Technical Assistance calls are an opportunity for FASD funded projects to share expertise, best practices and promote collaboration for FASD program effectiveness. FASD Technical Assistance Calls � 1 January „16 1 April 16 July 16 October 16 PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Case Abstraction Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis: Qualified individuals will perform medical record case abstraction for Fetal Infant Mortality Review to include the following: • Utilize the FIMR Sampling Plan for case selection template provided. • Review of medical records involved in fetal and infant death to include, but not limited to hospital, prenatal, emergency, and medical examiner's records. • Interact with other agencies and service providers involved in infant's death (Child Protective Services, local health department, law enforcement). • Develop de -identified case summaries from the above abstracted information, as well as the FIMR interview. • Attend the review team meetings to facilitate the presentation of the cases and develop recommendations, utilizing the Michigan FIMR CRT Recommendation Form and Michigan FIMR Log of Local Recommendations. • Utilize the Michigan FIMR Health Equity Toolkit and/or other resources for training FIMR CRT members on equity, bias, diversity, and inclusion. • Enter cases into the National Fatality Review Case Reporting System (FIMR database) at the National Center for Fatality Review and Prevention. • Present FIMR findings and recommendations to local FIMR Community Action Team (CAT) annually, at a minimum, to develop action plans. Reporting Requirements (if different than agreement language): Quarterly progress reports following the template provided. Quarterly reports are due the 15th of the month following the end of the quarter and are submitted to Audra Brummel, State coordinator, via email at brummelan.michigan.gov. Reporting Time Period Due Date j 1$t Quarter October 1 — December 31 January 15 2nd Quarter January 1 — March 31 April 15 3rd Quarter April 1 —June 30 July 15 4th Quarter July 1 — September 30 October 15 Any additional requirements (if applicable): Each completed case abstraction will be compensated at $270.00 per case. FIMR team recommendations and information will be used to inform the State of Michigan infant mortality reduction efforts. Maximum Program Reimbursement: Grantee Berrien County Health Department Calhoun County Public Health Department Detroit Health Department Genesee County Health Department Ingham County Health Department Jackson County Health Department Kalamazoo County Health and Community Services Department Kent County Health Department Macomb County Health Department Public Health Muskegon County Oakland County Department of Health and Human Services/Health Division Saginaw County Health Department Maximum Reimbursement Amount $ 4,050 $ 3,240 $ 2,700 $ 4,115 $ 3,240 $ 3,240 $ 6,480 $ 12,150 $ 4,050 $ 2,700 $ 6,480 PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Interviews Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis: Conduct Fetal Infant Mortality Review (FIMR) interviews with the intent of informing the FIMR case abstraction process and informing the infant mortality reduction efforts both locally and statewide. Reporting Requirements (if different than agreement language): Mid -year progress report and final report using the FIMR interviews template, which will address what was learned about preventability at the individual, clinical care, health system, community, and policy level are due April 15 and a final report due October 15 by submission to Audra Brummel, State coordinator, via email at brummela(a.michigan.gov. Any additional requirements (if applicable): Each completed FIMR interview will be compensated at $125.00 per interview. A maximum of 6 visits are reimbursable per fetal/infant death up to the contract allocation. FIMR team recommendations and information will be used to inform the State of Michigan infant mortality reduction efforts. Utilize the following Michigan FIMR Network resources: a) Michigan FIMR Network Maternal/Family Interview Guide b) FIMR Case Review Team (CRT) Recommendation Form and the Log of Local FIMR Recommendations c) Michigan FIMR Network Health Equity Toolkit Additional Requirements for Detroit Health Department oniv: At least 1 MMMS next of kin interviews will be completed by September 30, 2023. Each completed MMMS next of kin interview will be compensated at $250.00 per interview. A maximum of 6 visits are reimbursable per case up to the contract allocation. The MMMS next of kin interview will follow the FIMR methodology and the Michigan FIMR Interview Guide questionnaire with additional questions relevant to maternal deaths. Use of consent forms, questionnaire, and template for collecting interview summaries provided. The DHD FIMR Interviewer will be invited to MMMS Maternal Mortality Review Committee (MMRC) meetings when an interview is completed to provide an overview and additional details on the interview. Maximum Program Reimbursement: Grantee Berrien County Health Department Calhoun County Public Health Department Detroit Health Department Ingham County Health Department Jackson County Health Department Kalamazoo County Health and Community Services Department Kent County Health Department Macomb County Health Department Public Health Muskegon County Oakland County Department of Health and Human Services/Health Division Maximum Reimbursement Amount $ 1,875 $ 1,500 $ 6,750 — FIMR $ 2,000 — MMMS $ 2,500 $ 1,250 $ 2,250 $ 1,250 $ 1,500 $ 625 $ 2,000 PROJECT TITLE: FFPSA (Family First Prevention Services Act) HV Expansion Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The FFPSA project is a national initiative being implemented in Michigan to support the prevention of the placement of children into foster care. FFPSA support Positive Parenting Programs such as evidence -based home visiting models. Each HV Model is implemented in accordance with the standards and tenants of that particular model. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department reporting requirements. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the 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. In addition to other data required by MDHHS, LIAs are required to record and submit monthly FFPSA billable reporting through REDCap by the 51h business day of each month. This data includes: • Family demographic information (including MiSACWIS IDs) • The number of children in the family and corresponding MiSACWIS IN (per DHHS referral form) Enrollment date • Eligible/ineligible status • FFPSA eligibility change dates • Closure date if family has exited home visiting services c. Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter (January 30, April 30, July 30, and October 30). All reports and/or information (a-d), unless stated otherwise, shall be submitted electronically to the MDHHS Home Visiting mailbox at MDHHS- HVlnitiative(amichigan.gov. e. Implementation Monitoring Data and HRSA data collection requirements due in REDCap by the 5th business day of each month. HFA programs must use Home Visiting On -Line (HVOL) and NFP programs must use Flo for all model and other MDHHS required data. f. Quality Improvement Reporting: Documentation of a QI team will be submitted with the quarterly Work Plan Report. Documentation of QI activities will be submitted with the quarterly Work Plan Report. • Annual summary of QI activities will be submitted to the Model Consultant by February 15 g. HV ColIN Reporting (for those LIAs participating) for QI efforts shall occur in accordance with the ColIN'S schedule. Participating LIAs are required to use the HV ColIN site to complete monthly submissions of PDSA cycles and required data (the frequency of data collection may vary). Reports (e-g) shall be submitted as described above. Additional guidance concerning data collection and Quality Improvement is provided in the MDHHS Home Visiting Guidance Manual. Any additional requirements (if applicable): Home visitors funded through Family First Prevention Services Act will serve families referred from local Child Welfare agencies, in proportion to their FFPSA FTE. HFA Z= a. 10-12 FFPSA families per 1.0 FTE for first year of implementation as well as new home visitors. b. 12-16 FFPSA families per 1.0 FTE following second year of implementation. c. 25 FFPSA families per 1.0 FTE LIAs are required to work with MDHHS to complete a Memorandum of Understanding with MDHHS to establish expectations for the relationship that is being built between child welfare and the home visiting program. Healthy Families America (HFA) LIAs will need to submit the HFA's Child Welfare Protocol application to HFA National. They will also need to work with their assigned Child Welfare Service Analyst to obtain the signature of their local DHHS office on a letter of support. Both need to be completed before an HFA LIA can enroll any families under FFPSA or the Child Welfare Protocol. Maintain Fidelitv to the Model The LIA shall adhere to the Home Visiting model Best Practice Standards or Model Elements. In addition, all Healthy Families America affiliates shall comply with the requirements of the Central Administration for the Multi -Site State System (also known as "The State Office") housed within the Michigan Public Health Institute. Comply with MDHHS Program Requirements The LIA shall operate the program with fidelity to the requirements of MDHHS based on the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting Guidance Manual. The LIA will fulfill these requirements while strengthening efforts towards health and racial equity through staff education, programmatic data evaluation and client supportive services. P.A. 291 The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS Home Visiting Guidance Manual for requirements related to PA 291. Staffing The LTA's home visiting staff will reflect the community served. The LIA will provide documentation to demonstrate due diligence if unable to fully meet this requirement within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Guidance Manual for requirements related to program staffing. Performance Measures: The LIA shall comply with MDHHS expectations of demonstrating improvement in the performance measures as described in the MDHHS Home Visiting Guidance Manual. Program Monitorinq. Qualitv Assessment, Support and Technical Assistance. fiAZ The LIA shall fully participate with the Department and the Michigan Public Health Institute (MPHI) with regards to program development and monitoring (including annual site visits either in -person or virtual), training, support and technical assistance services. See the MDHHS Home Visiting Guidance Manual for requirements related to program monitoring, quality assessment, support and TA. Professional Development and Training: All of the LTA's program staff associated with this funding will participate in professional development and training activities as required by both the model and the Department. See the MDHHS Home Visiting Guidance Manual for requirements related to professional development and training activities. Supervision: The LIA shall adhere to the HV Model supervision requirements: HFA: Weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice Standards. NFP: LIA shall adhere to the NFP supervision requirements. Written policies and procedures shall specify how reflective supervision is included in, or added to, that time to ensure provision for each home visitor at a minimum of one hour per month. Engage and Coordinate with Communitv Members, Partners and Parents: The LIA shall build a relationship with their local DHHS office. LIAs are expected to inform the DHHS worker for their assigned FFPSA families of the enrollment date, referral status within two weeks of referral, if a home visitor has not been able to connect with a family in two weeks, and closure date. LIA will coordinate with DHHS when approaching annual review for any enrolled FFPSA families. The LIA shall ensure that there is a broad -based community advisory committee that is providing oversight for their specific model. The LIA shall build upon and maintain diverse community collaboration and support with authentic engagement of parent representatives who have the lived experience and expertise. The LIA shall participate in the Local Leadership Group (LLG) (if it is not the community advisory committee) or, if none, the Great Start Collaborative. See the MDHHS Home Visiting Guidance Manual for requirements related to engagement with community partners. Data Collection: The LIA shall comply with all model and MDHHS data training, collection, entry and submission requirements. See the MDHHS Home Visiting Guidance Manual for requirements related to data collection. Qualitv Improvement (QI): The LIA shall participate in all HV Model quality initiatives including research, evaluation, and continuous quality improvement. The LIA shall participate in all state and local Home Visiting QI activities as required by MDHHS. Required activities include, but are not limited to: • Developing and maintaining a QI team • Participating in QI activities during the fiscal year. • Consulting with QI coaches See the MDHHS Home Visiting Guidance Manual for requirements related to QI. Work Plan Requirements: By June 30, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox (MDHHS- HVlnitiative(@.michioan.gov) for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. Promotional Materials: If the LIA wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting Guidance Manual. PROJECT TITLE: Gonococcal Isolate Surveillance Project Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis: This project will monitor trends in antimicrobial susceptibilities in N. gonorrhoeae via collection and submission of required specimens and data to the Centers for Disease Control and Prevention. Patient demographics and specimen phenotypes, particularly for non -susceptible specimens, will be characterized, and genetic markers associated with antimicrobial resistance will be identified and monitored using remnant NAATS. Reporting Requirements (if different than agreement language): Report Submit clinical and demographic data to CDC Complete and submit shipping manifest Collect and submit N. gonorrhea isolates Collect and submit remnant NAAT samples for gonorrhea - positive isolates above Complete and submit annual progress report The number of culture specimens collected, and number of presumptive positive GC forwarded to CDC and their designated laboratories for further testing. Demographic and behavioral data to MDHHS for clients with GC positive isolates utilizing the CDC required format. Period Due Date(s) How to Submit Report Monthly 4 weeks after end of Via SAMS month Papercopy First Monday of the with isolates, Monthly following month and electronic FTP report to ARLN Monthly First Monday of the Ship to ARLN 1 following month 4 weeks after end of Ship directly to Monthly month CDC STD- LRRB 90 days after end of Collaborate Annually grant period, or as with kenti3(a�rnichia defined by CDC an.gov Written report January 15, April 15, submitted to Quarterly July 15, October 15 kentiUcbmichiq an.gov; Written report January 15, April 15, submitted to Quarterly July 15, October 15 kenti3 @michia. an.gov; Report of any specimen that exceeds the alert criteria: Ceftriaxone MIC >_ 0.125 pg/ml Cefixime MIC >_ 0.25 pg/ml Azithromycin MIC >_ 2.0 pg/ml GRANTEE REQUIREMENTS Grant Program Operation Immediate Per high -resistance specimen Phone or email to Jim Kent 517-243-4932, kentj3@michig an.gov 1. Monitor trends in antimicrobial susceptibilities in N. gonorrhoeae. 2. Characterize patients with gonorrhea (GC), particularly those infected with N. gonorrhoeae that are not susceptible to recommended antimicrobials. 3. Phenotypically characterize antimicrobial -resistant isolates to describe the diversity of antimicrobial resistance in N. gonorrhoeae. 4. For male STI clinic patients suspected of having GC, collect a NAAT sample during the same visit as the urogenital sample collected above. 5. For the first 25 clients with positive isolates, submit culture specimens to CDC assigned Regional Laboratory for further testing; and associated demographic and behavioral data to the CDC and MDHHS at agreed intervals. 6. For the first 25 clients with positive isolates, submit residual NAAT specimens directly to CDC molecular laboratory. 7. Monitor and track clinic totals including a. Number of men with urethral sample collected and tested for gonorrhea (positive and negative) b. Number of gonococcal isolates submitted to Region Laboratory c. Number of isolates found by Regional Laboratory to be non -viable or contaminated. d. Percentage of monthly isolate batches shipped to Regional Laboratory within one week after the end of the month e. Percentage of monthly demographic data transmissions submitted to CDC within one month after the end of the month f. Percentage of collected isolates that include a) age, b) gender of sex partner, c) HIV status, d) antibiotic use, and d) treatment g. Number of remnants NAAT samples submitted to CDC h. Number of remnants NAAT testing positive, negative, or equivocal Technical Assistance Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos://bit.1y/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SI-OARS- SUPPORTCo michician.00v PROJECT: Harm Reduction Support Services Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis Grantees and subrecipients of these funds are authorized by the State of Michigan to distribute syringes for the purposes of preventing the transmission of communicable diseases. These dollars will be used by the grantee to plan and implement syringe service programs within their jurisdictions. Grantees will develop policies and protocols following best practice guidance with respect to client registration, supply disposal and supply distribution, education of participants, staff training, referral to substance use treatment, referral or testing for infectious diseases, and provision of naloxone for overdose prevention. Reporting Requirements (if different than contract language) Grantees will be enrolled and submitting service delivery data to the Syringe Service Program Utilization Platform (SUP) Grantees will participate on monthly conference calls to discuss the state of SSP in Michigan, share successes, challenges, and best practices Any additional requirements (if applicable) • Funds may not be used to buy sterile needles or syringes • Grantees must establish relationships to link clients to care for substance use disorder treatment • Grantees must be able to provide clients with naloxone • If sites are performing HIV and/or HCV testing, grantees should establish relationships to link clients to care for HIV and/or HCV follow-up testing and treatment. • If sites are not performing HIV and or/HIV testing, grantees should establish relationships to refer clients to HIV and/or HCV testing. PROJECT TITLE: HIV Care Coordination Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis: The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income people living with HIV who are uninsured and underserved. The program provides funding to provide care and treatment services to people living with HIV to improve health outcomes and reduce HIV transmission among hard -to -reach populations. Reporting Requirements: The Grantee shall permit the Division of HIV/STI Programs (DHSP) or its designee to conduct site visits and to formulate an evaluation of the project. The Grantee and its subcontractors are required to use the HRSA-supported software CW to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 3. To complete the Ryan White Services Report (RSR), a Health Resources and Services Administration (HRSA) required annual data report, the Grantee must assure that all CAREWare data is complete, cleaned, and entered into the HRSA Electronic Handbook. RSR submission requirements include: a. The RSR shall have no more than 5% missing data variables. b. The Department validates the data within the Grantee's RSR submission before receipt by HRSA. c. Data in CAREWare must be checked and validated every quarter. Grantee Report Submission Schedule Report All Agencies: Ryan White services delivered to HIV - infected and affected clients All Agencies: Ryan White Services Report (RSR) Period Due Date(s) Monthly 10th of the following month Annual Generally, Grantee submission will open in early February and close early March. How to Submit Report Enter into CAREWare (CW) Submission to HRSA through Electronic Handbook (EHB) All Ryan White federally Annual December 31 st Email report to funded agencies providing at MDHHS- least one core medical HIVSTlooerations(a)mi service: Quality Management chigan.gov Plan All Ryan White federally 10/1/22 — As completed Email report to funded agencies: Complete 9/30/23 over contract year MDHHS- and submit at least one Plan- HIVSTlooerations(d).mi Do -Study -Act worksheets to chigan.gov document progress of QI project All Agencies: Complete Quarterly Thirty days after quarterly workplan progress the end of the reports budget period All Ryan White federally Quarterly Thirty days after funded agencies: FY23 actual the end of the expenditures by service budget period category, program income, and administrative costs through the RW Reporting Tool Submit in EGrAMS Email report to MDHHS- HIVSTIooerations(@mi chiaan.cov Attached to quarterly FSR All Ryan White federally Annually December 31 st Uploaded to EGrAMS funded agencies: RW Form Portal Agency Profile 2100 and RW Form 2300 *Reports and information shall be submitted to the Division of HIV/STI Programs (DHSP). Please refer to the table for where to submit reports and information. Any additional requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. Fees The Grantee must establish and implement a process to ensure that they are maximizing third party reimbursements, including: Requirement, in agreement, that the Grantee maximize and monitor third party reimbursements. b. Requirement that Grantee document, in client record, how each client has been screened for and enrolled in eligible programs. c. Monitoring to determine that Ryan White is serving as the payer of last resort, including review of client records and documentation of billing, collection policies and procedures, and information on third party contracts. d. Grantee must adhere to the National Monitoring Standards for Rvan White Part B Grantees: Prooram and the National Monitorina Standards for Rvan White Grantees: Fiscal; and bill for services that are billable in accordance with the above. Ensure appropriate billing, tracking, and reporting of program income to support appropriate use for program activities. Program income is added to funding provided by the State of Michigan for the budget period and used to advance eligible program objectives. g. Provide a report detailing the expenditure and reinvestment of program income in the program (template will be provided by MDHHS). Grant Program Operation 1. The Grantee will participate in the Department needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the Department. 3. The Grantee is responsible for ensuring that staff retain minimum educational requirements for staff positions and are proficient in Ryan White -funded service delivery in their respective roles within the organization. Ensure that Ryan White funded staff receive MDHHS required case management training within one (1) year of hire. 4. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for Ryan White funds must match the percentage claimed on the Ryan White FSR for the same period. Submit a budget modification to the Department in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. 5. The Grantee must submit all details on advertising campaigns (print and social media) completed via the quarterly workplan progress report submission in EGrAMS. 6. The Grantee must include the following language in all Client Consent and Release of Information forms used for services in this agreement: "Consent for the collection and sharing of client information to providers for persons living with HIV under the Ryan White Program provided through (grantee name) is mandated to collect certain personal information that is entered and saved in a federal data system called CAREWare. CAREWare records are maintained in an encrypted and secure statewide database. I understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same care and data network for the purpose of informing and coordinating my treatment and benefits that I receive under this Program. The CAREWare database program allows for certain medical and support service information to be shared among providers involved with my care, this includes but is not limited to health information, medical visits, lab results, medications, case management, transportation, Housing Opportunities for Persons with AIDS (HOPWA) program, substance abuse, and mental health counseling. I acknowledge that if I fail to show for scheduled medical appointments, I may be contacted by an authorized representative of (grantee name) in order to re-engage and link me back to care." 7. The Grantee must notify the Continuum of Care Unit staff at MDHHS- HIVSTIooerationsCa)michiaan.00v within 7 business days if a core medical or support service category is added or removed from the Ryan White services previously approved by DHSP. An approval from DHSP is required prior to the change being implemented. 8. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs. CDC Website: httos://www.cdc.gov/nchhstp/pmgraminteq ration/docs/pcsidatasecuritvquideI in es. df. 9. The Grantee will complete the collection of all required data variables and clean- up any missing data or service activities by the 10th day after the end of each calendar month. 10.Subrecipient quality management program should: a. Include: leadership support, dedicated staff time for QM activities, participation of staff from various disciplines, ongoing review of performance measure data and assessment of consumer satisfaction. b. Include consumer engagement which includes, but is not limited to, agency - level consumer advisory board, participation on quality management committee, focus groups and consumer satisfaction surveys. c. Include conduction of at least one quality improvement (QI) project throughout the year, using the Plan -Do -Study -Act (PDSA) method to document progress. This QI project must be aimed at improving client care, client satisfaction, or health outcomes. 11.If the Grantee is federally funded for Ryan White services (one of which is a core medical service), the Grantee will develop and/or revise a Quality Management Plan (QMP) annually, to be kept on file at agency. QM Plans must contain these eleven components: a. Quality statement b. Quality infrastructure c. Annual quality goals d. Capacity building e. Performance measurement f. Quality improvement g. Engagement of stakeholders h. Procedures for updating the QM plan i. Communication j. Evaluation k. Work Plan 12. The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02 established by Health Resources and Services Administration (HRSA). PCN #16-02 describes the core medical and support services that HRSA considers allowable uses of Ryan White grant funds and the individuals eligible to receive those services. A copy of the revised PCN 16-02 is available at this link. HRSA Unallowable Costs: *An expanded list of "unallowable" arant costs is available in the PCN 16-02. a. HRSA RWHAP funds may not be used to make cash payments to intended clients of HRSA RWHAP-funded services. This prohibition includes cash incentives and cash intended as payment for HRSA RWHAP core medical and support services. Where a direct provision of the service is not possible or effective, store gift cards, vouchers, coupons, or tickets that can be exchanged for a specific service or commodity (e.g., food or transportation) must be used. b. Off -premises social or recreational activities (movies, vacations, gym memberships, parties, retreats) c. Medical Marijuana d. Purchase or improve land or permanently improve buildings e. Direct cash payments or cash reimbursements to clients f. Clinical Trials: Funds may not be used to support the costs of operating clinical trials of investigational agents or treatments (to include administrative management or medical monitoring of patients) g. Clothing: Purchase of clothing h. Employment Services: Support employment, vocational rehabilitation, or employment -readiness services. Funerals: Funeral, burial, cremation, or related expenses j. Household Appliances k. Mortgages: Payment of private mortgages I. Needle Exchange: Syringe exchange programs, Materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual m. International travel n. The purchase or improvement of land o. The purchase, construction, or permanent improvement of any building or other facility p. Pets: Pet food or products Taxes: Paying local or state personal property taxes (for residential property, private automobiles, or any other personal property against which taxes may be levied) r. Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -owned vehicle or any additional costs associated with a privately -owned vehicle, such as a lease, loan payments, insurance, license or registration fees s. Water Filtration: Installation of permanent systems of filtration of all water entering a private residence unless in communities where issues of water safety exist. t. It is unallowable to divert program income (income generated from charges/ fees and copays from Medicare, Medicaid, other third -party payers collected to cover RW services provided) toward general agency costs or to use it for general purposes. u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02 v. Non -occupational Post -Exposure Prophylaxis (nPEP). w. General -use prepaid cards are considered "cash equivalent' and are therefore unallowable. Such cards generally bear the logo of a payment network, such as Visa, MasterCard, or American Express, and are accepted by any merchant that accepts those credit or debit cards as payment. Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general -use prepaid cards, not store gift cards, and therefore are unallowable. HRSA RWHAP recipients are advised to administer voucher and store gift card programs in a manner which assures that vouchers and store gift cards cannot be exchanged for cash or used for anything other than the allowable goods or services, and that systems are in place to account for disbursed vouchers and store gift cards, Personnel Systems Access/Transfer/Terminations 1. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperationsa.michigan.aov of CAREWare users who are separated from the agency for deactivation. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client files and charts from last date of service plus seven (7) years. For minors, Grantee will maintain client files and records from last date of service and until minor reaches the age of 18, whichever is longer, plus 3. seven (7) years. Software Compliance 1. The Grantee and its subcontractors are required to use the HRSA-supported software CAREWare to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Successfully create, run, and document the results of their HRSA RSR report in CAREWare in order to receive relevant support from data managers by the 10'h of the following month. Documentation is to include with identifying information omitted: i. Missing records as depicted in the RSR Viewer module in CAREWare ii. A list of alert, warning, and error messages as depicted in the RSR Validation Report module in CAREWare iii. Efforts or decisions (including collaboration with MDHHS) to resolve missing data or error messages as applicable d. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 2. The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up files stored in a secure location. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning sharing and Secured Electronic Data. 4. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 5. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations anmichigan.gov of CAREWare users who are separated from the agency for deactivation. 6. The Grantee shall as be required by HRSA submit the Rvan White HIV/AIDS Program Services Report (RSR) for the previous calendar year. The Grantee is required to use the HRSA Electronic Handbook (EHB) portal for their submission: a. The Grantee shall acquire access to their agency's Grant Contract Management System (GCMS) and their Provider Report prior to January when notified by HRSA of the required federal report. b. The Grantee is required to provide access to all staff and personnel responsible for reviewing and completing the RSR. c. The Grantee as per HRSA standards and compliance are mandated to require relevant staff members to update their EHB account passwords as dictated by HRSA email notifications. d. The Grantee is mandated to update or add contact information for staff responsible for completing and/or submitting the RSR and to notify MDHHS of any changes in personnel immediately. e. The Grantee shall correspond with MDHHS staff including data management users to compare units of service provided to the funded services listed on the EHB. f. The Grantee shall notify MDHHS immediateiv if there are any discrepancies between the funding sources and services listed for their agency's report on the Electronic Handbook (EHB) and their agency's contracts and records. g. The Grantee shall in these circumstances contact Ryan White Data Support by email or by phone number (1-888-640-9356) between the hours of 10 am — 6:30 pm Eastern Standard Time (EST) on weekdays regarding the HRSA EHB GCMS and/or RSR: Issues with account lockouts, lost credentials, or account creation Issues with accessing the GCMS through the HRSA EHB iii. Issues with accessing the Provider Report through the HRSA iv. Technical issues regarding functionality of the EHB portal h. The Grantee shall attend webinars and instructional sessions to answer questions about the RSR; Grantee shall utilize tools provided by data management users to check on the accuracy and completeness of their client level data (CLD) on a monthly basis leading up to the RSR. These include bui are not limited to: TargetHIV/DISQ webinars regarding the RSR HRSA produced documentation and manuals on RSR reporting requirements for the calendar year iii. Manuals on utilizing CAREWare for completing the RSR iv. PowerPoint presentations on aspects of the RSR V. Staff invitations to Teams meetings and breakout sessions to answer questions regarding the RSR vi. CAREWare custom reports and financial reports designed to assess 1. The number of eligible clients 2. The number of eligible clients that need to be marked as such 3. Services provided by the Grantee 4. CLD on ZIP codes, ethnicity, and other features vii. Emails from MDHHS staff regarding the above but also including: 1. Updates on HRSA reporting requirements 2. New information provided from HRSA 3. Other resources HRSA is providing/will provide The Grantee shall after notification from MDHHS staff including data management users implement needed corrections and additions to CLD in CAREWare to ensure compliance with HRSA federal reporting standards. Mandatory Disclosures 1. The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. b. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. c. Any staff vacancies funded for this project that exceed 30 days. All notifications should be made to DHSP by MDHHS-HIVSTIoperations(a).michiaan.gov. Technical Assistance Technical assistance (TA) may be requested on the implementation of the Ryan White program. This may include issues related to: CAREWare, Quality Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or other activities related to carrying out Ryan White activities. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos://bit.ly/3HS7xdG Grantee must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT(@michigan.gov. ASSURANCES Compliance with Applicable Laws 1. The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. 2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public Health Service (PHS) Act. 3. The Grantee should have procedures to protect the confidentiality and security of client information. PROJECT TITLE: HIV Data to Care Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Data to Care (D2C) is a Centers for Disease Control (CDC) program specifically focused on people living with HIV (PLWH) that are not engaged in care. D2C employs an intensive individualized outreach program which works to eliminate barriers (transportation, insurance, access/knowledge of access to medical care, stigma -related mental health issues, etc.) to accessing care through a combination of referrals and linkage to existing Early Intervention Services (EIS) providers, Ryan White Service providers and other community services. D2C is an essential program that facilitates access to HIV treatment. Reporting Requirements: The Grantee shall maintain up to date information in CAREWare (CW) in preparation for evaluation: NIC client level data and services provided list All Funded agencies: Complete quarterly workplan progress reports All Agencies: Ryan White Services Report (RSR) All Agencies: FY23 actual expenditures by service category, program income, and administrative costs through the RW Reporting Tool Period Due Date(s) Monthly 10th of the following month Quarterly 30 days after the end of the budget period Annual Generally, Grantee submission will open in early February and close early March. Monthly Thirty days after the end of the budget period How to Submit Report Enter into CAREWare Email report to MDHHS- H IVSTloperations(o)m ichiq an. ov Submission to HRSA through Electronic Handbook (EHB) Attached to monthly FSR 1. To complete the Ryan White Services Report (RSR), a Health Resources and Services Administration (HRSA) required annual data report, the Grantee must assure that all CW data is complete, cleaned, and entered into an online form via the HRSA EHB. RSR submission requirements include: a. The RSR shall have no more than 5% missing data variables. b. Exact dates for the Grantee submission will be provided by the Department each reporting year. c. The Department validates the data within the Grantee's RSR submission before receipt by HRSA. d. Data in CAREWare must be checked and validated every quarter. 2. Reports and information shall be submitted to the Division of HIV/STI Programs (DHSP). Please refer to the table for where to submit reports and information. 3. The Grantee shall permit the Division of HIV/STI Programs (DHSP) or its designee to conduct site visits and to formulate an evaluation of the project. Any additional requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. Fees The Grantee must establish and implement a process to ensure that they are maximizing third party reimbursements, including: a. Requirement, in agreement, that the Grantee maximize and monitor third party reimbursements. b. Requirement that Grantee document, in client record, how each client has been screened for and enrolled in eligible programs. c. Monitoring to determine that Ryan White is serving as the payer of last resort, including review of client records and documentation of billing, collection policies and procedures, and information on third party contracts. d. Grantee must adhere to the National Monitorinq Standards for Rvan White Part B Grantees: Proqram and the National Monitorinq Standards for Ryan White Grantees: Fiscal; and bill for services that are billable in accordance with the above. e. Ensure appropriate billing, tracking, and reporting of program income to support appropriate use for program activities. f. Program income is added to funding provided by the State of Michigan for the budget period and used to advance eligible program objectives. g. Provide a report detailing the expenditure and reinvestment of program income in the program (template will be provided by MDHHS). Grant Program Operation 1, If Grantee is receiving NIC list via secure transfer (e.g. DCH file transfer): a. Grantees must enter NIC lists into CW. b. Grantees must maintain password protected NIC lists on secure server locations and not in any portable storage devices. c. Grantees must store NIC lists on shared servers and not on desktops or personal computers. d. Grantees must transmit updated surveillance data to MDHHS in pre -approved secure manners (e.g. DCH file transfer). e. If NIC lists or partial lists are sent via US Mail, list size must not exceed 10 individuals in a given mailing and words indicating HIV infection must not be contained in the sent documents. 2. If Grantee is receiving NIC list via direct CW import, grantee must complete necessary fields in CW for transfer back to Surveillance. 3. Grantees must not email NIC lists or individual health information contained on NIC lists either internally or externally. 4. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs httiDs://www.edc.gov/nch hstiD/program integration/docs/r)csidatasecu ritvqu idel in es.pdf. 5. Grantees will document all data sharing agreements and share a copy with the Department. The data sharing agreements may be emailed to MDHHS- HIVSTIooerations(a)michigan.gov 6. Grantees must provide written documentation of annual Security and Confidentiality training for all staff that have access to NIC lists. 7. Grantees will maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs, httos://www.edc.ciov/nchhstr)/Drogramintearation/docs/iDcsidatasecuritvqu ideli nes.p df 8. The Grantee will participate in the DHSP needs assessment and planning activities, as requested. a. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the DHSP. b. The Grantee will use CW to report program activities, the Grantee must include the following language in all Client Consent and Release of Information forms used for services in this agreement: "I also understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same care and data network. [AGENCY] is mandated to collect certain personal information that is entered and saved in a database system called CAREWare. CW records are maintained in an encrypted and secure statewide database. The CW database program allows for certain medical and support service information to be shared among providers involved with your care, this includes but is not limited to medical visits, lab results, medications, case management, transportation, substance abuse, and mental health counseling. 9. The Grantee must notify the Continuum of Care Unit staff at MDHHS- HIVSTIODerations(o�.michioan.aov within 7 business days if a core medical or support service category is added or removed from the Ryan White services previously approved by DHSP. An approval from DHSP is required prior to the change being implemented. 10.The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs. CDC Website: httDs://www.cdc.00v/nch hstD/r)roaramintearation/docs/Dcsidatasecuritvau idel in es.pdf. 11.In CW, the Grantee will complete the collection of all required data variables and clean-up any missing data or service activities by the 10th day after the end of each calendar month. 12.The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16- 02 established by Health Resources and Services Administration (HRSA). PCN #16-02 describes the core medical and support services that HRSA considers allowable uses of Ryan White grant funds and the individuals eligible to receive those services. A copy of the revised PCN 16-02 is available at this link. HRSA Unallowable Costs: 'An expanded list of "unallowable" grant costs is available in the PCN 16-02. a. HRSA RWHAP funds may not be used to make cash payments to intended clients of HRSA RWHAP-funded services. This prohibition includes cash incentives and cash intended as payment for HRSA RWHAP core medical and support services. Where a direct provision of the service is not possible or effective, store gift cards, vouchers, coupons, or tickets that can be exchanged for a specific service or commodity (e.g., food or transportation) must be used. b. Off -premises social or recreational activities (movies, vacations, gym memberships, parties, retreats) c. Medical Marijuana d. Purchase or improve land or permanently improve buildings e. Direct cash payments or cash reimbursements to clients Clinical Trials: Funds may not be used to support the costs of operating clinical trials of investigational agents or treatments (to include administrative management or medical monitoring of patients) g. Clothing: Purchase of clothing h. Employment Services: Support employment, vocational rehabilitation, or employment -readiness services. Funerals: Funeral, burial, cremation, or related expenses j. Household Appliances k. Mortgages: Payment of private mortgages Needle Exchange: Syringe exchange programs, Materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual m. International travel n. The purchase or improvement of land o. The purchase, construction, or permanent improvement of any building or other facility p. Pets: Pet food or products Taxes: Paying local or state personal property taxes (for residential property, private automobiles, or any other personal property against which taxes may be levied) r. Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -owned vehicle or any additional costs associated with a privately -owned vehicle, such as a lease, loan payments, insurance, license or registration fees s. Water Filtration: Installation of permanent systems of filtration of all water entering a private residence unless in communities where issues of water safety exist. t. It is unallowable to divert program income (income generated from charges/ fees and copays from Medicare, Medicaid, other third -party payers collected to cover RW services provided) toward general agency costs or to use it for general purposes. u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02 v. Non -occupational Post -Exposure Prophylaxis (nPEP). w. General -use prepaid cards are considered "cash equivalent' and are therefore unallowable. Such cards generally bear the logo of a payment network, such as Visa, MasterCard, or American Express, and are accepted by any merchant that accepts those credit or debit cards as payment. Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general -use prepaid cards, not store gift cards, and therefore are unallowable. * HRSA RWHAP recipients are advised to administer voucher and store gift card programs in a manner which assures that vouchers and store gift cards cannot be exchanged for cash or used for anything other than the allowable goods or services, and that systems are in place to account for disbursed vouchers and store gift cards. Personnel Systems Access/Transfer/Terminations 1. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIooerations(a)michiaan.gov of CAREWare users who are separated from the agency for deactivation. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client files, charts, and electronic records from last date of service plus seven (7) years. For minors, Grantee will maintain client files and records from last date of service and until minor reaches the age of 18, whichever is longer, plus seven (7) years. Software Compliance The Grantee and its subcontractors are required to use the HRSA-supported software CAREWare to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Successfully create, run, and document the results of their HRSA RSR report in CAREWare in order to receive relevant support from data managers by the 10th of the following month. Documentation is to include with identifying information omitted: Missing records as depicted in the RSR Viewer module in CAREWare • A list of alert, warning, and error messages as depicted in the RSR Validation Report module in CAREWare. Efforts or decisions (including collaboration with MDHHS) to resolve missing data or error messages as applicable d. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up files stored in a secure location b. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses 3. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning sharing and Secured Electronic Data. 4. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 5. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIooeration st7a,michigan.gov of CAREWare users who are separated from the agency for deactivation. The Grantee shall as be required by HRSA submit the Rvan White HIV/AIDS Proqram Services Report (RSR) for the previous calendar year. The Grantee is required to use the HRSA Electronic Handbook (EHB) portal for their submission: a. The Grantee shall acquire access to their agency's Grant Contract Management System (GCMS) and their Provider Report prior to January when notified by HRSA of the required federal report. The Grantee is required to provide access to all staff and personnel responsible for reviewing and completing the RSR. c. The Grantee as per HRSA standards and compliance are mandated to require relevant staff members to update their EHB account passwords as dictated by HRSA email notifications. The Grantee is mandated to update or add contact information for staff responsible for completing and/or submitting the RSR and to notify MDHHS of any changes in personnel immediately. e. The Grantee shall correspond with MDHHS staff including data management users to compare units of service provided to the funded services listed on the EHB. f. The Grantee shall notify MDHHS immediately if there are any discrepancies between the funding sources and services listed for their agency's report on the Electronic Handbook (EHB) and their agency's contracts and records. The Grantee shall in these circumstances contact Ryan White Data Support by email or by phone number (1-888-640-9356) between the hours of 10 am — 6:30 pm Eastern Standard Time (EST) on weekdays regarding the HRSA EHB GCMS and/or RSR: • Issues with account lockouts, lost credentials, or account creation • Issues with accessing the GCMS through the HRSA EHB • Issues with accessing the Provider Report through the HRSA • Technical issues regarding functionality of the EHB portal The Grantee shall attend webinars and instructional sessions to answer questions about the RSR; Grantee shall utilize tools provided by data management users to check on the accuracy and completeness of their client level data (CLD) on a monthly basis leading up to the RSR. These include but are not limited to: • TargetHIV/DISQ webinars regarding the RSR HRSA produced documentation and manuals on RSR reporting requirements for the calendar year • Manuals on utilizing CAREWare for completing the RSR • PowerPoint presentations on aspects of the RSR • Staff invitations to Teams meetings and breakout sessions to answer questions regarding the RSR • CAREWare custom reports and financial reports designed to assess: 1. The number of eligible clients 2. The number of eligible clients that need to be marked as such 3. Services provided by the Grantee 4. CLD on ZIP codes, ethnicity, and other features • Emails from MDHHS staff regarding the above but also including: 1. Updates on HRSA reporting requirements 2. New information provided from HRSA 3. Other resources HRSA is providing/will provide The Grantee shall after notification from MDHHS staff including data management users implement needed corrections and additions to CLD in CAREWare to ensure compliance with HRSA federal reporting standards. Mandatory Disclosures The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. b. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. c. Any staff vacancies funded for this project that exceed 30 days. All notifications should be made to DHSP by MDHHS-HIVSTIooerations(a)michigan.gov. Technical Assistance Technical assistance (TA) may be requested on the implementation of the Ryan White program. This may include issues related to: CAREWare, Quality Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or other activities related to carrying out Ryan White activities. 2. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos://bit.ly/3HS7xdG 3. Grantee must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT(omichigan.gov. 4. ASSURANCES Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. 2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public Health Service (PHS) Act. 3. The Grantee should have procedures to protect the confidentiality and security of client information. PROJECT TITLE: HIV Housing Assistance Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The HIV Housing Assistance project will work to address issues related to housing for people living with HIV (PLWH). Housing has been shown as a significant barrier to achieving viral load suppression and this project will help provide support to PLWH to access stable housing to address this barrier and achieve positive outcomes. Reporting Requirements: The Grantee shall permit the Division of HIV/STI Programs (DHSP) or its designee to conduct site visits and to formulate an evaluation of the project. 2. The Grantee and its subcontractors are required to use the HRSA-supported software CW to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. Grantee Report Submission Schedule Report Period All Agencies: Ryan White Monthly services delivered to HIV - infected and affected clients All Funded agencies: Quarterly Complete quarterly workplan progress reports All Ryan White federally Quarterly funded agencies: FY23 actual expenditures by service category, program income, and Due Date(s) How to Submit Report 10th of the Enter into CAREWare following month (CW) Thirty days after Submit in EGrAMS the end of the Email report to budget period MDHHS- H IVSTloperations(aD,m i chigan.gov Thirty days after Attached to quarterly the end of the FSR budget period Report Period Due Date(s) How to Submit Report administrative costs through the RW Reportinq Tool All Ryan White federally Annually December 31 Uploaded to EGrAMS funded agencies: RW Form Portal Agency Profile 2100 and RW Form 2300 Reports and information shall be submitted to the Division of HIV/STI Programs (DHSP). Please refer to the table for where to submit reports and information. Any additional requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. Fees The Grantee must establish and implement a process to ensure that they are maximizing third party reimbursements, including: Requirement, in agreement, that the Grantee maximize and monitor third party reimbursements. b. Requirement that Grantee document, in client record, how each client has been screened for and enrolled in eligible programs. c. Monitoring to determine that Ryan White is serving as the payer of last resort, including review of client records and documentation of billing, collection policies and procedures, and information on third party contracts. a. Grantee must adhere to the National Monitoring Standards for Rvan White Part B Grantees: Program and the National Monitoring Standards for Rvan White Grantees: Fiscal; and bill for services that are billable in accordance with the above. b. Ensure appropriate billing, tracking, and reporting of program income to support appropriate use for program activities. c. Program income is added to funding provided by the State of Michigan for the budget period and used to advance eligible program objectives. d. Provide a report detailing the expenditure and reinvestment of program income in the program (template will be provided by MDHHS). Grant Program Operation 1. The Grantee will participate in the Department needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the Department. I The Grantee is responsible for ensuring that staff retain minimum educational requirements for staff positions and are proficient in Ryan White -funded service delivery in their respective roles within the organization. Ensure that Ryan White funded staff receive MDHHS required case management training within one (1) year of hire. 4. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for Ryan White funds must match the percentage claimed on the Ryan White FSR for the same period. d. Submit a budget modification to the Department in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. 5. The Grantee must submit all details on advertising campaigns (print and social media) completed via the quarterly workplan progress report submission in EGrAMS. 6. If Grantee is receiving NIC list via secure transfer (e.g. DCH file transfer): a. Grantees must enter NIC lists into CW. b. Grantees must maintain password protected NIC lists on secure server locations and not in any portable storage devices. c. Grantees must store NIC lists on shared servers and not on desktops or personal computers. d. Grantees must transmit updated surveillance data to MDHHS in pre -approved secure manners (e.g. DCH file transfer). If NIC lists or partial lists are sent via US Mail, list size must not exceed 10 individuals in a given mailing and words indicating HIV infection must not be contained in the sent documents. If Grantee is receiving NIC list via direct CW import, grantee must complete necessary fields in CW for transfer back to Surveillance. g. Grantees must not email NIC lists or individual health information contained on NIC lists either internally or externally. 7. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs httDs://www.cdc.00v/nchhstr)/program intearation/docs/13csidatasecu ritvauideli nes.pdf. e. Grantees will document all data sharing agreements and share a copy with the Department. The data sharing agreements may be emailed to MDHHS- HIVSTIoperationse.michigan.gov f. Grantees must provide written documentation of annual Security and Confidentiality training for all staff that have access to NIC lists. Grantees will maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs, httr)s://www.cdc.aov/nchhstp/i)roaramintea ration/docs/ocsidatasecu ritvciu ideli nes. df 8. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs. CDC Website: https://www.cdc.aovinchhstp/Droaramintearation/docs/l)csidatasecu ritvau idel i nes. df. 9. The Grantee will complete the collection of all required data variables and clean- up any missing data or service activities by the 10th day after the end of each calendar month. 10.The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02 established by Health Resources and Services Administration (HRSA). PCN #16-02 describes the core medical and support services that HRSA considers allowable uses of Ryan White grant funds and the individuals eligible to receive those services. A copy of the revised PCN 16-02 is available at this link. HRSA Unallowable Costs: *An expanded list of "unallowable" qrant costs is available in the PCN 16-02., a. HRSA RWHAP funds may not be used to make cash payments to intended clients of HRSA RWHAP-funded services. This prohibition includes cash incentives and cash intended as payment for HRSA RWHAP core medical and support services. Where a direct provision of the service is not possible or effective, store gift cards, vouchers, coupons, or tickets that can be exchanged for a specific service or commodity (e.g., food or transportation) must be used. Off -premises social or recreational activities (movies, vacations, gym memberships, parties, retreats) c. Medical Marijuana d. Purchase or improve land or permanently improve buildings e. Direct cash payments or cash reimbursements to clients Clinical Trials: Funds may not be used to support the costs of operating clinical trials of investigational agents or treatments (to include administrative management or medical monitoring of patients) g. Clothing: Purchase of clothing h. Employment Services: Support employment, vocational rehabilitation, or employment -readiness services. Funerals: Funeral, burial, cremation, or related expenses Household Appliances k. Mortgages: Payment of private mortgages Needle Exchange: Syringe exchange programs, Materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual m. International travel n. The purchase or improvement of land o. The purchase, construction, or permanent improvement of any building or other facility p. Pets: Pet food or products q. Taxes: Paying local or state personal property taxes (for residential property, private automobiles, or any other personal property against which taxes may be levied) r. Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -owned vehicle or any additional costs associated with a privately -owned vehicle, such as a lease, loan payments, insurance, license or registration fees Water Filtration: Installation of permanent systems of filtration of all water entering a private residence unless in communities where issues of water safety exist. t. It is unallowable to divert program income (income generated from charges/ fees and copays from Medicare, Medicaid, other third -party payers collected to cover RW services provided) toward general agency costs or to use it for general purposes. u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02 v. Non -occupational Post -Exposure Prophylaxis (nPEP). w. General -use prepaid cards are considered "cash equivalent' and are therefore unallowable. Such cards generally bear the logo of a payment network, such as Visa, MasterCard, or American Express, and are accepted by any merchant that accepts those credit or debit cards as payment. Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general -use prepaid cards, not store gift cards, and therefore are unallowable. HRSA RWHAP recipients are advised to administer voucher and store gift card programs in a manner which assures that vouchers and store gift cards cannot be exchanged for cash or used for anything other than the allowable goods or services, and that systems are in place to account for disbursed vouchers and store gift cards. Personnel Systems Access/Transfer/Terminations 1. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediatelv via email at MDHHS- HIVSTIooerations(o�michioan.aov of CAREWare users who are separated from the agency for deactivation. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client files and charts from last date of service plus seven (7) years. For minors, Grantee will maintain client files and records from last date of service and until minor reaches the age of 18, whichever is longer, plus seven (7) years. Software Compliance 1. The Grantee and its subcontractors are required to use the HRSA-supported software CW to enter client and service data into the centrally managed database on a secure server. 2. The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up files stored in a secure location. b. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning sharing and Secured Electronic Data. 4. New staff needing access to CAREWare are required to submit the CAREWare user request form through DHSP SHOARS. Mandatory Disclosures The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. b. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. c. Any staff vacancies funded for this project that exceed 30 days. 2. All notifications should be made to DHSP by MDHHS-HIVSTIoperationsCabmichician.aov Technical Assistance 1. Technical assistance (TA) can be requested on the implementation of the Ryan White program. This may include issues related to: CAREWare, Quality Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or other activities related to carrying out Ryan White activities. 2. Technical assistance (TA) requests must be submitted via the MDHHS SHOARIE system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https://bit.ly/3HS7xdG Grantee must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT(o�michigan.aov. ASSURANCES Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. 2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public Health Service (PHS) Act. The Grantee should have procedures to protect the confidentiality and security of client information. PROJECT TITLE: HIV/AIDS Linkage to Care Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: HIV/AIDS Linkage to Care is specifically focused on people living HIV (PLWH) that are not engaged in care. The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care. The project eliminates barriers to accessing care (transportation, insurance, access/knowledge of access to medical care, stigma -related mental health issues, etc.) and funds linking the patient to care and treatment services to people living with HIV to improve health outcomes and reduce HIV transmission among hard -to -reach populations. Reporting Requirements: The Grantee shall permit the Division of HIV/STI Programs (DHSP) or its designee to conduct site visits and to formulate an evaluation of the project. 2. The Grantee and its subcontractors are required to use the HRSA-supported software CW to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 3. The Grantee shall maintain up to date information in CAREWare (CW) in preparation for evaluation. 4. To complete the Ryan White Services Report (RSR), a Health Resources and Services Administration (HRSA) required annual data report, the Grantee must assure that all CAREWare data is complete, cleaned, and entered into the HRSA Electronic Handbook. RSR submission requirements include: a. The RSR shall have no more than 5% missing data variables. b. Exact dates for the Grantee submission will be provided by the Department each reporting year. c. The Department validates the data within the Grantee's RSR submission before receipt by HRSA. d. Data in CAREWare must be checked and validated every quarter. Grantee Report Submission Schedule NIC client level data and services provided list All Agencies: Ryan White Services Report (RSR) Period Due Date(s) Monthly 101h of the following month Generally, Grantee submission will Annual open in early February and close early March. All Agencies: Complete Quarterly Thirty days after quarterly workplan progress the end of the reports budget period. All Ryan White federally Quarterly Thirty days after funded agencies: FY23 the end of the actual expenditures by budget period service category, program income, and administrative costs through the RW Reporting Tool How to Submit Report Enter into CAREWare Submission to HRSA through Electronic Handbook (EHB) Email report to MDHHS- HIVSTIoperations(a)mi chigan.gov Attached to quarterly FSR All Ryan White federally Annually December 31, Uploaded to EGrAMS funded agencies: RW Form 2022 Portal Agency Profile 2100 and RW Form 2300 • Reports and information shall be submitted to the Division of HIV/STI Programs (DHSP). Please refer to the table for where to submit reports and information. Any additional requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. Fees The Grantee must establish and implement a process to ensure that they are maximizing third party reimbursements, including: a. Requirement, in agreement, that the Grantee maximize and monitor third party reimbursements. b. Requirement that Grantee document, in client record, how each client has been screened for and enrolled in eligible programs. c. Monitoring to determine that Ryan White is serving as the payer of last resort, including review of client records and documentation of billing, collection policies and procedures, and information on third party contracts. Grantee must adhere to the National Monitorina Standards for Rvan White Part B Grantees: Proaram and the National Monitorino Standards for Rvan White Grantees: Fiscal; and bill for services that are billable in accordance with the above. e. Ensure appropriate billing, tracking, and reporting of program income to support appropriate use for program activities. Program income is added to funding provided by the State of Michigan for the budget period and used to advance eligible program objectives. g. Provide a report detailing the expenditure and reinvestment of program income in the program (template will be provided by MDHHS). Grant Program Operation 1. The Grantee will participate in the Department needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the Department. 3. The Grantee is responsible for ensuring that staff retain minimum educational requirements for staff positions and are proficient in Ryan White -funded service delivery in their respective roles within the organization. Ensure that Ryan White funded staff receive MDHHS required case management training within one (1) year of hire. 4. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for Ryan White funds must match the percentage claimed on the Ryan White FSR for the same period. Submit a budget modification to the Department in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. 5. The Grantee must submit all details on advertising campaigns (print and social media) completed via the quarterly workplan progress report submission in EGrAMS. 6. If Grantee is receiving NIC list via secure transfer (e.g. DCH file transfer): a. Grantees must enter NIC lists into CW. b. Grantees must maintain password protected NIC lists on secure server locations and not in any portable storage devices. c. Grantees must store NIC lists on shared servers and not on desktops or personal computers. Grantees must transmit updated surveillance data to MDHHS in pre -approved secure manners (e.g. DCH file transfer). e. If NIC lists or partial lists are sent via US Mail, list size must not exceed 10 individuals in a given mailing and words indicating HIV infection must not be contained in the sent documents. If Grantee is receiving NIC list via direct CW import, grantee must complete necessary fields in CW for transfer back to Surveillance. g. Grantees must not email NIC lists or individual health information contained on NIC lists either internally or externally. h. The Grantee must submit all details on advertising campaigns (print and social media) completed via the quarterly workplan progress report submission in EGrAMS. 7. The Grantee must include the following language in all Client Consent and Release of Information forms used for services in this agreement: "Consent for the collection and sharing of client information to providers for persons living with HIV under the Ryan White Program provided through (grantee name) is mandated to collect certain personal information that is entered and saved in a federal data system called CAREWare. CAREWare records are maintained in an encrypted and secure statewide database. I understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same care and data network for the purpose of informing and coordinating my treatment and benefits that I receive under this Program. The CAREWare database program allows for certain medical and support service information to be shared among providers involved with my care, this includes but is not limited to health information, medical visits, lab results, medications, case management, transportation, Housing Opportunities for Persons with AIDS (HOPWA) program, substance abuse, and mental health counseling. I acknowledge that if I fail to show for scheduled medical appointments, I may be contacted by an authorized representative of (grantee name) in order to re- engage and link me back to care." The Grantee must notify the Continuum of Care Unit staff at MDHHS- HIVSTIoperations6a,michigan.00v within 7 business days if a core medical or support service category is added or removed from the Ryan White services previously approved by DHSP. An approval from DHSP is required prior to the change being implemented. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs httos://www.cdc.qov/nchhstD/r)rociramintearation/docs/pcsidatasecuritvauideli nes. df. e. Grantees will document all data sharing agreements and share a copy with the Department. The data sharing agreements may be emailed to MDHHS- HIVSTIoperations().michiaan.gov Grantees must provide written documentation of annual Security and Confidentiality training for all staff that have access to NIC lists. g. Grantees will maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs, httr)s://www.cdc.aov/nchhstr)/i)roq ram intearation/docs/pcsidatasecuritvauideli nes. df 9. The Grantee will complete the collection of all required data variables and clean- up any missing data or service activities by the 10th day after the end of each calendar month. 10.The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02 established by Health Resources and Services Administration (HRSA). PCN #16-02 describes the core medical and support services that HRSA considers allowable uses of Ryan White grant funds and the individuals eligible to receive those services. A copy of the revised PCN 16-02 is available at this link. HRSA Unallowable Costs: *An expanded list of "unallowable" grant costs is available in the PCN 16-02. HRSA RWHAP funds may not be used to make cash payments to intended clients of HRSA RWHAP-funded services. This prohibition includes cash incentives and cash intended as payment for HRSA RWHAP core medical and support services. Where a direct provision of the service is not possible or effective, store gift cards, vouchers, coupons, or tickets that can be exchanged for a specific service or commodity (e.g., food or transportation) must be used. b. Off -premises social or recreational activities (movies, vacations, gym memberships, parties, retreats) c. Medical Marijuana d. Purchase or improve land or permanently improve buildings e. Direct cash payments or cash reimbursements to clients f. Clinical Trials: Funds may not be used to support the costs of operating clinical trials of investigational agents or treatments (to include administrative management or medical monitoring of patients) g. Clothing: Purchase of clothing h. Employment Services: Support employment, vocational rehabilitation, or employment -readiness services. i. Funerals: Funeral, burial, cremation, or related expenses j. Household Appliances k. Mortgages: Payment of private mortgages I. Needle Exchange: Syringe exchange programs, Materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual m. International travel n. The purchase or improvement of land o. The purchase, construction, or permanent improvement of any building or other facility p. Pets: Pet food or products q. Taxes: Paying local or state personal property taxes (for residential property, private automobiles, or any other personal property against which taxes may be levied) r. Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -owned vehicle or any additional costs associated with a privately -owned vehicle, such as a lease, loan payments, insurance, license or registration fees s. Water Filtration: Installation of permanent systems of filtration of all water entering a private residence unless in communities where issues of water safety exist. t. It is unallowable to divert program income (income generated from charges/ fees and copays from Medicare, Medicaid, other third -party payers collected to cover RW services provided) toward general agency costs or to use it for general purposes. u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02 v. Non -occupational Post -Exposure Prophylaxis (nPEP). w. General -use prepaid cards are considered "cash equivalent' and are therefore unallowable. Such cards generally bear the logo of a payment network, such as Visa, MasterCard, or American Express, and are accepted by any merchant that accepts those credit or debit cards as payment. Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general -use prepaid cards, not store gift cards, and therefore are unallowable. HRSA RWHAP recipients are advised to administer voucher and store gift card programs in a manner which assures that vouchers and store gift cards cannot be exchanged for cash or used for anything other than the allowable goods or services, and that systems are in place to account for disbursed vouchers and store gift cards. Personnel Systems Access/Transfer/Terminations New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations @..michigan.gov of CAREWare users who are separated from the agency for deactivation. Record Maintenance/Retention 1. The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client files and charts from last date of service plus seven (7) years. For minors, Grantee will maintain client files and records from last date of service and until minor reaches the age of 18, whichever is longer, plus seven (7) years. Software Compliance The Grantee and its subcontractors are required to use the HRSA-supported software CAREWare to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Successfully create, run, and document the results of their HRSA RSR report in CAREWare in order to receive relevant support from data managers by the 10th of the following month. Documentation is to include with identifying information omitted: • Missing records as depicted in the RSR Viewer module in CAREWare A list of alert, warning, and error messages as depicted in the RSR Validation Report module in CAREWare Efforts or decisions (including collaboration with MDHHS) to resolve missing data or error messages as applicable Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 2. The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up fifes stored in a secure location. b. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses. 3. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning sharing and Secured Electronic Data. 4. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediatelv via email at MDHHS- HIVSTIoDerations(abmichioan.gov of CAREWare users who are separated from the agency for deactivation. 6. The Grantee shall as be required by HRSA submit the Ryan White HIV/AIDS Program Services Report (RSR) for the previous calendar year. The Grantee is required to use the HRSA Electronic Handbook (EHB) portal for their submission: a. The Grantee shall acquire access to their agency's Grant Contract Management System (GCMS) and their Provider Report prior to January when notified by HRSA of the required federal report. b. The Grantee is required to provide access to all staff and personnel responsible for reviewing and completing the RSR. c. The Grantee as per HRSA standards and compliance are mandated to require relevant staff members to update their EHB account passwords as dictated by HRSA email notifications. The Grantee is mandated to update or add contact information for staff responsible for completing and/or submitting the RSR and to notify MDHHS of any changes in personnel immediately. e. The Grantee shall correspond with MDHHS staff including data management users to compare units of service provided to the funded services listed on the EHB. f. The Grantee shall notify MDHHS immediately if there are any discrepancies between the funding sources and services listed for their agency's report on the Electronic Handbook (EHB) and their agency's contracts and records. g. The Grantee shall in these circumstances contact Ryan White Data Support by email or by phone number (1-888-640-9356) between the hours of 10 am — 6:30 pm Eastern Standard Time (EST) on weekdays regarding the HRSA EHB GCMS and/or RSR: Issues with account lockouts, lost credentials, or account creation • Issues with accessing the GCMS through the HRSA EHB Issues with accessing the Provider Report through the HRSA ® Technical issues regarding functionality of the EHB portal h. The Grantee shall attend webinars and instructional sessions to answer questions about the RSR; Grantee shall utilize tools provided by data management users to check on the accuracy and completeness of their client level data (CLD) on a monthly basis leading up to the RSR. These include but are not limited to: • TargetHlV/DISQ webinars regarding the RSR • HRSA produced documentation and manuals on RSR reporting requirements for the calendar year • Manuals on utilizing CAREWare for completing the RSR PowerPoint presentations on aspects of the RSR • Staff invitations to Teams meetings and breakout sessions to answer questions regarding the RSR • CAREWare custom reports and financial reports designed to assess: 1. The number of eligible clients 2. The number of eligible clients that need to be marked as such 3. Services provided by the Grantee 4. CLD on ZIP codes, ethnicity, and other features • Emails from MDHHS staff regarding the above but also including: 1. Updates on HRSA reporting requirements 2. New information provided from HRSA 3. Other resources HRSA is providing/will provide b. The Grantee shall after notification from MDHHS staff including data management users implement needed corrections and additions to CLD in CAREWare to ensure compliance with HRSA federal reporting standards. Mandatory Disclosures 1. The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. b. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. Any staff vacancies funded for this project that exceed 30 days. All notifications should be made to DHSP by MDHHS-HIVSTIoperations(a.michigan.gov. Technical Assistance Technical assistance (TA) may be requested on the implementation of the Ryan White program. This may include issues related to: CAREWare, Quality Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or other activities related to carrying out Ryan White activities. 2. TA requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos://b it.ly/3 H S7xd G 3. Grantee must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORTna.michigan.gov. ASSURANCES Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. 2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public Health Service (PHS) Act. 3. The Grantee should have procedures to protect the confidentiality and security of client information. PROJECT TITLE: HIV PrEP Clinic Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis: The purpose of this project is to establish HIV Pre -Exposure Prophylaxis (PrEP) services. Reporting Requirements: 1. The Grantee will clean-up missing data by the 10th day after the end of each calendar month. Grantee must report required variables as outlined by National HIV Monitoring and Evaluation (NHM&E) and MDHHS. 2. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Division of HIV and STI Programs (DHSP). 3. The Quality Control and Daily Client Logs may be sent to the Contract Manager via: Email — Mary Roach (roach m(d).michioan.gov) and Safina Thomas (thomass56(doichigan.gov) Fax - (517) 241-5922 Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727, Lansing, MI 48909 4. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by DHSP. Grantee Report Submission Schedule �.:-... _ -_;:. �;'.. -; , Fer�od .: „ �. Due.Dafs(s}.:„`, "::Report submission Repo' ssion Counseling, Testing, and referrals Quality Control Monthly 10th of the following Department Staff Reports month Daily Client Logs Monthly 10th of the following Department Staff month HIV Testing Annually Reviewed during Department Staff Proficiencies site visits HIV Testing Sent to MDHHS Competencies Annually before the end of Department Staff the fiscal year Non -Reactive As needed Within 7 days of test APHIRM Results 10th of the following PrEP Cascade Data Monthly APHIRM month Reactive Results As needed Within 24 hours of APHIRM test As needed in Adult Case Report LMS Case Report Forms the event of a Form Directions MDHHS Surveillance reactive result Partner Services & Linkage to Care (as applicable) Linkage to Care and Within 30 days of Partner Services As needed APHIRM Interview*** service Internet Partner Services (IPS) and Ongoing Within 30 days of APHIRM Partner Services service Interview**** Disposition on Within 30 days of Partners of HIV Ongoing APHIRM Cases service Evidence Based Risk Reduction Activities (as applicable) 10th of the following Syringe Utilization SSP Data Report, Quarterly month Platform (SUP) Clinical HIV/STI services (as applicable) 340b PrEP Weekly Every Friday by the DCH File Transfer — PrEP PT Prescription Log close of business ADT*MDHHS*340B Billing Revenue Quarterly 10th of the following month Department Staff Report Log into SGRX340BFlex.com STI 340B Within 10 days after website, generate a quarterly report on the Utilization/Inventory Quarterly the end of the reporting tab, and it will be Report, quarter transferred automatically to ScriptGuide/DHSP *CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social Marketing data; Evidence based intervention data; other prevention services and activities, if applicable ** Aggregated testing data ***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was interviewed by Partner Services within 30 days of diagnosis) ****(e.g. client identify dating apps used to meet partners), if applicable *****https://milogintp.michigan.gov Any additional Requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal fund, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal funds. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. 4. The Grantee will submit all educational materials (e.g., brochures, posters, pamphlets, and videos) used in conjunction with program activities to DHSP for review and approval prior to their use, regardless of the source of funding used to purchase these materials. Materials may be emailed to: MDHHS- HIVSTIoperations(a,michigan.gov. Grant Program Operation 1. The Grantee will participate in Division of HIV/STI Programs (DHSP) needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities, network detection response and interventions in collaboration with DHSP opportunities provided by DHSP. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for funds must match the percentage claimed on the FSR for the same period. d. Submit a budget modification to DHSP in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. e. If there are any changes in staff or agency operations, please email MDHHS Operations MDHHS-HIVSTIooerations(o)michiaan.gov. 4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with guidelines and standards issued by DHSP and: a. Provide medical oversight letter/agreement signed by a licensed physician is necessary to collect specimens and order HIV antibody/antigen, HIV genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C testing. According to Part 15 of the Public Health Code MCL 333.17001 Q), 'practice of medicine' is defined as "the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these act". b. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." • Ensure provision of Clinical Laboratory Improvement Amendments (CLIA) certificate. • Report discordant test results to DHSP Email — Mary Roach roach m a(,,michiaan.gov and Safina Thomas (thomass56a,michiaan.gov) Fax - (517) 241-5922 • Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course or Information Based Training (as applicable), test device training, and annual proficiency testing. • If conducting blood draws, the grantee must conduct the packaging and shipping training via Bureau of Laboratories. BashoreM(a michigan.gov Ensure that all staff and site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training and reviewed annually. Develop, implement, and monitor protocol and procedures to ensure that patients receive confirmatory test results. To maintain active test counselor certification, each HIV test counselor must submit one competency per year to the appropriate departmental staff. 5. If conducting SSP, the grantee will develop programs using MDHHS guidance documents and will address issues such as identification and registration of clients, exchange protocols, education, and trainings for staff, and referrals. a. Grantees will participate on monthly or quarterly conference calls to discuss best practices and identify barriers. 6. If conducting PS, the Grantee will comply with guidelines and standards issued by the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." The Grantee must: Provide Confidential PS follow-up to infected clients and their at -risk partners to ensure disease management and education is offered to reduce transmission. b. Effectively link infected clients and/or at -risk partners to HIV care and other support services. c. Work with Early Intervention Specialist to ensure infected clients are retained in HIV care. d. If applicable, • Procure TLC or a TLO-like search engine. • Ensure staff that are utilizing TLO or TLO-search engine complete the TLO training to maintain and understand the confidential use of the system. • Effectively utilize the Internet Partner Services (IPS) Guidance to provide confidential PS follow-up to at -risk partners named by infected clients who were identified to have been met through the use of dating apps. Ensure staff and site supervisors successfully complete the Internet Partner Services Training. • Ensure staff conducting Internet Partner Services participant in monthly, bi-monthly meetings, webinars or calls to discuss best practices and identify barriers. 7. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with guidelines and standards issued by DHSP and: 8. Funds generated by this program must be utilized to support the program, including to hire a Mid -level provider, supporting staff, and program materials to provide Pre -Exposure Prophylaxis (PrEP) services. 9. Any funds included in this agreement above must be re -invested in HIV/STI PrEP services. This could mean improving, enhancing, and/or expanding your current HIV/STI services or adding new services to improve patient health outcomes for HIV/STI. 10.Any revenue or income generated via billing from this agreement must be reinvested into this project. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. Software Compliance 1. The Grantee and its subcontractors are required to use APHIRM (formerly Evaluation Web) to enter HIV client and service data into the centrally managed database on a secure server. The Grantee and its subcontractors are required to use APHIRM to enter PrEP Cascade Data into the centrally managed database on a secure server. 3. The Grantee and its subcontractors are required to use APHIRM to enter EBI Data into the centrally managed database on a secure server. 4. The Grantee and its subcontractors are required to use APHIRM (formerly Partner Services Web) to enter Partner Services interview, linkage to care data, and identified dating apps through the use of Internet Partner Services (IPS) where appropriate. 5. The Grantee and its subcontractors are required to use SHOARS to request amendments, supplies, data, technical assistance and to register for trainings. 6. New staff needing access to APHIRM are required to submit the APHIRM user request form through SHOARS. 7. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations@michigan.gov of APHIRM users who are separated from the agency for deactivation. Mandatory Disclosures 1. The Grantee will provide immediate notification to DHSP, in writing, including but not limited to the following events: 2. Any formal grievance initiated by a client and subsequent resolution of that grievance. 3. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. 4. Any staff vacancies funded for this project that exceed 30 days. a. All notifications should be made to DHSP by MDHHS- HIVSTIooerations(a)michioan.aov. Technical Assistance Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos:Hbit.ly/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS- SUPPORT(@..michioan.gov. . 3. You may request TA on the implementation of the HIV Prevention program. This may include issues related to: APHIRM, Intervention Database, Programs, Budget/Fiscal, Grants and Contracts, Risk Reduction Activities, Training, or other activities related to carrying out HIV prevention activities. Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. PROJECT TITLE: HIV Prevention Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Purpose of this project is to implement a comprehensive HIV surveillance and prevention program. Funding aim to Prevent new HIV infections, Improve HIV -related health outcomes of people with HIV, Reduce HIV -related disparities and health inequities, This funding supports coordinated efforts that address the HIV epidemic including; implementation of integrated HIV/STI Services including referral and linkage to appropriate services, social marketing campaigns, community mobilization efforts and other evidence based risk reduction activities where feasible and appropriate and in accordance with current CDC guidelines and recommendations Reporting Requirements: 1. The Grantee will clean-up missing data by the 10th day after the end of each calendar month. Grantee must report required variables as outlined by National HIV Monitoring and Evaluation (NHM&E) and MDHHS. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Division of HIV and STI Programs (DHSP). 3. The Quality Control and Daily Client Logs may be sent to the Contract Manager via: Email — Mary Roach (roachmCa michiaan.gov) and Safina Thomas (thomass56ta'.michiaan.aov) Fax - (517) 241-5922 Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727, Lansing, MI 48909 4. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by DHSP. Grantee Report Submission Schedule Quality Control Reports Monthly 10'h of the following month Department Staff Daily Client Logs Monthly 10"' of the following Department Staff month HIV Testing Proficiencies A Annually Reviewed during site visits Department Staff HIV Testing Sent to MDHHS Competencies Annually before the end of Department Staff the fiscal year Non -Reactive Results As needed Within 7 days of test APHIRM PrEP Cascade Data Monthly 10'h of the following APHIRM month Reactive Results As needed Within 24 hours of APHIRM test Case Report Forms As needed in the event of a Adult Case Report LMS reactive result Form Directions MDHHS Surveillance Partner Services & Linkage to Care (as applicable) Linkage to Care and Partner Services As needed Within 30 days of APHIRM Interview*** service Internet Partner Services (IPS) and Ongoing Within 30 days of APHIRM Partner Services service Interview**** Disposition on Partners of HIV Ongoing Within 30 days of APHIRM Cases service Evidence Based Risk Reduction Activities (as applicable) SSP Data Report, Quarterly 110th of the following Syringe Utilization I month Platform (SUP) Clinical NN/STl services (as applicable) 340b PrEP Weekly Every Friday by the DCH File Transfer — MDHHS-340B PrEP PT Prescription Log close of business ADT***** Billing Revenue 10th of the following Report Quarterly month Department Staff Log into SGRX340BFlex.com STI 340B Within 10 days after website, generate a Utilization/Inventory Quarterly the end of the quarterly report on the Report, quarter reporting tab, and it will be transferred automatically to ScriptGuide/DHSP i i i `CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social Marketing data; Evidence based intervention data; other prevention services and activities, if applicable ** Aggregated testing data ***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was interviewed by Partner Services within 30 days of diagnosis) ****(e.g. client identify dating apps used to meet partners), if applicable *****https://milogintp.michigan.00v Any additional Requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal fund, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal funds. 2. The dollar amount of Federal funds for the projector program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. 4. The Grantee will submit all educational materials (e.g., brochures, posters, pamphlets, and videos) used in conjunction with program activities to DHSP for review and approval prior to their use, regardless of the source of funding used to purchase these materials. Materials may be emailed to: MDHHS- HNSTlooerations(@rnichioan.00v. Grant Program Operation The Grantee will participate in DHSP needs assessment and planning activities, as requested. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities, network detection response and interventions in collaboration with DHSP opportunities provided by DHSP. 3. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for funds must match the percentage claimed on the FSR for the same period. d. Submit a budget modification to DHSP in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. e. If there are any changes in staff or agency operations, please email MDHHS Operations MDHHS-HIVSTIoperationsna.michiaan.aov. 4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with guidelines and standards issued by DHSP and: a. Provide medical oversight letter/agreement signed by a licensed physician is necessary to collect specimens and order HIV antibody/antigen, HIV genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C testing. According to Part 15 of the Public Health Code MCL 333.17001(j), `practice of medicine' is defined as "the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these act". b. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." i. Ensure provision of Clinical Laboratory Improvement Amendments (CLIA) certificate. ii. Report discordant test results to DHSP Email — Mary Roach roach m(o).michiaan.aov and Safina Thomas (thomass56e,m ich iaan. oov) Fax - (517) 241-5922 iii. Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course or Information Based Training (as applicable), test device training, and annual proficiency testing. iv. If conducting blood draws, the grantee must conduct the packaging and shipping training via Bureau of Laboratories. BashoreM(d).michioan.aov v. Ensure that all staff and site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training and reviewed annually. vi. Develop, implement, and monitor protocol and procedures to ensure that patients receive confirmatory test results. vii. To maintain active test counselor certification, each HIV test counselor must submit one competency per year to the appropriate departmental staff. 5. If conducting SSP, the grantee will develop programs using MDHHS guidance documents and will address issues such as identification and registration of clients, exchange protocols, education, and trainings for staff, and referrals. a. Grantees will participate on monthly or quarterly conference calls to discuss best practices and identify barriers. 6. If conducting PS, the Grantee will comply with guidelines and standards issued by the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." The Grantee must: a. Provide Confidential PS follow-up to infected clients and their at -risk partners to ensure disease management and education is offered to reduce transmission. b. Effectively link infected clients and/or at -risk partners to HIV care and other support services. c. Work with Early Intervention Specialist to ensure infected clients are retained in HIV care. d. If applicable, i. Procure TLC or a TLO-like search engine. ii. Ensure staff that are utilizing TLC or TLO-search engine complete the TLC training to maintain and understand the confidential use of the system. iii. Effectively utilize the Internet Partner Services (IPS) Guidance to provide confidential PS follow-up to at -risk partners named by infected clients who were identified to have been met through the use of dating apps. iv. Ensure staff and site supervisors successfully complete the Internet Partner Services Training. v. Ensure staff conducting Internet Partner Services participant in monthly, bi-monthly meetings, webinars or calls to discuss best practices and identify barriers. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with guidelines and standards issued by DHSP and: 8. Funds generated by this program must be utilized to support the program, including to hire a Mid -level provider, supporting staff, and program materials to provide Pre -Exposure Prophylaxis (PrEP) services. Any funds included in this agreement above must be re -invested in HIV/STI PrEP services. This could mean improving, enhancing, and/or expanding your current HIV/STI services or adding new services to improve patient health outcomes for HIV/STI. 10. Any revenue or income generated via billing from this agreement must be reinvested into this project. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. Software Compliance The Grantee and its subcontractors are required to use APHIRM (formerly Evaluation Web) to enter HIV client and service data into the centrally managed database on a secure server. 2. The Grantee and its subcontractors are required to use APHIRM to enter PrEP Cascade Data into the centrally managed database on a secure server. 3. The Grantee and its subcontractors are required to use APHIRM to enter EBI Data into the centrally managed database on a secure server. 4. The Grantee and its subcontractors are required to use APHIRM (formerly Partner Services Web) to enter Partner Services interview, linkage to care data, and identified dating apps through the use of Internet Partner Services (IPS) where appropriate. 5. The Grantee and its subcontractors are required to use SHOARS to request amendments, supplies, data, technical assistance and to register for trainings. 6. New staff needing access to APHIRM are required to submit the APHIRM user request form through SHOARS. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations@michigan.gov of APHIRM users who are separated from the agency for deactivation. Mandatory Disclosures The Grantee will provide immediate notification to DHSP, in writing, including but not limited to the following events: Any formal grievance initiated by a client and subsequent resolution of that grievance. 3. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. 4. Any staff vacancies funded for this project that exceed 30 days. a. All notifications should be made to DHSP by MDHHS- HIVSTlooeration s(@michiaan.aov. Technical Assistance 1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos:Hbit.ly/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS- SUPPORT(@michioan.00v. . 3. Requests for technical assistance on the implementation of the HIV Prevention program can be made. These requests may include issues related to: APHIRM, Intervention Database Programs Budget/Fiscal Grants and Contracts Risk Reduction Activities, Training, or other activities related to carrying out HIV prevention activities. Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. PROJECT TITLE: HIV Ryan White Part B HIV Ryan White Part B MAI Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income people living with HIV who are uninsured and underserved. The program provides funding to provide care and treatment services to people living with HIV to improve health outcomes and reduce HIV transmission among hard -to -reach populations. Reporting Requirements: The Grantee shall permit the Division of HIV/STI Programs (DHSP) or its designee to conduct site visits and to formulate an evaluation of the project. 2. The Grantee and its subcontractors are required to use the HRSA-supported software CW to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 3. To complete the Ryan White Services Report (RSR), a Health Resources and Services Administration (HRSA) required annual data report, the Grantee must assure that all CAREWare data is complete, cleaned, and entered into the HRSA Electronic Handbook. RSR submission requirements include: a. The RSR shall have no more than 5% missing data variables. b. The Department validates the data within the Grantee's RSR submission before receipt by HRSA. c. Data in CAREWare must be checked and validated every quarter. Grantee Report Submission Schedule Report Period Due Date(s) How to Submit Report All Agencies: Ryan White Monthly 10th of the Enter into CAREWare services delivered to HIV- following month (CW) infected and affected clients All Agencies: Ryan White Annual Generally, Submission to HRSA Services Report (RSR) Grantee through Electronic submission will Handbook (EHB) open in early February and close early March All Ryan White federally Annual December 31 Email report to funded agencies providing at MDHHS- least one core medical HIVSTIoperations(a)mi service: Quality Management chigan.gov Plan All Ryan White federally 10/1 — 9/30 As completed Email report to funded agencies: Complete over contract year MDHHS- and submit at least one Plan- HIVSTlooerations(a)mi Do -Study -Act worksheets to chigan.gov document proqress of QI project All Agencies: Complete Quarterly Thirty days after Submit in EGrAMS quarterly workplan progress the end of the Email report to reports budget period MDHHS- H IVSTloperations(a-)mi chigan.gov All Ryan White federally Quarterly Thirty days after Attached to quarterly funded agencies: FY23 actual the end of the FSR expenditures by service budget period category, program income, and administrative costs through the RW Reporting Tool All Ryan White federally Annually December 31 Uploaded to EGrAMS funded agencies: RW Form Portal Agency Profile 2100 and RW Form 2300 Reports and information shall be submitted to the Division of HIV/STI Programs (DHSP). Please refer to the table for where to submit reports and information. Any additional requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. Fees The Grantee must establish and implement a process to ensure that they are maximizing third party reimbursements, including: a. Requirement, in agreement, that the Grantee maximize and monitor third party reimbursements. Requirement that Grantee document, in client record, how each client has been screened for and enrolled in eligible programs. c. Monitoring to determine that Ryan White is serving as the payer of last resort, including review of client records and documentation of billing, collection policies and procedures, and information on third party contracts. d. Grantee must adhere to the National Monitorina Standards for Rvan White Part B Grantees: Program and the National Monitorina Standards for Rvan White Grantees: Fiscal; and bill for services that are billable in accordance with the above. e. Ensure appropriate billing, tracking, and reporting of program income to support appropriate use for program activities. f. Program income is added to funding provided by the State of Michigan for the budget period and used to advance eligible program objectives. Provide a report detailing the expenditure and reinvestment of program income in the program (template will be provided by MDHHS). Grant Program Operation 1. The Grantee will participate in the Department needs assessment and planning activities, as requested. 2. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, trainings, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the Department. 3. The Grantee is responsible for ensuring that staff retain minimum educational requirements for staff positions and are proficient in Ryan White -funded service delivery in their respective roles within the organization. Ensure that Ryan White funded staff receive MDHHS required case management training within one (1) year of hire. 4. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for Ryan White funds must match the percentage claimed on the Ryan White FSR for the same period. d. Submit a budget modification to the Department in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. 5. The Grantee must submit all details on advertising campaigns (print and social media) completed via the quarterly workplan progress report submission in EGrAMS. 6. The Grantee must include the following language in all Client Consent and Release of Information forms used for services in this agreement: "Consent for the collection and sharing of client information to providers for persons living with HIV under the Ryan White Program provided through (grantee name) is mandated to collect certain personal information that is entered and saved in a federal data system called CAREWare. CAREWare records are maintained in an encrypted and secure statewide database. I understand that some limited information in the electronic data may be shared with other agencies if they also provide me with services and are part of the same care and data network for the purpose of informing and coordinating my treatment and benefits that I receive under this Program. The CAREWare database program allows for certain medical and support service information to be shared among providers involved with my care, this includes but is not limited to health information, medical visits, lab results, medications, case management, transportation, Housing Opportunities for Persons with AIDS (HOPWA) program, substance abuse, and mental health counseling. I acknowledge that if I fail to show for scheduled medical appointments, I may be contacted by an authorized representative of (grantee name) in order to re-engage and link me back to care." 7. The Grantee must notify the Continuum of Care Unit staff at MDHHS- HIVSTIoperations(a).michiaan.gov within 7 business days if a core medical or support service category is added or removed from the Ryan White services previously approved by DHSP. An approval from DHSP is required prior to the change being implemented. 8. The Grantee must adhere to security measures when working with client information and must: a. Not email individual health information either internally or externally. b. Keep all printed materials in locked storage cabinets in locked rooms. c. Provide written documentation of annual Security and Confidentiality training for all staff regarding the Health Insurance Portability Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH), and the Michigan Public Health Code. d. Maintain the standards of CDC's Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs. CDC Website: httr)s://www.cdc.00v/nchhsti)/Droaramintegration/docs/pcsidatasecuritvquidelin es. df. 9. The Grantee will complete the collection of all required data variables and clean- up any missing data or service activities by the 10th day after the end of each calendar month. 10. Subrecipient quality management program should: a. Include: leadership support, dedicated staff time for QM activities, participation of staff from various disciplines, ongoing review of performance measure data and assessment of consumer satisfaction. Include consumer engagement which includes, but is not limited to, agency - level consumer advisory board, participation on quality management committee, focus groups and consumer satisfaction surveys. c. Include conduction of at least one quality improvement (QI) project throughout the year, using the Plan -Do -Study -Act (PDSA) method to document progress. This QI project must be aimed at improving client care, client satisfaction, or health outcomes. 11. If the Grantee is federally funded for Ryan White services (one of which is a core medical service), the Grantee will develop and/or revise a Quality Management Plan (QMP) annually, to be kept on file at agency. QM Plans must contain these eleven components: • Quality statement • Quality infrastructure • Annual quality goals • Capacity building • Performance measurement • Quality improvement • Engagement of stakeholders • Procedures for updating the QM plan • Communication • Evaluation • Work Plan 12. The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-02 established by Health Resources and Services Administration (HRSA). PCN #16-02 describes the core medical and support services that HRSA considers allowable uses of Ryan White grant funds and the individuals eligible to receive those services. A copy of the revised PCN 16-02 is available at this link. HRSA Unallowable Costs: *An expanded list of "unallowable" grant costs is available in the PCN 16-02.. a. HRSA RWHAP funds may not be used to make cash payments to intended clients of HRSA RWHAP-funded services. This prohibition includes cash incentives and cash intended as payment for HRSA RWHAP core medical and support services. Where a direct provision of the service is not possible or effective, store gift cards, vouchers, coupons, or tickets that can be exchanged for a specific service or commodity (e.g., food or transportation) must be used. b. Off -premises social or recreational activities (movies, vacations, gym memberships, parties, retreats) c. Medical Marijuana d. Purchase or improve land or permanently improve buildings e. Direct cash payments or cash reimbursements to clients f. Clinical Trials: Funds may not be used to support the costs of operating clinical trials of investigational agents or treatments (to include administrative management or medical monitoring of patients) g. Clothing: Purchase of clothing h. Employment Services: Support employment, vocational rehabilitation, or employment -readiness services. Funerals: Funeral, burial, cremation, or related expenses Household Appliances k. Mortgages: Payment of private mortgages I. Needle Exchange: Syringe exchange programs, Materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual m. International travel n. The purchase or improvement of land o. The purchase, construction, or permanent improvement of any building or other facility p. Pets: Pet food or products q. Taxes: Paying local or state personal property taxes (for residential property, private automobiles, or any other personal property against which taxes may be levied) Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a privately -owned vehicle or any additional costs associated with a privately -owned vehicle, such as a lease, loan payments, insurance, license or registration fees s. Water Filtration: Installation of permanent systems of filtration of all water entering a private residence unless in communities where issues of water safety exist. t. It is unallowable to divert program income (income generated from charges/ fees and copays from Medicare, Medicaid, other third -party payers collected to cover RW services provided) toward general agency costs or to use it for general purposes. u. Pre -Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02 v. Non -occupational Post -Exposure Prophylaxis (nPEP). w. General -use prepaid cards are considered "cash equivalent' and are therefore unallowable. Such cards generally bear the logo of a payment network, such as Visa, MasterCard, or American Express, and are accepted by any merchant that accepts those credit or debit cards as payment. Gift cards that are cobranded with the logo of a payment network and the logo of a merchant or affiliated group of merchants are general -use prepaid cards, not store gift cards, and therefore are unallowable. * HRSA RWHAP recipients are advised to administer voucher and store gift card programs in a manner which assures that vouchers and store gift cards cannot be exchanged for cash or used for anything other than the allowable goods or services, and that systems are in place to account for disbursed vouchers and store gift cards. Personnel Systems Access/Transfer/Terminations New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperationsna.michioan.gov of CAREWare users who are separated from the agency for deactivation. Record Maintenance/Retention 1. The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client files and charts from last date of service plus seven (7) years. For minors, Grantee will maintain client files and records from last date of service and until minor reaches the age of 18, whichever is longer, plus seven (7) years. Software Compliance The Grantee and its subcontractors are required to use the HRSA-supported software CAREWare to enter client and service data into the centrally managed database on a secure server. The Grantee must: a. Enter all Ryan White services delivered to HIV -infected and affected clients. b. Enter all data by the 10th of the following month. c. Successfully create, run, and document the results of their HRSA RSR report in CAREWare in order to receive relevant support from data managers by the 10t" of the following month. Documentation is to include with identifying information omitted: • Missing records as depicted in the RSR Viewer module in CAREWare A list of alert, warning, and error messages as depicted in the RSR Validation Report module in CAREWare Efforts or decisions (including collaboration with MDHHS) to resolve missing data or error messages as applicable d. Complete collection of all required data variables and the clean-up of any missing data or service activities by the 10th of the following month. 2. The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up files stored in a secure location. b. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses. 3. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning sharing and Secured Electronic Data. 4. New staff needing access to CAREWare are required to submit the CAREWare user request form through SHOARS. 5. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS designated personnel in writing of any personnel transfers or terminations of personnel who possess information system privileges within CAREWare or MIDAP online data systems within 24 hours of change. a. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations(a.michiaan.gov of CAREWare users who are separated from the agency for deactivation. 6. The Grantee shall as be required by HRSA submit the Rvan White HIV/AIDS Proaram Services Report (RSR) for the previous calendar year. The Grantee is required to use the HRSA Electronic Handbook (EHB) portal for their submission: a. The Grantee shall acquire access to their agency's Grant Contract Management System (GCMS) and their Provider Report prior to January when notified by HRSA of the required federal report. b. The Grantee is required to provide access to all staff and personnel responsible for reviewing and completing the RSR. c. The Grantee as per HRSA standards and compliance are mandated to require relevant staff members to update their EHB account passwords as dictated by HRSA email notifications. d. The Grantee is mandated to update or add contact information for staff responsible for completing and/or submitting the RSR and to notify MDHHS of any changes in personnel immediately. e. The Grantee shall correspond with MDHHS staff including data management users to compare units of service provided to the funded services listed on the EHB. f. The Grantee shall notify MDHHS immediately if there are any discrepancies between the funding sources and services listed for their agency's report on the Electronic Handbook (EHB) and their agency's contracts and records. g. The Grantee shall in these circumstances contact Ryan White Data Support by email or by phone number (1-888-640-9356) between the hours of 10 am — 6:30 pm Eastern Standard Time (EST) on weekdays regarding the HRSA EHB GCMS and/or RSR: • Issues with account lockouts, lost credentials, or account creation • Issues with accessing the GCMS through the HRSA EHB • Issues with accessing the Provider Report through the HRSA i Technical issues regarding functionality of the EHB portal h. The Grantee shall attend webinars and instructional sessions to answer questions about the RSR; Grantee shall utilize tools provided by data management users to check on the accuracy and completeness of their client level data (CLD) on a monthly basis leading up to the RSR. These include but are not limited to: • TargetHIV/DISQ webinars regarding the RSR • HRSA produced documentation and manuals on RSR reporting requirements for the calendar year • Manuals on utilizing CAREWare for completing the RSR • PowerPoint presentations on aspects of the RSR • Staff invitations to Teams meetings and breakout sessions to answer questions regarding the RSR CAREWare custom reports and financial reports designed to assess: 1. The number of eligible clients 2. The number of eligible clients that need to be marked as such 3. Services provided by the Grantee 4. CLD on ZIP codes, ethnicity, and other features • Emails from MDHHS staff regarding the above but also including: 1. Updates on HRSA reporting requirements 2. New information provided from HRSA 3. Other resources HRSA is providing/will provide i. The Grantee shall after notification from MDHHS staff including data management users implement needed corrections and additions to CLD in CAREWare to ensure compliance with HRSA federal reporting standards. Mandatory Disclosures 1. The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. b. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. c. Any staff vacancies funded for this project that exceed 30 days. All notifications should be made to DHSP by MDHHS-HIVSTIoperations( michican.00v. Technical Assistance 1. Technical assistance (TA) can be requested on the implementation of the Ryan White program. This may include issues related to: CAREWare, Quality Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP, or other activities related to carrying out Ryan White activities. 2. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https://bit.ly/3HS7xdG 3. Grantee must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT(a)michiaan.00v. ASSURANCES Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public Health Service (PHS) Act. 3. The Grantee should have procedures to protect the confidentiality and security of client information. PROJECT TITLE: HIV STI Partner Services Program Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Grantee will provide STI and HIV partner services (PS) for select low morbidity health departments within the State of Michigan in accordance with program standards and Department oversight. Reporting Requirements (if different than agreement language): The Grantee shall submit the following reports on the following dates: Report Period Due Date(s) How to Submit Report n of the following not ficationn/services to Monthly month m Enter in Aphirm delivered to individuals Partner Services delivered Within 72 10th of the following Enter in Aphirm to individuals hours month Syphilis Partner Counseling Within 72 Within 72 hours MDSS and Referral hours The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by the Contract Manager. Any additional requirements (if applicable): Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal money, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal money. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. 4. The Grantee will submit all educational materials (e.g., brochures, posters, pamphlets, and videos) used in conjunction with program activities to the Department for review and approval prior to their use, regardless of the source of funding used to purchase these materials. These materials should be emailed to MDHHS-HIVSTIOoerations(L michigan.gov. Grant Program Operation Pursuant to a protocol established by the Department, the Grantee will provide positive test notification, HIV/STD and syphilis partner counseling and referral services, victim notification and recalcitrant investigation for the following local health departments: Bay County Health Department, Benzie-Leelanau District Health Department, Central Michigan District Health Department, Chippewa County Health Department, Dickinson -Iron District Health Department, District Health Department # 2, District Health Department # 4, District Health Department #10, Grand Traverse County Health Department, Luce-Mackinac-Alger- Schoolcraft District Health Department, Marquette County Health Department, Mid- Michigan District Health Department, Midland County Health Department, Northwest Michigan Community Health Agency, Public Health, Delta and Menominee Counties, and Western Upper Peninsula District Health Department. 2. The Grantee will establish, maintain and document (e.g., via MOU or MOA) linkages with community resources that are necessary and appropriate to addressing the needs of clients and that are essential to the success and effectiveness of services supported under this agreement. 3. The Grantee will provide these services fifty-two weeks a year. 4. The Grantee will participate in the Department needs assessment and planning activities, as requested. 5. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities provided by the Department. 6. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for Ryan White funds must match the percentage claimed on the Ryan White FSR for the same period. d. Submit a budget modification to the Department in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. The Grantee will complete the collection of all required data variables and clean- up any missing data or service activities by the 10th day after the end of each calendar month. Record Maintenance/Retention 1. The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. 2. The Grantee will maintain client records of HIV Positive or Negative with Syphilis diagnosis. MDHHS recommends that this information be retained indefinitely or until it is determined the client is deceased. Software Compliance 1. The Grantee will adhere to reporting deadlines for all contractual Grantee Reporting requirements. 2. The Grantee is required to use the following data systems to enter HIV and Syphilis case investigation data: Aphirm and Michigan Disease Surveillance System (MDSS) a. All reactive results must be entered into Aphirm within 48 hours b. All non -reactive results must be entered into Aphirm within seven days All APhirm must be entered and missing variables entered by the 10th day after the end of each calendar month. I The Grantee must establish written procedures for protecting client information kept electronically or in charts or other paper records. Protection of electronic client -level data will minimally include: a. Regular back-up of client records with back-up files stored in a secure location. b. Use of passwords to prevent unauthorized access to the computer or Client Level Data program. c. Use of virus protection software to guard against computer viruses. d. Provide annual training to staff on security and confidentiality of client level data and sharing of electronic data files according to MDHHS policies concerning Sharing and Secured Electronic Data. Mandatory Disclosures The Grantee will provide immediate notification to the Department, in writing, in the event of any of the following: a. Any formal grievance initiated by a client and subsequent resolution of that grievance. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. c. Any staff vacancies funded for this project that exceed 30 days. d. This information may be emailed to: MDHHS-HIVSTIOperationsl@michicianxiov ASSURANCES Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. PROJECT TITLE: HIV/STI Testing and Prevention Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The City of Detroit bares a disproportionate burden of reported sexually transmitted infection, including HIV. As a complement to public health clinical services, the Detroit Health Department provides community level education and awareness building, along with targeted screening activities to ensure additional access to service for early case detection and linkage to care. Reporting Requirements: The Grantee will clean-up missing data by the 10th day after the end of each calendar month. Grantee must report required variables as outlined by National HIV Monitoring and Evaluation (NHM&E) and MDHHS. 2. Any such other information as specified in the Statement of Work, Attachment A shall be developed and submitted by the Grantee as required by the Division of HIV and STI Programs (DHSP). 3. The Quality Control and Daily Client Logs may be sent to the Contract Manager via: Email — Mary Roach (roach m(cmichigan.gov) and Safina Thomas (thomass56(@michigan.aov) Fax - (517) 241-5922 Mailed - HIV Prevention Unit, Attn: CTR Coordinator PO Box 30727, Lansing, MI 48909 4. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by DHSP. Grantee Report Submission Schedule P.; ue.Date{s) Report;subinission Counseling, Testing, and referrals Quality Control Monthly 101h of the following Department Staff Reports month Daily Client Logs Monthly 10th of the following Department Staff month HIV Testing Reviewed during site Proficiencies Annually visits HIV Testing Sent to MDHHS Competencies Annually before the end of the fiscal year Non -Reactive Results As needed PrEP Cascade Data Monthly Reactive Results As needed Department Staff Department Staff Within 7 days of test APHIRM 10th of the following APHIRM month Within 24 hours of APHIRM test As needed in Adult Case Report Case Report Forms the event of a Form Directions reactive result Partner Services & Linkage to Care (a-, applicable) Linkage to Care and Within 30 days of Partner Services As needed Interview*** service Internet Partner Services (IPS) and Ongoing Within 30 days of Partner Services service Interview**** Disposition on Within 30 days of Partners of HIV Ongoing Cases service Evidence Based Risk Reduction Activities (as applicable) SSP Data Report, Quarterly 10th of the following month Clinical HIV/STI services (as applicable) 340b PrEP Weekly Every Friday by the Prescription Log close of business Billing Revenue 10th of the following Report Quarterly month STI 340B Within 10 days after Utilization/Inventory Quarterly the end of the Report, quarter LMS MDHHS Surveillance :'.:u APHIRM APHIRM Syringe Utilization Platform (SUP) DCH File Transfer - MDHHS-340B PrEP PT ADT***** Department Staff Log into SGRX340BFIex.com website, generate a quarterly report on the reporting tab, and it will be transferred automatically to ScriptGuide/DHSP *CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social Marketing data; Evidence based intervention data; other prevention services and activities, if applicable ** Aggregated testing data ***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was interviewed by Partner Services within 30 days of diagnosis) ****(e.g. client identify dating apps used to meet partners), if applicable *****httos://miloointp.michiaan.gov Any additional Requirements: Publication Rights When issuing statements, press releases, requests for proposals, bid solicitations and other documents describing projects or programs funded in whole or in part with Federal fund, the Grantee receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: 1. The percentage of the total costs of the program or project that will be financed with Federal funds. 2. The dollar amount of Federal funds for the project or program. 3. Percentage and dollar amount of the total costs of the project or program that will be financed by non -governmental sources. 4. The Grantee will submit all educational materials (e.g., brochures, posters, pamphlets, and videos) used in conjunction with program activities to DHSP for review and approval prior to their use, regardless of the source of funding used to purchase these materials. Materials may be emailed to: MDHHS- HIVSTIoperations o michigan.00v. Grant Program Operation 1. The Grantee will participate in DHSP needs assessment and planning activities, as requested. The Grantee will participate in regular Grantee meetings which may be face-to- face, teleconferences, webinars, etc. The Grantee is highly encouraged to participate in other training offerings and information -sharing opportunities, network detection response and interventions in collaboration with DHSP opportunities provided by DHSP. 3. Each employee funded in whole or in part with federal funds must record time and effort spent on the project(s) funded. The Grantee must: a. Have policies and procedures to ensure time and effort reporting. b. Assure the staff member clearly identifies the percentage of time devoted to contract activities in accordance with the approved budget. c. Denote accurately the percent of effort to the project. The percent of effort may vary from month to month, and the effort recorded for funds must match the percentage claimed on the FSR for the same period. d. Submit a budget modification to DHSP in instances where the percentage of effort of contract staff changes (FTE changes) during the contract period. e. If there are any changes in staff or agency operations, please email MDHHS Operations MDHHS-HIVSTIoperations(a michiaan.cov. 4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with guidelines and standards issued by DHSP and: a. Provide medical oversight letter/agreement signed by a licensed physician is necessary to collect specimens and order HIV antibody/antigen, HIV genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C testing. According to Part 15 of the Public Health Code MCL 333.17001 Q), 'practice of medicine' is defined as "the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these act". b. Conduct quality assurance activities, guided by written protocol and procedures. Protocols and procedures, as updated and revised Quality assurance activities are to be responsive to: Quality Assurance for Rapid HIV Testing, MDHHS. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." Ensure provision of Clinical Laboratory Improvement Amendments (CLIA) certificate. • Report discordant test results to DHSP Email — Mary Roach roach m(dmichioan.aov and Safina Thomas (thomass56 anmichiaan.aov) Fax - (517) 241-5922 Ensure that staff performing counseling and/or testing with rapid test technologies has completed, successfully, rapid test counselor certification course or Information Based Training (as applicable), test device training, and annual proficiency testing. • If conducting blood draws, the grantee must conduct the packaging and shipping training via Bureau of Laboratories. BashoreM(a).michioan.ciov • Ensure that all staff and site supervisors have completed, successfully, appropriate laboratory quality assurance training, blood borne pathogens training and rapid test device training and reviewed annually. • Develop, implement, and monitor protocol and procedures to ensure that patients receive confirmatory test results. • To maintain active test counselor certification, each HIV test counselor must submit one competency per year to the appropriate departmental staff. If conducting SSP, the grantee will develop programs using MDHHS guidance documents and will address issues such as identification and registration of clients, exchange protocols, education, and trainings for staff, and referrals. a. Grantees will participate on monthly or quarterly conference calls to discuss best practices and identify barriers. 6. If conducting PS, the Grantee will comply with guidelines and standards issued by the Department. See "Applicable Laws, Rules, Regulations, Policies, Procedures, and Manuals." The Grantee must: a. Provide Confidential PS follow-up to infected clients and their at -risk partners to ensure disease management and education is offered to reduce transmission. b. Effectively link infected clients and/or at -risk partners to HIV care and other support services. c. Work with Early Intervention Specialist to ensure infected clients are retained in HIV care. d. If applicable, O Procure TLO or a TLO-like search engine. Ensure staff that are utilizing TLO or TLO-search engine complete the TLO training to maintain and understand the confidential use of the system. • Effectively utilize the Internet Partner Services (IPS) Guidance to provide confidential PS follow-up to at -risk partners named by infected clients who were identified to have been met through the use of dating apps. • Ensure staff and site supervisors successfully complete the Internet Partner Services Training. • Ensure staff conducting Internet Partner Services participant in monthly, bi-monthly meetings, webinars or calls to discuss best practices and identify barriers. 7. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with guidelines and standards issued by DHSP and: 8. Funds generated by this program must be utilized to support the program, including to hire a Mid -level provider, supporting staff, and program materials to provide Pre -Exposure Prophylaxis (PrEP) services. 9. Any funds included in this agreement above must be re -invested in HIV/STI PrEP services. This could mean improving, enhancing, and/or expanding your current HIV/STI services or adding new services to improve patient health outcomes for HIV/STI. 10. Any revenue or income generated via billing from this agreement must be reinvested into this project. Record Maintenance/Retention The Grantee will maintain, for a minimum of five (5) years after the end of the grant period, program, fiscal records, including documentation to support program activities and expenditures, under the terms of this agreement, for clients residing in the State of Michigan. Software Compliance The Grantee and its subcontractors are required to use APHIRM (formerly Evaluation Web) to enter HIV client and service data into the centrally managed database on a secure server. The Grantee and its subcontractors are required to use APHIRM to enter PrEP Cascade Data into the centrally managed database on a secure server. The Grantee and its subcontractors are required to use APHIRM to enter EBI Data into the centrally managed database on a secure server. The Grantee and its subcontractors are required to use APHIRM (formerly Partner Services Web) to enter Partner Services interview, linkage to care data, and identified dating apps through the use of Internet Partner Services (IPS) where appropriate. 5. The Grantee and its subcontractors are required to use SHOARS to request amendments, supplies, data, technical assistance and to register for trainings. 6. New staff needing access to APHIRM are required to submit the APHIRM user request form through SHOARS. 7. The Grantee shall notify MDHHS immediately via email at MDHHS- HIVSTIoperations@michigan.gov of APHIRM users who are separated from the agency for deactivation. Mandatory Disclosures The Grantee will provide immediate notification to DHSP, in writing, including but not limited to the following events: 2. Any formal grievance initiated by a client and subsequent resolution of that grievance. 3. Any event occurring or notice received by the Grantee or subcontractor, that reasonably suggests that the Grantee or subcontractor may be the subject of, or a defendant in, legal action. This includes, but is not limited to, events or notices related to grievances by service recipients or Grantee or subcontractor employees. 4. Any staff vacancies funded for this project that exceed 30 days. a. All notifications should be made to DHSP by MDHHS- HIVSTIooerations(&michioan.aov. Technical Assistance Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https://bit.ly/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS- SUPPORTa.michioan.00v. . 3. You may request for TA on the implementation of the HIV Prevention program. This may include issues related to: APHIRM, Intervention Database, Programs, Budget/Fiscal, Grants and Contracts, Risk Reduction Activities, Training, or other activities related to carrying out HIV prevention activities. Compliance with Applicable Laws The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS treatment, disability accommodations, non-discrimination, and confidentiality. PROJECT: Immunization Action Plan Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis Offer immunization services to the public. • Collaborate with public and private sector organizations to promote childhood, adolescent and adult immunization activities in the county including but not limited to recall activities. • Educate providers about vaccines covered by Medicare and Medicaid. • Provide and implement strategies for addressing the immunization rates of special populations (i.e., college students, educators, health care workers, long term care centers, detention centers, homeless, tribal and migrant and childcare employees). • Develop mechanisms to improve jurisdictional and LHD immunization rates for children, adolescents and adults. • Ensure clinic hours are convenient and accessible to the community, operating both walk-in and scheduled appointment hours. • Coordinate immunization services, including WIC, Family Planning, and STD, developing plans or memorandums of understanding. • Collaboratively work with regional MCIR staff to ensure providers are using MCIR appropriately. • Develop strategies to identify and target local pocket of need areas. Reporting Requirements (if different than contract language) 1. IAP Reports are submitted electronically in accordance with due dates set by the Department. 2. IAP Plan will be submitted electronically using a template provided by the Department, in accordance with due dates set by the Department. 3. Utilize VAERS to report all adverse vaccine reactions 4. Ensure that all reportable diseases are reported to the Department in the time specified in the public health code and appropriate case investigation is completed. 5. By April 1, of each year provide one copy of the VFC provider with an online re - enrollment form which includes a profile for each provider who receives vaccine from the state. These documents must be submitted electronically in MCIR no later than April 1. Any additional requirements (if applicable) 1. Adhere to federal and state appropriation laws pertaining to use of programmatic funds. See Immunization Allowable Expenditures in Attachment I for appropriate use of Federal Funds. 2. Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of 1993, section 1928 Part IV — Immunizations and the most current CDC Vaccines for Children Operations Manual, Michigan Resource Book for VFC Providers, and documents that are updated throughout the year pertaining to the Vaccines for Children (VFC) Program. 3. Ensure that federally procured vaccine is administered to eligible children only and is properly documented per VFC guidelines. ® The VFC Program provides VFC vaccine to only eligible children who meet the following criteria: are Medicaid eligible, have no health insurance, are American Indian or Alaskan Native, are served at a Federally Qualified Health Center (FQHC), a Rural Health Center (RHC) or a public health clinic affiliated with a FQHC and are also under -insured. Ensure state -supplied vaccines provided in the jurisdiction are administered only to eligible clients as determined by the state. This program allows for the immunization of select populations who are underinsured and not served at a FQHC, RHC, or a public health immunization clinic affiliated with a FQHC as defined by current state program requirements. ® Ensure that all providers receiving vaccine from the state screen children for VFC eligibility for children 4. Fraud or abuse of federally procured vaccine must be monitored and reported. 5. Adhere to all Federal and Michigan Laws pertaining to immunization administration and reporting including reporting to the MCIR, VAERS and schools and daycare reporting 6. Coordinate the submission of immunization data from schools and childcare centers in your jurisdiction and follow-up with programs providing incomplete or inaccurate data. Assure compliance levels are adequate to protect the public. 7. Provide education to the parents of children seeking a non -medical exemption in your jurisdiction. 8. Monitor any provider receiving federally procured vaccine including but not limited to VFC/QI site visit. 9. Ensure on -site attendance of at least 1 LHD immunization program staff to two (2) Immunization Action Plan (IAP) meetings each year. 10.Implements Perinatal Hepatitis B program activities to prevent the spread of Hepatitis B Virus (HBV) from mother to newborn. Verify pregnancy status on all hepatitis B surface antigen (HBsAg) positive pregnant women of childbearing years (10-60 years of age.) Ensure HBsAg positive pregnant women are reported to the Perinatal Hepatitis B case manager and according to the Public Health Code. Coordinate Perinatal Hepatitis B case management activities between local health department, provider, and Perinatal Hepatitis B Case Manager to: 11. Ensure that all infants, born to women who are HBsAg positive receive hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of life, a complete hepatitis B vaccine series with post vaccination serology testing and program support services. 12. Ensure that all susceptible household and sexual contacts associated with HBsAg positive women receive appropriate testing, vaccination, and support services. 13, Ensure birthing hospitals are able to offer hepatitis B vaccine to all newborns prior to hospital discharge by enrolling them in the Universal Hepatitis B Vaccination Program for Newborns. 14,Surveillance of vaccine preventable disease (VPD) activities ® Conduct active surveillance when indicated (i.e, during an outbreak) and contact hospitals, laboratories, and/or other providers on a regular basis. PROJECT: Immunization Action Plan- Pilot Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis: Project to increase immunization rates within the jurisdiction with a focus on influenza vaccination. • Staffing to work with schools on implementing school -located vaccination clinics. • Staff school -located vaccination clinics and provide vaccines to eligible students. • Distribute report cards to providers within the jurisdiction and research methods to increase immunization rates within the practice. • Work with MDHHS staff to coordinate immunization services to schools. Reporting Requirements (if different than contract language) 1. On a quarterly basis provide: a. Number of clinics conducted and number of students vaccinated at school located clinics. b. The number of interventions initiated with provider offices to improve immunization rates. c. Number of influenza vaccines provided. d. Number of non -influenza vaccines provided. e. Number of educational materials created or updated. f. Information on any other immunization outreach efforts conducted using this funding. 2. At the end of Quarter 3 provide: a. Total number of Kindergarten Roundups conducted. b. Number of Kindergarten Roundups that offered vaccination opportunities. Reports and information should be emailed to: Kristina Paliwoda, Operations Section Manager PaliwodaK(@michioan.00v Any additional requirements (if applicable) PROJECT: Immunization Field Service Representative Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The Immunization Field Service Representative serves as a liaison, resource person and as a regional expert for local health jurisdictions regarding all the Department immunization programs and initiatives. Reporting Requirements (if different than contract language) Any additional requirements (if applicable) PROGRAM SUPPORT: • Assist with the regional MCIR activities and act as a regional resource on MCIR processes and assessment protocols. • Assist with the local implementation and monitoring of all state programs at the regional level- including IAP implementation, VFC, IQIP, Accreditation, Perinatal Hepatitis B, School / Childcare reporting, special projects and the INE program. • Participate in planning for regional conferences, IAP Coordinator meetings, and other Department programs and initiatives as needed. • Assist state, regional and local epidemiologists and communicable disease staff as needed with VPD surveillance and outbreak control. PROGRAM QUALITY ASSURANCE: • Assist in the orientation of new IAP Coordinators. • Work with local health departments to assess and increase immunization levels for all age groups, especially identifying and targeting pockets of need. Identify evidence -based strategies that support improved coverage levels in the region, including use of recall, support for the IQIP program, coordination of LHD services, and provider and LHD staff education. • Consult with the local health department on the immunization component of the accreditation process, including preparation for reviews and conducting a walk through or mock accreditation review. • Consult with local coalitions and private stakeholders to promote immunizations and ensure consistent messages are relayed to the public. • Consult with local health departments on the school and day care assessment process. • Encourage or provide educational updates and interventions on all immunization issues with staff at local health departments, healthcare providers, school and childcare staff and other stakeholders, may also include INE presentation if applicable. PROGRAM COMPLIANCE: Monitor compliance with policies/legislation at national/state and local levels such as: a. VFC program requirements and vaccine distribution and storage. b. VAERS program c. Public Health Code d. Administrative Rules e. School and childcare legislation and reporting requirements f. MCIR legislation and rules g. Communicable Disease Rules PROGRAM OVERSIGHT and PROGRAM REVIEW: • Perform oversight of the following programs with assigned local health departments. • Accreditation -Conduct reviews and monitor corrective actions. • VFC including orientation and observation of LHD staff to annual VFC site visit process, monitoring of VFC vaccine losses, submission of mandatory reports, annual LHD VFC site visits and quality assurance review of all provider public vaccine orders, perform E-VFC site visits to all LHD clinics, and unannounced VFC storage and handling site visits. • UP —including the required IQIP follow-up with VFC providers, and full implementation of recommendations. • Perinatal Hepatitis B-regional birth dose levels and universal vaccine program. • Review and summarize LHD IAP Annual Plans and Biannual IAP Reports. Monitor LHD compliance with Comprehensive agreements and special requirements relating to the Immunization program. • Subrecipient monitoring of funds Employ and oversee a full-time Immunization Field Representative for the Immunization Program who shall be acceptable to the Department and who shall be supported by this agreement, understanding that their full time is to be devoted for regional immunization related activities, including travel time. Provide the Immunization Field Representative with permanent office space and supplies, including, but not limited to a telephone, general office supplies, a computer with high speed internet capabilities, a printer, a cellular telephone and a use of vehicle or reimbursement mechanism for transportation unless otherwise arranged. Ensure the Immunization Field Representative will be available to all local health departments in the assigned regions to provide Immunization Program activities equitable and at the direction of the Department. Refer to field representative responsibilities as defined by the Department and distributed to the Grantee. Provide for reimbursement for reasonable telephone charges incurred in the conduct of business by the Immunization Field Representative unless otherwise arranged. Provide reasonable reimbursement for any travel and subsistence expenses incurred by the Immunization Field Representative necessary to the conduct of the Immunization Program. Travel could include the annual National Immunization Conference or other professional immunization related conferences, attendance at the Department Immunization staff meetings and trainings, and accreditation visits made in other areas of the state, as determined by the Division of Immunization. • Provide adequate office space, telephone connections, high-speed internet access, as well as access to fax and photocopiers. • Provide feedback to Section Manager as needed, on employee work -related conduct. PROJECT: Immunization Fixed Fee (VFC/QI Site Visits) Start Date: 10/01/2022 End Date: 9/30/2023 Project Synopsis The format of the site visit will be based on the completed site visit questionnaires, the CDC -PEAR and CDC-IQIP database systems reviewed at the most recent Fall IAP meeting, web -training with MDHHS VFC and QI coordinators, in -person training with Field Reps and the site visit guidance documents (VFC and QI) provided by the department and the CDC. All site visit information shall be entered into the appropriate database as required by CDC (PEAR and QI database system) within 10 days of the site visit by the individual who conducted the site visit. VFC site visit documentation must be entered online within PEAR during the time of the site visit. Reporting Requirements (if different than contract language) All reimbursement requests should be submitted on the quarterly Comprehensive Financial Status Report (FSR). The submission should include, as an attachment, detail all the visits during the quarter using the current spreadsheet information provided by the Department. Any additional requirements (if applicable) The rate of reimbursement is $150 for a VFC Enrollment, AVP Only visit, or VFC Only visit, $100 for a VFC Unscheduled Storage and Handling Visit, $350 for a Combined VFC/QI site visit or Birthing Hospital visit, and $200 for a QI Only visit. A VFC Enrollment visit is required for all new VFC enrolled provider sites. Unannounced Storage and Handling Visits are not required but when performed, must occur in conjunction with Immunization Nurse Education Sessions required for VFC Providers that experience a loss exceeding a VFC dollar amount of $1500. These visits can only be completed if eligible according to current CDC requirements (e.g., visits cannot be performed for providers who have any visit that is either in "In Progress" or "Submitted" status). Notify MDHHS VFC staff for approval prior to performing these visits. MDHHS VFC will monitor the number of Unannounced Storage and Handling visits performed and, if necessary, may limit the allowable number of those that can be performed. All LHD staff involved with any site visits must complete the Department site visit training webinar, presented by the Department VFC and QI Coordinator, prior to conducting any site visits. Annual VFC and QI visit guidance and review materials will be provided to each LHD at the IAP Meetings and consult will be conducted by the Department Immunization Field Representative for each Grantee. Data from the CDC PEAR and CDC IQIP databases regarding the number and type of site visits will be used to reconcile the agency request for reimbursement. For additional detail on the program requirements, refer to the Resource Guide for Vaccine for Children Providers and the current Department site visit guidance documents, as well as other current guidance provided by the Department/Immunization Program in correspondence to Immunization Action Plan (IAP), Immunization Coordinators, or through health officers. Every VFC visit performed for a QI-eligible provider must receive a QI visit within the same site visit cycle. This may be performed as either a Combined VFC-QI visit or separate VFC Only and QI Only visit, according to current MDHHS guidelines. A QI visit can only be conducted within a cycle in which a VFC visit has also been conducted for the same provider. Local health departments must complete an in -person VFC or VFC/QI site visit for every VFC provider at minimum, every 24-months, using the date of their previous visit as a starting point. Site visits will vary in time an average of 1 hour for QI and 2 hours for VFC Compliance and must not exceed the two-year time frame. Annual visits are encouraged but must not be conducted sooner than 11 months from the previous site visit date. Combined VFC/QI site visits will be conducted using MCIR QI reports and QI tools developed by the Department. All VFC and QI follow-up activities and outstanding issues must be completed within CDC guidelines. Detroit Department of Health and Wellness Promotion Immunization Program is required to complete visits annually to 100% of the VFC providers in accordance with the SEMHA Quality Assurance Specialist (QAS) contractual obligations, including the completed site visit questionnaires and the CDC -PEAR and the CDC-IQIP database systems reviewed at the most recent Fall IAP meeting, web - training with MDHHS VFC and QI coordinators, in -person training with Field Reps and the current site visit guidance documents (VFC and QI) provided by the department and the CDC. All site visit information shall be entered into the appropriate database as required by CDC (PEAR and QI database system) within 10 days of the site visit by the individual who conducted the site visit. VFC site visit documentation must be entered online within PEAR during the time of the site visit. PROJECT: Immunization Michigan Care Improvement Registry (MCIR) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis MCIR is organized into six regions across the state of Michigan to provide MCIR regional staff oversight for implementation, training of private and public providers, governance, and evaluation. The staff will also perform community immunization assessment and reporting to ensure providers report accurate data in a timely fashion. Reporting Requirements • Ensure the quarterly submission of status reports on work plan progress. Reports are due within 30 days of the end of each quarter: Report Period October 1 —December 31 January 1 - March 31 April 1 - June 30 July 1 - September 30 Report Due January 31 April 30 July 31 October 31 • Final quarterly report shall be an annual report. The annual report will be distributed to the Department. The report shall include a summary of all the required activities listed above in the quarterly reports. • Any other information as specified in the special requirements shall be developed and submitted by the Grantee as required by the Department. Reports and information should be submitted to: Bea Salada, MCIR Coordinator Michigan Department of Health & Human Services Immunization Division 333 South Grand Ave Lansing, MI 48909 Phone: (517) 284-4889 The Grantee shall permit the Department or its designee to visit and to evaluate on an as- needed basis. Any additional requirements (if applicable) • The Grantee shall ensure the performance of the following activities on behalf of the Department to support the MCIR: • Promote and train providers and Health Care Organizations (HCOs) on all features of the MCIR Web application. • Support regional MCIR users by operating the regional help desk in accordance with Department approved procedures. • Monitor and develop strategies to increase private provider and HCO enrollment and participation in the MCIR which includes development of strategies to encourage all providers to fully participate with the MCIR, (such as sites of excellence awards). • Process all user/usage agreements, according to the Department's approved procedures, to create user accounts. • Implement and update marketing plans in support of increased provider and parent acceptance and use of the MCIR. • Keep regional users updated on MCIR status and system changes. • Conduct ad hoc reporting and querying on behalf of MCIR users. Work with local health departments to establish a mechanism and internal process to assure persons who have died within their county are appropriately flagged in the MCIR. • Maintain a listing of HCO private and public immunization providers. This listing should be as comprehensive as possible and should include all providers in the region. • Conduct regular de -duplication activities to assure that duplicate records are removed from the MCIR as quickly as possible. • Process user petitions to change MCIR data according to Department approved procedures. • Monitor ongoing immunization data submission for all local health departments and private providers. • Conduct training functions as needed to assure that local health department staff can train and educate providers on how to access and submit data into MCIR. • Maintain a policy/procedure manual, approved by the Department. • Process and file all 'opt out' forms according to the Department approved procedures. • Attend regular MCIR regional Grantee/coordinator meeting. • Conduct Onboarding activities as required for providers submitting immunization data via HL7 messaging to MCIR. • Perform quality assurance checks on the MCIR data for the region as prescribed by the Department. Assist local health departments and private providers with methodologies to "clean up" their data. • Provide assistance to the Department on User Acceptance Testing (UAT) when required to verify MCIR system releases of bug fixes and enhancements. • Attend all UAT training sessions as required by the Department. • The Grantee shall provide to the MCIR Regional Coordinator: a) permanent office space b) general office supplies c) a land -based telephone d) a computer with high-speed internet capabilities e) a printer f) a cellular telephone g) use of a vehicle or in the alternative reimbursement mechanism for transportation unless otherwise arranged • When sufficient funding is available, provide to the MCIR Regional Coordinator reimbursement for travel to attend the National Registry related meetings if approved by the Department. This includes travel related expenses concerning air fare, lodging, baggage processing, taxi services, etc. ® Consult with the Department on any personnel or performance issues that could affect the above -mentioned contract requirements. ® Facilitate the Department's attendance in the interview process for hiring of a MCIR Regional Coordinator / MCIR staff. This process includes consultation with the Department regarding selection of interview candidates as well as participation in the hiring determination. PROJECT: Immunization Vaccine Quality Assurance Start Date: 10/01/2022 End Date: 9/30/2023 Project Synopsis Reporting Requirements (if different than contract language) Any additional requirements (if applicable) 1. Follow-up on vaccine losses and replacement for compromised vaccines for immunization providers within the jurisdiction. 2. Monitor and approve all temperature logs, doses administered reports and ending inventory reports received from participating VFC providers within the jurisdiction. 3. Monitor and approve vaccine orders for participating VFC providers within the jurisdiction. 4. Act as the Primary Point of Contact (PPOC) for VFC providers within the jurisdiction. 5. Provide education and intervention on inappropriate use of publicly purchased vaccine. 6. Follow-up on VFC site visit non-compliance issues. 7. Assist VFC providers within the jurisdiction on issues related to balancing vaccine inventories. 8. Assist with the redistribution of short -dated vaccine for providers within the jurisdiction. 9. Assist with the equitable allocation of vaccines to providers in the jurisdiction during a vaccine shortage. PROJECT TITLE: Infant Safe Sleep Start Date: 10/1/2022 End Date: 09/30/2023 Project Synopsis: Local health departments will provide safe sleep educational activities, conduct safe sleep community outreach/awareness efforts and engage community leaders to guide programming. Reporting Requirements (if different than agreement language): LHD will attach the completed 'Infant Safe Sleep Mini -Grant Work Plan" to the indirect cost line of the budget for review and approval by the Infant Safe Sleep program prior to the start of the fiscal year. 2. Prior to the submission of the proposed work plan, LHD will participate in an in - person or virtual meeting with all mini -grantees facilitated by the Infant Safe Sleep Program to review current data, discuss infant safe sleep best practices and answer any questions related to mini -grant requirements. 3. LHD will submit the "Infant Safe Sleep Mini -Grant Work Plan and Reporting Document' quarterly with the "Summary of Work Completed" and "Outputs" columns completed and the "Community Engagement Questions" answered. It must be attached to the indirect cost line of each quarterly FSR (Q1, Q2, Q3) and to the final FSR. 4. LHD will participate in a monthly meeting (in -person, virtual or call) with the Infant Safe Sleep Program to review progress, provide updates and coordinate activities statewide. LHD will participate in more frequent calls if requested by program staff. LHD will designate a staff person to serve as the contact with the Infant Safe Sleep Program. Any additional requirements: Grantee must provide safe sleep educational activities, conduct safe sleep community outreach/awareness efforts and engage community leaders to guide programming. 2. Programming must adhere to the policy statement titled "SIDS and Other Sleep - Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment' issued by the American Academy of Pediatrics or any subsequent updates to that policy statement. 3. Activities must: a. Be data driven and focus on communities or populations that experience a high rate of sleep -related infant death and disparity. Input and feedback from families at highest risk for sleep -related infant death must be utilized. b. Be culturally appropriate based on the communities served. c. Support families and encourage open and nonjudgmental conversations with families about infant sleep practices, including risk reduction strategies. 4. Grantee must participate in and/or coordinate a local advisory team or regional group (such as the county's Regional Perinatal Quality Collaborative) to coordinate efforts to promote infant safe sleep and reduce infant deaths related to unsafe sleep environments. Grantee must make efforts to ensure membership represents a diverse community of stakeholders and includes the following on the advisory team: a. Community partners that can address social determinates of health including partners that can meet resource needs of families and partners that work further upstream. b. Community members, such as families, parents and caregivers 5. Activities of the grantee must align with the Mother Infant Health and Equity Improvement Plan to address preventable infant deaths and disparities through evidence -based infant safe sleep program activities. 6. Funds may be used for the purchase of demonstration and/or educational items, however, grantee is encouraged to use department -provided educational materials when possible. Additionally, a maximum of 7% of the funding may be used for giveaway items that are directly related to infant safe sleep such as cribs, pack and - plays, and/or sleep sacks. A maximum of 5% of the funding may be used for advertising, including billboards, bus signage and the purchase of radio, TV, and/or print media. Grantee must adhere to the approved work plan. Deviations to the work plan must be approved by the Program Coordinator. Program Coordinator Colleen Nelson nelsonc7na,michioan.aov 517-243-1796 PROJECT: Informed Consent Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis The Department will provide funding, at the fixed rate of $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided a pregnancy test with a determination of the probable gestational stage of a confirmed pregnancy. Reporting Requirements (if different than contract language) The numberof services, rate per service and total amount due must be noted as a funding source, under the element where the staff providing the services are funded, on the FSR through the MI E-Grants system. Any additional requirements (if applicable) The following requirements apply to all Grantees, whether the Grantee operates a Family Planning Clinic or not: 1. When a woman states that she is seeking an abortion and is requesting services for that purpose the Grantee will provide: a. A pregnancy test with a determination of the probable gestational stage of a confirmed pregnancy. Important Note: The Grantee must destroy the individual "informed consent" files containing identifying information (Name, Address, etc.) after 30 days. 2. When a woman seeks a pregnancy test and does not explicitly state that she is doing so for the purpose of obtaining an abortion, she should be directed to a family planning clinic or to her primary care provider for a pregnancy test. Services to comply with PA 345 of 2000 should not be provided to a woman in a Title X funded family planning clinic. PROJECT: Laboratory Services Bio Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis As part of the emergency preparedness and response efforts, the regional laboratories have been designated as partner organizations that assist with testing, transport, and communications related to biothreat agents or other evolving infectious agent issues. Reporting Requirements (if different than contract language) Provide the Bureau of Laboratories records and reports as required, at least once per year or upon special request. Any additional requirements (if applicable) Meet established standards of performance and objectives in the following areas: Public Health Emergency Preparedness: • Maintain a current list of contact information for local community hospital laboratories to facilitate communication. • Facilitate response with local community hospital laboratories in preparation for and during public health threats. • Coordinate and facilitate specimen collection and transport with facilities within jurisdiction. This may include specimen packaging and shipping and coordination with the courier service. 6 Provide 24/7 contact information to hospital partners and BOL. • Participate in and provide support for Department PHEP exercises with community hospital laboratories within jurisdiction. • The Grantee will designate one staff member as a liaison to the Bureau of Laboratories. Each Grantee must designate appropriate staff to take part in LIMS training activities. • Provide information on specimen submission to local health jurisdictions to assure that specimens are submitted to the BOL LRN laboratory, or other appropriate LRN laboratory as determined by the Department. PROJECT: Lactation Consultant Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The Lactation Consultant project provides lactation support to persons living in Flint and the surrounding areas. All activities must support and promote human milk feeding. Reporting Requirements (if different than contract language) 1. In anticipation of the FY23 contract, grantees must submit a Lactation Consultant work plan to DrzalN(a)michiaan.gov by 9/1/2022. The work plan must include: a. Outcome objectives (a minimum of 2) for improved breastfeeding rates in Genesee County. b. Activities (a minimum of 3 per objective) that include names and numbers of specific populations targeted for interventions. c. The person responsible and deliverable quantifiable outcomes for each activity. 2. Changes to the work plan throughout the year can occur with prior approval from the MDHHS. 3. All activities, as specified in the initial approved work plan, shall be implemented. Workplan Report Due Dates: Work plan reports must be submitted quarterly or as requested by MDHHS. The reports are due 30 days after each quarter and year end and include the following timeframes: a. Initial work plan due August 1, 2022. b. First quarter (covering period October 1 through December 31) is due January 30. c. Second quarter report (covering period January 1 through March 31) is due April 30. d. Third quarter report (covering period April 1 through June 30) is due July 30. e. Fourth quarter report (covering period July 1 through September 30) is due October 30. Any additional requirements (if applicable) PROJECT: Lead Hazard Control Start Date: 10/01/2022 End Date: 9/30/2023 Project Synopsis The LHCCD grant funds local communities to provide residential lead hazard control (LHC) services within their communities per the Medicaid Children's Health Insurance Program State Plan Amendment. The purpose is to provide LHC services to eligible households with a Medicaid -enrolled child to reduce lead exposure in children. The program consists of outreach, education, identification of sources of lead, as well as remediation of lead hazards within the home that contribute to elevated blood lead levels. The grant allows grantees to establish a tailored, high quality, and sustainable lead hazard control program that best serves the residents in their community. Reporting Requirements (if different or in addition to contract language) A. Grantees must complete and submit monthly Enrollee Engagement Protocol Tracking Reports via secured MDHHS File Transfer Protocol (FTP) system by the 15th of each month for the prior month's activity. B. Grantees must complete and submit MDHHS-LSS Monthly Monitoring Reports via secured FTP by the 15th of each month for the prior month's activity. The method of reporting may change following the MiCLEAR application implementation. C. Grantees must complete monthly expenditure and general ledger reports by the 30th of each month for the prior month. Monthly financial reports will be submitted to applicable Program Coordinator on time. D. Quarterly Financial Status Reports in EGrAMS are due by the 30th of the month following the end of the quarter. Grantees shall provide applicable general ledgers attached to the quarterly Financial Status Report in an Excel or PDF format for reconciliation, review and analysis. E. Grantees must submit quarterly Work Plan reports via FTP by the 15th of the month following the end of each quarter, as specified in the Grant Agreement. F. Grantees must complete benchmark form detailing monthly projected environmental investigations, cleared projects and funds to be drawn. Community Development Unit will complete monthly review of benchmarks and develop a management plan on a quarterly basis for grantees who are not meeting benchmarks. If management plan does not achieve projected results, grantee must revise portions of contract including benchmarks and/or total contract award in the next amendment cycle. G. Grantees must have at least one representative participate in additional monitoring and information conference calls as requested by LLSD. H. Any other information as specified in the Statement of Work, shall be developed and submitted by the Grantee as required by the Contract Manager. Reports and information shall be submitted through the Lead Hazard Control Community Development File Transfer Protocol (LHCCD FTP) shared area and EGrAMS. Grantees shall follow the established MDHHS report and document naming conventions for reports submitted via secured FTP. The method of reporting may change following the MiCLEAR application implementation. J. The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager. Any additional requirements (if applicable) A. Ensure compliance with laws, regulations, licensing requirements, protocols, and guidelines for all funded activities under this RFP. Work must be conducted by firms and persons certified according to the Michigan Lead Abatement Act and/or EPA 40 CFR 745 possessing certification as lead abatement firms, EPA certified renovation firms, risk assessors, inspectors, abatement supervisors, abatement workers or certified renovators (for workers and supervisors performing non -abatement work), as applicable to each unit's scope of work. Any abatement activities conducted under this program require a properly certified abatement firm, certified abatement supervisor, certified abatement worker credentialing. Any activities or other renovation activities not performed during abatement activities under this program requires a properly certified EPA renovation firm using only EPA -certified renovators. Each project will have a clearance performed at the end of the abatement work and at the end of the project. Compliance with the following is required for all sub -contractors, sub - grantees, sub -recipients, and their contractors: • U.S. Department of Housing and Urban Development (HUD): 24 CFR 35 • U.S. Occupational Safety and Health Administration (OSHA): 29 CFR 1910.1025, 29 CFR 1926 (Lead Exposure in Construction) ■ U.S. Environmental Protection Agency (EPA): 40 CFR 745 • U.S. EPA, National Environmental Policy Act - Tier II Environmental Review: 29 CFR Part 50-58. • National Historic Preservation Act. The National Historic Preservation Act of 1966 (54 U.S.C. §300101) and the regulations at 36 CFR Part 800 apply to the lead -hazard control or rehabilitation activities that are undertaken pursuant to this RFP. • State of Michigan regulations, including the Michigan Lead Abatement Act (MCL 333.5451-333.3477), Lead Hazard Control Administrative Rules (R325.991 01 -R325.99409), and Article 24 of Public Act 299 of 1980, as amended, regarding residential building, maintenance, and alteration contractor licensing and regulations. ■ Local regulations as applicable. Applicants applying as a consortium must identify all partners, one Lead Applicant, and Authorizing Official in their proposal. Identify the geographic region each consortium partner is serving and their role. C. Create an Enrollee Engagement Prioritization Plan that specifies how you will adhere to the minimum requirements in the Enrollee Engagement Protocol. Grantees must ensure that prioritized at -risk eligible households receive adequate outreach for equitable inclusion and enrollment. Grantees shall maintain a documented Enrollee Engagement Prioritization Plan for their community, prioritizing the most at -risk families (e.g. pregnant women, children with EBLs, age of child, housing stock, etc.). Upon completion of a Data Use Agreement, MDHHS-LSS will provide Grantees with a monthly Medicaid enrollee and Elevated Blood Lead Level (EBLL) report for their geographic region to support this activity. Grantee's plan shall include enough potential participants to attain benchmarks. Conversely, Grantee's plan must be targeted to avoid a lengthy backlog of applicants. iii. Once a Grantee has contacted a potential enrollee, the engagement protocol shall be followed until an application is received or they are disengaged according to the disengagement protocol. iv. Grantee enrollee engagement must include application completion assistance, if needed. V. Grantee's plan shall address how an applicant backlog will be tracked and monitored if there are more applicants than they can serve. vi. If Grantee doesn't have a backlog, all eligible applicants shall be served regardless of their prioritization status. vii. If Grantee plans to use a partner to oversee or conduct their Enrollee Engagement Prioritization Plan and Tracking, they must identify the partner, agreements they have in place, and how PII and PHI data are shared and protected. viii. If Grantee proceeds with an application that does not follow their Enrollee Engagement Prioritization Plan, Grantee must document the justification in their project file. D. Ensure lead abatement requirements are followed including: A lead abatement supervisor is required for each lead abatement job and must be present at the job site while all abatement work is being done. This requirement includes set up and clean up time. The lead abatement supervisor must ensure that all abatement work is done within the limits of federal, state, and local laws. ii. Services may be rendered to eligible physical structures and include the surrounding land up to the property line. iii. Services must be coordinated with water service line removal that occurs outside of the property line. iv. A certified lead inspector or risk assessor, who is independent of the abatement company, shall perform clearance testing after abatement work is completed and at the end of the project. v. All laboratories selected for use in the lead -based paint hazards and evaluation reports shall hold and maintain an accreditation to the ISO/IEC 17025:2005 standard, through an appropriate accreditation body, to conduct lead testing services. The laboratory must be recognized by the U.S. Environmental Protection Agency (EPA) National Lead Laboratory Accreditation Program (NLLAP) for the analyses performed under this contract, and shall, for work under this grant, use the same analytical method used for obtaining the most recent NLLAP recognition. Additionally, the laboratory must employ individuals, who perform the testing and review and report out results, which meet the MDHHS Civil Service requirements for staffing capabilities, which can be found below. Grantee has two analytical laboratory options, which are to either (1) identify the laboratory they plan to use; submit documentation of compliance with the requirements stated in the RFP; (2) use the MDHHS Trace Metals Laboratory. Copies of the chain -of -custody and sample results must be included within the EBL El or Lead Inspection/Risk Assessment report. vi. Ensure water sampling protocols are followed in compliance with the EPA Lead and Copper Rule and the MDHHS-LSS Residential Lead Hazard Control -Lead in Water Protocol. A Michigan Department of Environment, Great Lakes and Energy Certified Drinking Water Laboratory for Lead and Copper must be used. All water samples must be analyzed within fourteen (14) days of collection. It is recommended that all water samples be delivered to the approved laboratory within ten (10) days of collection. Copies of the chain -of -custody and sample results must be included within all Lead Hazard Control Environmental Investigation, Clearance and Addendum reports. vii. All residences designated within a Historic Preservation District must adhere to state and local historical preservation requirements. viii. The LSS — Local Lead Services and Development Unit (LLSD) is responsible for conducting the Tier I Environment Review through the issuance of a public notice in the form of a press release. Grantees are required to complete site specific Tier II Environmental Reviews in accordance with U.S. EPA National Environmental Policy Act, 24 CFR 50-58. Grantees must complete the required Tiered Environmental Review Checklist for each project. The following components shall be included in the review and adhered to: a. Airport Runway Clear Zones and Clear Zones Disclosures b. Coastal Barrier Resources Act c. Coastal Zone Management d. Flood Insurance e. Flood Plain Management f. Wetland Protection g. Wild and Scenic Rivers h. Clean Air Act i. Contaminated and Toxic Substances j. Endangered Species k. Farmlands Protection I. Explosive and Flammable Operations m. Environmental Justice E. Applicants must complete minimum work plan requirements, identify specific program objectives and activities to be accomplished in a work plan. Objectives should relate to the identified target community needs and be SMART (specific, measurable, appropriate, realistic, and time -based). Each objective must have a minimum of one related activity. F. The following minimum objectives and activities shall be included in Applicant's work plan: Objective: Education & Engagement Activity: Adhere to Enrollee Engagement Protocol while utilizing Program Prioritization Plan Responsible Staff: [Please include responsible entitylindividual who is also listed in Budget section] Date Range: Expected Outcome: Receive and approve XX applications. Measurement: Number of applications received/approved and families contacted. Objective: Investigations Activity: Complete XX EBL/LIRA investigations including water sampling according to MDHHS Water Protocol Responsible Staff: [Please include responsible entitylindividual who is also listed in Budget section] Date Range: Expected Outcome: XX completed EBL/LIRA investigations Measurement: Number of EBL/LIRA reports received Objective: Abatement Activity: Complete and clear NW abatement projects Responsible Staff: [Please include responsible entitylindividual who is also listed in Budget section] Date Range: Expected Outcome: XX projects completed/cleared Measurement: Number of projects completed/cleared G. Collaboration and coordination requirements include: i. If MDHHS-LSS-Lead Safe Home Program (LSHP) receives an application from a Medicaid resident in a Grantee community, LSHP and the LLSD will determine who shall be responsible for serving the applicant. LLSD will work with Grantees to coordinate referrals. ii. Services performed must be part of a coordinated plan that ensures abatement activities of the eligible residential unit align with the community's water service line replacement plan (if applicable). The Grantee must replace the service line if water test results are above acceptable limits. Applicants must include their coordination plan as part of their proposal. iii. MDHHS-LSS encourages collaboration and coordination to meet the requirements of this RFP with other non-profit: communities, agencies, and partners (such as childhood lead poisoning prevention programs, health agencies, community development agencies, weatherization assistance agencies, fair housing organizations, code enforcement agencies, community - based organizations, faith -based organizations, financial institutions, or other philanthropic entities). iv. Grantees are required to enter into formal arrangements, such as memorandums of understanding or similar contractual agreements, with service delivery organizations receiving funds. H. All high -cost projects exceeding $70,000 require MDHHS approval prior to abatement. I. Control/Elimination Strategies. All lead -based paint hazards identified in eligible housing units and in common areas of multifamily housing enrolled in this Medicaid CHIP program must be controlled or eliminated in accordance with the Michigan Lead Abatement Act. J. Data Collection and Use. Grantees must collect, maintain, assure data integrity, and provide to MDHHS-LSS the data necessary to document, report, and evaluate program outputs and outcomes. Grantees must document how PII or PHI data will be securely shared with partnering entities, including the following components: Data source, purpose, and use ii. Specific data elements (e.g., age, gender, etc.) iii. Time periods (e.g. October 1, 2020 through September 30, 2021) iv. Identify what data transfer medium will be used (e.g., electronic through secured FTP, hard copy via facsimile, encrypted email, etc.) V. Identify who will have access to the data (e.g., project director, intake specialist, etc.), and how access will be controlled. vi. Identify how you will receive authorization from participants to share data with any subcontractors or partners. Include how you will share the authorized data with subcontractors or partners, and ensure those accessing data agree to the same restrictions and conditions. vii. Identify where data will be stored and how access will be restricted to authorized individuals (e.g. encrypted or password protected) viii. Identify how data will be retained in secured storage once the program is completed to comply with records retention. Include how the data is destroyed at conclusion of the retention period. ix. Grantees are required to immediately notify LLSD if a staff member who has access to FTP or Michigan Comprehensive Lead Abatement and Registry (MICLEAR) is no longer employed with the agency and/or permitted to have access to PHI. LLSD will revoke their access immediately. K. Grantee shall enter and maintain program and project data in an MDHHS online application, MICLEAR, when available. Until such time, data shall be provided on Excel spreadsheets or on data collection forms listed in Reporting Requirements. L. Grantee must obtain Data Use Agreement with LLSD if the program is sharing PHI. M. Required Trainings. Grantees are required to send a minimum of two representatives to attend an annual Grantee Orientation and any additional Grantee mandatory meetings scheduled by MDHHS-LLS throughout the fiscal year. N. Lead -Based Paint and Lead Hazard Identification. A complete lead -based paint inspection, lead hazard risk assessment, EBL environmental investigation (for children with a blood level >_5 pg/dL), and lead in water sampling assessment/evaluation will be conducted; either separate reports or a combined report is required for all properties enrolled under this program. Presumption of the presence of lead -based paint or lead hazards is not permitted. Paint inspections and risk assessments must follow the procedures as defined in the Michigan Lead Abatement Act and HUD Guidelines for the Evaluation and Control of Lead -Based Paint Hazards in Housing investigation, abatement and clearance. Lead in water sampling must be conducted in accordance with MDHHS-LSS Residential Lead Hazard Control -Lead in Water Protocol. Individuals performing EBL/Lead Inspection Risk Assessments and/or water sampling must use MDHHS approved Lead Hazard Control Environmental Investigation, Clearance and Addendum report templates. O. Demolition. In rare cases, a portion of the housing unit or structure with lead hazards may be determined to be of so little value, unfit for occupancy, or in a state of extreme disrepair that pursuing lead hazard control may not be cost effective. Partial demolition and removal of contaminated materials, soil, etc. is a covered service only if pre -approved in writing by MDHHS-LSS. P. Minimal residential rehabilitation is allowed to the extent that this work extends the life of the lead abatement work done consistent with HUD guidelines, including activities that are specifically required in order to cant' out effective hazard control, and without which the hazard control could not be completed, maintained, and sustained, as defined by HUD Policy Guidance Number 2008-02 Q. Notification Requirements. All lead -based paint testing results, summaries of lead - based paint hazard control treatments, and clearances must be provided to the owner of the unit, together with a notice describing the owner's legal duty to disclose the results to tenants and buyers in accordance with 24 CFR 35.88 of the Lead Disclosure Rule. Applicants must ensure that this information is provided in a manner that is effective for persons with disabilities (24 CFR 8.6) and those persons with limited English proficiency (LEP) will have meaningful access to it (see Executive Order 13166). Applicant files must contain verifiable evidence of providing lead hazard evaluation and control reports to owners and tenants, such as a signed and dated receipt. Applicants must also describe how they will provide owners with lead hazard evaluation and control information generated by activities under this program, so that the owner can comply with the Lead Disclosure Rule (24 CFR part 35, subpart A, or the equivalent 40 CFR part 745, subpart F), the Lead Safe Housing Rule (24 CFR part 35, subparts B—R), and the EPA's Renovation, Repair, and Painting (RRP) Rule (see 40 CFR part 745 and http://wvvw2.epa.gov/lead/renovation-repair-and-painting-prog ram). R. Procurement Requirements. Recipients must follow State of Michigan or established grantee policies and procedures. S. Temporary Relocation. Costs for the temporary relocation for residents required to vacate housing during abatement activities must be controlled and reasonable for the area. MDHHS-LSS expects that the lead hazard control work and temporary relocation will take ten (10) days or less, unless pre -approved by MDHHS-LSS. Rental unit landlords shall identify alternate relocation for residents during abatement, if available. T. If an X-ray fluorescent (XRF) instrument is used, all risk assessors must possess current training, certification and licensing in the use of the XRF equipment under appropriate federal, state or local authority. U. Waste Disposal must adhere to the requirements of the Michigan Lead Abatement Act, appropriate local, state, and federal regulatory agencies, and HUD Guidelines. V. Written Policies and Procedures. Grantees will be required to develop written policies and procedures to comply with the requirements of this RFP within the first sixty (60) days of the new award. MDHHS-LSS Lead Safe Home Program will provide Grantees with a minimum set of procedures to be followed. The policies and procedures must describe how your program will handle items such as, but not limited, to: i. Enrollee Engagement Prioritization Plan and Tracking, including a plan for targeted outreach, prioritization, maintenance of a backlog, documentation, and reporting. ii. Workforce development related to lead hazard control iii. Processing program applications, validating unit eligibility, prioritization, and selection iv. All phases of lead hazard evaluation and control, including risk assessments, inspections, water sampling, reporting, abatement and clearance, development of specifications for contractor bids v. Resident temporary relocation vi. Procurement of abatement contractor vii. Quality assurance of program data collection and data entry viii. Financial controls ix. Quality assurance abatement Plan W.Grantees are required to retain all project records in a secured location for five (5) years after project closeout. X. Program administrative costs are recommended to not exceed ten percent (10%) of the award for payments of reasonable administrative costs related to planning and executing the project, preparation/submission of LLSD reports, etc. Administrative costs are the reasonable, necessary, allocable, and otherwise allowable costs of general management, oversight, and coordination of the proposal (i.e., program administration). Administrative costs must be outlined in the budget narrative. If administrative costs exceed ten percent (10%), justification must be provided. Y. The Grantee can choose to use one of the approved methods outlined below in their budget. In any method, grantee must provide appropriate documentation of proof. i. Federal approved rate ii. State approved rate iii. Cost allocation plans iv. De minimis rate: If the Grantee does not have an existing approved indirect rate above and grantee elects to charge indirect costs, they must use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200. De Minimis Rate cannot exceed 10% and de minimis calculation form must be completed and attached. Z. The Grantee is responsible for assuring that environmental and pollution insurance is obtained by certified abatement contractor and/or abatement fine. Contractor and/or firm will provide the program with a copy of its current insurance certificate, which will name the property owner and the State of Michigan as additionally insured. The appropriate pollution/environmental coverage requirements as stated above will be included in the certificate. The certificate must be received prior to the issuance of a purchase order. AA. Eligibility of Expenses i. Roofs: Medicaid CHIP abatement project is eligible for roof replacement when roof is beyond minimal rehab and repairable condition. Documentation is needed stating that roof disrepair would affect the integrity of the lead hazard control work being completed on the property. ii. Multi -Units: Multi -family rental properties are eligible and follows compliance with HUD policy 5-66. iii. Public Housing: Following HUD policy, properties that are HUD voucher based/tenant-based are eligible for lead abatement services. However, project -based housing owned by HUD is not eligible for the Medicaid CHIP grant. iv. Consent Decree: Following HUD policy, properties that have an existing consent decree on the property are not eligible for the Medicaid CHIP grant. V. Demolition: In rare cases, a portion of the residential unit or accessory structure with lead hazards may be determined to be unfit for occupancy or in a state of extreme disrepair that pursuing lead hazard control may not be cost effective or feasible. Partial demolition and removal of contaminated materials, soil, etc. is a covered service only if pre -approved by MDHHS-LSS and the following CMS guidelines are adhered to: i. Conduct clearance testing of the site and soil upon completion of the project to make sure that the demolition did not create new hazards. ii. Attest that certified professionals are contracted to work on the demolition to guarantee that it is conducted safely to protect neighboring structures and residents. iii. Obtain consent from the resident and property owner for the demolition, to ensure all parties are in agreement. vi. Dumpsters: Dumpsters or storage containers/pods are an allowable expense for households where there are extreme hoarding issues that would prevent contractors and inspectors from performing Lead Hazard Control work. vii. Fire Protection: Medicaid CHIP enrolled properties are eligible to receive carbon monoxide detectors and smoke alarms based on local code. viii. Minimal Rehabilitation: Minimal residential rehabilitation is allowed to the extent that this work extends the life of the lead abatement work done consistent with HUD guidelines, including activities that are specifically required in order to carry out effective hazard control, and without which the hazard control could not be completed, maintained, and sustained, as defined by HUD Policy Guidance Number 2008-02. ix. Relocation: Temporary relocation expenses are eligible when family is required to vacate home during abatement activities. When possible, the State rate for hotels should be used. X. Fire Protection: Medicaid CHIP LLSD enrolled properties are eligible to receive carbon monoxide detectors and smoke alarms based on local code. A. Equipment: Any purchase or lease of equipment having a per - unit cost in excess of $5,000 must be pre -approved by MDHHS including the purchase or lease of X-ray fluorescence (XRF) analyzers. xii. Lead Certifications: Payment of professional certifications and licenses are eligible which includes securing and maintaining required certification and licenses for identification, remediation, and clearance of lead and other housing -related health and safety hazards. xiii. Resident blood lead testing and analysis are not eligible services or costs. xiv. Costs of case management are not eligible services or costs. CC. Grantee is responsible for overseeing internal Quality Assurance Plan and COVID19 Preparedness Plan. To ensure safety of workers and residents, grantee will confirm lead safe work practices are being performed as well as COVIDI9-related precautions are being adhered to. xv. Vendors must submit a COVID19 Preparedness Plan to grantees and Community Development Unit before lead hazard control activities can begin. DD. Grantee agrees to follow asbestos recommendations and protocols as prescribed by Healthy Homes Section. EE. MDHHS Local Lead Services and Development Unit will complete quarterly reviews of EBL/LIRA reports, specifications, site visits, file audits, abatement projects completed, and financial expenditures. If significant findings are concluded from quarterly reviews including but not limited to failure to meet projected benchmarks or adhering to reporting requirements, grantee will develop a Plan of Action. If Plan of Action does not achieve projected results in specified amount of time, grantee must revise portions of contract including benchmarks and/or total contract award in next amendment cycle. After previous measures are implemented and grantee still fails to comply with grant requirements, MDHHS reserves the right to rescind grant award. PROJECT: Local Health Department Sharing Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis Local health departments participating in the project will utilize funds to support activities pertinent to the exploration, preparation, planning, implementing, and improving sharing of local health department services, programs or personnel. Reporting Requirements (if different than contract language) Grantees will receive notification of reports along with reporting templates. Reporting is twice per year based on reporting dates required by the CDC. Any additional requirements (if applicable) Local health departments must submit a continuation workplan and budget for continuation funding of the project "Local Health Department Collaboration and Exploration of Shared Approach to Delivery of Services," Eligible Activities: • Meeting activities, including time and travel costs • Cost of research activities • Supplies and presentation materials • Legal fees and other professional services related to the project • IT cost related to service sharing (grant funds may not be used to reimburse equipment costs) PROJECT TITLE: Local Maternal Child Health (LMCH) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Local Maternal Child Health (LMCH) LMCH funding is made available to local health departments to support the health of women, children, and families in communities across Michigan. Funding addresses one or more Title V Maternal and Child Health Block Grant national and state priority areas and/or a local MCH priority need identified through a needs assessment process. Local health departments complete an annual LMCH plan, and a year end report. Target populations are women of childbearing age, infants, and children aged 1-21 years and their families, with a special focus on those who are low income. The LMCH allocated funds are to be budgeted as a funding source in two project categories for FY 2021 LMCH Local Maternal and Child Health (MCH) ESCMCH MCH - Children OTHERMCHV MCH — All Other Reporting Requirements (if different than agreement language): The LMCH Plan submission and due date will be communicated through a notification mailing. The department will provide the format for the LMCH Plan. The LMCH Plan, approved by the department, is to be uploaded with the budget application into EGrAMS. The Plan and Plan amendments, if needed, need to be approved in advance of the budget application and budget amendment. The FY 2023 LMCH Year -End Report submission and due date will be communicated through a notification mailing. The department will provide the format for the LMCH Year -End Report. The Local MCH Year -End Report, approved by the department, is to be uploaded in EGrAMS with the final FSR. The Year -End Report must be approved in advance of the final FSR. Any additional requirements (if applicable): 1. Local MCH funding must be used to address the unmet needs of the maternal child health population and based on data and need(s) identified through the Local Health Department community health assessment process. 2. Activities and programs supported with Local MCH funds must be evidence- based/informed. Exceptions must be submitted in writing and pre -approved by MDHHS. 3. Local MCH funding cannot be used under the WIC element, except in extreme circumstances where a waiver is requested in advance of the expenditures and evidence is provided that the expenditures satisfy all funding requirements. 4. Local MCH funds may not be used to supplant available/billable program income such as Medicaid or Healthy Michigan Plan fees or additional funding under the Medicaid Cost -Based Reimbursement process. 5. Local Health Departments should leverage all other funding sources, especially third -party payers (Medicaid, private insurers) before utilizing LMCH MCH block grant funds. LMCH funds are to be used for those services that cannot be paid for through other sources or for gap filling services. Third party fees should be listed in other funding sources. If no 3rd party fees are listed, an explanation must be noted. 6. The approved LMCH Plan allocation table and the budget application MCH source of funds must match. If an agency needs to move funds between projects, an amended LMCH Plan must be approved in advance of the budget amendment request period. Any specified expenditure in the LMCH Plan must be detailed in the budget (e.g. incentives). 7. The LMCH program follows the same principle on budget transfers and adjustments outlined in the comprehensive agreement. The comprehensive agreement allows for budget transfers and adjustments of $10,000 or 15%, whichever is greater. However, if the transfer or adjustment is greater than the $10,000 or 15%, OR there are any changes made to any of the children performance measures an amended LMCH Work Plan and budget will be required. 8. LMCH is unable to accept cost distributions from MDHHS-ELPHS due to the nature of the block grant and LMCH reporting requirements. LMCH will continue to accept other cost distributions as in the past (such as Family Planning, CSHCS Outreach and Advocacy, VQA, IAP, and Lead Prevention). 9. LMCH has adopted Title 2 Code of Federal Regulations 200 Cost principles. PROJECT TITLE: Maternal Infant and Early Childhood Home Visiting Initiative Local Home Visiting Group Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The purpose of the Local Leadership Group (LLG) is to support the development of a local home visiting system that leads to improvement and coordination of home visiting programs at the community or regional level. Reporting Requirements (if different than agreement language): The LLG shall submit all required reports in accordance with the Department reporting requirements. a. Staffing Changes: Within 10 days of a staffing change, notify the notify the State LLG Coordinator via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. LLG Work Plan: Due annually on June 30 for preapproval. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter (January 30, April 30, July 30, and October 30). d. See the MDHHS Home Visiting Guidance Manual for specific Continuous Quality Improvement (CQI) reporting requirements which include: monthly data tracking, PDSA cycle updates (due the 15th of each month) and story board and team charter submissions. e. The Contract Manager or his/her designee shall evaluate the reports submitted as described for their completeness and adequacy. f. The Grantee shall permit the Department or its designee to visit, either in person or virtually, and make an evaluation of the project as determined by the Contract Manager. All reports and/or information (a-f), unless stated otherwise, shall be submitted electronically to the Home Visiting mailbox at MDHHS-HVlnitiative(a.michiaan.gov. Any additional requirements (if applicable): Comply with MDHHS Home Visiting Proqram Requirements: The Grantee shall operate the program with fidelity to the requirements of MDHHS as outlined in the MDHHS Home Visiting Guidance Manual. The LLG will work with the State LLG Coordinator and the Michigan Public Health Institute (MPHI). See the MDHHS Home Visiting Guidance Manual for details. 2. The LLG will continue the following efforts started in previous years: a. Ensure recruitment and participation of both required and strongly encouraged LLG representatives. b. Integrate parent leaders as active members of the LLG. Membership on the LLG CQI team must include a parent leader. This includes their attendance at local CQI meetings and the three LLG Grantee meetings. c. Implement one strategy from the respective community's local Home Visiting Continuum of Models Project Plan. d. Conduct a LLG Quality Improvement project. e. Implement the community's Sustainability Plan. See the MDHHS Home Visiting Guidance Manual for requirements related to LLG membership/participation, development of CQI strategies, as well as the implementation of Continuum and Sustainability Plans. Fundinq Requirements: The funding can be used to: a. Enable the LLG to pay for staff support. b. Financially support LLG parent leaders to attend the Michigan Home Visiting Conference. c. Financially support LLG members, including parent leaders, to be part of the LLG and CQI efforts. d. Carry out MDHHS Home Visiting Unit activities as specified in this agreement. Promotional Materials If the LLG wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements as outlined in the MDHHS Home Visiting Guidance Manual. PROJECT TITLE: Maternal Infant Early Child Home Visiting Initiative Rural Local Home Visiting Group and Maternal Infant Early Child Home Visiting Initiative Rural Local Home Visiting Group 3 Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The purpose of the Local Leadership Group (LLG) is to support the development of a local home visiting system that leads to improvement and coordination of home visiting programs at the community or regional level. Reporting Requirements (if different than agreement language): The LLG shall submit all required reports in accordance with the Department reporting requirements. a. Staffing Changes: Within 10 days of a staffing change, notify the State LLG Coordinator via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. LLG Work Plan: Due annually on June 30 for preapproval. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter (January 30, April 30, July 30, and October 30). d. See the MDHHS Home Visiting Guidance Manual for specific Continuous Quality Improvement (CQI) reporting requirements which include: monthly data tracking, PDSA cycle updates (due the 15th of each month) and story board and team charter submissions. e. The Contract Manager or his/her designee shall evaluate the reports submitted as described for their completeness and adequacy. f. The Grantee shall permit the Department or its designee to visit, either in person or virtually, and make an evaluation of the project as determined by the Contract Manager. All reports and/or information (a-f), unless stated otherwise, shall be submitted electronically to the Home Visiting mailbox at MDHHS-HVlnitiativena michioan.cov. Any additional requirements (if applicable): ComDIV with MDHHS Home Visitinq Program Requirements: The Grantee shall operate the program with fidelity to the requirements of MDHHS as outlined in the MDHHS Home Visiting Guidance Manual. The LLG will work with the State LLG Coordinator and the Michigan Public Health Institute (MPHI). See the MDHHS Home Visiting Guidance Manual for details. 2. The LLG will continue the following efforts started in previous years: a. Ensure recruitment and participation of both required and strongly encouraged LLG representatives. b. Integrate parent leaders as active members of the LLG. Membership on the LLG CQI team must include a parent leader. This includes their attendance at local CQI meetings and the three LLG Grantee meetings. c. Implement one strategy from the respective community's local Home Visiting Continuum of Models Project Plan. d. Conduct a LLG Quality Improvement project. e. Implement the community's Sustainability Plan. See the MDHHS Home Visiting Guidance Manual for requirements related to LLG membership/participation, development of CQI strategies, as well as the implementation of Continuum and Sustainability Plans. Funding Requirements: The funding can be used to: a. Enable the LLG to pay for staff support. b. Financially support LLG parent leaders to attend the Michigan Home Visiting Conference. c. Financially support LLG members, including parent leaders, to be part of the LLG and CQI efforts. d. Carry out MDHHS Home Visiting activities as specified in this agreement. Promotional Materials If the LLG wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements as outlined in the MDHHS Home Visiting Guidance Manual. PROJECT: Medicaid Outreach Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis Medicaid Outreach activities are performed to inform Medicaid beneficiaries or potential beneficiaries about Medicaid, enroll individuals in Medicaid and improve access and utilization of Medicaid covered services. All outreach activities must be specific to Medicaid. Reference bulletin: MSA 18-41 Additional instructions can be found in Attachment I. Reporting Requirements (if different than contract language) Submit quarterly reports no later than 1 month after the end of the quarter. The exception is the 4th quarter report which is due at the time as the final FSR. If the report due date falls on a weekend or holiday, the report the next business day. Reporting Period October 1 — December 31 January 1 — March 31 April 1 — June 30 July 1 — September 30 Due Date, January 31 April 30 July 31 November 30 Quarterly reports must be attached/uploaded on the Source of Funds/Federal Medicaid Outreach line on the FSR in EGrAMS. Reimbursements occur based on actual expenditures reported on Financial Status Reports (FSR) using the reporting format and deadlines as required by the Department through EGrAMS. Any additional requirements (if applicable) All claimable outreach activities must be in support of the Medicaid program. Activities that are part of a direct service are not claimable as Medicaid Outreach. Must maintain documentation in support of administrative claims which are sufficiently detailed to allow determination of whether the activities were necessary for the proper and efficient administration of the Medicaid State Plan. Must maintain a system to appropriately identify the activities and costs in accordance with federal requirements. Must provide quarterly summary reports of Medicaid outreach activities conducted during the quarter. The following reporting elements must be included in the quarterly report: 1. Name of Health Department 2. Name and contact information of the individual completing the report. 3. Time period the report covers (e.g., FY 20: 1st quarter, or October - December) 4. Types of services provided during the quarter (Note: the types of services provided do not have to include every single activity the LHD conducted during the quarter. Rather, simply include examples of the types of services provided. The Grantee can include as much or as little detail as they chose.) 5. Number of clients served. 6. Amount of funds expended during the quarter and total expenditures. 7. Number of FTEs who provided these activities. Successes/Challenges This is not a reporting requirement but provides an opportunity for the LHD to share successes during the quarter (e.g., For the first time, someone from the school board attended the Infant Mortality Reduction Coalition meeting) or to describe any challenges encountered during the quarter (e.g., the health advocate quit, and the lactation consultant went on maternity leave, so we are down 2 staff) PROJECT TITLE: Michigan Adolescent Pregnancy and Parenting Program Start Date: 10/1 /2022 End Date: 9/31/2023 Project Synopsis: The goal of Michigan Adolescent Pregnancy and Parenting Program (MI-APPP) is to create an integrated system of care, including linkages to support services, for pregnant and parenting adolescents 15-19 years of age, the fathers, and their families. MI-APPP grantees implement the Adolescent Family Life Program -Positive Youth Development (AFLP-PYD; a California model), an evidence -informed case management curriculum designed to elicit strengths, address various risk behaviors, the impact of trauma, and provide a connection to health care and community services. In addition, MI-APPP grantees engage communities through locally driven steering committees, a comprehensive needs assessment, and creation of support services to ensure the program is responsive to the needs of pregnant and parenting teens. MI-APPP aims to: 1. Reduce repeat, unintended pregnancies, 2. Strengthen access to and completion of secondary education, 3. Improve parental and child health outcomes, and 4. Strengthen familial connections between adolescents and their support networks Reporting Requirements (if different than agreement language): Report = Time Period - I Due Date Program Narrative Evaluation/Data Submission October 1- December 31 January 1-March 31 April 1-June 30 July 1-September 30 Monthly Any additional requirements (if applicable): January 15 April 15 July 15 October 15 Submit the loth of every month Submit To I Program Coordinator REDcap • Information provided must be medically accurate, age -appropriate, culturally relevant, and up-to-date. • Pregnancy prevention education must be delivered separate and apart from any religious education or promotion. MI-APPP funding cannot not be used to support inherently religious activities including, but not limited to, religious instruction, worship, prayer, or proselytizing (45 CFR Part 87). Family planning drugs and/or devices cannot be prescribed, dispensed, or otherwise distributed on school property as part of the pregnancy prevention education funded by MI-APPP as mandated in the Michigan School Code. Abortion services, counseling and/or referrals for abortion services cannot be provided as part of the pregnancy prevention education funded under MI-APPP. • Must adhere to the Minimum Program Requirements for MI-APPP. MI-APPP funding cannot be used to supplant funding for an existing program supported with another source of funds. PROJECT TITLE: MI Home Visiting Initiative Rural Expansion Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Healthy Families America (HFA) program was designed by Prevent Child Abuse America and is built on the tenants of trauma -informed care. The program is designed to promote positive parent -child relationships and healthy attachment. It is a strengths - based and family -centered approach. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department reporting requirements. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the HFA model consultant via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. HFA Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. 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). All reports and/or information (a-c), unless stated otherwise, shall be submitted electronically to the MDHHS Home Visiting mailbox at MDHHS- HVlnitiative(&michiclan.gov. d. Implementation Monitoring Data and HRSA data collection requirements due in REDCap and/or HVOL by the 5th business day of each month. e. Quality Improvement Reporting: • Documentation of a QI team will be submitted with the quarterly Work Plan Report. • Documentation of QI activities will be submitted with the quarterly Work Plan Report. • Annual summary of QI activities will be submitted to the Model Consultant by February 15. f. HV CollN Reporting (for those LIAs participating) for QI efforts shall occur in accordance with the CollN's schedule. Participating LIAs are required to use the HV CollN site to complete monthly submissions of PDSA cycles and required data (the frequency of data collection may vary). Reports (d-f) shall be submitted as described above. Additional guidance concerning data collection and Quality Improvement is provided in the MDHHS Home Visiting Guidance Manual. Any additional requirements (if applicable): The LIA shall serve families as a result of outreach efforts based on the findings of their MDHHS- HVU Outreach Toolkit. a. The Healthy Families Northern Michigan HFA Program (operated from the Health Department of Northwest Michigan in collaboration with District Health Department #2 and Central Michigan District Health Department) will serve the applicable number of families in communities experiencing disadvantage per section d. below. b. The District Health Department #10 HFA Program will serve the applicable number of families in communities experiencing disadvantage per section d. below. c. The Healthy Families Upper Peninsula (operated from the Luce-Mackinac- Alger-Schoolcraft Health Department in collaboration with the Western Upper Peninsula Health Department, Marquette County Health Department, Dickinson -Iron District Health, and Public Health Delta Menominee counties) HFA Program will serve the applicable number of families in communities experiencing disadvantage per section d. below. d. In general, across all regions, the home visitor -to -family ratio should agree with the following: a. 15 families per 1.0 experienced FTE serving one county b. 14 families per 1.0 experienced FTE serving two counties c. 12 families per 1.0 experienced FTE serving three or more counties e. Total FY23 caseloads including experience levels of FSSs and number of counties served by FSSs are expected as follows: a. Day One — 6 families FFPSA b. DHD #10 — 60 families Rural, 8 families FFPSA c. HFNM — 103 families Rural d. HFUP — 59 families Rural, 5 families FFPSA Maintain FidelitV to the Model The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy Families America affiliates shall comply with the requirements of the Central Administration for the Multi -Site State System (also known as "The State Office") housed within the Michigan Public Health Institute. All HFA model -required training will be accessed through the Central Administration as available. Contact the HFA State Office for details. Comnly with MDHHS Proaram Reauirements The LIA shall operate the program with fidelity to the requirements of MDHHS based on the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting Guidance Manual. The LIA will fulfill these requirements while strengthening efforts towards health and racial equity through staff education, programmatic data evaluation and client supportive services. P.A. 291 The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS Home Visiting Guidance Manual for requirements related to PA 291. Staffing The LTA's HFA home visiting staff will reflect the community served. The LIA will provide documentation to demonstrate due diligence if unable to fully meet this requirement within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Guidance Manual for requirements related to program staffing. Performance Measures: The LIA shall comply with MDHHS expectations of demonstrating improvement in the performance measures as described in the MDHHS Home Visiting Guidance Manual. Proaram Monitoring, Qualltv Assessment, Sunnort and Technical Assistance (TA): The LIA shall fully participate with the Department and the Michigan Public Health Institute (MPHI) with regards to program development and monitoring (including annual site visits either in -person or virtual), training, support and technical assistance services. See the MDHHS Home Visiting Guidance Manual for requirements related to program monitoring, quality assessment, support and TA. Professional Development and Trainina: All of the LIA's HFA program staff associated with this funding will participate in professional development and training activities as required by both HFA and the Department. All LIA HFA program staff must receive HFA-specific training from a Michigan -based approved HFA training entity. See the MDHHS Home Visiting Guidance Manual for requirements related to professional development and training activities. Supervision: The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice Standards. Written policies and procedures shall specify how reflective supervision is included in, or added to, that time to ensure provision for each home visitor at a minimum of one hour per month. Engage and Coordinate with Communitv Members, Partners and Parents: The LIA shall ensure that there is a broad -based community advisory committee that is providing oversight for HFA. The LIA shall build upon and maintain diverse community collaboration and support with authentic engagement of parent representatives who have the lived experience and expertise. The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start Collaborative. See the MDHHS Home Visiting Guidance Manual for requirements related to engagement with community partners. Data Collection: The LIA shall comply with all HFA and MDHHS data training, collection, entry and submission requirements. See the MDHHS Home Visiting Guidance Manual for requirements related to data collection. Qualitv Improvement (QI): The LIA shall participate in all HFA quality initiatives including research, evaluation and continuous quality improvement. The LIA shall participate in all state and local Home Visiting Qi activities as required by MDHHS. Required activities include, but are not limited to: a. Developing and maintaining a QI team b. Participating in QI activities during the fiscal year c. Consulting with QI coaches See the MDHHS Home Visiting Guidance Manual for requirements related to QI. Work Plan Requirements: By June 30, the LIA must submit a Work Plan for the next fiscal year to the MDHHS Home Visiting mailbox (MDHHS-HVlnitiativeCa).michioan.aov) for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting including Outreach and Retention plans. Promotional Materials: If the LIA wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting Guidance Manual. PROJECT TITLE: Maternal Infant Childhood Home Visiting Program (MIECHVP) Healthy Families America Expansion Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Healthy Families America (HFA) program was designed by Prevent Child Abuse America and is built on the tenants of trauma -informed care. The program is designed to promote positive parent -child relationships and healthy attachment. It is a strengths - based and family -centered approach. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department reporting requirements. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the HFA Model Consultant via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. HFA Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. 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). All reports and/or information (a-c), unless stated otherwise, shall be submitted electronically to the MDHHS Home Visiting mailbox at MDHHS- HVlnitiative(amichiaan.aov. d. Implementation Monitoring Data and HRSA data collection requirements due in REDCap and/or HVOL by the 5th business day of each month. e. Quality Improvement Reporting: • Documentation of a QI team will be submitted with the quarterly Work Plan Report. • Documentation of QI activities will be submitted with the quarterly Work Plan Report. • Annual summary of QI activities will be submitted to the Model Consultant by February 15. f. HV ColIN Reporting (for those LIAs participating) for QI efforts shall occur in accordance with the ColIN's schedule. Participating LIAs are required to use the HV ColIN site to complete monthly submissions of PDSA cycles and required data (the frequency of data collection may vary). Reports (d-f) shall be submitted as described above. Additional guidance concerning data collection and Quality Improvement is provided in the MDHHS Home Visiting Guidance Manual. Any additional requirements (if applicable): Grantee Specific Requirements: The LIA shall serve families as a result of outreach efforts based on the findings of their MDHHS-HVU Outreach Toolkit. a. The Kalamazoo County Health and Community Services Department HFA program will serve a minimum of 29 families under MIECHV funding plus 22 families under FFPSA. Kalamazoo home visiting programs should prioritize outreach to families who have low-income and pregnant persons and families who are African -American, Hispanic, Asian, Native -American, or multi -racial who have historically experienced racism and are living in the City of Kalamazoo and adjacent townships. Outreach priorities should also include families with a history of child abuse or maltreatment, including parents who were abused as children. In addition, Kalamazoo County should conduct outreach to young (under 21) pregnant persons and families with low educational attainment. b. The Wayne County Babies HFA program will serve a minimum of 50 families under MIECHV funding plus 40 families under FFPSA. Wayne County should prioritize low-income families, families with pregnant persons who have not attained age 21, families with a history of child abuse or neglect (including parents who experienced abuse as children), families that have low educational attainment, and families with children with developmental delays or disabilities. Additionally, Wayne County should prioritize families who have historically experienced racism, engaging families who identify as African - American, Hispanic, Asian, Native -American, or multi -racial. Maintain Fidelitv to the Model The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy Families America affiliates shall comply with the requirements of the Central Administration for the Multi -Site State System (also known as "The State Office") housed within the Michigan Public Health Institute. All HFA model -required training will be accessed through the Central Administration as available. Contact the HFA State Office for details. Comply with MDHHS Program Requirements The LIA shall operate the program with fidelity to the requirements of MDHHS based on the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting Guidance Manual. The ILIA will fulfill these requirements while strengthening efforts towards health and racial equity through staff education, programmatic data evaluation and client supportive services. P.A. 291 The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS Home Visiting Guidance Manual for requirements related to PA 291. Staffing The LTA's HFA home visiting staff will reflect the community served. The LIA will provide documentation to demonstrate due diligence if unable to fully meet this requirement within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Guidance Manual for requirements related to program staffing. Performance Measures: The LIA shall comply with MDHHS expectations of demonstrating improvement in the performance measures as described in the MDHHS Home Visiting Guidance Manual. Prooram Monitoring. Qualitv Assessment. Support and Technical Assistance (TAI: The LIA shall fully participate with the Department and the Michigan Public Health Institute (MPHI) with regards to program development and monitoring (including annual site visits either in -person or virtual), training, support and technical assistance services. See the MDHHS Home Visiting Guidance Manual for requirements related to program monitoring, quality assessment, support and TA. Professional Development and Traininq: All of the LIA's HFA program staff associated with this funding will participate in professional development and training activities as required by both HFA and the Department. All LIA HFA program staff must receive HFA-specific training from a Michigan -based approved HFA training entity. See the MDHHS Home Visiting Guidance Manual for requirements related to professional development and training activities. Supervision: The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro -rated as allowed by the Best Practice Standards. Written policies and procedures shall specify how reflective supervision is included in, or added to, that time to ensure provision for each home visitor at a minimum of one hour per month. Engage and Coordinate with Communitv Members. Partners and Parents: The LIA shall ensure that there is a broad -based community advisory committee that is providing oversight for HFA. The LIA shall build upon and maintain diverse community collaboration and support with authentic engagement of parent representatives who have the lived experience and expertise. The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start Collaborative. See the MDHHS Home Visiting Guidance Manual for requirements related to engagement with community partners. Data Collection: The LIA shall comply with all HFA and MDHHS data training, collection, entry and submission requirements. See the MDHHS Home Visiting Guidance Manual for requirements related to data collection. Qualitv Improvement Mill: The LIA shall participate in all HFA quality initiatives including research, evaluation and continuous quality improvement. The LIA shall participate in all state and local Home Visiting QI activities as required by MDHHS. Required activities include, but are not limited to: a. Developing and maintaining a QI team b. Participating in QI activities during the fiscal year c. Consulting with QI coaches See the MDHHS Home Visiting Guidance Manual for requirements related to CIL Work Plan Requirements: By June 30, the LIA must submit a Work Plan for the next fiscal year to the MDHHS Home Visiting mailbox (MDHHS-HVlnitiative(-a�.michioan.00v) for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting including Outreach and Retention plans. Promotional Materials: If the LIA wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting Guidance Manual. PROJECT: Minority Health Community Capacity Building Initiative Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The focus of the program is to support culturally and linguistically appropriate community - level projects that build capacity to identify and implement programs, policies, and practices to address social determinants of health that contribute to health inequities for racial and ethnic minority populations in Michigan. Reporting Requirements (if different than contract language) Quarterly Narrative Progress Report Submit quarterly narrative progress reports in accordance with the following dates: Reporting Time Period October 1 - December 31 January 1 - March 31 April 1 - June 30 July 1 - September 30 Any additional requirements (if applicable) Due Date January 31 April 30 July 31 October 31 A. Ensure that activities implemented under this grant award are in accordance with established OEMH program standards,,as well as State and Federal policy and statutes including HIPPA. B. Participate in technical assistance, training, and/or skills enhancement opportunities as recommended or required by MDHHS/OEMH. Training participation should include one representative of the Lead Organization (funded organization), the local evaluator/s, and one representative from a partner organization in the multi -sector team. Representatives attending the training will be responsible for the sharing and dissemination of information received at the training with the complete multi -sectored team. C. Convene and document agenda and minutes for a minimum of one monthly multi -sector team meeting to obtain input from team members related to the progress, barriers, and next steps in the implementation of work plan objectives. Team meetings may be face to face, conference call, web based. D. Adhere to timelines and work plans, budgets, and staffing plans submitted and approved by MDHHS/OEMH. Deviations from approved timelines, work plans, budgets and staffing plans must receive advance authorization from MDHHS/OEMH. Failure to make reasonable progress in program development may result in revocation or reduction of the grant award. E. Collaborate with evaluation team consisting of OEMH staff and an evaluator. The contractor must adhere to MDHHS policies and standards related to Institutional Review Board. F. Ensure that services and materials are culturally and linguistically appropriate to meet the needs of the respective client populations. G. Permit the OEMH staff or its designee to visit and to evaluate the project, on an annual basis as determined by the Contract Manager. Contractors shall agree to participate in an annual site visit during the three-year funding cycle The designated months for completion of program sites visits to be conducted: June - August PROJECT TITLE: Nurse Family Partnership (NFP) Services Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Nurse -Family Partnership (NFP) program offers families one-on-one home visits with a registered nurse. The model is grounded in human attachment, human ecology, and self -efficacy theories. Home visitors use model -specific resources to build on a parent's own interests to attain the model goals. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department reporting requirements. See the Michigan Department of Health and Human Services' (MDHHS) Home Visiting Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the NFP Model Consultant via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. Medicaid Outreach Report (Berrien, Calhoun, Kalamazoo and Kent counties only): Due within 30 days of the end of each quarter. c. NFP Work Plan: Due annually on June 30 for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. d. Work Plan Reports: Must be submitted within 30 days of the end of each quarter (January 30, April 30, July 30 and October 30). All reports and/or information (a-d), unless stated otherwise, shall be submitted electronically to the MDHHS Home Visiting mailbox at MDHHS- HVlnitiativena.michigan.gov. . e. Implementation Monitoring Data and HRSA data collection requirements due in REDCap and Flo on the 5'h business day of each month. f. Quality Improvement Reporting: ® Documentation of a QI team will be submitted with the quarterly Work Plan Report. Documentation of QI activities will be submitted with the quarterly Work Plan Report. Annual summary of QI activities will be submitted to the Model Consultant by February 15. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in accordance with the ColIN'S schedule. Participating LIAs are required to use the HV ColIN site to complete monthly submissions of PDSA cycles and required data (the frequency of data collection may vary). Reports (e-g) shall be submitted as described above. Additional guidance concerning data collection and Quality Improvement is provided in the MDHHS Home Visiting Guidance Manual. Any additional requirements (if applicable): Maintain Fidelity to the Model: The LIA shall adhere to the Nurse Family Partnership National Service Office (NSO) program standards and operate the program with fidelity to the NSO Application Review Team's approved Implementation Plan. Comply with MDHHS Program Requirements: The LIA shall operate the program with fidelity to the requirements of MDHHS based on the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting Guidance Manual. The LIA will fulfill these requirements while strengthening efforts towards health and racial equity through staff education, programmatic data evaluation and client supportive services. Data -Informed Outreach: Michigan is using NFP as a specialized home visiting service strategy for first-time mothers who are low-income. This specialized service strategy is a focused way of using limited resources, directing them to populations who live in communities placing them at higher risk. The LIA will conduct outreach activities to the population groups identified in their MDHHS-HVU Outreach Toolkit in order to enroll families from those outreach efforts. The MDHHS expects LIAs to maintain a caseload capacity of 25 families per 1.0 FTE. arl"Ka E The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS Home Visiting Guidance Manual for requirements related to PA 291. Staffing: The LIA's NFP home visiting staff will reflect the community served. The LIA will provide documentation to demonstrate due diligence if unable to fully meet this requirement within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Guidance Manual for requirements related to program staffing. Performance Measures: The LIA shall comply with MDHHS expectations of demonstrating improvement in the performance measures described in the MDHHS Home Visiting Guidance Manual. Program Monitoring. Quality Assessment. Support and Technical Assistance ITA): The LIA shall fully participate with the NFP NSO, the Department and the Michigan Public Health Institute (MPHI) with regards to program development and monitoring (including annual site visits either in -person or virtual), training, support and technical assistance services. See the MDHHS Home Visiting Guidance Manual for requirements related to program monitoring, quality assessment, support and TA. Professional Development and Traininq: All the LIA's NFP staff associated with this funding will participate in professional development and training activities as required by the NFP, NSO and the Department. See the MDHHS Home Visiting Guidance Manual for requirements related to professional development and training activities. Supervision: The LIA shall adhere to the NFP supervision requirements. Enaaae and Coordinate with Communitv Members. Partners and Parents:, The LIA shall ensure that there is a broad -based community advisory committee that is providing oversight for NFP. The LIA shall build upon and maintain diverse community collaboration and support with authentic engagement of parent representatives who have the lived experience and expertise. The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start Collaborative. See the MDHHS Home Visiting Guidance Manual for requirements related to engagement with community partners. Data Collection: The LIA shall comply with all NFP and MDHHS data training, collection, entry and submission requirements. See the MDHHS Home Visiting Guidance Manual for requirements related to data collection. Qualitv Improvement (QII: The LIA shall participate in all NFP quality initiatives including research, evaluation, and continuous quality improvement. The LIA shall participate in all state and local Home Visiting QI activities as required by MDHHS. Required activities include, but are not limited to: a, Developing and maintaining a QI team b. Participating in QI activities during the fiscal year c. Consulting with Qi coaches See the MDHHS Home Visiting Guidance Manual for requirements related to QI. Work Plan Requirements: By June 30, the LIA must submit a Work Plan for the next fiscal year to the MDHHS Home Visiting mailbox (MDHHS-HVlnitiativena michiaan.aov) for preapproval. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting including Outreach and Retention plans. Promotional Materials: If the LIA wishes to produce any marketing, advertising or educational materials using grant agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting Guidance Manual. PROJECT: Oral Health Kindergarten Assessment Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The focus of the program is to perform an oral health assessment of children entering kindergarten or first grade to help identify dental needs if any. The assessment will provide information on whether the child needs preventive, restorative or urgent needs, along with the need for referral for treatment. Data to be gathered by LHD and submitted to the Oral Health Program for analysis and review. Reporting Requirements (if different than contract language) Any additional requirements (if applicable) PROJECT: Public Health Emergency Preparedness (PHEP) and Cities Readiness Initiative (CRI) as applicable 9 Month Project — BIONINE/CRININE Beginning Date: 10/1/2022 End Date: 6/30/2023 3 Month Project — BIOTHREE/CRiTHREE Beginning Date: 7/1/2023 End Date: 9/30/2023 Project Synopsis As a Grantee of funding provided through the Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness (PHEP) Cooperative Agreement, each Grantee shall conduct activities to build preparedness and response capacity and capability. These activities shall be conducted in accordance with the PHEP Cooperative Agreement guidance for BP4 (2022-2023) plus any and all related guidance from the CDC and the Department that is issued for the purpose of clarifying or interpreting overall program requirements. Reporting Requirements (if different than contract language) Grantee are required to submit a 3-month (July 1 to September 30) budget and a 9-month (October 1 to June 30) for both Base PHEP and CRI funding, including the 10% MATCH for those periods (see below for detail regarding Match). Submitted to MDHHS-BETP-DEPR-PHEP a(7michiaan.aov by April 15, 2022. 2. ALL activities funded through the PHEP cooperative agreement must be completed between July 1, and June 30, and all BP4 funding must be obligated by June 30, 2023, and activity completed by the August 15, 2023 Final FSR submission deadline. Grantee must submit required PHEP program data and reports by the stated deadlines. This includes, but is not limited to, progress reports, performance measure data reports, National Incident Management System (NIMS) compliance reports, updated emergency plans, budget narratives, Financial Status Reports (FSR), etc. Failure to do so will constitute a benchmark failure. All deliverables must be submitted by the designated due date in the LHD BP4 work plan. 4. Grantee must maintain National Incident Management System (NIMS) compliance as detailed in the LHD work plan and submit annually to the Department — DEPR per the LHD BP4 work plan. 5. Each subrecipient Grantee must retain program -related documentation for activities and expenditures consistent with Title 2 CFR Part 200; Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards, to the standards that will pass the scrutiny of audit. Any additional requirements (if applicable) All Grantee activities shall be consistent with all approved BP4 work plan(s) and budget(s) on file with the Department through the EGrAMS. In addition to these broad requirements, the Grantee will comply with the following: Grantee provides the required 10% MATCH for July 1 to September 30 and October 1 to June 30. Grantee are required to submit a letter (on agency letterhead) stating the source, calculation, and narrative description of how the match was achieved, unless said match is met using local dollars. This was due with the narrative budget submission to the Division of Emergency Preparedness and Response-DEPR. • One (1) full time equivalent (FTE) emergency preparedness coordinator (EPC) position, as a point of contact. In addition to the Grantee health officer, the EPC shall participate in collaborative capacity building activities of the PHEP Cooperative Agreement, all required reporting and exercise requirements and in regional Healthcare Coalition (HCC) initiatives. Anv chances to this staffina model must be approved by the Public Health Emeraencv Preparedness Program Manager at the Division of Emeraencv Preparedness and Response (517-335- 8150 . • Under the PHEP cooperative agreements, Grantees must continue to partner with the Regional Healthcare Coalitions (HCC) and support HCC initiatives to ensure that healthcare organizations receive resources to meet medical surge demands. Working well together during a crisis is facilitated by meeting on a regular basis. To this end, EPCs, supported by CDC PHEP are required to participate in and support regional HCC initiatives. In addition, the EPC or designee is required to attend regional HCC planning or advisory board meetings. The intent is for LHDs that cross regional boundaries to align with one regional coalition. • There are a number of special initiatives, projects, and/or supplemental funding opportunities that are facilitated under this cooperative agreement. For example, the Cities Readiness Initiative (CRI) performance and evaluation initiatives. Each Grantee that is designated to participate in any of these types of supplemental opportunities is required to comply with all CDC and the Department — Division of Emergency Preparedness and Response (DEPR) guidance, and all accompanying work plan and budgeting requirements implemented for the purpose of subrecipient monitoring and accountability. Some or all supplemental opportunities may require separate recordkeeping of expenditures. If so, this separate accounting will be identified in separate project budgets in the EGrAMS. These supplemental opportunities may also require additional reporting and exercise activities. All budget amendments must be submitted to the Division of Emergency Preparedness and Response (DEPR) for review prior to submitting them in the EGrAMS. Budget amendments that contain line items deviating more than 15% or $10,000 (whichever is greater) from the original budgeted line item must be approved by DEPR prior to implementation via email to MDHHS-BETP-DEPR- PHEP( .michiQan.aov. In response to repeated communications from CDC strongly urging states to ensure all funds are spent each year a threshold has been established to limit the amount of unspent funds. A maximum of 2% of the Grantee allocation or $3,000 (whichever is greater) of unspent funds is allowable each budget period. Failure to meet this requirement, or misuse of funds, will affect the amount that is allocated in subsequent budget periods. Unallowable and Allowable Costs • Grantee may not use funds for research. • Grantee may not use funds for clinic care except as allowed by law. • Generally, Grantee may not use funds to purchase furniture or equipment. Any such proposed spending must be clearly identified in the budget. • Reimbursement of pre -award costs generally is not allowed unless the CDC provides written approval to the recipient. • Other than for normal and recognized executive -legislative relationships, no funds may be used for: a. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body. b. The salary or expenses of any grant or contract recipient, or agent acting for such recipient related to any activity designed to influence the enactment of legislation, appropriations regulation, administrative action, or Executive order proposed or pending before any legislative body. 0 Lobbying is prohibited. The direct and primary recipient in a cooperative agreement must perform a substantial role in carrying out project outcomes and not merely serve as a conduit for an award to another party or provider who is ineligible. • Grantee may not use funds to purchase vehicles to be used as means of transportation for carrying people or goods, e.g., passenger cars or trucks, electrical or gas -driven motorized carts. • Grantee can (with prior approval) use funds to lease vehicles to be used as means of transportation for carrying people or goods, e.g., passenger cars or trucks and electrical or gas -driven motorized carts. • Payment or reimbursement of backfilling costs for staff is not allowed. • No clothing may be purchased with these funds. • Items considered as give away such as first aid kits, flashlights, shirts etc., are not allowable. • None of the funds awarded to these programs may be used to pay the salary of an individual at a rate in excess of Executive Level II or $181,500 per year. Grantee may not use funds for construction or major renovations. • Grantee may not use funds to purchase a house or other living quarter for those under quarantine. • PHEP funds may not be used to purchase or support (feed) animals for labs, including mice. Any requests for such must receive prior approval of protocols from the Animal Control Office within CDC and subsequent approval from the CDC OGS as to the allowable of costs. Grantee may use funds only for reasonable program purposes, including travel, supplies, and services. • Grantee may supplement but not supplant existing state or federal funds for activities described in the budget. Supplantation is the replacement of non-federal funds with federal funds to support the same activities. Under Public Health Service Act, Title I, Section 319(c), it strictly and expressly prohibits using cooperative agreement funds to supplant any current state or local expenditures. Grantee may use funds only for reasonable program purposes including personnel, travel, supplies and services. Grantee may (with prior approval) use funds for overtime for individuals directly associated (listed in personnel costs) with the award. Grantee can (with prior approval) use funds to purchase material -handling equipment (MHE) such as industrial or warehouse -use trucks to be used to move materials, such as forklifts, lift trucks, turret trucks, etc. Vehicles must be of a type not licensed to travel on public roads. • Grantee can use funds to purchase caches of medical or non -medical Counter measures for use by public health first responders and their families to ensure the health and safety of the public health workforce. • Grantee can use funds to support appropriate accreditation activities that meet the Public Health Accreditation Board's preparedness -related standards. Audit Requirement A grantee may use its Single Audit to comply with 42 USC 247d — 3ao)(2) if at least once every two years the awardee obtains an audit in accordance with the Single Audit Act (31 USC 7501 — 7507) and Title 2 CFR, Part 200 Subpart F; submits that audit to and has the audit accepted by the Federal Audit Clearinghouse; and ensures that applicable PHEP CFDA number 93.069 are listed on the Schedule of Expenditures of Federal Awards (SEFA) contained in that audit. Pandemic and All Hazards Preparedness and Advancing Innovation Act of 2018 Requires the withholding of amounts from entities that fail to achieve PHEP benchmarks. The following PHEP benchmarks have been identified by CDC and MDHHS-DEPR for the Fiscal Year: Demonstrated adherence to all PHEP aonlication and reporting deadlines. Grantees must submit required PHEP program data and reports by the stated deadlines. This includes, but is not limited to, progress reports, performance measure data reports, National Incident Management System (NIMS) compliance reports, updated emergency plans, budget narratives, Financial Status Reports (FSR), etc. Failure to do so will constitute a benchmark failure. All deliverables must be submitted by the designated due date in the LHD BP4 work plan. • Demonstrated capability to receive, stage, store, distribute, and dispense medical countermeasures (MCM) I during a public health emergency, per the LHD BP4 Work Plan. Further guidance related to specific preparedness deliverables will be included in the LHD workplan. Benchmark Failure Awardees are expected to "substantially meet' the PAHPIA benchmarks. Per the Cooperative Agreement, failure to do so constitutes a benchmark failure, which carries an allowable penalty withholding of funds. Failure to meet any one of the two benchmarks and/or the spending threshold is considered a single benchmark failure. Any awardee (or sub-awardee) that does not meet a benchmark, and/or the spending threshold will have an opportunity to correct the deficiency during a probationary period. If the deficiency is not corrected during this period, the awardee is subject to a 10% withholding of funds the following budget period. Failure to meet the pandemic influenza plan requirement constitutes a separate benchmark failure and is also subject to a 10% withholding. The total potential withholding allowable is 20% the first year. If the deficiency is not corrected, the allowable penalty withholding increases to 30% in year two and 40% in year three. Regional Epidemiology Support For those Grantee receiving additional funds to provide workspace for Regional Epidemiologists, the grantee must provide adequate office space, telephone connections, and high-speed Internet access. The position must also have access to fax and photocopiers. PROJECT TITLE: Regional Perinatal Care System Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis: The aim of the Regional Perinatal Quality Collaboratives (RPPCs) is to develop data - driven innovative strategies and efforts that are tailored to the strengths and challenges of each region to improve maternal, infant, and family outcomes; especially looking at preterm birth, very low birth weight infants, low birth weight infants, and maternal health. Furthermore, RPQCs ensure statewide alignment with the strategies and goals outlined in the Michigan Mother Infant Health and Equity Improvement Plan (MIHEIP) and are tasked with addressing disparities in birth outcomes and health inequities. Each RPQC engages cross -sector, diverse stakeholders and implements evidence -based, or promising practice, interventions utilizing quality improvement methodology. Reporting Requirements (if different than agreement language): The Grantee shall submit the following reports on a quarterly basis: Report on Aim statement, measures, and corresponding outcomes, as identified by the grantee and MDHHS, through submission of quarterly progress reports. RPQCs will submit quarterly narrative reports summarizing member agency efforts, new partnerships, community achievements, member participation in and status of other MDHHS initiatives, as well as the composition and number of attendees at each Collaborative meeting. This report will be submitted with the quarterly progress report to the Contract Manager, Emily Goerge, via email at: GoeroeE(d)michioan.gov. A template for the narrative report will be provided. RPQCs will be required to report on the number of participants with 'active membership' in their quarterly progress reports. See definitions below for what qualifies as 'active membership'. Any such other information as specified above shall be developed and submitted by the Grantee as required by the Contract Manager. Any additional requirements (if applicable): In alignment with the Regional Perinatal Quality Collaborative's (RPQC) role of authentically engaging families and convening diverse stakeholders, the Collaborative must be comprised of a multi -stakeholder and diverse membership; ensuring to recruit families, faith -based organizations, clinicians, Medicaid Health Plans, community -based organizations, business partners, and etcetera. • MDHHS stresses the importance of garnering the input and feedback of families most impacted by adverse birth outcomes. Therefore, continuing in fiscal year 2023, there must be family representation in the RPQC's membership Family engagement is essential to the success of the RPQCs and can be fostered via various avenues, for example: family groups through Great Start Collaborative and Children Special Health Care Services, community centers, local churches, focus groups, parent panel and etcetera RPQCs are expected to convene periodic (with frequency of at least quarterly) collaborative meetings, inclusive of diverse regional partners, to garner feedback and discussion, including but not limited to, regional maternal and infant vitality concerns, review of data, analysis of gaps in care and birth outcomes, quality improvement efforts, alignment with the Mother Infant Health and Equity Improvement Plan and etcetera *The collaborative meetings are to be in addition to any leadership or steering team meetings that the RPQC may choose to convene as oversight for the RPQC. Definitions Active membership is defined as attending a minimum of two (2) Collaborative meetings, participating in RPQC quality improvement efforts, reporting out on their respective agency's efforts related to maternal and infant mortality, and etcetera Family active membership is defined as a family presence at a minimum of two (2) Collaborative meetings, garnering family input at least twice per fiscal year, and/or participation in the planning or implementation of quality improvement efforts • Family and community presence should comprise 10% of the RPQC's active membership. Membership includes, but is not limited to: Y Families • Clinicians • Community -based organizations • Local public health • Medicaid health plans • Faith -based organizations • Business partners • Others To ensure regional stakeholders are aligned with the Mother Infant Health and Equity Improvement Plan (MIHEIP), RPQCs will need to infuse maternal and infant Statewide initiatives into their Collaborative (example: MMMS, FIMR, MI AIM, CDR, etc.) • Each Collaborative will dedicate time during meetings for members to share updates, as well as time for reporting out on participation in other Statewide initiatives. • Continuing in fiscal year 2023, RPQCs will specifically be required to: Invite MI -AIM leads to share region -specific MI -AIM efforts at two (2) fiscal year 2023 collaborative meetings. A list of MI -AIM leads in the region can be obtained from your assigned State consultant. 2. Know the current MI -AIM designation status of the birthing hospitals in their respective region. The names and titles of the RPQC leadership, and the Quality Improvement project team leads, for fiscal year 2023, must be identified on the work plans submitted to the Contract Manager via email, GoeroeE(d)michigan.gOV Selected quality improvement objective(s), corresponding evidence -based or promising practices intervention(s), and all efforts put forth, must align with the MIHEIP All quality improvement efforts must: • Be data driven. • Utilize quality improvement methodology. • Address disparate outcomes. • Utilize evidence -based and/or promising practices interventions that address improving outcomes for mothers, infants, and families. • RPQCs must also actively address health inequities, social determinants of health, and disparate outcomes throughout all efforts and as inclusive of their dedication to improving birth outcomes • As the RPQCs are a conduit to the community, the region must provide representation at MIHEIP-related MDHHS meetings, such as the Mother Infant Health and Equity Collaborative (MIHEC) meeting and the State Perinatal Quality Collaborative meetings (i.e., RPQC Leadership meetings). 1. Attendance is required unless prior approval received from State consultant. 2. For MIHEC meetings, each RPQC should have two attendees present, with at least one representing the leadership team. 3. For the quarterly State Perinatal Quality Collaborative meetings, at least two members of the RPQC leadership team are required to attend. 4. Each region will be required to report on their efforts, challenges, successes and etcetera at one of the quarterly MIHEC meetings. 5. Regional collaborative leadership is expected to work collectively with assigned State consultant and other members of the MIHEIP team. Budget Allowances To ensure most of the awarded funding is funneled into the community for quality improvement efforts: Budgets line items for external consultants must be capped at 25% for contractors/consultants who have been hired as subject matter experts. Budgets must be capped at 75% for contractors hired to carry out the quality improvement tasks of the collaborative. PROJECT TITLE: SEAL! MI Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: SEAL! MI is the School Based Dental Sealant Program, providing oral health prevention to students in Michigan schools. Reporting Requirements (if different than agreement language): • Quarterly Report Dental Sealant Tracking Form's at the end of each quarter to the Michigan Department of Health and Human Services Oral Health Program. • Submit completed copies of the SEAL! MI MDHHS Student Data and Event Data forms within two weeks of the end of the fiscal year and upon request. Any additional requirements (if applicable): • All program staff (paid and unpaid) must attend the annual SEAL! MI Training via webinar. • At least one person from program must attend the SEAL! MI Annual Workshop, in person, all day. • All monies collected from insurance billing from dental sealants must be allocated back into the SEAL! MI program (equipment, staff, supplies, travel, incentives etc.). • There must be one EXTRA complete treatment set up available for program use in the event of equipment failure (including: portable dental unit, curing light, Isolite other isolation system, patient chair, operator light and operator chair). • Patient privacy screens must be available for use • Any MDHHS infection control policies specific to Covid-19 must be followed in all SEAL! Michigan events. PROJECT: Sexual Violence Prevention Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis This project will be used continue to implement community and societal -level approaches to build capacity of current and future healthcare professionals to prevent sexual violence. Reporting Requirements (if different than contract language) Submit programmatic quarterly reports in REDCaps on January 15tn, April 15tn July 151n, and October 15tn Submit financial information documenting program expenses for January 1-31, 2023, by March 15, 2023. Any additional requirements (if applicable) Complete Required Disclosures for Federal Awardee Performance and Integrity Information System (FAPIS): Consistent with 45 CFR 75.113, applicants and recipients must disclose in a timely manner, in writing to the CDC, with a copy to the HHS Office of Inspector General (OIG), all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Subrecipients must disclose, in a timely manner in writing to the prime recipient (pass through entity) and the HHS OIG, all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Disclosures must be sent in writing to the CDC and to the HHS OIG at the following addresses: CDC, Office of Grants Services Monique Tatum, Grants Management Officer/Specialist Centers for Disease Control and Prevention OGS BRANCH 5 2939 Flowers Rd Atlanta, Ga 30341 AND U.S. Department of Health and Human Services Office of the Inspector General ATTN: Mandatory Grant Disclosures, Intake Coordinator 330 Independence Avenue, SW Cohen Building, Room 5527 Washington, DC 20201 Fax: (202)-205-0604 (Include "Mandatory Grant Disclosures" in subject line) or Email: MandatoryGranteeDisclosures@oig.hhs.gov Recipients must include this mandatory disclosure requirement in all subawards and contracts under this award. Failure to make required disclosures can result in any of the remedies described in 45 CFR 75.371. Remedies for noncompliance, including suspension or debarment (See 2 CFR parts 180 and 376, and 31 U.S.C. 3321). PROJECT TITLE: Sexually Transmitted Infection (STI) Control Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health care cost. Women, especially those of child-bearing age, and adolescents are particularly at risk for negative health outcomes. Local health STI programs ensure prompt reporting of cases, provide screening and treatment services for Michigan's citizens, and respond to critical morbidity increases in their jurisdiction. Reporting Requirements (if different than agreement language): Report Period Due Date(s) How to Submit Report STI 340B Within 10 days Log into SGRX340BFlex. com website, Utilization/ Quarterly after the end of the generate a quarterly report on the Inventory reporting tab, and it will be transferred Report quarter automatically to ScriptGuide/DHSP Any additional requirements (if applicable): Grant Program Operation Maintain core STI clinical service, including prioritizing the testing, treatment of individuals referred by MDHHS DIS; this includes people reported with a positive lab result and those identified as contacts to incident cases of syphilis, gonorrhea, and HIV. 2. Participate in technical assistance/capacity development, quality assurance, and program evaluation activities as directed by Division of HIV and STI Programs/Sexually Transmitted Infections (DHSP/STI). 3. Implement program standards and practices to ensure the delivery of culturally, linguistically, and developmentally appropriate services. Standards and practices must address sexual minorities. 4. For gonorrhea and chlamydia cases in the Michigan Disease Surveillance System, 50% shall be completed within 30 days and 60% within 60 days from the date of specimen collection. 5. For gonorrhea and chlamydia cases, develop plans to respond to issues in quality, completeness, and timeliness. Mandatory Disclosures 1. Inform DHSP/STI at least two weeks prior to changes in clinic operation (hours, scope of service, etc.). Technical Assistance 1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: httos://bit.ly/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORTa.michioan.gov PROJECT TITLE: Sexually Transmitted Infection (STI) Specialty Services Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health care cost. The purpose of this project is to provide a community access point for specialty STI clinical service with a focus on the LGBTQ+ community. Reporting Requirements (if different than agreement language): How to Report Period Due Date(s) Submit Report Quarterly Progress Report & 30 days after the end Email to Data Report Quarterly of the quarter MDHHS contract liaison Any additional requirements (if applicable): Mandatory Disclosures Inform the Division of HIV and STI Programs (DHSP) at least two weeks prior to changes in clinic operation (key staff, hours of operation, scope of service, etc.). Technical Assistance 1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS system. In addition, if your contract is to be amended, the request will have to be logged into SHOARS. Registration instructions and further information can be found at: https://bit.ly/3HS7xdG 2. Recipient agency must register an Authorized Official and Program Manager in the DHSP SHOARS system. These roles must match what the agency has listed for these roles in the EGrAMS system. If you have access related questions, contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORTa-michioan.00v PROJECT TITLE: Southeast MI Infant Vitality Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: In 2019 Michigan achieved its lowest infant mortality rate both Statewide and in the City of Detroit. This initiative is intended to provide insight into what may have led to the decreased rate. The proposed initiative focuses on creating a comprehensive, collective analysis of events, programs, and preventative efforts aimed at reducing infant mortality within the City of Detroit, Wayne, Oakland, and Macomb counties in 2019 and in the years preceding with the goals of garnering insight into actions that can be taken to sustain health gains and inform decision making within systems and policy. This will be achieved by partnering with community stakeholders, investigating qualitative and quantitative data, and analyzing vital records. The recommendations will be compiled, reported and used to inform the next iteration of the States Mother Infant Health & Equity Improvement Plan. Reporting Requirements (if different than agreement language): The Grantee shall submit the following reports at the end of the Grant Cycle: Grantee will be required to partner with key informants, organizations, and entities in the gathering and collating of information regarding successful programming interventions and a comprehensive understanding of thriving mothers and infants for 2019 and preceding years. • Grantee will be required to hold at least 4 strength -based discussion sessions, community conversations, and/or listening sessions to garner feedback from the community, this includes the communities' views on successful programming and interventions, and their feedback on current and recommended policy and regulation related to maternal and infant health outcomes. • An asset -based report on the above data is required by the end of the grant cycle, this should include any relevant mixed methods data, discussion sessions, community conversations, listening sessions, surveys, and recommendations. The final contract report is due by October 31 (30 days after the agreement end date). • Grantees are expected to submit quarterly work plan updates. ® The report and workplan will be submitted to the Contract Manager, Heather Boyd, via email at: BoydH1@michigan.gov. Any additional requirements (if applicable): MDHHS stresses the importance of authentically engaging families and convening diverse stakeholders, the asset -based assessments and strength - based discussion sessions and listening sessions should include multi - stakeholder and diverse participation; ensuring to recruit families, faith -based organizations, clinicians, Medicaid Health Plans, community -based organizations, community leaders, grass roots organizations, business partners, and etcetera. Grantees are expected to meet periodically with MDHHS and the Southeast Michigan partners working on the Infant Vitality project (Partnering organizations include, but are not limited to, Birth Detroit, Focus: Hope & the Southeast Michigan Perinatal Quality Improvement Coalition (SEMPQIC), as well as the Wayne, Oakland, Macomb, and the City of Detroit Health Departments.) PROJECT: Statewide Lead Case Management Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis All local health departments in Michigan are eligible to participate in this program to receive reimbursement for nursing case management services to children not enrolled in Medicaid, as well as reimbursement for community health workers (CHWs) to complete case management activities. This will allow LHD nurses to offer case management to all children regardless of insurance status. NCM visits will be reimbursed at a rate of $201.58 and community health worker visits at a rate of $100. This funding is to support local health departments in providing case management services to all children with elevated blood lead levels in Michigan. Ail services should be provided according to CLPPP guidance documents for case management for nurses and community health workers. Reporting Requirements (if different than contract language) Quarterlv FSR and FSR Supplemental Attachment Submit request for reimbursement through the EGrAMS system based on the "fixed unit rate" method. The fixed rate for case management services is $201.58 per home visit, for up to 6 home visits and $100 for community health worker visits, for up to 2 visits. Additionally, a FSR supplemental attachment form is required to be uploaded in EGrAMS that specifies the number of children and home visits for which reimbursement is being requested on. The FSR and the FSR supplemental attachment form must be submitted no later than thirty (30) days after the close of the quarter. Quarterly Case Management Logs A complete spreadsheet of CM activities is due quarterly, submitted electronically through the CLPPP's secure DCH-File Transfer Site available through MiLogin, using a template provided by CLPPP. There are two spreadsheets, one for nursing case management and one for community health worker visits. The quarterly spreadsheets must be submitted no later than thirty (30) days after the close of the quarter. Annual Report An Annual Report covering the reporting period for FY23 is October 1 — September 30. The format and due date for the submission will be determined by CLPPP, communicated to the local health departments. Any additional requirements (if applicable) Continuation of this project is contingent upon funding availability. The local health department shall: • For NCM visits, have home case management conducted by a registered nurse trained by MDHHS CLPPP. To be reimbursed for a home visit, the visit must be completed by a registered nurse. • For CHW visits, have home case management conducted by a certified community health worker trained by MDHHS CLPPP. To be reimbursed for a home visit, the visit must be completed by a certified community health worker. • Sign up for the DCH-File Transfer Site available through MiLogin maintained by MDHHS CLPPP, to be used for data sharing of confidential information. • Complete case management activities according to the MDHHS CLPPP Case Management Guide. • Document all required case management activities in the child's electronic file in the HHLPPS database. Required documentation includes an initial home visit form, follow-up visit forms, dates of chelation therapy, and plan of care. PROJECT: TAKING PRIDE IN PREVENTION (TPIP) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The purpose of this project is to implement a comprehensive, evidence -based teen pregnancy prevention program for youth 12-19 years of age. Reporting Requirements The Grantee shall submit the following reports and data via the appropriate reporting mechanism on the dates specified below: Report Work Plan Program Narrative Participant Level Data (Youth) Program Level Data (Parents) Program Level Data (Performance Measures) Fidelity Logs Time Period October 1 - December 31 January 1 - March 31 April 1 - June 30 July 1 - September 30 October 1 - December 31 January 1 - March 31 April 1 - June 30 July 1 - September 30 October 1 - December 31 January 1 - March 31 April 1 -June 30 July 1 - September 30 October 1 - December 31 January 1 - March 31 April 1 — June 30 July 1 - September 30 October 1, 2022 — September 30, 2023 (MPHI will open this data section in REDCap in June) February 2023 May 2023 Due Date Submit To January 31 April 15 I EGrAMS July 31 httos://earams-mi.com/mdhhs October 15 January 31 April 15 I EGrAMS July 31 httr)s://earams-mi.com/mdhhs October 15 January 15 April REDCap July 15 tI httos:Hchc.mnhi.org October 5 i January 15 April I REDCap July 15 httgs://chc.mphi.ora October 5 July 15 REDCap httos:Hchc.mphi.orq March 31 Email to MDHHS June 30 andersonk10(@michiaan.gov A. Any other information, as specified in the Statement of Work and TPIP Report Fact Sheet, shall be developed and submitted by the Grantee as required by the Contract Manager. Additional Program Requirements TPIP programs must serve 80, 175 or 250 unduplicated youth each fiscal year (FY) who complete at least 75% of the program, which is determined by the intensity level of the selected curriculum: Number of unduplicated youth who complete at 90% of the target least 75% of program number each FY Teen Outreach Program High 80 72 (TOP) Michigan Model -Healthy & Medium 175 156 Responsible Relationships Making Proud Choices Low 250 225 • TPIP programming must be delivered separate and apart from any religious education or promotion and funding cannot be used to support inherently religious activities including, but not limited to, religious instruction, worship, prayer, or proselytizing. • Family planning drugs and/or devices cannot be prescribed, dispensed, or otherwise distributed on school property at any time, including as part of the pregnancy prevention education funded under TPIP. • Abortion services, counseling and/or referrals for abortion services cannot be provided as part of the pregnancy prevention education funded under TPIP. • TPIP funding may not be used to pay for costs associated with health care services, for which referrals are made. • TPIP funding may not be used for fundraising activities, political education, or lobbying. • TPIP grantees must adhere to all of the TPIP Minimum Program Requirements (MPRs) The Grantee shall permit the Department or its designee to visit and to make an evaluation of the projects as determined by the Contract Manager. PROJECT: Tobacco Control Grant Program Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis The focus of the program is to reduce tobacco use by Michigan residents by providing an evidence -based telephonic tobacco cessation counseling program which will be titled as the Michigan Tobacco Quitline. Reporting Requirements (if different than contract language) The Grantee shall submit the following reports on the following dates: 1. Evaluation data tracking tool bi-annually in April 15 and October 15 (format to be provided by MDHHS TCP). 2. Quarterly progress reports are due January 15, April 15, July 15, and October 15, 2023. Any additional requirements (if applicable) Grantee will create action plans for any recommendation of the MDHHS TCP Contract Manager. Grantee will meet weekly with the MDHHS TCP Contract Manager. Grantee will submit twice monthly budget projections (October 2022-February 2023) and weekly projections the last 2 months of the CDC budget (March 2023- April 2023) and the SOM Fiscal Year (August 2023-September 2023). Grantee will submit 2022 outcomes report for enrollees to the Michigan Tobacco Quitline by May 1 2023. PROJECT: Transforming Youth Suicide Prevention Start Date: 10/1/2022 End Date: 09/30/2023 Project Synopsis The Transforming Youth Suicide Prevention project focuses on early identification and intervention of suicide risk in young adults aged 18-24 years old via creative marketing, trainings, and loss support group facilitation. Reporting Requirements (if different than contract language) The Grantee shall submit the following reports on the following dates: 1. An Annual Report, to include a summary of activities, challenges, and successes is due by September 1. The format and information to be concluded will be determined by MDHHS in consultation with the Grantee. 2. Quarterly Reports, to include agreed upon evaluation metrics and activities, challenges, and successes, will be due 15 days after the end of each quarter. 3. Reports and information shall be submitted to the Contract Manager by e-mail to decamD10,michioan.aov. a. Any request for extension of a reporting deadline must be approved in advance by MDHHS and may not exceed an additional 5 business days from the original due date. Any additional requirements (if applicable) The Grantee shall permit the Department or its designee to visit and to make an evaluation of the project as determined by Contract Manager PROJECT: Tuberculosis Control Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis Each Grantee as a sub -recipient of the CDC Tuberculosis Elimination Cooperative Agreement shall conduct activities for the purposes of tuberculosis control and elimination. Funds may be used to support personnel, purchase equipment and supplies, and provide services directly related to core TB control front-line activities, with a priority emphasis on DOT (Directly Observed Therapy) and electronic DOT, case management, completion of treatment and contact investigations. Funds may also be used to support incentive or enabler offerings to mitigate barriers for patients to complete treatment. Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds to purchase anti -tuberculosis medications or to pay for inpatient services. Examples of appropriate incentive/enabler offerings include retail coupons, public transit tickets, food, non-alcoholic beverages, or other goods/services that may be desirable or critical to a particular patient. For more information and suggested uses of incentive/enabler options, refer to CDC's Self -Study Module #6, Managing Tuberculosis Patients and Improving Adherence, at Self-Studv Modules - Continuino Education Activities I TB I CDC. Reporting Requirements (if different than contract language) DOT Logs are maintained on site and available if needed. All other data must be entered into MDSS as stipulated in contract specific requirements. Ensure that confidential public health data is maintained and transmitted to the Department in compliance with applicable standards defined in the "CDC Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Programs" httD://www.cdc.(iov/nch hst6/i)rogramintearation/docs/PCS I DataSecuritvGuidelines.pdf Any additional requirements (if applicable) Utilize DOT as the standard of care to achieve at minimum 80% of TB cases enrolled in DOT or electronic DOT (Jan 1- Dec 31). Document in Michigan Disease Surveillance System (MDSS) all changes to treatment regimen using the Report of Verified Case of Tuberculosis (RVCT) comments field (pg. 12), and completion of therapy using RVCT Follow -Up 2 (pg. 7). Maintain evidence of monthly DOT logs on site (to be made available if needed). Submission of DOT logs to the MDHHS TB Program is not required. Achieve at least 94% completion of treatment within 12 months for eligible TB cases. The determination of treatment completion is based on the total number of doses taken, not solely on the duration of therapy. Consult the most current ATS document Treatment of Tuberculosis for guidance in the number of doses needed and the length of treatment required following any interruptions in therapy. Maintain appropriate documentation on site (to be made available if needed). Document the appropriate use of expenditures for incentive and enablers for clients to best meet their needs to complete appropriate therapy. Ensure >90% completion of RVCT pages 1 - 6 in MDSS within one month of diagnosis. Unallowable Costs per federal guidelines Funds cannot be used for procurement of anti -tuberculosis medications. Funds cannot be used for research. Funds cannot be used for inpatient services. PROJECT: Vector -Borne Disease Surveillance Beginning Date: 4/1/2023 End Date: 9/30/2023 Project Synopsis This agreement is intended to support the development of vector -borne disease surveillance and control capacity at the local health department level. Funds may be used to support a low-cost, community -level surveillance system for 1) the early detection of arbovirus threats by identifying potential invasive mosquito vectors or local virus transmission in mosquitoes and 2) populations of ticks including Ixodes scapularis, Amblyomma americanum, and Haemaphysalis longicornis. This information can be utilized by participating local health departments to notify its citizens of any local transmission risk using education campaigns and to potentially work with local municipalities to conduct vector control activities such as drain management, scrap -tire campaigns, breeding site removal, landscape modifications, or pesticide application. Requirements for participation in this program include providing for the placement of a minimum number of mosquito traps, operating for at least five "trap -nights" per week, conducting a minimum number of targeted tick "drags," and identifying ticks and mosquitoes. Bi-weekly (occurring every two weeks) reporting to MDHHS of grant activities is also required. MDHHS EZID should be notified immediately if an invasive mosquito or tick species is identified. Reporting Requirements (if different than contract language) The subrecipient shall submit bi-weekly tables of surveillance data (template provided) documenting trap rates and disease detections to Emily Dinh (dinhe(@michioan.cov) and Rachel Wilkins (rwilkins3(a),michigan.gov) at the MDHHS EZID Section. • A final report on all activities completed is due by October 15, 2023. Any additional requirements (if applicable) • Mosquito and/or Tick Surveillance • Minimum recommended mosquito and tick surveillance effort according to the point formula in Table 1 (below) over a period of 14 weeks. • Provide bi-weekly reporting of surveillance results to MDHHS EZID Section (see contact information below). • Use surveillance data to notify the public of risks related to vector borne disease in mosquitoes or ticks in the jurisdiction. • The total funds allocated for this project to participating local health departments must be utilized prior to September 30. Each local health department as a sub -recipient of the State of Michigan Emerging Public Health Funds shall conduct activities for the purposes of mosquito and tick surveillance in their jurisdiction. For mosquito surveillance, funds may be used to support personnel, to purchase equipment and supplies related to conducting mosquito surveillance in areas of historically high incidence of arboviral disease, and to produce and distribute educational and other materials related to mosquito - borne disease prevention and control. For tick surveillance, funds may be used to support personnel, to purchase equipment and supplies, and to produce and/or distribute educational and other materials related to tick -borne disease prevention and control. Activities can be conducted according to the needs of the local jurisdiction but must conform to the point allocation formula in the table below. For instance, if mosquitoes are more of a concern in the jurisdiction, the funded LHD can focus its efforts on mosquito surveillance, educational activities, etc. If ticks are more of a concern in the jurisdiction, the funded LHD can focus its efforts on tick surveillance, educational activities, etc. Local Health Department VBDSP Activity Formula Activity 5 mosquito collection devices* placed for 24-hour period 2 mosquito collection devices* placed for 24-hour period in Auqust 1,000 meter tick drag Educational outreach activity / event Press release Coordination of control efforts with local municipalities / other prevention efforts Required Metric Activity / Weeks 20/10 Report to MDHHS bi-weekly 2/4 Report to MDHHS bi-weekly 4/2 Report to MDHHS bi-weekly Report to MDHHS bi-weekly Report to MDHHS bi-weekly Report to MDHHS bi-weekly *Devices can include BG-2 traps, CDC light traps, resting boxes, etc. PROJECT: West Nile Virus Community Surveillance Start Date: 5/1/2023 End Date: 9/30/2023 Project Synopsis This agreement is intended to support the development of a low-cost surveillance system for the early detection of West Nile virus in mosquitoes at the community level, for the purpose of educating the public and healthcare providers and preventing outbreaks. This information can be utilized by participating local health departments to notify its citizens and healthcare providers of any local transmission risk using education campaigns, press -releases and other means, and to potentially work with local municipalities to conduct mosquito population mitigation activities such as drain management, scrap -tire campaigns, breeding site removal, Iarviciding, and adulticiding. Requirements for participation in this program include providing for the placement of a minimum number of mosquito traps, operating for at least two "trap nights" per week, identifying mosquitoes, and weekly reporting to the Department of surveillance results. Reporting Requirements (if different than contract language) The Grantee shall submit weekly tables of surveillance data (template provided) documenting trap rates and disease detections to Emily Dinh (dinhe@michigan.gov), and Rachel Wilkins (wilkinsr3(a)michioan.00v) at the MDHHS EZID Section. ® A final report on all activities completed is due by October 15, 2023. Any additional requirements (if applicable) Each Grantee as a sub -recipient of the Centers for Disease Control and Prevention (CDC) Epidemiology and Laboratory Capacity Cooperative Agreement shall conduct activities for the purposes of West Nile virus (WNV) surveillance among mosquito populations in their jurisdiction. Funds may be used to support personnel and travel, to purchase equipment and supplies related to conducting mosquito surveillance in areas of historically high incidence of WNV, and to produce and/or distribute educational and other materials related to West Nile virus prevention and control. Mosquito Surveillance: Minimum recommended mosquito traps for this project is 5 traps utilized per county, operating 2 nights per week for a total of 10 "trap nights" per week for approximately 16 weeks. • Provide weekly reporting of surveillance results to the Department EZID Section (see contact information below). Use surveillance data to notify the public and healthcare providers of any risk related to West Nile Virus in mosquitoes in the jurisdiction. The total funds allocated for this project to participating local health departments must be utilized prior to September 30. PROJECT TITLE: Wisewoman Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: WISEWOMAN (Well -Integrated Screening and Evaluation for Women Across the Nation) is a program designed to screen women for chronic disease risk factors, counsel them about lifestyle changes to reduce risk factors, and refer them for medical treatment of hypertension, hyperlipidemia, and/or diabetes mellitus. Reporting Requirements (if different than agreement language): All Grantees implementing WISEWOMAN shall submit Quarterly Progress Reports Period Covered Report Due October 1 - December 31 January 31 January 1 - March 31 April 30 April 1 -June 30 July 31 July 1 - September 30 October 31 Quarterly Reports shall be submitted to the Program Director: Courtney Cole E-mail: ColeC13@michigan.gov Each agency must provide matching funds in the amount of $1 for each $3 of Coordination dollars. A WISEWOMAN Matching Funds Report form along with instructions is issued by MDHHS for LCAs to use for documentation of amounts and types of community match. It is available at www.michloan.aov/wisewoman The Matching Funds Report should be submitted in EGrAMS as an attachment to the final Financial Status Report. Any additional requirements (if applicable): Instructions for contractor use of MBCIS, the statewide database, are provided in manuals for programs that contribute data to this database. The CPCS will exchange relevant program reports with appropriate contractors through a secure file transfer system, as noted in the same program manuals. For specific WISEWOMAN Program requirements, refer to the most current WISEWOMAN Program Manual available at www.michigan.00v/wisewoman. PROJECT: Women Infant Children (WIC) WIC Breastfeeding WIC Migrant WIC Resident WIG Special Supplemental Start Date: 10/1 /2022 End Date: 9/30/2023 Project Synopsis Women, Infants, and Children (WIC) is a federally funded Special Supplemental Nutrition Program of the Food and Nutrition Service of the United States Department of Agriculture and is administered by the Michigan Department of Health and Human Services to serve low and moderate income pregnant, breastfeeding, and postpartum women, infants, and children up to age five who are found to be at nutritional risk through its statewide local WIC agencies. WIC is a health and nutrition program that has demonstrated a positive effect on pregnancy outcomes, child growth and development. The program provides a combination of nutrition education, supplemental foods, breastfeeding promotion and support, and referrals to health care. Participants redeem WIC food benefits at approved retail grocery stores and pharmacies. WIC foods are selected to meet nutrient needs such as calcium, iron, folic acid, vitamins A & C. Reporting Requirements (if different than contract language) • A Financial Status Report (FSR) must be submitted to the Department on a quarterly basis by deadlines as defined by MDHHS Expenditure Operations. Grantees shall (when requested) annually report expenditures on a supplemental form, if needed and required, to be provided by the Department and attached to the final Financial Status Report (FSR)which is due on November 30 after the end of the fiscal year in EGrAMS. • As part of the Breastfeeding Peer Counseling Grant, the Grantee must submit quarterly progress reports to the State Breastfeeding Peer Counselor Coordinator (or designee) by the 15th of the month following end of quarter. • Funds allocated for the Breastfeeding Peer Counseling Program are exempt from the WIC Nutrition Education and Breastfeeding Time Study. Additional Requirements • The Grantee is required to comply with all applicable WIC federal regulations, policy and guidance. The Grantee is required to comply withal[ State WIC Policies. ® The Grantee is required to complete the NE and BF Time Study as instructed by the MDHHS WIC Program. Breastfeeding Peer Counseling grant, if supported with funds allocated through the WIC funding formula, must report as time study data. • The Grantee must follow the allowable expense guidelines provided by USDA FNS for the Peer Counselor Grant. The primary purpose of these funds is to provide breastfeeding support services through peer counseling to WIC participants. The Grantee must follow the staffing requirements as set forth in the WIC Breastfeeding Model Components for Peer Counseling and through a signed allocation letter for the Breastfeeding Peer Counseling Grant. This signed letter needs to be returned annually to the State Breastfeeding Peer Counselor Coordinator. Due to the limited nature of the Breastfeeding Peer Counselor Funding total indirect cost shall not exceed 30% of the total grant award. To maintain consistency across budgets, County -City Central Services reported under a direct expense line item will be included as indirect cost even if captured outside of indirect line item on the budget. Additional local funds can be supplemented to cover indirect costs exceeding 30%. • Comply with the requirements of the WIC program as prescribed in the Code of Federal Regulations (7 CFR, Part 246) including the following special provisions from Part 246.6 (f)(1)(2): (f) Outreach/Certification In Hospitals. The State agency shall ensure that each local agency operating the program within a hospital and/or that has a cooperative arrangement with a hospital: (1) Advises potentially eligible individuals that receive inpatient or outpatient prenatal, maternity, or postpartum services, or that accompany a child under the age of 5 who receives well -child services, of the availability of program services; and (2) To the extent feasible, provides an opportunity for individuals who may be eligible to be certified within the hospital for participation in the WIC Program. [246.6(F)(1)]. • The Grantee in accordance with the general purposes and objectives of this agreement, will comply with the federal regulations requiring that any individual that embezzles, willfully misapplies, steals or obtains by fraud, any funds, assets or property provided, whether received directly or indirectly from the USDA, that are of a value of $100 or more, shall be subject to a fine of not more than $25,000. • The Grantee is required to operate the Project FRESH Program within the guidelines as laid out in the "WIC Project FRESH Local Agency Guidebook". • The Grantee is required to abide by the Dissemination License Agreement between Michigan State University and Michigan Department of Health and Human Services for "Mothers in Motion." Any use of these licensed materials in the provision of program related services is subject to the terms and conditions outlined in the licensure agreement, which is included in Addendum 1, as reference. WIC Resident Services/Migrant/Breastfeeding Peer Counseling Grant Training and Education Requirements: The Grantee is required to comply with MI -WIC Policy 1.07L Staff Training Plan as detailed for applicable staff as it pertains to all State WIC training opportunities. Dissemination License Agreement for"Mothers in Motion" Between Michigan State University And Michigan Department of Health and Human Services This License Agreement ("Agreement"), effective as of October 16,2015 ("Effective Date'), is made by and between Michigan State University, having offices at 325 E. Grand River, Suite 350, East Lansing, MI 48823 ("Licensor") and State of Michigan Department of Health and Human Services Women, Infants and Children, having offices at 320 S. Walnut, Lansing, MI 48913 ("Licensee") (individually a "Party" and collectively, the 'Parties"). WHEREAS, Licensor has created the "Mothers in Motion" materials (herein, "Physical Materials"), MSU reference number TEC2015-0036 utilizing funds from a grant from the National Institutes of Health (NIH), grant number 1R18-DKO83934-01A2 ("Grant"). WHEREAS, Licensor isthe ownerof certain rights, title and interest in the Physical Materials and has the right to grant licenses thereunder. WHEREAS, Licensee wishes to license the Physical Materials for dissemination purposes and Licensor, in orderto meet its obligations underthe N IH grant, desires to grant such license to Licensee on the terms and conditions herein. WHEREAS, Licensee wishes to obtain this Agreement in orderto carry outthe intent of their master agreement between Licensee and Licensor with an effective date of FY 2015-2016. NOW THEREFORE, the parties agree as follows: I. Definitions. a. 'Physical Materials" shall mean all physical items listed in Schedule A. b. "Sublicenseable Materials" shall mean one electronic copy of the Physical Materials. c. "Materials Modification Guide" shall mean the specifications outlined in Schedule B. d.'Derivative Works" means all works developed by Licensee or Sublicensee which would be characterized as derivative works of the Physical Materials and/or Sublicenseable Materials under the United States Copyright Act of 1976, or subsequent revisions thereof, specifically including, but not limited to, translations, abridgments, condensations, recastings, transformations, oradaptations thereof, or works consisting of editorial revisions, annotations, elaborations, or other modifications thereof. The term "Derivative Work" shall not include those derivative works which are developed by Licensor. e. "Sublicense" means an agreementwhich maytake the form of, but is not limited to, a sublicense agreement, memorandum of understanding, or special provisions added as an amendment to an existing agreement between Licensee and a Sublicensee in which Licensee grants or otherwise transfers any of the rights licensed to Licensee hereunderorotherrightsthatare relevantto using the Sublicenseable Materials. AGR2015-01 146 TEC2015-0036 f. "Sublicensee" means any entity to which a Sublicense is granted. 1. Grant of License 1.1 Subject to the terms and conditions of this Agreement, to the extent that Licensee's rights to Physical Materials as a result of Licensor's grant of rights to the Federal Government in accordance with the terms and conditions of the Grant are insufficient for Licensee's activities hereunder, Licensor hereby grants to Licensee a nonexclusive, nontransferable, worldwide, license to use, perform, reproduce, publically display and create Derivative Works (as outlined in the Physical Materials Modification Guide) of the Physical Materials. Notwithstanding the foregoing, Licensee may only distribute the Physical Materials within Licensee managed locations within the state of Michigan. Licensee is not permitted to sell or receive consideration for any of the Physical Materials or reproductions of the Physical Materials. 1.2. Licensor grants Licensee the right to grant Sublicenses of its rights under Section 1.1 of the Sublicensable Materials to Sublicensee for the sole purpose of placing the content contained in the Sublicenseable Materials on a website that is controlled by Sublicensee and that is access limited, password protected. Any Sublicense shall be in accordance with Article 3 below. Sublicensee may be granted the right to create Derivative Works of the Sublicenseable Materials limited to that which is described in the Materials Modification Guide and only to ensure that the Sublicenseable Materials meet - technical specifications necessary to place the content contained in the Sublicenseable Materials on Sublicensee's controlled website. Notwithstanding the foregoing, Sublicensee may create split-up lessons (meaning placing the content of a full-length lesson into multiple videos) of the full-length lessons contained in the DVD portion of the Sublicenseable Materials only in order to conform to the technical format of Sublicensee's website platform; the content, however, shall not be modified. Sublicensee is not permitted to sell or receive consideration for the Sublicenseable Materials in any format. Any content created solely by Sublicensee that supports the implementation of the Sublicensable Materials shall be owned by Sublicensee. If Derivative Work is created by Sublicensee, Sublicensee shall own their creative contribution to the Derivative Work and Licensor retain all copyright rights to the original Sublicensable Materials contained in such Derivative Work. Licensee and Sublicensee may address ownership of Sublicensee's creative contribution to Derivative Works in the Sublicense agreement. 1.3 In such incidences where, for financial reasons, Licensee is not able to reproduce the label displayed on the original master copy of the DVD portion of the Physical Materials, Licensee must ensure that the entire content of the DVD portion of the Physical Materials are reproduced in its entirety so that the inclusion of the copyright notice, Licensor owned logos (including wordmark), grant number information, title of each lesson, and acknowledgements are maintained. 1.4 Except as provided in Section 1.2 and 1.3, Licensee will refrain, and shall require Sublicensees to refrain, from using the name of the Licensor in publicity or advertising without the prior written approval of Licensor. Notwithstanding the foregoing, Licensee may, without- prior approval from Licensor, use Licensor's name in a manner that is (a) informational in nature (i.e. describes the existence, scope and/or nature of the relationship of the Parties and/or the fact that the Physical Materials were developed by Licensor), (b) does not suggest Licensor's endorsement of Licensee or its goods or services, (c) does not create the appearance that the source of the communication is Licensor or any party other than Licensee, and (d) otherwise consistent with the terms of the Agreement. AG R2015-01 146 2 TEC2015-0036 Except as described in Section 1.2 and 1.3 and this Section 1.4, the use of the name of the Licensor does not extend to any trademark, logo, or other name or unit of Licensor. 1.5 Licensor shall provide Physical Materials to Licensee by October 31, 2015. Licensor assumes no responsibility for distributing Physical Materials to the state of Michigan Licensee locations. 2. Licensor's Rights 2.1 Notwithstanding the rights granted in Article I hereof, Licensee acknowledges that all right, title and interest in the Physical Materials, including any copyright applicable thereto, shall remain the property of Licensor and/or the third party rights holders. With the exception of the portion contributed by Licensee or Sublicensee in a Derivative Work of the Physical Materials, Licensee or Sublicensee shall have no right, title or interest in the Physical Materials, including any copyright applicable thereto, except as expressly set forth in this Agreement. 2.2 Any rights not granted hereunder are reserved by Licensor and/or the third party rights holders. 2.3 As of Licensor's present knowledge, MSU Extension (which is a unit within Licensor) is the copyright holder of the pizza recipe included in the Physical Materials. If Licensor is notified that a third party is the copyright holder to the pizza recipe, Licensor will in good faith attempt to secure the copyright rights from the third party rights holder in order for Licensor, Licensee and Sublicensee to maintain using the Physical Materials as described in the Agreement herein. In the event Licensor is unable to secure such rights, Licensor will use reasonable efforts to identify a replacement for such third party material. 3. Sublicense 3.1 (a) Any Sublicense entered into hereunder (i) shall contain terms no less protective of Licensor's rights than those set forth in this Agreement, (ii) shall not be in conflict with this Agreement, and (iii) shall identify Licensor as an intended third party beneficiary of the Sublicense. Licensee shall provide Licensor with a complete electronic or paper copy of each Sublicense within thirty (30) days after execution of the Sublicense. Licensee shall provide Licensor with a copy of each report received by Licensee pertinent to any data produced by Sublicensee that would pertain to the report due under Section 4. Licensee shall be fully responsible to Licensor for any breach of the terms of this Agreement by a Sublicensee. Licensee and Sublicensee may address ownership of Sublicensee's creative contribution to Derivative Works in the Sublicense agreement. (b) Upon termination of this Agreement for any reason, all Sublicenses shall terminate. If a Sublicensee was in compliance with the terms of its Sublicense in effect on the date of termination, Licensor may grant such Sublicensee that so requests, a license with terms and use _ rights as are acceptable to Licensor. In no event shall Licensor have any obligations of any nature whatsoever with respect to (i) any past, current or future obligations that Licensee may have had, or may in the future have, for the payment of any amounts owing to any Sublicensee, (ii) any past obligations whatsoever, and (iii) any future obligations to any Sublicensee beyond those set forth in the new license between Licensor and such Sublicensee. AG R2015-01 146 3 TEC2015-0036 4. Consideration In consideration of the rights granted herein, Licensee will provide to Licensor two effectiveness and utilization data reports based on the use of the Physical Materials. One data report shall include: a) number of clients who access the Physical Materials lessons; h) number of times specific lessons are completed; c) number of unique users; d) client perceptions for usefulness and helpfulness of lessons; and e) client beliefs in relation to ability to make changes based on lesson completion and shall be due to Licensor two years from the Effective Date and one data report containing the same data as described above shall be due thirty (30) days after the end of the five (5) year term. The reports shall be sent to Mci-Wei.Chang@.ht.msu.edu and msulagrr@msu.edu. 5. Diligence Licensee shall use its reasonable efforts to disseminate the Physical Materials in a fashion that Licensee determines aliens with its mission in order to provide public benefit. 6. Term and Termination 6.1 This Agreement shall commence as of the Effective Date and shall extend for a period of five (5) years unless earlier terminated in accordance with paragraph 6.2 hereof. 6.2. In the event that either Party believes that the other has materially breached any obligation under this Agreement, such Party shall so notify the breaching Party in writing. The breaching Party shall have thirty (30) days from the receipt of notice to cure the a Ileged breach and to notify the non -breaching Party in writing that said cure has been affected. If the breach is not cured within said period, the non- breaching Party shall have the right to terminate the Agreement without further notice. 1.3 Effect of Termination. 6.3.1 Upon termination, Licensee shall cease using, distributing and displaying the Physical Materials, and shall confirm in writing to Licensor that the Physical Materials have either been returned to Licensor or have been destroyed (in Licensor's sole discretion). All Sublicenses shall terminate upon termination of this Agreement pursuant to Section 3(b). 6.3.2 Upon termination, the following provisions shall survive and remain in effect; 2.1; 4; 6.3; 8. 7. Representations and Warranties 7.1 Licensor and third parties hereby represent that it has. full right, power and authority to enter into this Agreement and to provide the license of rights granted under this Agreement. 7.2 LICENSOR, INCLUDING ITS TRUSTEES, OFFICERS AND EMPLOYEES, MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS AND HEREBY DISCLAIMS ALL REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OR NON INFRINGEMENT. LICENSEE ASSUMES THE ENTIRE RISK AGR2015-01 146 4 TEC1015-0036 AND RESPONSIBILITY FOR THE SAFETY, EFFICACY, PERFORMANCE, DESIGN, MARKETABILITY AND QUALITY OF THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE PARTIES, INCLUDING THEIR OFFICERS AND EMPLOYEES, ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS AND DERIVATIVE WORKS ARE PROVIDED "AS IS";(B) NEITHER THE PHYSICAL MATERIALS NOR SUBLICENSEABLE MATERIALS MAY BE FUNCTIONAL ON EVERY MACHINE OR IN EVERY ENVIRONMENT; AND (C) THE PHYSICAL MATERIALS AND SUBLICENSEABLE MATERIALS ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT IS ERROR -FREE OR THAT LICENSOR IS UNDER ANY OBLIGATION TO CORRECT SUCH ERRORS. S. Limitation of Liability 8.1 Each Party acknowledges and represents that it will be responsible for any claim for personal injury or property damage asserted by a third party and arising out of or related to its acts or omissions in the performance of its obligations hereunder to the extent that a court of competent jurisdiction determines such Party to be at fault orotherwise legally responsible for such claim. 8.2 In no event shall either Party be liable to the other Party or to any third party, whether under theory of contract, tort or otherwise, for any indirect, incidental, punitive, consequential, or special damages, whether foreseeable or not and whether such Party is advised of the possibility of such damages. 9. Assignment and Transfer Neither Party may assign, directly or indirectly, all or part of its rights or delegate its obligations under this Agreement without the prior written consent of the other Party. 10. Dispute Resolution 10.1 In the event of any dispute or controversy arising out of or relating to this Agreement or the subject matter hereof, the Parties shall use their best efforts to resolve the dispute as soon as possible. The Parties shall, without delay, continue to perform their respective obligations under this Agreement which are not affected by the dispute. 10.2 This Agreement and any disputes arising out of or relating to this Agreement shall be governed by and construed in accordance with the laws of the State of Michigan without regard to the conflicts of law provisions thereof. In any action to enforce this Agreement, the prevailing Party will be entitled to recover reasonable costs and attorneys' fees. 11. Force Majeure Neither Party shall be liable for damages or subject to injunctive or other relief, or have the right to terminate this Agreement, for any delay or default in performance hereunder if such delay or default is caused by conditions beyond its control including, but not limited to, Acts of God or force majeure, government restrictions (including the denial or cancellation of any necessary license), wars, insurrections and/or any other cause beyond the reasonable control of the Party whose performance is affected. AG R2015-01 146 5 TEC2015-0036 12. Entire Agreement This Agreement constitutes the entire agreement of the Parties and supersedes all prior communications, understandings and agreements relating to the subject matter hereof, whether orator written. 1A Amendment No modification or claimed waiver of any provision of this Agreement shall be valid except by written amendment signed by authorized representatives of Licensor and Licensee. 14 Severability If any provision of this Agreement is determined to be invalid or unenforceable under applicable law, it shall not affect the validity or enforceability of the remainder of the terms of this Agreement, and without further action by the Parties hereto, such provision shall be reformed to the minimum extent necessary to make such provision valid and enforceable. 15 Waiver Waiver of any provision herein .shall not be deemed a waiver of any other provision herein, nor shall waiver of any breach of this Agreement be construed as a continuing waiver of other breaches of the same or other provisions of this Agreement. 16. Notices All notices given pursuant to this Agreement shall be in writing and may be hand delivered, or shall be deemed received within three (3) days after mailing if sent by registered or certified mail, return receipt requested. Ifany notice is sent by facsimile, confi rmation copies must be sent by mail or hand delivery to the specified address. Either party may from time -to -time change its notice address by written notice to the other Party. If to Licensor: Licensing Notices: MSU Technologies Attention: Agreement Coordinator AGR2015-01146 325 E. Grand RiverSuite 350 City Center Building East Lansing, M148823 517-884.1605 msutagr@.msu.edu AGR2015-0 1146 TEC2015-0036 If to Licensee: Michigan Department of Health and Attn: Kristen Hanulcik Manager, Consultation and Nutrition 320 S. Walnut, Lewis Cass Bldg., 6th Lansing, MI48913 517-335-8545 hanuicikk@michigan.gov 17. Article Headings ti Human Services, WIC Division Services Unit Floor The Parties have carefully considered this Agreement and have determined that ambiguities, if any, shall not be construed or enforced against the drafter. Furthermore, the headings of Articles have been inserted for convenience of reference only and shall not control or affect the meaning or construction of any of the agreements, terms, covenants or conditions ofthisAgreement i n any manner. is Relationship of Parties Licensor and Licensee each acknowledge pnd agree that the other is an independent contractor in the performance of each and every part of this Agreement and is solely responsible for all of its employees and students and such Party's labor costs and expenses arising in connection therewith. The Parties are not partners, joint venturers or otherwise affiliated, and neither has any right or authority to make any statements, representations or commitments of any kind, orto take any action, which shall be binding on the other Party, without the prior written consent of such other Party. (remainder of page intentionally left blank) AG R2015-01 146 TEC201 5-0036 IN WITNESS WHEREOF, the Parties have executed this Agreement by their respective, duly authorized representative as of the date first above written. LICENSOR: Michigan State University Signature on file Date: 10/15/15 By: Dr. Richard W. Chylla Executive Director, MSU Technologies LICENSEE: State of Michigan Department of Health and Human Services Women; Infants& Children Signature on file By Kim Stephen Date: 10/16/15 Bureau of Purchasing Michigan Department of Health and Human Services stephenk@michigan.gov 517-241-1196 Signature on file By: Stan Bien, Director Date: 10/16/15 WIC Division Michigan Department of Health and Human Services 320 S. Walnut, Lewis Cass Bldg., 6th Floor Lansing, MI48913 biens@michigan.gov 517-335-8448 AGRZO 15-Ql 146 TEC2QI 5-0036 0 Schedule A Physical Materials I. Client Materials A. Mothers in Motion intervention materials 1.260 sets packaged in Mothers in Motion bag. One set includes: a. I Mothers in Motion DVD set (I set is comprised of 3 DVDs) b. I looped DVD of Mothers in Motion Overview and Introduction c. Folder containing Mothers in Motion worksheets (e.g., "Goal and Plans" and 'Where Do I Go from Here?" worksheets, and stress log) and reference/guidance sheet detailing contents of each Mothers in Motion lesson (Total of 11 lessons) d. 1 CD containing PDF formatted documents of Mothers in Motion worksheets to accommodate additional printing needs. 2. All Mothers in Motion intervention materials listed above will also be saved on 2 external drives provided by WIC. II. Staff Materials A. "Rethinking How We Listen and Respond in WIC" Videos/DVDs 1.260 "Rethinking How We Listen and Respond in WIC" DVDs [included in Mothers In Motion bag described above (I DVD per bag)] 2. "Rethinking How We Listen and Respond in WIC" contents saved in video format on 2 external drives provided by WIC ""All Items listed above will be saved on total of 4 external drives, provided by WIC"" AG R2015-01146 TEC2015-0036 Schedule B Materials Modification Guide I. Client Materials 1 A. Mothers In Motion DVD I. The following Items are NOT permitted to be altered on DVDs a. DVD content i. MSU and Mothers in Motion logo ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2) iii. All lesson module and intervention content [exception: food label reading if contents become outdated] iv. Acknowledgement section v. Copyrightnotice b. Label on Disks' i. MSU and Mothers in Motion logo ii. Grant number (NIH-NIDDK,1RI8-DK083934-01A2) iii. Title of each lesson iv. Copyright notice 2. Items that may be reproduced a. Mothers in Motion DVDs b. CD contains all Mothers in Motion worksheets B. Mothers In Motion Worksheets I. The following items are NOT permitted to be altered on worksheets a. Grant number(NIH-NIDDK, IR18-DK083934-01A2) b. Mothers In Motion logo c. Title of each lesson d. Copyright notice 2. The following items are permitted to be altered on Worksheets A. Contents in the worksheets 3. Items that may be reproduced a. All worksheets b. Reference/guidance sheet detailing contents of each Mothers In Motion lesson II. Staff Materials I A. "Rethinking How We Listen and Respond in WIC" Videos/DVD I. Items that are NOT permitted to be altered on DVD a. DVD content i. MSU and Mothers in Motion logo ii. Grant number (NIH-NIDDK,1RI8-DK083934-01A2) iii. Acknowledgement section iv. Video/DVD Contents v. Copyright notice b. Label on Disks* i. MSU and Mothers in Motion logo ii. Grant number (NIH-NIDDK, 1RI8-DK083934-01A2) iii. Title of each lesson iv. Copyright notice AG R2015-01 146 TEC2015-0036 10 *WIC is allowed to duplicate DVDs without label orgrant number on the disks, if necessary. 1 Sublicensee may create content that supports the implementation of the content contained in the Mothers in Motion DVDs, Mothers in Motion Worksheets and "Rethinking How We Listen and Respond in WIC"Videos/DVD. Any content created solely by Sublicenseeshall be owned in accordance with Section 1.2 and Section 3.1(a). Implementation of the content contained in the Mothers in Motion DVDs, Mothers in Motion Worksheets and "Rethinking How We Listen and Respond in WIC' Videos/DVD shall be in accordancewith Section 1.2. AGR2015-Oi 146 11 TE C2015-0036 AnnCKtr"tt ton 13 Vlou-I-C19l-1S- Alssemination license Agreement for "Commnaicate to Mot�ivota'" Among Michigan State University, Ohio State Innovatlon Foondat on And Mkbigan Tlepar#m®nt of Health and Human Services iiiis License Agreement '°A gat tment"�, effeotiva as of iaatnet3 I, 211i7 ("EHhCtivo T)ate"}, is M140 by and arxang Michigan State University, having ofilt:es at 32S L'. Cxanat liiver, Stttta 39ff, Last Leasing, M[ 48823 { `tu1811"}, Dhio State Imtovation Noundatlon, having otirocs at 1524 bl Hlab Sines, Caiumlars, t�H $32ti1(aSli""} (together °licit"} and State of Midtigan i7aptutatstrt or V&ft and unman Sarviees Womrn, Infants sand Chlldreo having oiflras at 324 fi, tV alnut, Lmasittg, M148913 ("i.icrnsae'") (iaadividueily a "Party" and colleativety, the ""PanNos" j. WHEREAS, Liaettsos has Intellrctttai property dgbts In Ibe "'Cot mtuxicata to MDtivate"matedats (hareht,"Phyaieal Miaterish"°j, WU mfmftcc number TEC201&0178, tiSl t reference number T2017- 132, developed uilllxing fluids fmm a gram tram the National institutes of Health (MR), liwit nnntW R18-M-093934.41(-Ckut"). it HROEAS, 1.1rensor is the owner orcertain rights, We and Interest in klna Physical Materials and has Ike right to grant licenses thereander. WHIRIWAS, Licensee wishes to Hcenso the Physlost Materials for dissemination purposes and Licensor desires to great such licroso to Uctn= on the #arms saki conditions herein, NOW TMEREPOPE, the Parties agree as follows: L Definitlen% a "physical Mlaterisle" sball mean ail physical it4tats Intend to Schedule A. b. "Sublicensable Materials" shall mean one ckcteoalc copy of the Physbaal bdatetials, e. "Materials Modification Guide'shall meant the speolketiutts ouilined in Schedule B. d. "De6va0V4 WOW marts ail wnovits developed by Licensee or Subiicensee whim wroatd W ahAtularixed as derivative works of the Phples i Materials anWor Subtira usable hdattxials under tho [halted States Copyright Act or 1976, or subsequent revision dtornaf, spoclflcally ittcluding, but not lltrdted in, buslaiions, abridgments, condensations, raca9tinp, tract ns or adaptatlans theecat,, or Worksoonslding ofedilurlai revisiboo, annotations, ciabomikaas, or other toodifications thereof: The tam 'l ytaive Wank'° shall nut lrtniude [hoes derivative works which are developed by Licamor. a, " Sttbl9anrtta" meant an ugreenieat which may take the fora of, but is not limited to, a sublicense agreement, manorandum of understnrtdint, or spaei41 provittlens added as an arriotdment to an existing agmsmo it betweto Lint wo mad a Sublieensee in which Licenser Warm orotlmiwEsit erantlers any ofthe rights tteensed to L%nme hcremder or other sights that are relevant 10 tairig pea Sublicerasalt o Matcriait. 1. Granto(Mmse 1.1 Subject to the terns and conditions of this Agreesnen4 to the extent brat Like's tights to Physicai'Materials wet result of L'aconsor's grant of rights to the Vederd Government In accarxianco with the terns and conditions of the Grant are Irrufftclent for Licensee's settvides hereunder, Licensor hereby grants to Licensee a noneaiclusi% nontranmfersble, worldwide, 'license to use, perform, reproduce, publkxlly display the Physical Materials. Meensee is granted the limited 4& to create Derivative Works of the Physical Materials, specifically Licensee stall have rite right to create Derivative Works which are (a) cunapanhan gttirience handouts its the Physical Materials for educational use by instructors in the course of employing Physical Materials, (b) materials for potion of the availability of educational opportunities employing. the Physical Materials, and (c) instruments for collecting evaluations and feedback flow course pedlolpmom Nowithstsuding the foregoing. Licensee may only dimrtibule the Physical Materials whilln Licensee tuaaaged locations within the state of Michigan. License Isnotpernrinedtosell or receive consideration f6r any of the Physical MalerIalsor reproductions of the Physical Material€, L2, L ccusos grants Lioonsea time light to grant Subliccr= of its rights kmdcr Section 1.1 of the Suhlleensable Mewrimb to Sublicon sco for the rule purpose of placing this content contained in the Subllcensable Materials (including Use videos) on a wobsite that is controlled by SuMfoome, and that is access limited, password Wortecicd. Any Sublicense shall be in occta-d"m wit#. Ardole 3 below. Sublicensee It not permitted to roll or receive cottsideratlorr for the Subliectuable Materials In any forand. Any content created solely by Sublicenscc chat supports the Implementation ofthe Sublicetaable Materials sball be owned by Suhdicensee. 1.3 In such incidences whete, Car fumanclal reasons, Licensee is not able to reprodama the label displayed on the original muster copy of the DVD portion of the Physical Materials, Licensee must ensure that the entire content of the DVD portion of the Physical Materials are reproduced to its entice to that the Inclusion of the copyright notice, grant number informatiom title of each lesson, and adatowledgar ants am rnaintainr'd. IA Licor ce will refrain, and shall requite Sublicnonsccs to refuel», from using the ratite of the Licensor or The Ohio Stele Vaalverstty ("OSU'l hi publicity of advertising without the prlar written approval of Licensor. 1.5 L(cmw shall provide Physical Materials to Licensee by May 1, 2017. Licensor asswx es no responsibility fur disidbodas Physical Materials to the stale cfMiiehiSan Llcenttec locations. I Ucansor's Rights 2.1 Notwithrianding rile rights granted In Article I hercot Ll"uste acknowledges t i all right, title and Interest In the Physicat Materials, Irtetudlug any copyrlgltt appliable tlleselo, sllald remain the ,property of Licensor. Licetsee or Sublicensw stall have no right, title or Iutaremt in the physical lvlatedals, inehtuiing Soy copyright applicribic theme, except am e>garessly set farth in this Agreement, 2.2 Any rights not granted hereumier are reserved by Licensor. 3. Sublicense 3,1 (a) Any Sublicense entered into hcreumla (i)shall contain Isms no teas pmtecfivr of Licenser's rights titan these sel lhnh ha this Agreenteat, (llj shall not be in conflict with this AOMI7.OM 2 OSOA2lt17-1172 TECMIGA17a Agreement, and (lit) shall identify Licensor as an Intended third party benaiichuy of the Sublicense. LicensaeskilProvide Licensor with acomldetaslectmnIcorPaper copy Ofeach Subiteen" wMln thirty (30) days after exccution of the Sublicense. License$ shall provide Licensor with it copy of each report received by i.ioensee pertinent to any data produced by Subliansee that would pertain to the report dice under Section 4. Licensee alralt be fully responsible to Licensor for any breach of the terms of this Agrearrent by a Subiir ensee. (b) Upon termination of this Agreement for any ressoa, all Subilcemes shall terrvinate, if a 3ublicensee was in compliance with the terms of Its Sublicense in effect on the date of terminatlen, Licensor may grant such Subllcensee that so requests, a license with terms and use rights as are acceptable, to Licensor. in no event shall Ucensor have any obligations of any new whatsoever with respesd to (1) any past, current or future obligations that Licensee may have had, ar rosy in the future have, for the payment of any amounts owing to any Soblicensce, (li) any past obligatlons whalvwer, and (ill) any future obligations to any Subiacasea beyond those set forth is the new license between Licensor and such Sublimmok 4.. Courvidaration 14 consideration of the rights granters herein, Licensee vAH provide to Licensor two efi'activaness and utilization data reports based on the use of the Physical lvlatcdals» One data repart shall include: a) number of clients who access; the Physical hlalcriats lessons; b) number of limes specific lamMi axe completed; c) number of unique users; d) client pemeptlous for usefulness egad halpfuinass oflessons; end a) olicat betide In relation to ability to make changes based on lesson completion and shall be dare to Licensor two years from the Ef active Data and one data report containing the same data as desecrated shove;hail be due thirty (30) days alter the end of the five (S) year term. Such data ropirds shall segregate the information provided in a-c by CPA (dictittans and nurses) or bmulfbedingpcor cannselom The reports shalt he sent to changi�72(�asu,adu, innovation&swedu and msuta su.edu. Nif�t^'i Licensee shall use its reasonable efforts to disserninaate The Physical, Materials in a fmbibn that Li detannines aligns with in; mission in order to provide pubtte benefit. 6, TumandTerminaden 6.l This Agreement shall commence as of theEfteiive Date and shall extend for aperiod oaff f (5) years unto;; earlier terminated in accordance with paragraph 6.2 ha reef This Agreement may be renewed or emearded by written amernlmcnt signed by authorized representatives of Licensor and Liccosce in accordance with Article 13. &2. In the event (bar a Party believes that another Party has materially breacheal any obligation under this Agreement, such Party shall to notify the breaching Party in writing, The hunching Party shall have tldrty (30) days figm the rcecipt of notice to cure the alleged branch and to notify, the nan-broaching Party in writing that said care has been affeeled. if the breach is not cured within veld period, the nma- brcaohim Party shall have the right to terminate the Agreement wlthout further notate. 63 EfCectof`Tcrminatlon. A13tty617-00453 3 09UA2017>1172 TEM616t176 63.1 Upon termination. Livensea shall rsase using, distributing and displaying tha Physical Materials, and shall cordirut in Writing to Licensor that the Physical Materials have eithar been returned to Licensor or have been destroyed (in Llocusor's style dismaon). All Sublicomes Shall termrinelc upon termination ofthis Agreement pursuant to Section 3(b). 6.3.2 Upon terminadou, the fallowing provisions shah survive end remain in eifeeL, It; 4; 6.3; & 7, RepresentattowandWarraudes 7.1 Lladmsor represcnts that to the knowl ofTMc oils Stale Univotsity"s and MSU's to IMOIagy transfer otiicra that it has full right, power and authority to enter into this Agreement and to provide the license of rights granted under this Agreemet. 7.2 LICENSOR AND OSU, INCLUDING THEIR CREATORS, TRUSTEES, OFFICERS, EWLOYEK AGENTS OR AFFILIATED ENTERPRISES MAKE NO RgMSENTATEONS OR WARRANTIES OF ANY KIND CONCERNING THE PHYSICAL MATERIALS AND SUBUCENSABLE MATERIALS AND HEREBY DISCLAIM ALL REPA99NTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, rNCLUDING, WITHOUT LIMITATION, ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, NoNiNxMOEMEN% ;IAF'ETY, EFFICACY, APPROVAgILITY BY REGULATORY AUTHORITIES, TIME AND COST OF DEVELOPMENT, OR PATENTABILITY. LICENSEE ASSUMES 713.E ENTIRE RISK AND RESPONSIBILITY FOR. THE SAFETY, EFFICACY, PERPORMANCE, DEMON, MARKETABILITY AND QUALITY OF THE PHYSICAL MATERIALS AND SUBLIC,ENSABLE MATERIALS.. WITHOUT LIMITING THE GEN41ALITY OF THE FOREGOING, THE PARTIES, INCLUDING THEIR GMCERS AND EMPLOYEES, ACKNOWLEDGE THAT (A) THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS ARE PROVIDED *AS IS"; (B) NEITHER THE PHYSICAL MATERIALS NOR SU11LICENSABLE MATERIALS MAY BE FUNCTIONAL ON EVERY MACHINE OR IN RMY ERVI , AND (C) THE PHYSICAL MATERIALS AND SUBLICENSABLE MATERIALS ARE PROVIDED WITHOUT ANY WARRANTIES THAT IT IS ERROR -FREE OR THAT LICENSOR IS UNDER ANY OBLIOA noN TO CORRECT SUCH ERRORS. S. L&ziitaaon of Liabitity 1.1 Each Pasty ackr"Medges and represents that It will bo rospunslble faramy elatrn for Irersun l Injury er propedy damage asserted by a third party and arising out of or wlaW to IN actscromisslons In the performance of its obligations hereunder to the extent that a court of comtpeaent jurisdiction determines such Party to beat fault or othmviso legally responsible for such claim. Nothing in this Agreement shell be deemed or treated many waiver of any Party's sovereign immunity or immunity gmrftd by statule or out lair, If g4ffiaable. E.2 In no event shall a Party W liable to arwilier Party or to any il&d party, whether under thorny of m4act, tort of otherwise, lot any inditect, Incidental, punitive, Conseniuealtlal, or special damages. whot er foreseeable or not and whedwrsuch Pariyisodvised of the possibility ofsueh damages. 9. Assignment and Transfer No Parry may asshga, directly or Indirectly, all or part of Its riabts or delegate Its obligations reader this A t wltiottt the prior written congeal of the Other Parties. AtiR24l7fio933 d 0WA2D17.1172 TEMD16-0179 Ift.i In the event of any dispute or controversy arising out of or slating to this Agreement at the subject matter herecd, the Parties shall we their beat efforts to resolve the dispute as saran as pMlble. The Parties shall, Without delay, continue to prform their rev"live obligstiatns under this Agreemeaat which ore not affected by the dispute, 7MEnn. M, ttt No Parry shall be liable for damages or subject to Injunctive or other relief, or have the right to terruinaret this Agreement, for any delay or default in perfarnnance hereunder if sack delay or default is caused by conditions beyond its control including, but not limited to, Picts of God or fiance nrajeura, government restrictions (including the denial or cancellation of any necessary liccrtsel wars, Inatatrections andtor say other came beyond the reasonable control of the Party whose performaatce Is affected. 12. Mira. Agraar®tat This Agreement constitutes the entire agreement of the Panics and supersedes all prior co mnnniccliorts, understandings and agreements relating to the auk]cct matter hereof, vrhetlw oral or written. 13 Amenilment No modification or claimed wsivar of any provlslem of this Agreement shall be valid except by written m=dment signed: by ante wdzod roprrscntatives of Licensw nod [Acensee. It.. Sevembftity Ifauy provision of this Agreement is deterrnivad to be invalid or usaod'orceable under applicable law, it shall not nfl`ect the validity or enforceability of the remainder of the terms of this Agreernamt, and without hirthor action by the Panics hereto. such provision shall be reformed to the minimum extent accessary to make such provision valid and enforceable. 115. VVaie,rr Vtanrer of any provision heroin shall not be detmtd a waiver of any other provision herein, nor shall walver of any breach of this Agreement be construed as a continuing waiver of other breaches of the sameor otherprovIslons of Ala Agmarrient, if =1 7 All natiku given pursuant to this Agrecownt shall be in writing and may be hand delivered, or shall be deemed received within dames (3) days after mailing If sent by registered or certified mail, return receipt requested. if may oartlee is sent by lbcsimille, conflmntion copies must be sent by mail or hand delivery to the specif ed address. hither patty may foam time-W time change its notion address by writtsn notice to the other Party. AOR201740433 $ 4SU A20174 I72 TOM164176 If to Licensor. MSU TvAnvl &s Attentisait. Agreement Coordinator AGR1tt17-bti451 325 E. Ornail River Suite 350 Laity Center wilding East Lansing., Ml488I3 517-884-1605 MMUMMUMIM Ohio State kinravation Foondopliort 1524 M Hitia Street. Columbus, OH 43201 614-292-1315 If to Licensem Michigan Department of Health and Human 8ervic es, WIC Division Mai Kaistab Hanuloik Manager, Consultation and-lubitltnt Services Limit 320& Walnut, Lewis Cass Bldg„ & Floor Lansing., MC 48913 517-335-8545 banuleikk@michigart4ov 11. Article Headings The Ponies have corefttlly considered this Afire mem and have determined that ambiguities, if any, shall not be construed or enrcatced sEpinst the drafter. Furthermore, the headings of Articles have been inserted for convenience of reference only and shad not control or at Wt the meaning or aonsirucdon of any ofihe agreements, teems, covenants or corAllons of this Agrectaem in ratty rnon or. 18. Rrlatlonship of Pariles Licensor and Licame each acknowledge and agree that the other is an independent conlroam in the performance of Gant and every part of this Agreement and is solely responsible for all of its employees and students and such PtAy's labor costs anti expeam arising in connection tharewida. The Patties are not joint venturers or otbarrvise aliiliattd, and neither has any right air auliiaity to make any statements, mpreseMallons or commilmetts of any kind, or to take any action wbieh shell be thAng on the other Party, without the prior vnium consent ofs=h OIW Party. A 017.4d4D b OSU A2617A 02 xt=.c281a.a178 M WITNESS WHAtiEOF, the Porous )u;vo cyma wIL: l this A;ru mctit by tltrit'tk�spi:divc, dLily .authorized mplescn;naIV" its 4f the date Rest above mitten, LICEN'SOM Miichipli Staae tJtt'svcrsit J [yr. inch d W. CbyY-M [Necutive DIrgzittr, mSV rt;Uftnoto�ics Ohin Stale Innovation ron,ttlatton By, I'� � Date, Dipanjal Mug ; Vito President LtC13ta'SEr. Saate nFdf'scltip�n+t I��:p,utmetst. oE1lee[tt, itne! human $rrv[eea Wutn�n, Infants �, Children tay lia7tc: Jeanette Hensler. DiiractDr Grants Division, Bureau of Puichasing t � Stan Dion, t}iccctC-r WIC Diviskmt I'�icb"r6nn I)eliurirnnrtt ul-l�ealtlt.istc3 !{tatna3r Scn�iccs 320 S. 1"l133nul, Lcwis CnsS €BW&, 6111 Moor bier.5eDinichil+,ata,gov St7-135•8448 AG R11317-eGO] 7 051,11A,2017- t 172 TE 16oin Schedule A Physical Materials A. Communjewe to Id'ailwas, videos — up to I tt sets In I)VD format 15 Usmos. 12 video lessotIN reminder and geaetal tip lesson, introduction and preview B. FeMinaT what wethktkandnespandhiWIC video . Tip Sheets —6SOcopies, (color print.1mninaW andvoll) D. CDs "contain the Followino materials teixted io Listrtwimicale ro Ado Imte saved Id PDP {up to 10 Copt" . a i ap sheets; h, Rawer point slides of all 12 lessons, reminder end general tip lessvra; c, Swoon" of key points is each video lessota; d� ltrstruelimta for use saf the videos. t; Examal hard drives ) that contain the rollowling materials: a. Communkale to Adksttuale videor 15 video lessons; 11% RetldrrHng what we think nand rexp "d In WIC video; c. Tip Sham in PDV; d. Pouter point stidaa of all 12 lessorm remInder wW general tip lesson 41 PDF, e. Summmy of key poltats in each video testate In PDF; f. Instntctions for use of the videos in ME AGRM "3 g OSU A2017-1172 TEC201&4179 &eheduia B Materials Modification Guide AOR2017-tOM 9 OSUA20MI172 TOMO16.0178 Agreement #: {ctrt_no} Agreement Between (dept_name)Services hereinafter referred to as the "Department" and (board —of —health) (local_gov_tag) on Behalf of Health Department (agency_name) (add_li ne_1 } (add_line_2} Federal I.D.#: (fed_id), Unique Entity Identifier: (uei_no) hereinafter referred to as the "Grantee" for The Delivery of Public Health Services under the Local Health Department Agreement Part 1 1. Purpose This Agreement is entered into for the purpose of setting forth a joint and cooperative Grantee/Department relationship and basis for facilitating the delivery of public health services to the citizens of Michigan under their jurisdiction, as described in the attached Annual Budget, established Minimum Program Requirements, and all other applicable federal, state and local laws and regulations pertaining to the Grantee and the Department. Public health services to be delivered under this Agreement include Essential Local Public Health Services (ELPHS) and Categorical Programs as specified in the attachments to this Agreement. 2. Period of Agreement This Agreement will commence on the date of the Grantee's signature or (start_dt}, whichever is later, and continue through {end_dt}. Throughout the Agreement, the date of the Grantee's signature or (start _dt}, whichever is later, will be referred to as the start date. This Agreement is in full force and effect for the period specified. 3. Program Budget and Agreement Amount A. Agreement Amount In accordance with Attachment IV - Funding/Reimbursement Matrix, the total State budget and amount committed for this period for the program elements covered by this Agreement is ${max_amt). B. Equipment Purchases and Title Any Grantee equipment purchases supported in whole or in part through this Agreement must be listed in the supporting Equipment Inventory Schedule which should be attached to the Final Financial Status Report. Equipment means tangible, non -expendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. Title to items having a unit acquisition cost of less than $5,000 will vest with the Grantee upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department's proportionate interest in such equipment supports such retention or transfer of title. C. Budget Transfers and Adjustments 1. Transfers between categories within any program element budget supported in whole or in part by state/federal categorical sources of funding will be limited to increases in an expenditure budget category by $10,000 or 15% whichever is greater. This transfer authority does not authorize purchase of additional equipment items or new subcontracts with state/federal categorical funds without prior written approval of the Department. 2. Except as otherwise provided, any transfers or adjustments involving state/federal categorical funds, other than those covered by C.1, including any related adjustment to the total state amount of the budget, must be made in writing through a formal amendment executed by all parties to this Agreement in accordance with Section IX. A. of Part 2. 3. The C.1 and C.2 provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the Department will be recovered proportionately from each local Grantee that, during the course of the Agreement period, chose to reduce or transfer local funds from the Family Planning program. 4. Agreement Attachments A. The following documents are attachments to this Agreement Part 1 and Part 2 - General Provisions, which are part of this Agreement: 1. Attachment I - Annual Budget 2. Attachment III -Program Specific Assurances and Requirements 3. Attachment IV - Funding/Reimbursement Matrix 5. Statement of Work The Grantee agrees to undertake, perform and complete the activities described in Attachment III - Program Specific Assurances and Requirements and the other applicable attachments to this Agreement which are part of this Agreement. 6. Financial Requirements The financial requirements must be followed as described in Part 2 and Attachment I - Annual Budget and Attachment IV - Funding/Reimbursement Matrix, which are part of this Agreement. 7. Performance/Progress Report Requirements The progress reporting methods, as applicable, must be followed as described in part 2 and Attachment III, Program Specific Assurances and Requirements, which are part of this Agreement. 8. General Provisions The Grantee agrees to comply with the General Provisions outlined in Part 2, which is part of this Agreement. 9. Administration of the Agreement The person acting for the Department in administering this Agreement (hereinafter referred to as the Contract Consultant) is: Name: Carissa Reece Title: Department Analyst E-Mail Address ReeceC@michigan.gov The financial contact acting on behalf of the Grantee for this Agreement is: ffin_name) Name ffin_email) E-Mail Address Title Telephone No. 10. Special Conditions A. This Agreement is valid upon approval and execution by the Department which may be contingent upon approval by the State Administrative Board and signature by the Grantee. B. This Agreement is conditionally approved subject to and contingent upon availability of funding and other applicable conditions. C. Based on the availability of funding, the Department may specify the amount of funding the Grantee may expend during a specific time period within the Agreement Period. D. The Department has the option to assume no responsibility or liability for costs incurred by the Grantee prior to the start date of this Agreement. E. The Grantee is required by 2004 PA 533 to receive payments by electronic funds transfer. 11. Special Certification The individual or officer signing this Agreement certifies by their signature that they are authorized to sign this Agreement on behalf of the responsible governing board, official or Grantee. 12. Signature Section For {agency_name} {auth_name} Name For the {dept_name} Christine H. Sanches Title {current date} Christine H. Sanches, Director Date Bureau of Grants and Purchasing Part 2 General Provisions Responsibilities - Grantee The Grantee, in accordance with the general purposes and objectives of this Agreement, must: A. Publication Rights 1. Copyright materials only when the Grantee exclusively develops books, films or other such copyrightable materials through activities supported by this Agreement. The copyrighted materials cannot include recipient information or personal identification data. Grantee provides the Department a royalty -free, non-exclusive and irrevocable license to reproduce, publish and use such materials copyrighted by the Grantee and authorizes others to reproduce and use such materials. 2. Obtain prior written authorization from the Department's Office of Communications for any materials copyrighted by the Grantee or modifications bearing acknowledgment of the Department's name prior to reproduction and use of such materials. The state of Michigan may modify the material copyrighted by the Grantee and may combine it with other copyrightable intellectual property to form a derivative work. The state of Michigan will own and hold all copyright and other intellectual property rights in any such derivative work, excluding any rights or interest granted in this Agreement to the Grantee. If the Grantee ceases to conduct business for any reason or ceases to support the copyrightable materials developed under this Agreement, the state of Michigan has the right to convert its licenses into transferable licenses to the extent consistent with any applicable obligations the Grantee has. 3. Obtain written authorization, at least 14 days in advance, from the Department's Office of Communications and give recognition to the Department in any and all publications, papers and presentations arising from the Agreement activities. 4. Notify the Department's Bureau of Grants and Purchasing 30 days before applying to register a copyright with the U.S. Copyright Office. The Grantee must submit an annual report for all copyrighted materials developed by the Grantee through activities supported by this Agreement and must submit a final invention statement and certification within 60 days of the end of the Agreement period. 5. Not make any media releases related to this Agreement, without prior written authorization from the Department's Office of Communications. B. Fees 1. Guarantee that any claims made to the Department under this Agreement will not be financed by any sources other than the through any other source, the Grantee agrees to budget the additional source of funds and reflect the source of funding on the Financial Status Report. 2. Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report those collections on the Financial Status Report. Any under recoveries of otherwise available fees resulting from failure to bill for eligible activities will be excluded from reimbursable expenditures. C. Grant Program Operation Provide the necessary administrative, professional and technical staff for operation of the grant program. The Grantee must obtain and maintain all necessary licenses, permits or other authorizations necessary for the performance of this Agreement. Use an accounting system that can identify and account for the funds received from each separate grant, regardless of funding source, and assure that grant funds are not commingled. D. Reporting Utilize all report forms and reporting formats required by the Department at the start date of this Agreement and provide the Department with timely review and commentary on any new report forms and reporting formats proposed for issuance thereafter. E. Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than four years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. F. Authorized Access 1. Permit within 10 calendar days of providing notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Inspector Generals, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to records, papers, files, documentation and personnel related to this Agreement, to the extent authorized by applicable state or federal law, rule or regulation. 2. Acknowledge the rights of access in this section are not limited to the records are retained. 3. Cooperate and provide reasonable assistance to authorized representatives of the Department and others when those individuals have access to the Grantee's grant records. G. Audits 1. Single Audit The Grantee must submit to the Department a Single Audit consistent with the regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200, Subpart F. The Single Audit reporting package must include all components described in Title 2 Code of Federal Regulations, Section 200.512 (c) including a Corrective Action Plan, and management letter (if one is issued) with a response to the Department. The Grantee must assure that the Schedule of Expenditures of Federal Awards includes expenditures for all federally -funded grants. 2. Other Audits The Department or federal agencies may also conduct or arrange for agreed upon procedures or additional audits to meet their needs. 3. Due Date and Where to Send The required audit and any other required submissions (i.e., corrective action plan, and management letter with a corrective action plan), and/or Audit Exemption Notice must be submitted to the Department within nine months after the end of the Grantee's fiscal year by e-mail at, MDHHS-AuditReports@michigan.gov. Single Audit reports must be submitted simultaneously to the Department and Federal Audit Clearinghouse, in accordance with 2 CFR 200.512(a), The required submission must be assembled as one document in a PDF file and compatible with Adobe Acrobat (read only). The subject line must state the agency name and fiscal year end. The Department reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. 4. Penalty a. Delinquent Single Audit or Financial Related Audit If the Grantee does not submit the required Single Audit reporting package, management letter (if one is issued) with a response, and Corrective Action Plan within nine months after the end of the Grantee's fiscal year and an extension has not been approved by the cognizant or oversight agency for audit, the Department may withhold from the current funding an amount equal to five percent of the audit year's grant funding (not to exceed $200,000) until the required filing is received by the Department. The Department may retain the amount withheld if the Grantee is more than 120 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. The Department may terminate the current grant if the Grantee is more than 180 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. b. Delinquent Audit Exemption Notice Failure to submit the Audit Exemption Notice, when required, may result in withholding payment from Department to Grantee an amount equal to one percent of the audit year's grant funding until the Audit Exemption Notice is received. H. Subrecipient/Contractor Monitoring 1. When passing federal funds through to a subrecipient (if the Agreement does not prohibit the passing of federal funds through to a subrecipient), the Grantee must: a. Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the information required by 2 CFR 200.332. b. Ensure the subrecipient complies with all the requirements of this Agreement. C. Evaluate each subrecipient's risk for noncompliance as required by 2 CFR 200.332(b). d. Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with federal statutes, regulations and the terms and conditions of the subawards; that subaward performance goals are achieved; and that all monitoring requirements of 2 CFR 200.332(d) are met including reviewing financial and programmatic reports, following up on corrective actions and issuing management decisions for audit findings. e. Verify that every subrecipient is audited as required by 2 CFR 200 Subpart F. 2. Develop a subrecipient monitoring plan that addresses the above requirements and provides reasonable assurance that the subrecipient administers federal awards in compliance with laws, regulations and the provisions of this Agreement, and that performance goals are achieved. The subrecipient monitoring plan should include a risk -based assessment to determine the level of oversight and monitoring activities, such as reviewing financial and performance reports, performing site visits and maintaining regular contact with subrecipients. as required by 2 CFR 200.501(h), as applicable. 4. Ensure that transactions with subrecipients/contractors comply with laws, regulations and provisions of contracts or grant agreements. I. Notification of Modifications Provide timely notification to the Department, in writing, of any action by its governing board or any other funding source that would require or result in significant modification in the provision of activities, funding or compliance with operational procedures. J. Software Compliance Ensure software compliance and compatibility with the Department's data systems for activities provided under this Agreement, including but not limited to stored data, databases and interfaces for the production of work products and reports. All required data under this Agreement must be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Grantee's business operations for processing data. All information systems, electronic or hard copy, that contain state or federal data must be protected from unauthorized access. K. Human Subjects Comply with Federal Policy for the Protection of Human Subjects, 45 CFR 46. The Grantee agrees that prior to the initiation of the research, the Grantee will submit Institutional Review Board (IRB) application material for all research involving human subjects, which is conducted in programs sponsored by the Department or in programs which receive funding from or through the state of Michigan, to the Department's IRB for review and approval, or the IRB application and approval materials for acceptance of the review of another IRB. All such research must be approved by a federally assured IRB, but the Department's IRB can only accept the review and approval of another institution's IRB under a formally approved interdepartmental agreement. The manner of the review will be agreed upon between the Department's IRB Chairperson and the Grantee's authorized official. L. Mandatory Disclosures 1. Disclose to the Department in writing within 14 days of receiving notice of any litigation, investigation, arbitration or other proceeding (collectively, "Proceeding") involving Grantee, a subcontractor or an officer or director of Grantee or subcontractor that arises during the term of this Agreement including: a. All violations of federal and state criminal law involving fraud, bribery, or gratuity violations potentially affecting the Agreement. b. A criminal Proceeding; C. A parole or probation Proceeding; e. A civil Proceeding involving: 1. A claim that might reasonably be expected to adversely affect Grantee's viability or financial stability; or 2. A governmental or public entity's claim or written allegation of fraud; or 3. Any complaint filed in a legal or administrative proceeding alleging the Grantee or its subcontractors discriminated against its employees, subcontractors, vendors, or suppliers during the term of this Agreement; or f. A Proceeding involving any license that Grantee is required to possess in order to perform under this Agreement. 2. Notify the Department, at least 90 calendar days before the effective date, of a change in Grantee's ownership or executive management. M. Minimum Program Requirements Comply with Minimum Program Requirements established in accordance with Section 2472.3 of 1978 PA 368 as amended, MCL 333.2472 (3), MSA 14.15 (2472.3), for each applicable program element funded under this Agreement. N. Annual Budget and Plan Submission Submit an Annual Budget and Plan request to the Department, in accordance with instructions established by the Department, to serve as the basis for completion of specific details for Attachments I, III, and IV of this Agreement via Grantee/Department negotiated amendment(s). Failure to submit a complete Annual Budget and Plan by the due date through MI E-Grants will result in the deferral of Department payments until these documents are submitted. O. Maintenance of Effort Comply with maintenance of effort requirements for Essential Local Public Health Services (ELPHS), as defined in the current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part I. P. Accreditation 1. Comply with the local public health accreditation standards and follow the accreditation process and schedule established by the Department to achieve full accreditation status. a. Failure to meet all accreditation requirements or implement corrective plans of action within the prescribed time period will result in the status of "Not Accredited." Grantees designated as "Not Accredited" may have their Department allocations b. Submit a written request for inquiry to the Department should the Grantee disagree with on -site review findings or their accreditation status. The request must identify the disagreement and resolution sought. The inquiry participants will be comprised of Grantee staff, Department staff, the Accreditation Commission Chair, and the Accreditation Coordinator as needed. Participants will clarify facts, verify information and seek resolution. 2. Consent Agreements/Administrative Compliance Orders/Administrative Hearings for "Not Accredited" Grantees: a. If designated as "Not Accredited", the Grantee will receive a Consent Agreement Package from the Department. Grantees and their local governing entities will be given 75 days to review the package, meet with the Department, and sign and return the Consent Agreement. b. Fulfillment of the terms and conditions of the Consent Agreement will not affect accreditation status, but impacts the Grantees' ability to fulfill its contractual obligations under the Local Health Department Grant Agreement. Grantees designated as "Not Accredited", will retain this designation until the subsequent accreditation cycle. C. Failure to fulfill the terms and conditions of the Consent Agreement within the prescribed time period will result in the issuance of an Administrative Compliance Order by the Department. d. Within 60 working days after receipt of an Administrative Compliance Order and proposed compliance period, a local governing entity may petition the Department for an administrative hearing. If the local governing entity does not petition the Department for a hearing within 60 days after receipt of an Administrative Compliance Order, the order and proposed compliance date will be final. After a hearing, the Department may reaffirm, modify, or revoke the order or modify the time permitted for compliance. e. If the local governing entity fails to correct a deficiency for which a final order has been issued within the period permitted for compliance, the Department may petition the appropriate circuit court for a writ of mandamus to compel correction. Q. Medicaid Outreach Activities Reimbursement Report allowable costs and request reimbursement for the Medicaid Outreach activities it provides in accordance with 2 CFR, Part 200 and the requirements in KAArlinnirl Riillatin niimhar KACA nri-)Q Submit a Cost Allocation Plan Certification to the Department to bill for the Medicaid Outreach Activities. The Cost Allocation Plan Certification is valid until a change is made to the cost allocation plan or the Department determines it is invalid. Submit quarterly FSRs for the Medicaid Outreach activities and an annual FSR for the Children with Special Health Care Services Medicaid Outreach activities in accordance with the instructions contained in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, agree to target Medicaid outreach effort toward Department established priorities. For fiscal year 2021, the Department priorities are: lead testing, outreach and enrollment for the Family Planning waiver, and outreach for pregnant women, mothers and infants for the Maternal and Infant Health Program. The Grantee will submit a report using the MDHHS Local Health Department Medicaid Outreach form describing their outreach activities targeting the priorities 30 days after the end of a fiscal year quarter and at the same time as the final FSR is due to the Department. The Local Health Department Medicaid Outreach reports are to be sent through MI E-Grants as an attachment report to the Financial Status Report. R. Conflict of Interest and Code of Conduct Standards 1. Be subject to the provisions of 1968 PA 317, as amended, 1973 PA 196, as amended, and 2 CFR 200.318 (c)(1) and (2). 2. Uphold high ethical standards and be prohibited from the following: a. Holding or acquiring an interest that would conflict with this Agreement; b. Doing anything that creates an appearance of impropriety with respect to the award or performance of this Agreement; C. Attempting to influence or appearing to influence any state employee by the direct or indirect offer of anything of value; or d. Paying or agreeing to pay any person, other than employees and consultants working for Grantee, any consideration contingent upon the award of this Agreement. 3. Immediately notify the Department of any violation or potential violation of these standards. This section applies to Grantee, any parent, affiliate or subsidiary organization of Grantee, and any subcontractor that performs activities in connection with this Agreement. S. Travel Costs 1. Be reimbursed for travel costs (including mileage, meals, and lodging) budgeted and incurred related to services provided under this Agreement. a. If the Grantee has a documented policy related to travel reimbursement for employees and if the Grantee follows that for travel costs at the Grantee's documented reimbursement rate for employees. Otherwise, the State of Michigan travel reimbursement rate applies. b. State of Michigan travel rates may be found at the following website: https://www.michigan.gov/dtmb/0,5552,7-358- 82548 13132---,00.html. C. International travel must be preapproved by the Department and itemized in the budget. T. Insurance Requirements 1. Maintain at least a minimum of the insurances or governmental self - insurances listed below and be responsible for all deductibles. All required insurance or self-insurance must: a. Protect the state of Michigan from claims that may arise out of, are alleged to arise out of, or result from Grantee's or a subcontractor's performance; b. Be primary and non-contributing to any comparable liability insurance (including self-insurance) carried by the state; and C. Be provided by a company with an A.M. Best rating of "A-" or better and a financial size of VII or better. 2. Insurance Types a. Commercial General Liability Insurance or Governmental Self - Insurance: Except for Governmental Self -Insurance, policies must be endorsed to add "the state of Michigan, its departments, divisions, agencies, offices, commissions, officers, employees, and agents" as additional insureds using endorsement CG 20 10 11 85, or both CG 2010 12 19 and CG 2037 12 19. If the Grantee will interact with children, schools, or the cognitively impaired, the Grantee must maintain appropriate insurance coverage related to sexual abuse and molestation liability. b. Workers' Compensation Insurance or Governmental Self - Insurance: Coverage according to applicable laws governing work activities. Policies must include waiver of subrogation, except where waiver is prohibited by law. C. Employers Liability Insurance or Governmental Self -Insurance. d. Privacy and Security Liability (Cyber Liability) Insurance: cover information security and privacy liability, privacy notification costs, regulatory defense and penalties, and website media content liability. 3. Require that subcontractors maintain the required insurances contained in this Section. 4. This Section is not intended to and is not to be construed in any manner as waiving, restricting or limiting the liability of the Grantee from any obligations under this Agreement. 5. Each Party must promptly notify the other Party of any knowledge regarding an occurrence which the notifying Party reasonably believes may result in a claim against either Party. The Parties must cooperate with each other regarding such claim. U. Fiscal Questionnaire 1. Complete and upload the yearly fiscal questionnaire to the EGrAMS agency profile within three months of the start of the Agreement. 2. The fiscal questionnaire template can be found in EGrAMS documents. V. Criminal Background Check 1. Conduct or cause to be conducted a search that reveals information similar or substantially similar to information found on an Internet Criminal History Access Tool (ICHAT) check and a national and state sex offender registry check for each new employee, employee, subcontractor, subcontractor employee, or volunteer who under this Agreement works directly with clients or has access to client information. a. ]CHAT: http://apps.michigan.gov/ichat b. Michigan Public Sex Offender Registry: http://www.mipsor.state.mi.us C. National Sex Offender Registry: http://www.nsopw.gov 2. Conduct or cause to be conducted a Central Registry (CR) check for each employee, subcontractor, subcontractor employee, or volunteer who, under this Agreement works directly with children. a. Central Registry: https://www.michigan.gov/mdhhs/0,5885,7- 339-73971 7119 50648 48330-180331--,OO.html 3. Require each new employee, employee, subcontractor, subcontractor employee or volunteer who, under this Agreement, works directly with clients or who has access to client information to notify the Grantee in writing of criminal convictions (felony or misdemeanor), pending felony charges, or placement on the Central Registry as a perpetrator, at hire or within 10 days of the event after hiring. 4. Determine whether to prohibit any employee, subcontractor, subcontractor employee, or volunteer from performing work directly with clients or accessing client information related to clients under this reported criminal felony conviction or perpetrator identification. 5. Determine whether to prohibit any employee, subcontractor, subcontractor employee or volunteer from performing work directly with children under this Agreement, based on the results of a positive CR response or reported perpetrator identification. 6. Require any employee, subcontractor, subcontractor employee or volunteer who may have access to any databases of information maintained by the federal government that contain confidential or personal information, including but not limited to federal tax information, to have a fingerprint background check performed by the Michigan State Police. II. Responsibilities - Department The Department in accordance with the general purposes and objectives of this Agreement will: A. Reimbursement Provide reimbursement in accordance with the terms and conditions of this Agreement based upon appropriate reports, records, and documentation maintained by the Grantee. B. Report Forms Provide any report forms and reporting formats required by the Department at the start date of this Agreement and provide to the Grantee any new report forms and reporting formats proposed for issuance thereafter at least 90 days prior to their required usage in order to afford the Grantee an opportunity to review. C. Notification of Modifications Notify the Grantee in writing of modifications to federal or state laws, rules and regulations affecting this Agreement. D. Identification of Laws Identify for the Grantee relevant laws, rules, regulations, policies, procedures, guidelines and state and federal manuals, and provide the Grantee with copies of these documents to the extent they are not otherwise available to the Grantee. E. Modification of Funding Notify the Grantee in writing within 30 calendar days of becoming aware of the need for any modifications in Agreement funding commitments made necessary by action of the federal government, the governor, the legislature or the Department of Technology Management and Budget on behalf of the governor or the legislature. Implementation of the modifications will be determined jointly by the Grantee and the Department. F. Monitor Compliance Monitor comnliance with all enniicahle nrovisinns contained in federal grant awards and their attendant rules, regulations and requirements pertaining to program elements covered by this Agreement. G. Technical Assistance Make technical assistance available to the Grantee for the implementation of this Agreement. H. Accreditation Adhere to the accreditation requirements including the process for "Not Accredited" Grantees. The process includes developing and monitoring consent agreements, issuing and monitoring administrative compliance orders, participating in administrative hearings and petitioning appropriate circuit courts. I. Medicaid Outreach Activities Reimbursement Agrees to reimburse the Grantee for all allowable Medicaid Outreach activities that meet the standards of the Medicaid Bulletin: MSA 05-29 including the cost allocation plan certification and that are billed in accordance with the requirements in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, the Department will identify each fiscal year the Medicaid Outreach priorities and establish a reporting requirement for the Grantee. III. Assurances The following assurances are hereby given to the Department: A. Compliance with Applicable Laws The Grantee will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this Agreement. The Grantee will also comply with all applicable general administrative requirements, such as 2 CFR 200, covering cost principles, grant/agreement principles and audits, in carrying out the terms of this Agreement. The Grantee will comply with all applicable requirements in the original grant awarded to the Department if the Grantee is a subgrantee. The Department may determine that the Grantee has not complied with applicable federal or state laws, guidelines, rules and regulations in carrying out the terms of this Agreement and may then terminate this Agreement under Part 2, Section V. B. Anti -Lobbying Act The Grantee will comply with the Anti -Lobbying Act (31 U.S.C. 1352) as revised by the Lobbying Disclosure Act of 1995 (2 U.S.C. 1601 et seq.), Federal Acquisition Regulations 52.203.11 and 52.203.12, and Section 503 of the Departments of Labor, Health & Human Services, and Education, and Related Agencies section of the current fiscal year Omnibus Consolidated Appropriations Act. Further, the Grantee must require that the language of this assurance be included in the award documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and accordingly. C. Non -Discrimination 1. The Grantee must comply with the Department's non-discrimination statement: The Michigan Department of Health and Human Services will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, height, weight, marital status, gender identification or expression, sexual orientation, partisan considerations, or a disability or genetic information that is unrelated to the person's ability to perform the duties of a particular job or position. The Grantee further agrees that every subcontract entered into for the performance of any contract or purchase order resulting therefrom, will contain a provision requiring non-discrimination in employment, activity delivery and access, as herein specified, binding upon each subcontractor. This covenant is required pursuant to the Elliot -Larsen Civil Rights Act (1976 PA 453, as amended; MCL 37.2101 et seq.) and the Persons with Disabilities Civil Rights Act (1976 PA 220, as amended; MCL 37.1101 et seq.), and any breach thereof may be regarded as a material breach of this Agreement. 2. The Grantee will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: a. Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination based on race, color or national origin; b. Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, 1685-1686), which prohibits discrimination based on sex; C. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination based on disabilities; d. The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination based on age; e. The Drug Abuse Office and Treatment Act of 1972 (P.L. 92- 255), as amended, relating to nondiscrimination based on drug abuse; f. The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 (P.L. 91-616) as amended, relating to nondiscrimination based on alcohol abuse or alcoholism; g. Sections 523 and 527 of the Public Health Service Act of 1944 (42 U.S.C. 290dd-2), as amended, relating to confidentiality of alcohol and drug abuse patient records; h. Any other nondiscrimination provisions in the specific statute(s) and, i. The requirements of any other nondiscrimination statute(s) which may apply to the application. 3. Additionally, assurance is given to the Department that proactive efforts will be made to identify and encourage the participation of minority - owned and women -owned businesses, and businesses owned by persons with disabilities in contract solicitations. The Grantee must include language in all contracts awarded under this Agreement which (1) prohibits discrimination against minority -owned and women -owned businesses and businesses owned by persons with disabilities in subcontracting; and (2) makes discrimination a material breach of contract. D. Debarment and Suspension The Grantee will comply with federal regulation 2 CFR 180 and certifies to the best of its knowledge and belief that it, its employees and its subcontractors: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or contractor; 2. Have not within a five-year period preceding this Agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) or private transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or obstruction of justice; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in section 2; 4. Have not within a five-year period preceding this Agreement had one or more public transactions (federal, state or local) terminated for cause or default; and 5. Have not committed an act of so serious or compelling a nature that it affects the Grantee's present responsibilities. E. Federal Requirement: Pro -Children Act 1. The Grantee will comply with the Pro -Children Act of 1994 (P.L. 103- 227; 20 U.S.C. 6081, et seq.), which requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted by and used routinely or regularly for the provision of health, day care, early childhood development activities, education or library federal programs either directly or through state or local governments, by federal grant, contract, loan or loan guarantee. The law also applies to children's activities that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's activities provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; activity providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where Women, Infants, and Children (WIC) coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. The Grantee also assures that this language will be included in any subawards which contain provisions for children's activities. 2. The Grantee also assures, in addition to compliance with P.L. 103-227, any activity funded in whole or in part through this Agreement will be delivered in a smoke -free facility or environment. Smoking must not be permitted anywhere in the facility, or those parts of the facility under the control of the Grantee. If activities are delivered in facilities or areas that are not under the control of the Grantee (e.g., a mall, restaurant or private work site), the activities must be smoke -free. F. Hatch Act and Intergovernmental Personnel Act The Grantee will comply with the Hatch Act (5 U.S.C. 1501-1508, 5 U.S.C. 7321-7326), and the Intergovernmental Personnel Act of 1970 (P.L. 91-648) as amended by Title VI of the Civil Service Reform Act of 1978 (P.L. 95-454). Federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally assisted programs. G. Employee Whistleblower Protections The Grantee will comply with 41 U.S.C. 4712 and must insert this clause in all subcontracts. H. Clean Air Act and Federal Water Pollution Control Act The Grantee will comply with the Clean Air Act (42 U.S.C. 7401-7671(q)) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1388), as amended. This Agreement and anyone working on this Agreement will be subject to the Clean Air Act and Federal Water Pollution Control Act and must comply with all applicable standards, orders or regulations issued pursuant to these Acts. Violations must be reported to the Department. Victims of Trafficking and Violence Protection Act The Grantee will comply with the Victims of Trafficking and Violence Protection Act of 2000 (P.L. 106-386), as amended. 106-386 and must comply with all applicable standards, orders or regulations issued pursuant to this Act. Violations must be reported to the Department. J. Procurement of Recovered Materials The Grantee will comply with section 6002 of the Solid Waste Disposal Act of 1965 (P.L. 89-272), as amended. This Agreement and anyone working on this Agreement will be subject to section 6002 of P.L. 89-272, as amended, and must comply with all applicable standards, orders or regulations issued pursuant to this act. Violations must be reported to the Department. K. Subcontracts For any subcontracted activity or product, the Grantee will ensure: 1. That a written subcontract is executed by all affected parties prior to the initiation of any new subcontract activity or delivery of any subcontracted product. Exceptions to this policy may be granted by the Department if the Grantee asks the Department in writing within 30 days of execution of the Agreement. 2. That any executed subcontract to this Agreement must require the subcontractor to comply with all applicable terms and conditions of this Agreement. In the event of a conflict between this Agreement and the provisions of the subcontract, the provisions of this Agreement will prevail. A conflict between this Agreement and a subcontract, however, will not be deemed to exist where the subcontract: a. Contains additional non -conflicting provisions not set forth in this Agreement; b. Restates provisions of this Agreement to afford the Grantee the same or substantially the same rights and privileges as the Department; or C. Requires the subcontractor to perform duties and services in less time than that afforded the Grantee in this Agreement. 3. That the subcontract does not affect the Grantee's accountability to the Department for the subcontracted activity. 4. That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5. That the Grantee will submit a copy of the executed subcontract if requested by the Department. 6. That subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $10,000 must contain provisions or conditions that will a. Allow the Grantee or Department to seek administrative, contractual or legal remedies in instances in which the subcontractor violates or breaches contract terms, and provide for such remedial action as may be appropriate. b. Provide for termination by the Grantee, including the manner by which termination will be effected and the basis for settlement. 7. That all subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government of amounts in excess of $100,000 must contain a provision that requires compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970 (42 USC 1857(h)), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738 and Environmental Protection Agency regulations (40 CFR Part 15). 8. That all subcontracts and subgrants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Grantee must include a provision: a. For compliance with the Copeland "Anti -Kickback" Act (18 U.S.C. 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b. For compliance with the Davis -Bacon Act (40 U.S.C. 276a to a- 7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). C. For compliance with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-330) as supplemented by Department of Labor regulations (29 CFR, Part 5). This provision also applies to all other contracts in excess of $2,500 that involve the employment of mechanics or laborers. L. Procurement 1. Grantee will ensure that all purchase transactions, whether negotiated or advertised, are conducted openly and competitively in accordance with the principles and requirements of 2 CFR 200. 2. Funding from this Agreement must not be used for the purchase of foreign goods or services. 3. Preference must be given to goods and services manufactured or provided by Michigan businesses, if they are competitively priced and of comparable quality. 4. Preference must be given to goods and services that are manufactured they are competitively priced and of comparable quality. 5. Records must be sufficient to document the significant history of all purchases and must be maintained for a minimum of four years after the end of the Agreement period. M. Health Insurance Portability and Accountability Act To the extent that the Health Insurance Portability and Accountability Act (HIPAA) is applicable to the Grantee under this Agreement, the Grantee assures that it is in compliance with requirements of HIPAA including the following: 1. The Grantee must not share any protected health information provided by the Department that is covered by HIPAA except as permitted or required by applicable law, or to a subcontractor as appropriate under this Agreement. 2. The Grantee will ensure that any subcontractor will have the same obligations as the Grantee not to share any protected health data and information from the Department that falls under HIPAA requirements in the terms and conditions of the subcontract. 3. The Grantee must only use the protected health data and information for the purposes of this Agreement. 4. The Grantee must have written policies and procedures addressing the use of protected health data and information that falls under the HIPAA requirements. The policies and procedures must meet all applicable federal and state requirements including the HIPAA regulations. These policies and procedures must include restricting access to the protected health data and information by the Grantee's employees. 5. The Grantee must have a policy and procedure to immediately report to the Department any suspected or confirmed unauthorized use or disclosure of protected health information that falls under the HIPAA requirements of which the Grantee becomes aware. The Grantee will work with the Department to mitigate the breach and will provide assurances to the Department of corrective actions to prevent further unauthorized uses or disclosures. The Department may demand specific corrective actions and assurances and the Grantee must provide the same to the Department. 6. Failure to comply with any of these contractual requirements may result in the termination of this Agreement in accordance with Part 2, Section V. 7. In accordance with HIPAA requirements, the Grantee is liable for any claim, loss or damage relating to unauthorized use or disclosure of protected health data and information, including without limitation the Department's costs in responding to a breach, received by the Grantee 8. The Grantee will enter into a business associate agreement should the Department determine such an agreement is required under HIPAA. N. Home Health Services If the Grantee provides Home Health Services (as defined in Medicare Part B), the following requirements apply: 1. The Grantee must not use State ELPHS or categorical grant funds provided under this Agreement to unfairly compete for home health services available from private providers of the same type of services in the Grantee's service area. 2. For purposes of this Agreement, the term "unfair competition" will be defined as offering of home health services at fees substantially less than those generally charged by private providers of the same type of services in the Grantee's area, except as allowed under Medicare customary charge regulations involving sliding fee scale discounts for low-income clients based upon their ability to pay. 3. If the Department finds that the Grantee is not in compliance with its assurance not to use state ELPHS and categorical grant funds to unfairly compete, the Department will follow the procedure required for failure by local health departments to adequately provide required services set forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15 (2497) and (2498). O. Website Incorporation The Department is not bound by any content on Grantee's website or other internet communication platforms or technologies, unless expressly incorporated directly into this Agreement. The Department is not bound by any end user license agreement or terms of use unless specifically incorporated in this Agreement or any other agreement signed by the Department. The Grantee must not refer to the Department on the Grantee's website or other internet communication platforms or technologies without the prior written approval of the Department. P. Survival The provisions of this Agreement that impose continuing obligations will survive the expiration or termination of this Agreement. Q. Non -Disclosure of Confidential Information 1. The Grantee agrees that it will use confidential information solely for the purpose of this Agreement. The Grantee agrees to hold all confidential information in strict confidence and not to copy, reproduce, sell, transfer or otherwise dispose of, give or disclose such confidential information to third parties other than employees, agents, or subcontractors of a party who have a need to know in connection with this Agreement or to use performance of this Agreement. The Grantee must take all reasonable precautions to safeguard the confidential information. These precautions must be at least as great as the precautions the Grantee takes to protect its own confidential or proprietary information. 2. Meaning of Confidential Information For the purpose of this Agreement the term "confidential information" means all information and documentation that: a. Has been marked "confidential" or with words of similar meaning, at the time of disclosure by such party; b. If disclosed orally or not marked "confidential" or with words of similar meaning, was subsequently summarized in writing by the disclosing party and marked "confidential" or with words of similar meaning; C. Should reasonably be recognized as confidential information of the disclosing party; d. Is unpublished or not available to the general public; or e. Is designated by law as confidential. 3. The term "confidential information" does not include any information or documentation that was: a. Subject to disclosure under the Michigan Freedom of Information Act (FOIA); b. Already in the possession of the receiving party without an obligation of confidentiality; C. Developed independently by the receiving party, as demonstrated by the receiving party, without violating the disclosing party's proprietary rights; d. Obtained from a source other than the disclosing party without an obligation of confidentiality; or e. Publicly available when received or thereafter became publicly available (other than through an unauthorized disclosure by, through or on behalf of, the receiving party). 4. The Grantee must notify the Department within one business day after discovering any unauthorized use or disclosure of confidential information. The Grantee will cooperate with the Department in every way possible to regain possession of the confidential information and prevent further unauthorized use or disclosure. R. Cap on Salaries None of the funds awarded to the Grantee through this Agreement will be used to pay, either through a grant or other external mechanism, the salary of an individual at a rate in excess of Executive Level II. The current rates of pay for Management web site, http://www.opm.gov, by navigating to Policy — Pay & Leave — Salaries & Wages. The salary rate limitation does not restrict the salary that a Grantee may pay an individual under its employment; rather, it merely limits the portion of that salary that may be paid with funds from this Agreement. IV, Financial Requirements A. Operating Advance Under the pre -payment reimbursement method, no additional operating advances will be issued. B. Payment Method 1. Prepayments a. The Department will make monthly prepayments equal to 1/12th of the Agreement amount for each non -fee -for -service program contained in Attachment IV of this Agreement. One single payment covering all non -fee -for -service programs will be made within the first week of each month. The Grantee can view their monthly prepayment within the MI E-Grants system. b. Prepayments for the months of October thru January will be based upon the initial Agreement amounts in Attachment IV. Subsequent monthly prepayments may be adjusted based upon Agreement amendments or Grantee adjustment requests. C. If the sum of the prepayments does not equal at least 90% of the Grantee's expenditures for a quarter of the contract period, the Grantee may submit documentation for an adjustment to the monthly prepayment amount via the following process: i. Submit a written request for the adjustment to the Department's Accounting Expenditure Operations Division. ii. The adjustment request must be itemized by program and must list the amount received from the Department, the expenditure amount reported per the quarterly Financial Status Report (FSR), and the difference. The amount received from the Department and the expenditures must be for the same reporting quarterly FSR period. iii. The Department will review the requests and if an adjustment is approved, it will be included in the next scheduled monthly prepayment. iv. Adjustment requests will not be accepted prior to submission of the FSR for the quarter ending December 31. No adjustments will be made prior to the February monthly prepavment. v. The ability of the Department to approve adjustments may be limited by the quarterly allotments of spending authority in the Department's appropriation account mandated by the Office of the State Budget Director. The quarterly allotment limits the amount of each account (program) that the Department may expend during each fiscal quarter. 2. Fixed Fee Reimbursement a. Quarterly reimbursement for fixed fee projects is based on Attachment IV and approved quarterly Financial Status Reports. C. Financial Status Report Submission 1. The Grantee must electronically prepare and submit FSRs to the Department via the EGrAMS website (http://egrams-mi.com/mdhhs). A Financial Status Report (FSR) must be submitted on a quarterly basis no later than 30 days after the close of the calendar quarter for all programs listed on Attachment IV and fee for services project budgeted. Failure to meet financial reporting responsibilities as identified in this Agreement may result in withholding future payments. 2. FSR's must report total actual program expenditures regardless of the source of funds. The Department will reimburse the Grantee for expenditures in accordance with the terms and conditions of this Agreement. Failure to comply with the reporting due dates will result in the deferral of the Grantee's monthly prepayment. 3. The Grantee representative who submits the FSR is certifying to the best of their knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements, and cash receipts are for the purposes and objectives set forth in the terms and conditions of this Agreement. The individual submitting the FSR should be aware that any false, fictitious, or fraudulent information, or the omission of any material facts, may subject them to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. 4. The instructions for completing the FSR form are available on the website http://egrams-mi.com/dch. Send FSR questions to FSRMDHHS@michigan.gov. D. Reimbursement Method The Grantee will be reimbursed in accordance with the reimbursement methods for applicable program elements described as follows: 1. Performance Reimbursement - A reimbursement method by which Grantees are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of state funds. Any local funds used to support program elements operated under such provisions of this Agreement may be transferred by the Grantee within, among, to or from the affected elements without Department approval, subject to applicable provisions of Sections 3.13. and 3.C.3 of Part 1. If Grantee's performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation will be reduced equivalent to actual performance in relation to the minimum performance. 2. Actual Cost Reimbursement - A reimbursement method by which Grantees are reimbursed based upon the understanding that state dollars will be paid up to total costs in relation to the state's share of the total costs and up to the total state allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable as a source before any local funding requirement unless a specific local match condition exists. 3. Fixed Unit Rate Reimbursement - A reimbursement method by which Grantee is reimbursed a specific amount for each output actually delivered and reported. 4. Essential Local Public Health Services (ELPHS) - A reimbursement method by which Grantees are reimbursed a share of reasonable and allowable costs incurred for required services, as noted in the current Appropriations Act. E. Reimbursement Mechanism All Grantees must sign up through the on-line vendor registration process to receive all State of Michigan payments as Electronic Funds Transfers (EFT)/Direct Deposits. Vendor registration information is available through the Department of Technology, Management and Budget's web site: http://www.michigan.gov/sigmayss F. Unobligated Funds Any unobligated balance of funds held by the Grantee at the end of the Agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. G. Final Obligation Reporting Requirements An Obligation Report, based on annual guidelines, must be submitted by the due date using the format provided by the Department through MI E-Grants. The Grantee must provide, by program, an estimate of total expenditures for the entire Agreement period (October 1 through September 30). This report must represent the Grantee's best estimate of total program expenditures for the Agreement period. The information on the report will be used to record the Department's year-end accounts payables and receivables by program for this Agreement. The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this Agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Grantee in the monthly prepayments and quarterly fee -for -service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of Agreement amendments, the Grantee may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of a program at fiscal year-end. Within 60 days after the Agreement fiscal year-end, the Grantee must liquidate any unpaid year-end commitments and obligations. Any obligation remaining unliquidated after 60 days from the end of the Agreement period will revert to the Department for disposition in accordance with applicable state and/or federal requirements, except as specifically authorized in writing by the Department. H. Final Financial Status Reporting Requirements Final FSRs are due on the following dates following the Agreement period end date: Project Final FSR Due Date Public Health Emergency Preparedness 11/15/2023 All Remaining Projects 11 /30/2023 Upon receipt of the final FSR electronically through MI E-Grants, the Department will determine by program, if funds are owed to the Grantee or if the Grantee owes funds to the Department. If funds are owed to the Grantee, payment will be processed. However, if the Grantee underestimated their year-end obligations in the Obligation Report as compared to the final FSR and the total reimbursement requested does not exceed the Agreement amount that is due to the Grantee, the Department will make every effort to process full reimbursement to the Grantee per the final FSR. Final payment may be delayed pending final disposition of the Department's year-end obligations. If funds are owed to the Department, it will generally not be necessary for Grantee to send in a payment. Instead, the Department will make the necessary entries to offset other payments and as a result the Grantee will receive a net monthly prepayment. When this does occur, clarifying documentation will be provided to the Grantee by the Department's Bureau of Finnnra and Arrnunfinn I. Penalties for Reporting Noncompliance For failure to submit the final total Grantee FSR report by November 30, through MI E-Grants after the Agreement period end date, the Grantee may be penalized with a one-time reduction in their current ELPHS allocation for noncompliance with the fiscal year-end reporting deadlines. Any penalty funds will be reallocated to other Local Health Department Grantees. Reductions will be one-time only and will not carryforward to the next fiscal year as an ongoing reduction to a Grantee's ELPHS allocation. Penalties will be assessed based upon the submitted date in MI E-Grants: ELPHS Penalties for Noncompliance with Reporting Requirements: 1. 1 % - 1 day to 30 days late; 2. 2% - 31 days to 60 days late; 3. 3% - over 60 days late with a maximum of 3% reduction in the Grantee's ELPHS allocation. J. Indirect Costs and Cost Allocations/Distribution Plans The Grantee is allowed to use approved federal indirect rate, 10% de minimis indirect rate or cost allocation/distribution plans in their budget calculations. 1. Costs must be consistently charged as indirect, direct or cost allocated, but may not be double charged or inconsistently charged. 2. If the Grantee does not have an existing approved federal indirect rate, they may use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 to recover their indirect costs. 3. Grantees using the cost allocation/distribution method must develop certified plan in accordance with the requirements described in Title 2 CFR, Part 200 which includes detailed budget narratives and is retained by the Grantee and subject to Department review. 4. There must be a documented, well-defined rationale and audit trail for any cost distribution or allocation based upon Title 2 CFR, Part 200 Cost Principles and subject to Department review. V. Agreement Termination This Agreement may be terminated without further liability or penalty to the Department for any of the following reasons: A. By either party by giving 30 days written notice to the other party stating the reasons for termination and the effective date. B. By either party with 30 days written notice upon the failure of either party to carry out the terms and conditions of this Agreement, provided the alleged defaulting party is given notice of the alleged breach and fails to cure the default within the 30-day period. C. Immediately if the Grantee or an official of the Grantee or an owner is convicted of any activity referenced in Part 2 Section III. D. of this Agreement durina the term of this Anreement or anv extension therenf_ Further, this Agreement may be terminated or modified immediately upon a finding by the Department in accordance with MCL 333.2235 that the Grantee local health department for the delivery of public health services under this Agreement is unable or unwilling to provide any or all of the services as provided in this Agreement, and the Department may redirect funds as necessary to ensure that the public health services are provided within the Grantee's jurisdiction. VI. Stop Work Order The Department may suspend any or all activities under this Agreement at any time. The Department will provide the Grantee with a written stop work order detailing the suspension. Grantee must comply with the stop work order upon receipt. The Department will not pay for activities, Grantee's incurred expenses or financial losses, or any additional compensation during a stop work period. VII. Final Reporting upon Termination Should this Agreement be terminated by either party, within 30 days after the termination, the Grantee must provide the Department with all financial, performance and other reports required as a condition of this Agreement. The Department will make payments to the Grantee for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Grantee must immediately refund to the Department any funds not authorized for use and any payments or funds advanced to the Grantee in excess of allowable reimbursable expenditures. Vill. Severability If any part of this Agreement is held invalid or unenforceable by any court of competent jurisdiction, that part will be deemed deleted from this Agreement and the severed part will be replaced by agreed upon language that achieves the same or similar objectives. The remaining parts of the Agreement will continue in full force and effect. IX. Amendments A. Except as otherwise provided, any changes to this Agreement will be valid only if made in writing and accepted by all parties to this Agreement. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Grantee's or Department's control, which reduce or otherwise interfere with the Grantee's or Department's ability to provide or maintain specified services or operational procedures, immediate written notification must be provided to the other party. Any change proposed by the Grantee which would affect the state funding of any project, in whole or in part as provided in Part 1, Section 3.C. of the Agreement, must be submitted in writing to the Department for approval immediately upon determining the need for such change. The proposed change may be implemented upon receipt of written notification from the Department. B. Except as otherwise provided, amendments to this Agreement will be made Grantee. Amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the Agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Grantee, in writing, at any time prior to June 7. The Department will provide a written response within 30 calendar days. All amendments must be submitted to the Department within three weeks of receipt through MI E-Grants to assure the amendment can be executed prior to the end of the Agreement period. X. Liability A. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as direct service delivery, by the Grantee, Grantee's subcontractors or anyone directly or indirectly employed by the Grantee in the performance of this Agreement will be the responsibility of the Grantee, and not the responsibility of the Department. Nothing herein will be construed as a waiver of any governmental immunity that has been provided to the Grantee or its employees by law. B. In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Grantee and the Department in fulfillment of their responsibilities under this Agreement, such liability, loss, or damage will be borne by the Grantee and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein will be construed as a waiver of any governmental immunity by the Grantee, the state, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. XI. Waiver Failure to enforce any provision of this Agreement will not constitute a waiver. Any clause or condition of this Agreement found to be an impediment to the intended and effective operation of this Agreement may be waived in writing by the Department or the Grantee, upon presentation of written justification by the requesting party. Such waiver may be temporary or for the life of the Agreement and may affect any or all program elements covered by this Agreement. XI I. State of Michigan Agreement This Agreement is governed, construed, and enforced in accordance with Michigan law, excluding choice -of -law principles, and all claims relating to or arising out of this Agreement are governed by Michigan law, excluding choice -of -law principles. Any dispute arising from this Agreement must be resolved in the Michigan Court of Claims. Complaints against the State must be initiated in Ingham County, Michigan. Grantee Nnraivac Anv nhiarfinns m ich ac lack of narsnnal h iricriirrfinn nr fnn im nnn cnnvanianc Grantee must appoint an agent in Michigan to receive service of process. XIII. Funding A. State funding for this Agreement will be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds will be as stated in the approved Annual Budget - Attachment I Instructions for the Annual Budget, Attachment III, Program Specific Assurances and Requirements, and as outlined in Attachment IV, Funding/Reimbursement Matrix. B. The funding provided through the Department for this Agreement will not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Grantee must advise the Department in writing by May 1, if the amount of Department funding may not be used in its entirety or appears to be insufficient for any program element. ELPHS transfer requests between MDHHS, MDARD and MDEQ must also be requested in writing by May 1. All ELPHS required services must be maintained throughout the entire period of the Agreement. C. The Department may periodically redistribute funds between agencies during the Agreement period in order to ensure that funds are expended to meet the varying needs for services. AA Attachments Al Attachment I - Instructions for the Annual Budget A2 Attachment III - Program Specific Assurances and Requirements Attachment IV Notes Summary of Budget Source of Funds