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HomeMy WebLinkAboutResolutions - 2022.12.08 - 37786 AGENDA ITEM: Grant Amendment #1 from the Michigan Department of Health and Human Services to the FY 2023 Local Health Department Emerging Threats Agreement 22-418 COMMITTEE MEETING: Board of Commissioners DATE: Thursday, December 8, 2022 9:52 AM - Click to View Agenda ITEM SUMMARY SHEET DEPARTMENT SPONSORED BY Health & Human Services - Health Division Penny Luebs INTRODUCTION AND BACKGROUND This is a request to accept amendment #1 to the FY 2023 Emerging Threats Local Health Department Agreement from the Michigan Department of Health and Human Services, which decreases the total amount of the agreement from $10,835,066 to $6,329,816. The original agreement was adopted by the Board of Commissioners on September 29, 2022 via Miscellaneous Resolution #22328. BUDGET AMENDMENT REQUIRED: Yes Committee members can contact Michael Andrews, Policy and Fiscal Analysis Supervisor at 248.858.5115 (office) or andrewsmb@oakgov.com, or the department contact persons listed for additional information. CONTACT Leigh-Anne Stafford, Director Health & Human Services-APP staffordl@oakgov.com ITEM REVIEW TRACKING Penny Luebs, Created/Initiated - 12/8/2022 David Woodward, Board of Commissioners Approved - 12/8/2022 Hilarie Chambers, Executive's Office Approved - 12/9/2022 Lisa Brown, Clerk/Register of Deeds Final Approval - 12/13/2022 AGENDA DEADLINE: 12/08/2022 11:15 AM COMMITTEE TRACKING 2022-11-29 Public Health & Safety - Recommend and Forward to Finance 2022-11-30 Finance - Recommend to Board 2022-12-08 Full Board - Adopted ATTACHMENTS 1. PH&S - Health FY2023 Emerging Threats #1_Schedule A 2. Grant Review Sign-Off 3. Att I 4. ATT III 5. ATT IV 6. Draft Contract December 8, 2022 RESOLUTION #2022-2296 _ 22-418 Sponsored By: Penny Luebs Health & Human Services - Health Division - Grant Amendment #1 from the Michigan Department of Health and Human Services to the FY 2023 Local Health Department Emerging Threats Agreement Chairperson and Members of the Board: WHEREAS Oakland County Health Division has received Amendment #1 to the Michigan Department of Health and Human Services (MDHHS) Fiscal Year (FY) 2023 Emerging Threats Local Health Department, and WHEREAS the original agreement amount of $10,835,066 was approved by the BOC on September 29, 2022, via resolution #22-328; and WHEREAS Amendment #1 decreases the total amount of the agreement from $10,835,066 to $6,329,816 for the period October 1, 2022 to September 30, 2023, a net decrease of $4,509,190; and WHEREAS Amendment #1 reflects a decrease in funding for COVID-19 immunizations and additional funding in the amount of $3,940 to assist with home visiting programs responding to immediate needs resulting from the impact of COVID-19; and WHEREAS no positions are impacted and the County match is not required; and WHEREAS Amendment #1 has completed the Grant Review Process in accordance with the Grants Policy approved by the Board of Commissioners at their January 21, 2021, meeting. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves Amendment #1 to the Fiscal Year 2023 Emerging Threats Local Health Department Agreement in the amount of $6,329,816 for the period of October 1, 2022, through September 30, 2023. BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the county to any future commitment and continuation of this program is contingent upon continued future levels of grant funding. BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute this agreement and to approve any grant extensions or changes, within fifteen percent (15%) of the original award, which is consistent with the agreement as originally approved. BE IT FURTHER RESOLVED that the budget is amended as detailed in the attached Schedule A budget amendment. Chairperson, the following Commissioners are sponsoring the foregoing Resolution: Penny Luebs. Date: December 08, 2022 David Woodward, Commissioner Date: December 09, 2022 Hilarie Chambers, Deputy County Executive II Date: December 13, 2022 Lisa Brown, County Clerk / Register of Deeds COMMITTEE TRACKING 2022-11-29 Public Health & Safety - Recommend and Forward to Finance 2022-11-30 Finance - Recommend to Board 2022-12-08 Full Board - Adopted VOTE TRACKING Motioned by Commissioner Penny Luebs seconded by Commissioner Karen Joliat to adopt the attached Grant Amendment: #1 from the Michigan Department of Health and Human Services to the FY 2023 Local Health Department Emerging Threats Agreement. Yes: David Woodward, Michael Gingell, Michael Spisz, Karen Joliat, Kristen Nelson, Eileen Kowall, Christine Long, Philip Weipert, Gwen Markham, Angela Powell, Chuck Moss, Marcia Gershenson, William Miller III, Yolanda Smith Charles, Charles Cavell, Penny Luebs, Janet Jackson, Gary McGillivray, Robert Hoffman, Adam Kochenderfer (20) No: None (0) Abstain: None (0) Absent: (0) Passed ATTACHMENTS 1. PH&S - Health FY2023 Emerging Threats #1_Schedule A 2. Grant Review Sign-Off 3. Att I 4. ATT III 5. ATT IV 6. Draft Contract STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on December 8, 2022, with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court at Pontiac, Michigan on Thursday, December 8, 2022. Lisa Brown, Oakland County Clerk / Register of Deeds Oakland County, Michigan HEALTH AND HUMAN SERVICES DEPARTMENT/HEALTH DIVISION - FY 2023 EMERGING THREATS LOCAL HEALTH DEPARTMENT AGREEMENT AMENDMENT #1 Schedule "A" DETAIL R/E Fund Name Division Name Fund # (FND)Cost Center (CCN) # Account # (RC/SC) Program # (PRG)Grant ID (GRN) # Project ID # (PROJ) Region (REG) Budget Fund Affiliate (BFA) Ledger Account Summary Account Title FY 2023 Amendment FY 2024 Amendment FY 2025 Amendment R Human Services Grants Health FND11007 CCN1060201 RC610313 PRG133095 GRN-1003904 610000 Federal Operating Grants $3,940 $-$- Total Revenues $3,940 $-$- E Human Services Grants Health FND11007 CCN1060201 SC702010 PRG133095 GRN-1003904 702000 Salaries $-$-$- E Human Services Grants Health FND11007 CCN1060201 SC722740 PRG133095 GRN-1003904 722000 Fringe Benefits --- E Human Services Grants Health FND11007 CCN1060201 SC730926 PRG133095 GRN-1003904 730000 Indirect Costs --- E Human Services Grants Health FND11007 CCN1060201 SC731346 PRG133095 GRN-1003904 730000 Personal Mileage 3,940 -- E Human Services Grants Health FND11007 CCN1060201 SC732018 PRG133095 GRN-1003904 730000 Travel and Conference --- E Human Services Grants Health FND11007 CCN1060201 SC731997 PRG133095 GRN-1003904 730000 Client Transportation --- E Human Services Grants Health FND11007 CCN1060201 SC750245 PRG133095 GRN-1003904 750000 Incentives --- E Human Services Grants Health FND11007 CCN1060201 SC774677 PRG133095 GRN-1003904 770000 Insurance Fund --- E Human Services Grants Health FND11007 CCN1060201 SC774636 PRG133095 GRN-1003904 770000 IT Operations --- E Human Services Grants Health FND11007 CCN1060201 SC778675 PRG133095 GRN-1003904 770000 Telephone Communications --- Total Expenditures $3,940 $-$- R Human Services Grants Health FND11007 CCN1060201 RC610313 PRG133095 GRN-1003905 610000 Federal Operating Grants $(4,509,190)$-$- Total Revenues $(4,509,190)$-$- E Human Services Grants Health FND11007 CCN1060201 SC702010 PRG133095 GRN-1003905 702000 Salaries $(1,730,769)$-$- E Human Services Grants Health FND11007 CCN1060201 SC722740 PRG133095 GRN-1003905 722000 Fringe Benefits (780,057)-- E Human Services Grants Health FND11007 CCN1060201 SC730926 PRG133095 GRN-1003905 730000 Indirect Costs (239,192)-- E Human Services Grants Health FND11007 CCN1060201 SC731346 PRG133095 GRN-1003905 730000 Personal Mileage (31,250)-- E Human Services Grants Health FND11007 CCN1060201 SC750399 PRG133095 GRN-1003905 750000 Office Supplies (2,951)-- E Human Services Grants Health FND11007 CCN1060201 SC750077 PRG133095 GRN-1003905 750000 Disaster Supplies (18,000)-- E Human Services Grants Health FND11007 CCN1060201 SC750294 PRG133095 GRN-1003905 750000 Material and Supplies (5,000)-- E Human Services Grants Health FND11007 CCN1060201 SC731388 PRG133095 GRN-1003905 730000 Printing (20,000)-- E Human Services Grants Health FND11007 CCN1060201 SC750301 PRG133095 GRN-1003905 750000 Medical Supplies (3,000)-- E Human Services Grants Health FND11007 CCN1060201 SC731626 PRG133095 GRN-1003905 730000 Rent (200,000)-- E Human Services Grants Health FND11007 CCN1060201 SC731458 PRG133095 GRN-1003905 730000 Professional Services (856,396)-- E Human Services Grants Health FND11007 CCN1060201 SC730072 PRG133095 GRN-1003905 730000 Advertising (4,000)-- E Human Services Grants Health FND11007 CCN1060201 SC731059 PRG133095 GRN-1003905 730000 Laundry & Cleaning (200)-- E Human Services Grants Health FND11007 CCN1060201 SC730982 PRG133095 GRN-1003905 730000 Interpreter Fees (500)-- E Human Services Grants Health FND11007 CCN1060201 SC731997 PRG133095 GRN-1003905 730000 Transportation of Clients (875)-- E Human Services Grants Health FND11007 CCN1060201 SC774636 PRG133095 GRN-1003905 770000 IT Operations (374,000)-- E Human Services Grants Health FND11007 CCN1060201 SC778675 PRG133095 GRN-1003905 770000 Telephone Communications (243,000)-- Total Expenditures $(4,509,190)$-$- GRANT REVIEW SIGN-OFF – Health & Human Services / Health Division GRANT NAME: FY 2023 Emerging Threat Local Health Department Agreement FUNDING AGENCY: Michigan Department of Health & Human Services DEPARTMENT CONTACT: Raquel Lewis 248-858-5254 STATUS: Grant Amendment #1 (Greater than 15% of Award) DATE: 11/16/2022 Please be advised the captioned grant materials have completed internal grant review. Below are the returned comments. The Board of Commissioners’ liaison committee resolution and grant amendment package (which should include this sign-off and the grant amendment with related documentation) may be requested to be placed on the agenda(s) of the appropriate Board of Commissioners’ committee(s) for grant amendment by Board resolution. DEPARTMENT REVIEW Management and Budget: Approved. Fiscal Services – Sheryl Johnson (11/14/2022) Human Resources: Approved by Human Resources. No position implications. – Heather Mason (11/14/2022) Risk Management: As long as document ATT III is not applicable to this grant Risk Management has no objection to it moving forward and approves. Robert Erlenbeck (11/16/2022) Corporation Counsel: There are no legal issues with the amendment. Sharon Kessler – (10/31/2022) ATTACHMENT I MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Local Health Department Agreement October 1, 2022- September 30, 2023 Fiscal Year 2023 INSTRUCTIONS FOR THE ANNUAL BUDGET 1 INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES TABLE OF CONTENTS Page I.INTRODUCTION ............................................................................................................ 2 II.MINIMUM BUDGETING REQUIREMENTS ................................................................... 2 III.REIMBURSEMENT CHART ........................................................................................... 3 IV.LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES .............................................................................................................. 3 V.FORM PREPARATION - GENERAL .............................................................................. 4 VI.FORM PREPARATION - EXPENDITURE CATEGORIES ............................................. 4 VII.FORM PREPARATION - SOURCE OF FUNDS ............................................................. 6 VIII.SPECIAL BUDGET INSTRUCTIONS A. Public Health Emergency Preparedness (PHEP) .................................................... 9 B. Program Budget Detail- Cost Detail Schedule Preparation .................................... 10 C. Immunization 317 and VFC Allowable Expenditures ............................................ 18 2 INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH SERVICES I.INTRODUCTION The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs’ funding and Essential Local Public Health Services (ELPHS) (formerly known as the local public health operation’s funding) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. II.MINIMUM BUDGETING REQUIREMENTS A.Cost Principles - Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. B.Federal Block Grant Funds - Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (other than minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. C.Expenditure and 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 Program 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). 3 III.REIMBURSEMENT CHART A.Program Element/Funding Source The Program Element/Funding Source column has been moved to Attachment III and provides the listing of all currently funded MDHHS programs that are included in the Comprehensive Local Health Department Agreement. B.Type of Project The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Research and development (R&D) means all research activities, both basic and applied, and all development activities that are performed by non-Federal entities. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. C.Reimbursement Chart The Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures 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. 4 V. FORM PREPARATION - GENERAL The MI E-Grants System on-line application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Grantee. The system is designed to accommodate any number of local program elements including those unique to a particular local Grantee. Applications, including budget forms, are completed for all program elements, regardless of the reimbursement mechanism, including Agency administration(s) fee for service program elements, categorical program elements, performance- based program elements and Medicaid Outreach associated program elements. Budget entry is required for each major expenditure and source of fund categories for which costs/funds are identified. VI. FORM PREPARATION - EXPENDITURE CATEGORIES Budgeted expenditures are to be entered for each program element, project or group of services by applicable major category. A. Salaries and Wages- 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 5 other approved travel costs incurred by the employee. Travel of private, non-employee consultants should be reported under Other Expenses. G.Communication Costs - These are costs for telephone, Internet, telegraph, data lines, websites, fax, email, etc., when related directly to the operation of the program element. H.County/City Central Services - These are costs associated with central support activities of the local governing unit allocated to the local health department in accordance with Title 2 CFR, part 200. I.Space Costs - These are costs of building space necessary for the operation of the program. J.All Others (Line 11) - These are costs for all other items purchased exclusively for the operation of the program element and not appropriately included in any of the other categories including items such as repairs, janitorial services, consultant services, vendor services, equipment rental, insurance, Automated Data Processing (ADP) systems, etc. K.Total Direct Expenditures – The MI E-Grants System sums the direct expenditures budgeted for each program element, project or service grouping and records in the Total Direct Expenditure line of the Budget Summary. L.Indirect Cost – These cost categories are used to distribute costs of general administrative operations that have not been directly charged to individual subrecipient programs. The Indirect Cost expenditures distribute administrative overhead costs to each program element, project or service grouping. Two separate local rates may apply to the agreement period (i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter part. Indirect costs are not allowed on programs elements designated as vendor relationship. An indirect rate proposal and related supporting documentation must be retained for audit in accordance with records retention requirements. In addition, these documents are reviewed as part of the Single Audit, subrecipient monitoring visit, or other State of Michigan reviews. Following is further clarification regarding indirect rate and/or cost allocation approval requirements to distribute administrative overhead costs, in accordance with Title 2 CFR Part 200 (formerly Circular A-87 2 CFR Part 225, Appendix E), for Local Health Departments budgeting indirect costs: 1.Local Health Departments 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 MI E-Grants Grantee Profile. 4.Local Health Departments with cost allocation plans should reflect these allocations in the Other Cost Distributions budget category. See Section M. Other Cost Distribution for budgeting guidance. 5.As a Subrecipient of federal funds from MDHHS, a Local Health Department that has 6 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 Budget 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 any cost distribution or allocation based upon Title 2 CFR, Part 200 Cost Principles Local Health Departments using the cost distribution or cost allocation must develop the plan in accordance with the requirements described in Title 2 CFR, Part 200. Local Health Departments should maintain supporting documentation for audit in accordance with record retention requirements. The plan should include a Certification of Cost Allocation plan in accordance with Title 2 CFR, Part 200 Appendix V. The cost allocation plan documentation is not required to be submitted unless specifically requested. Cost associated with the Essential Local Public Health Services (ELPHS), Maternal and Child Health (MCH) Block Grant and Fixed Fee may be budgeted in the associated program element and distributed to the associated projects. Federal Provided Vaccine Value should be reported on a separate line and clearly identified. N. Total Direct & Admin. Expenditures – The MI E-Grants System sums the indirect expenditures program element and records in the Total Indirect Expenditure line of the Budget Summary. O. Total Expenditures – The MI E-Grants System sums the direct and indirect expenditures and records in the Total Expenditure line of the Budget Summary. VII. FORM PREPARATION - SOURCE OF FUNDS Source of Funds are to be entered for each program element, project or group of services by applicable major category as follows: 7 A. Fees & Collections - Fees 1st & 2nd Party– i. 1st 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 Funding (Non-MDHHS) - Funds received directly from the federal government and from any state Contractor other than MDHHS, such as the Department of Natural Resources and Environment (MDNRE). This line should also be used to exclude state aid funds such as those provided through the Michigan Department of Treasury under P.A. 264 of 1987 (cigarette tax). D. Federal Cost Based Reimbursement – Funds received for Federal Cost Based Reimbursement which should be budgeted in the program in which they were earned. E. Federally Provided Vaccines – The projected value of federally provided vaccine. F. Federal Medicaid Outreach – (Please note: to be used only for Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership Medicaid Outreach program elements.) Funds projected to be received from the federal government for allowable Medicaid Outreach activities. This amount represents the anticipated 50% federal administrative match of local contributions. G. Required Match - Local – Funds projected to be local contribution for programs that have a match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) H. Local Non-ELPHS - Local funds budgeted for the following expenditures: 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 for the principal purpose 8 of providing required and allowable health services at free or reduced cost to the public served by the Grantee. An example would be keeping fees for services at a reduced level for the benefit of the people served by the Grantee while recognizing that to do so limits recovery from third parties for the same types of services. 3. Contributions to a contingency reserve or any similar provisions for unforeseen events. 4. Charitable contributions and donations. 5. Salaries and other incidental expenditures of the chief executive of a political subdivision (i.e., county executive and mayor). 6. Legislative expenditures, such as, salaries and other incidental expenditures of local governing bodies (i.e., county commissioners and city councils). Do not enter board of health expenses. 7. Expenditures for amusements, social activities and other incidental expenditures related to, such as, meals, beverages, lodging, rentals, transportation and gratuities. 8. Fines, penalties and interest on borrowings. 9. Capital Expenditures - Local capital outlay for purchase of facilities and equipment (assets) are excluded from ELPHS funding. I. Other Non- ELPHS - Funds budgeted from sources other than state, federal and local appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local substance abuse coordinating grantee, local area on aging grantees). J. MDHHS - NON-COMPREHENSIVE - Funds budgeted for services provided under separate MDHHS agreements. Examples include funding provided directly by the Community Services for Substance Abuse for community grants, etc. K. MDHHS - COMPREHENSIVE - This section includes all funding projected to be due under the Comprehensive Agreement from categorical programs and needs to equal the allocation. L. ELPHS - MDHHS Hearing – This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Hearing program and has to equal the MDHHS ELPHS Hearing allocation. Additional ELPHS to be budgeted for the Hearing Program must be entered into ELPHS – MDHHS Other. Hearing allocations may only be spent on the Hearing Program. M. ELPHS - MDHHS Vision – This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Vision program and has to equal the ELPHS MDHHS Vision allocation. Additional ELPHS to be budgeted for the Vision Program must be entered into ELPHS – MDHHS Other. Vision allocations may only be spent on the Vision Program. N. ELPHS – MDHHS Other – This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS MDHHS Other program for eligible program elements. Please note: The MI E-Grants System validates the ELPHS MDHHS Other budgeted funds across the applicable program elements to assure the agreement does exceed the ELPHS – MDHHS Other allocation. O. ELPHS – Food - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS Food program and has to equal the ELPHS Food allocation. P. ELPHS – Drinking Water - This section includes all funding projected to be due under 9 Comprehensive Agreement specific to the ELPHS Drinking Water program and has to equal the ELPHS Drinking Water allocation. Q. ELPHS – On-site Sewage - This section includes all funding projected to be due under Comprehensive Agreement specific to the ELPHS On-site Sewage program and has to equal the ELPHS On-site Sewage allocation. R. MCH Funding - This section includes all funding projected to be due under Comprehensive Agreement specific to the MCH eligible program elements. Please note: The MI E-Grants System validates the MCH budgeted funds across applicable program elements to assure the agreement does exceed the MCH allocation. S. Local Funds - Other - Enter all local support in the appropriate element, project or service group column. This may include local property tax, and other local revenues (does not include fees). T. Inkind Match – Enter Local Support from donated time or services. U. MDHHS Fixed Unit Rate – Select the type of fee-for-services from the lookup to correspond with the program element. VIII. SPECIAL BUDGET INSTRUCTIONS Certain elements are supported by federal or other categorical program funds for which special budgeting requirements are placed upon grantees and subgrantees. These include: Element Federal or Other Funding Contractor Public Health Emergency Preparedness U.S. Department of Health & Human Services, Centers for Disease Control 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 Emergency Preparedness (PHEP) Special Budget Requirements Local Health Departments will receive the initial FY 21/22 allocation of the CDC Public Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period October 1, 2021 through June 30, 2022. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE Local Health Department program elements: 1. Public Health Emergency Preparedness (PHEP) (October 1 – June 30) 2. Public Health Emergency Preparedness (PHEP)– Cities of Readiness (October 1 – June 30) 3. Laboratory Services - Bioterrorism (October 1 – September 30) Costs Allowable Only With Prior Approval - The following costs are allowable only withprior review/approval of the Michigan Department of Health & Human Services as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR 10 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 Systems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B. Capital Expenditures of $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. Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1. Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Grantee level. F. Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out-of-service training over extended periods of time. G. Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H. Non-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. B. Program Budget - 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 1 for reference). 1. Salary and Wages - a. Position Description - Select from the expenditure row look-up all position titles or job 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 11 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 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. Program Budget-Cost Detail Schedule Preparation 12 B1 Attachment B1-Program Budget Summary 13 Source of Funds 14 B2 Attachment B2-Program Budget Cost Detail 15 16 I. Budget Preparation A. 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. B. Indirect Costs There are three (3) options for indirect costs. They are: 1. an approved federal or state indirect rate 2. a 10% de minimis rate; or 3. a cost allocation/distribution plan Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go to VI. Form Preparation, L. Indirect Cost section on this document. C. Cost Allocation Certification The Cost Allocation Certification remains on file with the Department until there is a change in the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS- Medicaid-Outreach), the local health department must: 1) submit a copy of the revised cost allocation plan with the budget request; and 2) complete a revised cost allocation methodology certification. Both documents are to be attached to a Detailed Budget line in EGrAMS. II. Financial Status Report (FSR) – LHDs seeking 50% federal administrative match must request reimbursement by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through MI E-Grants. A. Quarterly and Final FSR LHDs must reflect the actual Medicaid Outreach expenses incurred on the quarterly and final FSR. Actual expenses incurred must be specific to Medicaid Outreach as defined by the MSA Bulletin 05-29 and not part of a direct service. All expenses should be supported by an approved methodology and appropriate support documentation. 1. Required Match - Local Should be used to report the local match for Medicaid Outreach, both the federal and local amounts must match. 2. Source of Funds 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 17 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. III.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. 18 19 20 21 22 ATTACHMENT III MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES LOCAL HEALTH DEPARTMENT AGREEMENT October 1, 2022 – September 30, 2023 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. Special requirements are applicable for the program elements listed in the attached pages. Attachment IV Reimbursement Chart Program Element: The Program Element indicates currently funded Department programs that are included in the Comprehensive Local Health Department Agreement. Reimbursement Methods 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 starting from the last year's negotiated target and the most recent year's actual numbers except for programs in which caseload targets are directly tied to funding formulas/annual allocations. Other considerations in setting performance targets include changes in state allocations from past years, local fiscal and programmatic factors requiring adjustment of caseloads, etc. Once total performance targets are negotiated, a minimum state funded performance target percentage is applied (typically 90% unless otherwise specified). If local Grantee actual performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation for cost reimbursement will be reduced equivalent to actual performance in relation to the minimum performance. Fixed Unit Rate Reimbursement A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. ELPHS 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. Performance Level If Applicable 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 New for FY23, there will be a budget category amendment only, released in May. The timeline and process to request the budget changes will be released to the Health Departments when official process is determined. Amendment Schedule will be added in first amendment. Key Terms • Amendment Request Due Date – The date amendment requests are due to the program office. a. Budget category amendment requests need to be submitted to the program office. • Anticipated Consolidation Date – The day the agreement (original/amendment) will be released to the health department for final signature. • New Project Start/Effective Date – The date new projects are expected to start, unless otherwise communicated by the program office. PROJECT PROGRAM CONTACT EMAIL American Rescue Plan Tiffany Kostelec kostelect@michigan.gov COVID Immunization Terri Adams adamst2@michigan.gov COVID-19 Mobile Testing Brenda Jegede jegedeb@michigan.gov COVID Workforce Development Laura de la Rambelje DelaRambeljeL@michigan.gov ELC Contract Tracing, Investigation, Testing Coord., and Infection Prevention Laura de la Rambelje DelaRambeljeL@michigan.gov ELC Regional Lab Marty Soehnlen soehnlenm@michigan.gov ELC Sewer Network Mary Stobierski stobierskim@michigan.gov Expanding Public Health Workforce Tedra Jackson jacksont7@michigan.gov Lead Response Laura de la Rambelje DelaRambeljeL@michigan.gov Local Public Health Nursing Case Management Expansion Carin Speidel speidelc@michigan.gov PFAS Response (All Locations)Laura de la Rambelje DelaRambeljeL@michigan.gov Reopening Schools HRA Joseph Coyle coylej@michigan.gov PROJECT TITLE: American Rescue Plan American Rescue Plan – HFA American Rescue Plan – NFP Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The American Rescue Plan (ARP) funding is federal funding issued to assist Home Visiting programs and associated families with the means to respond to immediate needs resulting from the impacts of COVID-19. This funding will assist Home Visiting programs with addressing the impacts of COVID-19 by providing services and supplies to families while also supporting the programmatic costs and training needs of Home Visiting agencies. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department reporting requirements. See the Michigan Department of Health and Human Services’ (MDHHS) Home Visiting Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the appropriate Model Consultant via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. ARP Work Plan: By June 30, 2022, the LIA must submit a Work Plan to the MDHHS Home Visiting mailbox (MDHHS-HVInitiative@michigan.gov) for preapproval. An ARP Work Plan template will be provided. See the MDHHS Home Visiting Guidance Manual for requirements related to Work Plan development and reporting. c. Work Plan Reports: Must be submitted to the MDHHS Home Visiting mailbox (MDHHS-HVInitiative@michigan.gov) within 30 days of the end of each quarter (January 30, April 30, July 30 and October 30). The template mentioned in section b. above can also be used for Work Plan Report submissions. d. ARP Quarterly Report: This report is unique to ARP funding asking for specific information relating to the allowable uses of ARP funds. These reports will assist the MDHHS Home Visiting Unit in complying with HRSA requirements and are due on the 15th of the month following each calendar quarter. The report template is available in EGrAMS. All ARP Quarterly Reports should be submitted to the MDHHS Home Visiting mailbox (MDHHS-HVInitiative@michigan.gov). All reports and/or information (a-d), unless stated otherwise, shall be submitted electronically to the MDHHS Home Visiting mailbox at MDHHS- HVInitiative@michigan.gov. PROJECT: COVID Immunization Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: This grant should be directed to increase COVID vaccination within Michigan. will be used to support awardee and local Health Department (HD) staffing, communications campaigns, pandemic preparedness, mass vaccination and all COVID-19 vaccine response work. Reporting Requirements (if different than contract language) Completion of the Vaccination Situation Report. Any additional requirements (if applicable) Allowable expenses include staffing, communications, and supplies to support COVID-19 vaccination events, including PPE, vaccine refrigerators, data loggers, vaccine coolers, and indirect costs for COVID-19 related work. Are not allowable expenses: Vehicles purchasing, Food, Alcoholic beverages, Building purchases, construction, capital improvements, Entertainment Cost, Goods and services for personal use and Promotional and/or Incentive Material such as: Mugs/Cups, Pens, or Bags. PROJECT: COVID Workforce Development Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Funding for COVID Workforce Development to establish, expand, and sustain a public health workforce, including school nurses. Reporting Requirements (if different than contract language) Reporting requirements will be provided at a later date. Any additional requirements (if applicable) Eligible purchases include: • Hiring personnel (including wages and benefits) for roles that may range from senior leadership positions to early career or entry-level positions (including, but not limited to permanent full-time and part-time staff, temporary or term-limited staff, fellows, interns, and contractors or contracted employees). Examples of personnel include professional or clinical staff, disease investigation staff, school nurses and school- based health services personnel, program staff, administrative staff, and any other positions that may be required to prevent, prepare for, and respond to COVID-19. • Purchase of equipment and supplies necessary to support the expanded workforce including personal protective equipment, equipment needed to perform the duties of the position, computers, cell phones, internet costs, cybersecurity software, and other costs associated with support of the expanded workforce (to the extent these are not included in recipient indirect costs). • Administrative support services necessary to implement activities funded under this section, including travel and training (to the extent these are not included in recipient indirect costs). PROJECT: COVID-19 Mobile Testing Start Date: 10/1/2022 End Date: 10/1/2023 Project Synopsis Mobile testing deployment to high-risk areas of need. Walk or drive up testing. Partnerships with community organizations. Eliminate barriers by offering no appointments or prescription. Testing and include vaccinations and health screening. Services include social determinant assessments and linkage to services and care. Reporting Requirements (if different than contract language) Monthly Project Updates Please submit monthly project updates via email to Shronda Grigsby Grigsbys1@michigan.gov and Nina Talarico TalaricoN@michigan.gov no later than the 15th of each calendar month. Quarterly Narrative Progress Reports Submit quarterly narrative progress reports utilizing the template provided via email to Shronda Grigsby at Grigsbys1@Michigan.gov and Nina Talarico TalaricoN@michigan.gov in accordance with the following schedule: Reporting Period Report Due Date October 1 - December 31 January 31 January -March 31 April 30 April 1 - June 30 July 31 October 1 - Septmeber 30 (entire FY) October 31 Any additional requirements (if applicable) A. Ensure that activities implemented under this grant award are in accordance with established MDHHS program standards, as well as State and Federal policy and statutes, including HIPAA. B. Adhere to timelines and work plans, budgets, and staffing plans submitted and approved by MDHHS. Deviations from approved timelines, work plans, budgets and staffing plans must receive advance authorization from MDHHS. Failure to make reasonable progress in program development may result in revocation or reduction of the grant award. C. Collaborate with and build on other MDHHS COVID-19 response programs wherever possible, rather than duplicating or rebuilding efforts. D. Ensure that services and materials are culturally and linguistically appropriate to meet the needs of the respective client populations. E. Utilize results from the Social Vulnerability Index/mortality analysis from the State of Michigan at the census tract level for Southeast Michigan to help identify priority areas for the mobile testing program within high priority census tracts, and share data maps of COVID-19 “hot spots” with MDHHS. F. Assess insurance status of each individual being tested. Bill relevant insurers, including private insurers, Medicaid health plans, and the Health Resources and Services Administration for COVID-19 testing costs when possible. G. Store, refuel, and maintain vehicles to ensure optimum vehicle performance. Take all reasonable precautions to keep vehicles safe against fire, water, and traffic damage, and maintain cleanliness of the vehicles. Submit documentation and billing for storage, fuel, and maintenance reimbursement. H. As part of any vaccination activities, follow all relevant MDHHS protocols, including record and account of all doses of vaccine administered in the Michigan Care Improvement Registry (MCIR) and assuring vaccines are stored at recommended temperatures at all times. 1. Reports from temperature data logger showing temperatures within recommended range may be requested at any time by MDHHS. The terms below are in addition to the standard terms in the County Health Department Agreement, and apply only to this specific project: Insurance Requirements. Grantee, at its sole expense, must maintain the insurance coverage identified below. All required insurance must: (i) Protect the State from claims that arise out of, are alleged to arise out of, or otherwise result from Grantee's performance; (ii) Be primary and non-contributing to any comparable liability insurance (including self-insurance) carried by the State; and (iii) Be provided by a company with an A.M. Best rating of "A-" or better, and a financial size of VII or better. Required Limits Additional Requirements Commercial General Liability Insurance Minimum Limits: $1,000,000 Each Occurrence $1,000,000 Personal & Advertising Injury $2,000,000 Products/Completed Operations $2,000,000 General Aggregate Coverage must not have exclusions or limitations related to sexual abuse and molestation liability. Automobile Liability Insurance Minimum Limits: $1,000,000 Per Accident Policy must include Hired and Non-Owned Automobile coverage. Workers' Compensation Insurance Minimum Limits: Coverage according to applicable laws governing work activities Waiver of subrogation, except where waiver is prohibited by law. Employers Liability Insurance Minimum Limits: $500,000 Each Accident $500,000 Each Employee by Disease $500,000 Aggregate Disease Privacy and Security Liability (Cyber Liability) Insurance Minimum Limits: $1,000,000 Each Occurrence $1,000,000 Annual Aggregate Policy must cover information security and privacy liability, privacy notification costs, regulatory defense and penalties, and website media content liability. Medical Malpractice Insurance Minimum Limits: $1,000,000 Each Occurrence $3,000,000 Annual Aggregate If any required policies provide claims-made coverage, the Grantee must: 1. Provide coverage with a retroactive date before the Effective Date of the Grant or the beginning of Grant Activities; 2. Maintain coverage and provide evidence of coverage for at least three (3) years after completion of the Grant Activities; and 3. If coverage is cancelled or not renewed, and not replaced with another claims- made policy form with a retroactive date prior to the Effective Date of this Grant, Grantee must purchase extended reporting coverage for a minimum of three (3) years after completion of work. Grantee must: 1. Provide insurance certificates to the Grant Administrator, containing the agreement or delivery order number, at Grant formation and within twenty (20) calendar days of the expiration date of the applicable policies; 2. Require that subgrantees maintain the required insurances contained in this Section; 3. Notify the Grant Administrator within five (5) business days if any policy is cancelled; and (iv) waive all rights against the State for damages covered by insurance. Failure to maintain the required insurance does not limit this waiver. This Section is not intended to and is not to be construed in any manner as waiving, restricting or limiting the liability of either party for any obligations under this Grant (including any provisions hereof requiring Grantee to indemnify, defend and hold harmless the State). PROJECT: ELC (Epi Lab Capacity) Contact Tracing, Case Investigation, Testing Coordination, and Infection Prevention Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: For COVID-19 funding from ELC Supplemental for Case Investigations and Contact Tracing and Infection Prevention. The inability to meet quality standards will elicit the following response from MDHHS related to this funding: • Technical assistance • Corrective action/performance improvement plans with MDHHS • Required support from MDHHS Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase. COVID-19 activities must remain the primary purpose of this expansion and MPV is in addition to the approved services provided and within scope. Please ensure these activities are conducted concurrently. MPV ONLY activities are not allowable with COVID-19 funding. Reporting Requirements (if different than contract language) Related to Case Investigation Quality: LHD’s will continue to perform high quality case investigation and contact tracing for Department-recommended priorities. Local health departments should focus on interview completion, timeliness, and race and ethnicity completion, as well as effective communication with providers, individuals, the general public, and businesses related to isolation and quarantine. LHD’s shall focus work on outbreak investigations in populations of interest. LHD’s can procure tools to increase case investigation quality (people finding software, communications, printed materials for testing events, EMR access, etc.). Case investigation data will be reported in MDSS. Allowable expenses include staffing, IT, communications, computers and or phones or other office needs, access to people finding software or EMR, supports to cases for isolation and quarantine (not including wraparound services). Funding cannot be used for clinical care or research. Related to Contact Tracing: Dependent on MDHHS guidance, LHDs will collaborate with MDHHS to assure timely contact notification and education of close contacts of a COVID-19 case or monkeypox case. Related to testing: LHDs will provide staffing and support for testing activities related to outbreak response. This funding can be used to staff testing events or assure testing strategies are Deleted: . completed. Related to Infection Prevention: MDHHS SHARP/IPRAT will serve as a statewide technical assistance provider to LHD Infection Prevention personnel, including but not limited to train-the-trainer models, job shadowing, assistance with onsite and virtual facility assessments, pre-and post-visit consultation and follow-up, cluster/outbreak reporting, response and containment. 1. The LHD will designate a staff member or members responsible for leading virtual and onsite infection prevention assessments: a. Proactive IP assessments (preparedness) b. Assessments in response to an outbreak/cluster 2. A list of LHD IP team members and contact information will be available to MDHHS 3. Team members will participate in a Project kickoff meeting and routinely 4. scheduled coordination calls with MDHHS 5. Dedicated LHD staff will complete Project FirstLine Training provided by CDC and/or MDHHS 6. Dedicated LHD staff will participate in an APIC training sponsored by MDHHS 7. LHDs will conduct ongoing outreach to high-risk settings to assess communicable disease reporting and existing infection prevention resources, policies, practices, processes and provide facilities with best practice recommendations for infection prevention. a. High risk settings include but are not limited to healthcare settings (hospitals, nursing homes, other long term care facilities), jails, prisons, and shelters. 8. LHDs shall submit ICARs to MDHHS at https://dhhshivstd.iad1.qualtrics.com/jfe/form/SV_0dNux70o256K6B7 This data will be reported to MDHHS in a quarterly survey (Qualtrics/SurveyMonkey): 1. # of LHD staff completing Project FirstLine Training 2. # of LHD staff completing APIC training 3. # of proactive virtual site visits conducted 4. # of proactive onsite visits conducted 5. # of outbreak/cluster site visits conducted 6. # of trainings coordinated by LHD personnel 7. # of infection prevention consultations conducted 8. # of IP meetings coordinated by the LHD Allowable expenses include staffing, IT, communications, computers and/or phones or other office needs, travel, PPE, professional development/trainings/conferences for staff, expenses related to hosting events/trainings. Funding cannot be used for clinical care or research. For local health departments: Use staffing to collaborate to conduct contact tracing, contact notification, and mitigation for high-priority settings like schools, jails, dorms, congregate settings, etc. 1. LHDs will report to MDHHS the number of clusters/outbreaks investigated with supported staff 2. LHD’s will provide education to contacts on public health recommendations for COVID-19 ,monkeypox, to other emerging communicable disease threats. 3. LHD will provide information to close contacts such as websites, printed materials, social media, or hotlines. Staffing can be used to support: • connecting people with supportive services and treatments when indicated • assisting with expanding public education and outreach • promoting vaccination — including scheduling and booster reminders • TPOXX outreach, provider education, and distribution • Staff can be cross trained to support other communicable disease investigation activities such as: • monkeypox • sexually transmitted infection and • HIV partner services, • Hepatitis C infection, • foodborne outbreak response, • tuberculosis investigations, • healthcare associated and antibiotic resistant organisms, • other programs that can benefit from the skills of this highly-trained workforce. 4. LHDs should report to MDHHS, on a quarterly basis, which non-COVID-19 conditions were investigated by staff supported under this award 5. LHDs will support local public health staff impacted by COVID-19 and monkeypox by providing development and training opportunities, including addressing the physical and behavioral health impact of COVID-19 on the public health workforce. 6. LHDs will support staff workforce development and training, including conference fees and associated travel. Formatted Formatted Allowable expenses include staffing, IT, communications, computers and or phones or other office needs, access to people finding software or EMR, supports to cases and contacts for isolation and quarantine for COVID-19, monkeypox, and/or other infectious disease threats. Any additional requirements (if applicable) PROJECT: ELC Regional Lab Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis ELC Regional Lab funds are dedicated to developing lab, epi, and other public health efforts to modernize and expand testing and response capabilities of pandemics with special emphasis on the responses to COVID-19. The Regional laboratory system is intended to serve as a “hub-and-spoke” model in conjunction with the state public health laboratory to rapidly respond to community needs. Funding is expected in personnel, equipment, overhead (discreationary of county or district needs if in support of public health), and lab supplies/consumables or materials that directly support sampling for return to the lab. Reporting Requirements (if different than contract language) None, but sites may be asked to provide tally counts of testing if not directly available from StarLIMS or to answer occasional question from CDC on capabilities. Any additional requirements (if applicable) PROJECT: ELC SEWER Network Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The State of Michigan SARS-CoV-2 Epidemiology - Wastewater Evaluation and Reporting Network, also known as the SEWER Network, is a wastewater monitoring project that utilizes locally coordinated projects to conduct surveillance for SARS-CoV-2 virus shed into Michigan public sewer systems. The overarching goal of the Michigan SEWER Network is to rapidly detect circulation of SARS-CoV-2 virus within specific communities via wastewater testing. The SEWER Network is designed to support local project participation through the collection, transportation, and testing of wastewater samples, analysis and reporting of results, coordination and communications within local projects and with state agencies, and submission of results to MDHHS and EGLE. The emphasis for this funding is that the funded activities provide useful, timely, and consistent wastewater data to support local COVID-19 public health responses. Reporting Requirements (if different than contract language) All local projects may be required to submit a weekly summary of project activities to MDHHS via email or uploading to the existing Microsoft Teams site for the project. This could include information on sample collection, testing, data reporting and utility, and partner communication. A template for this report will be provided by MDHHS. MDHHS will communicate any changes in reporting requirements to project participants. Quarterly workplan updates will be required from all local projects. Lead agencies who are not local health departments will be required to complete a quarterly workplan report in EGrAMS that details the activities and objectives during that time period. LHD leads for local projects will submit quarterly workplan reports directly to MDHHS project staff. Failure to implement project requirements or submit required financial and performance reports in accordance with this agreement may result in reduction of funds or non- renewal of future contracts. Any additional requirements (if applicable) This agreement reflects the sampling commitments written in the proposal. Any changes in the sampling plan need to be discussed with SEWER Network project staff. PROJECT: Expanding Public Health Workforce Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The Health Department will hire a ‘Disability Health Specialist’ to provide culturally affirmative and linguistically accessible information, in plain language. They will also provide activities that support public health and well being of people with developmental disabilities. The community coordinator will: • Develop specialized clinical training programs that will help health professionals understand how to work with individuals with disabilities. • Create an ADA guide for health professionals that include the latest regulations and best practices for working with clients with disabilities. Health and wellness education and information: • The Health Department, in partnership with CRIO (ODA), will host community education on health and wellness, customized for the disability population (e.g., hosting a workshop on signing up for ABLE Account, understanding Medicaid/Medicare, SSDI). • Additionally, hosting preventive health education in plain language that is easy to follow • Other activities that support the public health and wellbeing of people with disabilities o Developing training and education to healthcare professionals • Conducting evaluation to identify to identify gaps in services o Advocating for people with disabilities' health and well-being, as well as access to service providers and hospitals o Collaborating with community partners to improve health equity of people with disabilities. Reporting Requirements (if different or in addition to contract language) Required reports include semi-annual federal financial reports (FFR) and annual program reports that include: • Number of full-time equivalents (FTEs), • Type of public health professional(s) hired, and • The activities they are engaged in to advance public health Any additional requirements (if applicable) Participation in this funding opportunity requires any organization directly involved in vaccine administration to follow the CDC COVID-19 Vaccination Program Provider Agreement and the State of Michigan/MDHHS COVID-19 vaccine guidance including (but not limited to): • Maintaining enrollment in the CDC COVID-19 Vaccination Program • Adhering to state vaccine prioritization guidance • Following CDC/ACIP recommendations and clinical considerations • Adhering to CDC/FDA/MDHHS/Manufacturer vaccine storage, handling, and administration directions. Entering administered vaccines into MCIR in the timeframe defined by MDHHS, including completing optional MCIR fields such as race and ethnicity • Following MDHHS, CMS, and HRSA billing guidelines for vaccine administration • Participating in ‘VaccineFinder’ inventory and VAERS reporting, as well as ‘VaccineFinder's’ "Find COVID-19 Vaccines Near You" tool • Providing required patient education materials and vaccine record cards as well as encouraging patients use of v-safe Unallowable Costs/Services: 1. Purchase a vehicle to transport people with disabilities or older adults to vaccination appointments 2. The provision of transportation stipends/vouchers to individuals 3. General equipment purchases for staff who are not involved in public health activities, or for the organization Non-Supplanting Use of Funds Funds MAY NOT supplant existing funds. This means federal funds must be used to supplement existing state or local funds for program activities and may not replace state or local funds that have been appropriated or allocated for the same purpose. Publication Rights All products, including, but not limited to: reports, training manuals, service models, curricula, web sites, electronic information, videotapes, or files, which arise from grant projects funded by the Michigan Developmental Disabilities Council shall contain the following language: “Production of this {Product Type} was supported by Grant {Grant #} from the Michigan Developmental Disabilities Council, awarded pursuant to P.L. 106-402, as amended, the Developmental Disabilities Assistance and Bill of Rights Act, through the Michigan Department of Department of Health and Human Services, the Council’s designated state administering agency.” All dissemination of products, including, but not limited to: reports, training manuals, service models, curricula, electronic information, videotapes, or films produced by grant projects funded by Michigan Developmental Disabilities Council funds, shall be reviewed by the Michigan Developmental Disabilities Council, or its designee, prior to dissemination. PROJECT TITLE: Lead Response Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: Lead Action Level Exceedance (ALE) response capacity encompasses public outreach, including education on water testing and results, water filter usage, flushing recommendations, and the interim provision of water filtration systems. The Michigan Department of Health and Human Services (MDHHS), through a legislative funding allocation, can provide lead-reducing water filter systems and replacement cartridges if the local water supply cannot provide them, and if the LHD or local unit of government doesn’t have the resources to provide them. Filters from MDHHS can be offered at no cost to low-income households that meet these criteria: Requirement 1: To qualify for a filter, both requirements must be met: o Household receives water from the ALE Community Water Supply o Household has NOT received a water filter from ALE Community Water Supply, the Local Health Department, or the Michigan Department of Health and Human Services. Requirement 2: To qualify for a filter, one requirement must be met: o A child under age 18 lives at the applicant’s address. o A child under age 18 spends a few hours a day and several days a week at the applicant’s address for at least 3 months of the year. o A pregnant woman lives at the applicant’s address. Requirement 3: To qualify for a filter, one requirement must be met: o Household includes a person who receives WIC benefits or Medicaid insurance. o Household attests they can’t afford a filter and replacement cartridges (filters cost about $35 and replacement cartridges cost about $15.) If an eligible household’s water test result is above the action level (AL = 15 ppb) for lead, or the resident’s home is on the public water system experiencing an ALE for lead, a faucet mount filter and 2 replacement cartridges will be offered. A pitcher filter and 3 replacement cartridges may be offered, when necessary (e.g., faucet mount does not fit their faucet). These measures will be provided until a permanent solution can be identified and implemented, as resources allow, or a determination is made by MDHHS Division of Environmental Health that filtration is no longer recommended or advised. Reporting Requirements By Wednesday at noon each week, grantees are required to enter all data collected on the Water Filter Request Forms in the attached Excel file. The file will be submitted to Gabriella Dionise, at dioniseg1@michigan.gov. Additional Requirements: Requesting Funding Local Health Departments requesting funds for Lead ALE response will provide an estimated budget, as well as a description of expenses on Form DCH-0385(E) and DCH- 0386(E). Lead ALE response funds are not capacity building funds but are limited-term funding to achieve a critical public health response on behalf of the MDHHS for environmental public health needs related to lead in drinking water. Eligible Expenses Include: a) Staff time and fringe dedicated to Lead ALE response in association with the interim response. • Eligible staff activities for Lead ALE response include filtration system distribution, home visits, organizing and hosting town hall meetings or other public education, phone banks, water sample collection or other activities approved by and conducted in collaboration with MDHHS Division of Environmental Health. b) Printing materials associated with ALE response; c) Mileage associated with lead ALE response and MDHHS-provided training; d) Lead and copper analysis fees for health departments with certified drinking water laboratories when costs are in alignment with the Michigan Department of Environment, Great Lakes, and Energy’s (EGLE) Drinking Water Laboratory fees ($26/sample). e) Other items as need is determined, such as public meeting venue rental or phone bank expenses. Other expenses that are not on this list must receive prior approval by DEH before submission to Division of Local Health Services. Any deviation or amendment to existing Lead ALE response projects requires DEH approval. Local Health Departments submit all budget requests to DEH Community Engagement Unit. Ineligible Expenses Include: • Training • Association membership fees; and • Travel not associated with direct Lead ALE service delivery. Providing Interim Filtration Systems When distributing water filters to residents, health departments will obtain a signed Water Filter Request Form from each resident. A site-specific form will be provided as a fillable PDF. Health Departments may choose to type resident’s information into the fillable PDF or print off the form. Residents will complete Page 1 of the form, and health department staff (or their designees) will complete Page 2 of the form. Grantees are requested to maintain hard copies of the Water Filter Request Forms for audit purposes. Completion of the Water Filter Request Form is NOT intended to be a barrier to the provision of filtration systems for households with pregnant women and children under age 18. - A note here: sometimes the filter distributions happen at CE events that are not run by LHDs, in that case, Lakecia holds onto the PDF forms. PROJECT: Local Public Health Nurse Case Management Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The purpose of this project is to fund nursing case management support for children 6-16 years of age with elevated lead levels in Berrien County, as well as children under 6 years of age with an elevated blood lead level who are not enrolled in a Medicaid Health Plan in Berrien County. This project also supports funding to InterCare FQHC, as needed, for reimbursement blood lead sample analysis at $7.00 each. Finally, this project supports efforts to increase blood lead testing within Berrien County, with high priority to Benton Harbor. This funding can support Berrien County in identifying barriers to blood lead testing, reduction strategies for these identified barriers and methods to increase access to blood lead testing, focusing messaging on blood lead testing for children and pregnant persons. Reporting Requirements (if different than contract language) N/A Any additional requirements (if applicable) N/A PROJECT: PFAS Response (All Locations) Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis: The Michigan Department of Health and Human Services (MDHHS) Division of Environmental Health (DEH), in consultation and collaboration with local health departments, provides drinking water recommendations to residents with private residential wells contaminated with PFAS. Local health departments are eligible for PFAS Response funding when filtration or another source of drinking water is recommended as a health protective measure. PFAS Response encompasses the components below: • Educational outreach such as, but not limited to, education regarding drinking water testing and results. • Interim provision of water filtration systems or an alternate source(s) of water until a determination is made by MDHHS DEH that filtration or alternate water is no longer recommended. • Follow-up with residents who have received a water filter to offer free replacement filter cartridges every six months. Local health departments requesting funds for PFAS response will provide an estimated budget as well as a description of expenses on forms DCH-0385E and -0386E. PFAS Response funds are not capacity building funds but are limited-term funding to achieve a critical public health response on behalf of MDHHS DEH for environmental public health needs related to PFAS. Eligible expenses Include: • Water filters certified for PFAS reduction. • Installation of certified water filters by a plumber licensed in the State of Michigan. • Replacement water filter cartridges provided approximately every 6 months or after 800 gallons of water has been filtered, depending on residents’ water usage. • Alternate water such as water coolers/dispensers or bottled water, as need is determined and approved by MDHHS DEH. • Mileage. • Supplies. • Staff time and fringe dedicated to PFAS response. Required staff activities for PFAS response include: a. Distribution of certified water filtration systems and replacement cartridges. b. Coordination of water filter installation by a licensed plumber when requested by the resident. c. Provision of semi-annual filter replacement cartridge offers and reminders. These offers and reminders are made to residents previously provided with water filters until:  a determination is made by MDHHS DEH that water filtration is no longer recommended. d. Documentation of water filter and replacement cartridge distribution. e. Data entry and submission to MDHHS DEH. • When necessary, staff activities may include: a. Bottled water distribution. b. Home visits. c. Organizing and hosting town hall meetings or other public education. d. Phone banks. e. Water sample collection support when requested by MDHHS DEH. • Other items as need is determined such as public meeting venue rental or phone bank expenses. • Indirect costs. Expenses not on this list must receive prior approval by MDHHS DEH before submission. Any deviation from or amendment to existing PFAS response projects requires MDHHS DEH approval. Ineligible expenses include: • Training. • Association membership fees. • Travel not associated with direct PFAS service delivery. • The cost to remove filters unless the water filter is found to be defective and requires replacement. Reporting Requirements (if different than contract language): By the first Wednesday of each month, grantees are required to submit: • Site-specific, updated tracking forms including: a. Site name. b. Resident’s name, address, contact information. c. Water filter or alternate water type provided. d. Water filter or alternate water quantity distributed. e. Filter replacement cartridges distributed. f. Date of each distribution. g. Permission to contact resident. h. Filter declination. i. Staff name. • Site-specific updated information on number of bottles of water distributed. Submit tracking forms to MDHHS DEH via email to MDHHS-DEHresponse@michigan.gov with the subject line PFAS Alternate Water Tracker – (add reported month). Any additional requirements (if applicable) • Local health departments submit all budget requests to MDHHS DEH for approval. • Application for funds in subsequent fiscal years is expected where there is an ongoing recommendation for water filtration or an alternate water source. • Local health department are to maintain number of staff hours expended on the grant. Acknowledgement of Receiving or Declining Water Filter Form When providing a water filter to a resident, grantees will complete the Acknowledgement of Water Filter Receipt form, or similar acknowledgment form based on the grantee’s legal review, including the resident’s signature. The forms will be retained by the grantees. • Please note that an acknowledgement form is NOT intended to be a barrier to provision of water assistance. PROJECT: Reopening Schools HRA Reopening Schools HRA -2 Start Date: 10/1/2022 End Date: 9/30/2023 Project Synopsis The Michigan Department of Health and Human Services (MDHHS) is offering a voluntary program to provide rapid antigen testing to educators, staff, and students at public and private schools. In addition, MDHHS is providing funds to school districts that have indicated the need for additional technical support with the intent to participate in testing programs, among other factors. Funding provided will support hiring health resource advocates (HRAs). Individuals serving in the role as an HRA will provide front- line support for COVID-19 testing and reporting, help districts identify emerging COVID- 19 related health concerns, and amplify best health practices. Any additional requirements (if applicable) Reporting Requirements (if different than contract language) Bi-Monthly reports by school district to include the following (additional information may be requested): 1. Total enrollment 2. PCR tests conducted 3. Antigen tests conducted 4. Total positive cases 5. # HRAs hired 6. Qualitative feedback on: • barriers • successes • lessons learned • verification of funding use for HRA positions Reports should be submitted via email to MDHHS-HRAreporting@michigan.gov. For any, additional questions or concerns can be submitted to MDHHS- COVIDTestingSupport@michigan.gov. Funding may only be used for hiring an HRA(s). The funding shall not be used for any other purpose beyond hiring and/or funding an HRA(s), which may include supporting existing positions. These funds must also be accompanied by a plan to conduct COVID- 19 testing in school settings. PROJECT: U4U Tuberculosis Services Start Date: 10/01/2022 End Date: 09/30/2023 Project Synopsis Each recipient shall conduct activities for the purposes of tuberculosis (TB) testing, evaluation, and treatment in Ukrainian Nationals resettling in Michigan under the Federal Uniting for Ukraine (U4U) program. Allowable costs include: • Outpatient services related to TB control and clinical care (e.g., Interferon Gamma Release Assay (IGRA) testing, tuberculin skin testing, chest radiography, medical evaluation, treatment). • Procurement and provision of medications for the treatment of TB infection and TB disease. • Reasonable program purposes, including personnel, travel, supplies, and services. • Integration of services when it is intended to specifically reduce TB transmission or improve TB screening, testing, or treatment in populations disproportionately affected by other infections or comorbidities including diabetes mellitus, hepatitis B or C virus, STDs, and HIV. Reporting Requirements (if different than contract language) MDHHS TB Program will collaborate with each recipient to track and monitor the following: • Number of people tested • Number of people evaluated • Number of people who start treatment for TB Infection • Number of people who complete treatment for TB Infection • Number of people who start treatment for TB Disease • Number of people who complete treatment for TB Disease Reporting for people diagnosed and treated for TB Disease will occur through MDSS following standard process. Processes for reporting and monitoring people with TB Infection will be developed and communicated as soon as possible. Any additional requirements (if applicable) FOOTNOTES: FY 2022/2023 a)Refer to Plan and Budget Framework for element definitions. b)Refer to master comprehensive agreement and program and budget instructions package for further explanation of applicability of these reimbursement methods. c)Negotiated starting from the average of the past two complete years' actual number where available. d)Calculated by multiplying the "Total Performance Expectation" column by the ratio of the elements total State funding (DCH 0410, Line 24) to "Total Expenditures” DCH 0410, Line 17). Prior to calculation, adjustments will be made for unallowable cost, equipment funded by local funds and MDHHS reimbursement not performance based (I.E., fixed unit rate, staffing). e)Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. f)Refer to master comprehensive agreement and budget instructions package for further explanation regarding these designations. (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 (PHEP) funding BP1 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. DRAFT10/18/2022 Contract #: 20230195-00 Amendment Number: 1 to the Between Michigan Department of Health and Human Services and County of Oakland hereinafter referred to as the "Local Governing Entity" on Behalf of Health Department Oakland County Department of Health and Human Services/ Health Division AMENDMENT PURPOSE AND JUSTIFICATION 1.The purpose of this amendment is to: 1. Add/revise information in Attachment I - Annual Budget Instructions; 2. Add/revise information in Attachment III - Program Specific Assurance and Requirements; and 3. Incorporate Attachment IV- Funding/Reimbursement Matrix as revised for the Essential Local Public Health Service (ELPHS) and categorical budget details, output measures and performance criteria. 4. Decrease the Department's agreement amount from $10,835,066 to $6,329,816, as shown on the Attachment B budget pages. 2.Amendment Revisions: The following are the additions/revisions to Attachment I and III A) The following projects include additions/revisions as highlighted in Attachment I - Annual Budget Instructions: No Change B) The following projects include additions/revisions as highlighted in Attachment III - Program Specific Assurance and Requirements: Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 1 of 15 DRAFT10/18/2022 1. ELC Contact Tracing, Testing, Coord., Infection Prevention 2. Expanding Public Health Workforce - New 3. U4U Tuberculosis Services - New Following are adjustments to funding levels of the Local Health Department agreement as reflected in Attachment IV: Budget line item changes are reflected in the attached budgets for the following elements: Project Title Current Amount Amended Amount New Project Amount American Rescue Plan 189,404 3,940 193,344 COVID Immunization 5,163,603 (4,509,190)654,413 Total Comprehensive Funding 5,353,007 (4,505,250)847,757 Performance Level Adjustments N/A Budget category Adjustments It is understood and agreed that all other conditions of the original agreement remains the same. Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 2 of 15 DRAFT10/18/2022 3.Signing this amendment The individual or officer sigining this amendment certifies by his or her signature that he or she is authorized to sign this amedment on behalf of the reponsible governing board official or agency. Signature Section For Oakland County Department of Health and Human Services/ Health Division Andrea Powers Administrator ___________________________________________________________________ Name (please print) Title For the Michigan Department of Health and Human Services Christine H. Sanches 10/18/2022 ___________________________________________________________________ Christine H. Sanches, Director Date Bureau of Purchasing Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 3 of 15 DRAFT10/18/2022 Attachments Attachment I - Instructions for the Annual Budget Attachment III - Program Specific Assurances and Requirements Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 4 of 15 DRAFTContract # Date: 10/18/2022MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESATTACHMENT IV - Emerging Threats- Local Health Department- 2023CONTRACT MANAGEMENT SECTIONOakland County Department of Health and Human Services/ Health Division Program Element/Funding Source(a)MDHHSSourceFed/StFundingAmountReimbursementMethod(b)PerformanceTargetOutputMeasurementTotal (c)PerformExpectState (d)FundedTargetPerformState Funded MinimumPerformancePercentNumber (e)Contractor /Subrecepient(f)American Rescue PlanReg. Alloc.F189,404Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientCOVID ImmunizationReg. Alloc.F5,163,603Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientCOVID Workforce DevelopmentReg. Alloc.F172,605Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientELC Contract Tracing,Investigation, Testing Coord., andInfection PreventionReg. Alloc.F3,826,390Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientELC Regional LabReg. Alloc.F512,420Actual CostReimbursementN/AN/AN/AN/AN/ARecepientELC Sewer NetworkReg. Alloc.F909,057Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientPFAS Response - AirportReg. Alloc.S60,390Actual CostReimbursementN/AN/AN/AN/AN/ARecepientPFAS Response - Falk RdReg. Alloc.S1,197Actual CostReimbursementN/AN/AN/AN/AN/ARecepientTOTAL MDHHS FUNDING10,835,066*SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENTAttachment IV NotesEmerging Threats- Local Health Department- 2023, Date: 10/18/2022________________________________________________________________________________________________________________Page: 5 of 15 DRAFTContract # Date: 10/18/2022 Project Budgets 1 Program Budget Summary PROGRAM / PROJECT Emerging Threats- Local Health Department- 2023 / American Rescue Plan DATE PREPARED 10/18/2022 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2022 To : 9/30/2023 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 1 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 84,942.00 84,942.00 2 Fringe Benefits 44,099.00 44,099.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 28,754.00 28,754.00 6 Travel 14,737.00 14,737.00 7 Communication 1,300.00 1,300.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)3,833.00 3,833.00 Total Program Expenses 177,665.00 177,665.00 TOTAL DIRECT EXPENSES 177,665.00 177,665.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 11,739.00 11,739.00 Total Indirect Costs 11,739.00 11,739.00 TOTAL INDIRECT EXPENSES 11,739.00 11,739.00 TOTAL EXPENDITURES 189,404.00 189,404.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 6 of 15 DRAFTContract # Date: 10/18/2022 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 MDHHS Comprehensive 189,404.00 189,404.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 189,404.00 189,404.00 0.00 0.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 7 of 15 DRAFTContract # Date: 10/18/2022 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse Notes : TBD 66487.0000 1.000 0.000 FTE 66,487.00 Coordinator Notes : Health Program Coordinator Position # P00004736 M. Maloff 93680.0000 0.197 0.000 FTE 18,455.00 Total for Salary & Wages 84,942.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT AND LONG TERM DISABILITY 0.0000 51.917 84942.000 44,099.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Client pre-paid grocery cards Notes : Incentives Breakdown: Client pre-paid transportation - $10,650 Client pre-paid phones - $1,500 Client pre-paid grocery cards - $27,254 Total Incentives - $39,404 0.0000 0.000 0.000 27,254.00 Client pre-paid phone cards 0.0000 0.000 0.000 1,500.00 Total for Supplies and Materials 28,754.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 8 of 15 DRAFTContract # Date: 10/18/2022 Line Item Qty Rate Units UOM Total 6 Travel Mileage Notes : 1,000 miles * 0.625 per mile 0.0000 0.000 0.000 625.00 Conferences 0.0000 0.000 0.000 3,462.00 Client Transporttion 0.0000 0.000 0.000 10,650.00 Total for Travel 14,737.00 7 Communication Telephone 0.0000 0.000 0.000 1,300.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) IT Operations 0.0000 0.000 0.000 3,376.00 Insurance 0.0000 0.000 0.000 457.00 Total for All Others (ADP, Con. Employees, Misc.)3,833.00 Total Program Expenses 177,665.00 TOTAL DIRECT EXPENSES 177,665.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.82% 0.0000 0.000 0.000 11,739.00 Total Indirect Costs 11,739.00 TOTAL INDIRECT EXPENSES 11,739.00 TOTAL EXPENDITURES 189,404.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 9 of 15 DRAFTContract # Date: 10/18/2022 1 Program Budget Summary PROGRAM / PROJECT Emerging Threats- Local Health Department- 2023 / COVID Immunization DATE PREPARED 10/18/2022 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2022 To : 9/30/2023 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 1 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 1,971,154.00 1,971,154.00 2 Fringe Benefits 888,399.00 888,399.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 48,951.00 48,951.00 6 Travel 31,250.00 31,250.00 7 Communication 250,000.00 250,000.00 8 County-City Central Services 0.00 0.00 9 Space Costs 200,000.00 200,000.00 10 All Others (ADP, Con. Employees, Misc.)1,501,436.00 1,501,436.00 Total Program Expenses 4,891,190.00 4,891,190.00 TOTAL DIRECT EXPENSES 4,891,190.00 4,891,190.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 272,413.00 272,413.00 Total Indirect Costs 272,413.00 272,413.00 TOTAL INDIRECT EXPENSES 272,413.00 272,413.00 TOTAL EXPENDITURES 5,163,603.00 5,163,603.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 10 of 15 DRAFTContract # Date: 10/18/2022 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 MDHHS Comprehensive 5,163,603.00 5,163,603.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 5,163,603.00 5,163,603.00 0.00 0.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 11 of 15 DRAFTContract # Date: 10/18/2022 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Various OCHD Positions Notes : Various OCHD staff to host COVID Outreach Clinics - staff names unknown at this time as various staff signs up for the events. 1.0000 1971154.000 0.000 FTE 1,971,154.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT AND LONG TERM DISABILITY 0.0000 45.070 1971154.00 0 888,399.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 2,951.00 Materials and Supplies 0.0000 0.000 0.000 5,000.00 Disaster Supplies 0.0000 0.000 0.000 18,000.00 Printing 0.0000 0.000 0.000 20,000.00 Medical Supplies 0.0000 0.000 0.000 3,000.00 Total for Supplies and Materials 48,951.00 6 Travel Mileage Notes : 50,000 miles @ 0.625 per mile 0.0000 0.000 0.000 31,250.00 7 Communication Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 12 of 15 DRAFTContract # Date: 10/18/2022 Line Item Qty Rate Units UOM Total Telephone Communications 0.0000 0.000 0.000 250,000.00 8 County-City Central Services 9 Space Costs Space/Rental Costs 0.0000 0.000 0.000 200,000.00 10 All Others (ADP, Con. Employees, Misc.) Professional Services - Entech Staffing 0.0000 0.000 0.000 1,118,236.00 Laundry and Cleaning 0.0000 0.000 0.000 200.00 IT Operations 0.0000 0.000 0.000 374,000.00 Transportation of Clients 0.0000 0.000 0.000 4,000.00 Interpretation Fees 0.0000 0.000 0.000 1,000.00 Advertising 0.0000 0.000 0.000 4,000.00 Total for All Others (ADP, Con. Employees, Misc.)1,501,436.00 Total Program Expenses 4,891,190.00 TOTAL DIRECT EXPENSES 4,891,190.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.82% 0.0000 0.000 0.000 272,413.00 Total Indirect Costs 272,413.00 TOTAL INDIRECT EXPENSES 272,413.00 TOTAL EXPENDITURES 5,163,603.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 13 of 15 DRAFTContract # Date: 10/18/2022 Summary of Budget PROGRAM / PROJECT Emerging Threats- Local Health Department- 2023 / Emerging Threats- Local Health Department- 2023 DATE PREPARED 10/18/2022 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2022 To : 9/30/2023 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 1 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 2,626,155.00 2,626,155.00 2 Fringe Benefits 1,212,323.00 1,212,323.00 3 Cap. Exp. for Equip & Fac.62,420.00 62,420.00 4 Supplies and Materials 372,645.00 372,645.00 5 Travel 48,275.00 48,275.00 6 Communication 262,900.00 262,900.00 7 Space Costs 200,000.00 200,000.00 8 All Others (ADP, Con. Employees, Misc.)5,687,414.00 5,687,414.00 Total Program Expenses 10,472,132.00 10,472,132.00 TOTAL DIRECT EXPENSES 10,472,132.00 10,472,132.00 INDIRECT EXPENSES Indirect Costs 1 Cost Allocation Plan / Other 362,934.00 362,934.00 Total Indirect Costs 362,934.00 362,934.00 TOTAL INDIRECT EXPENSES 362,934.00 362,934.00 TOTAL EXPENDITURES 10,835,066.00 10,835,066.00 SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 2 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 3 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 14 of 15 DRAFTContract # Date: 10/18/2022 4 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 5 Federally Provided Vaccines 0.00 0.00 0.00 0.00 6 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 7 Required Match - Local 0.00 0.00 0.00 0.00 8 Local Non-ELPHS 0.00 0.00 0.00 0.00 9 Local Non-ELPHS 0.00 0.00 0.00 0.00 10 Local Non-ELPHS 0.00 0.00 0.00 0.00 11 Other Non-ELPHS 0.00 0.00 0.00 0.00 12 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 13 MDHHS Comprehensive 10,835,066.00 10,835,066.00 0.00 0.00 14 MCH Funding 0.00 0.00 0.00 0.00 15 Local Funds - Other 0.00 0.00 0.00 0.00 16 Inkind Match 0.00 0.00 0.00 0.00 17 MDHHS Fixed Unit Rate 0.00 0.00 0.00 0.00 TOTAL 10,835,066.00 10,835,066.00 0.00 0.00 Emerging Threats- Local Health Department- 2023, Date: 10/18/2022 __________________________________________________________________________ Page: 15 of 15