HomeMy WebLinkAboutResolutions - 2022.12.08 - 37787
AGENDA ITEM: Grant Amendment #2 to the Interlocal Agreement with Oakland County Health
Network for Substance Use Disorder Prevention Services 22-419
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 approve amendment #2 to the Interlocal Agreement with the Oakland
Community Health Network (OCHN), to reflect updated work plan objectives for substance-use
disorder prevention services for the period October 1, 2022 through September 30. The existing
agreement was adopted by the Board of Commissioners on December 9, 2021, via Miscellaneous
Resolution #21502 and amendment #1 added funding in the amount of $20,000 to address the
social emotional needs of youth and the risks of substance-use disorders and mental health.
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 to Board
2022-12-08 Full Board - Adopted
ATTACHMENTS
1. PH&S - Health_Substance Use Disorder Prevention (SUDP) #2_Sch.A
2. Grant Review Sign-Off FY22
3. 2022-0215-SUDP #2 OCHD
December 8, 2022
RESOLUTION #2022-2288 _ 22-419
Sponsored By: Penny Luebs
Health & Human Services - Health Division - Grant Amendment #2 to the Interlocal Agreement
with Oakland County Health Network for Substance Use Disorder Prevention Services
Chairperson and Members of the Board:
WHEREAS Oakland County has received amendment #2 to the Interlocal Agreement from the
Oakland Community Health Network (OCHN), to reflect updated work plan objectives for substance
use disorder prevention services for the period October 1, 2022 through September 30, 2023; and
WHEREAS the existing agreement was adopted by the Board of Commissioners on December 9,
2021, via Miscellaneous Resolution (M.R.) #21502; and
WHEREAS Amendment #1 added funding in the amount of $20,000 to address the social emotional
needs of youth and risks for substance and mental health; and
WHEREAS Amendment #2 includes Health Education Substance Use Disorder Prevention Services
funding in the amount of $219,991, which consists of $199,992 in grant funding and a local in-kind
match of $19,999; and
WHEREAS the $19,999 local in-kind match is budgeted within the Health Division General Fund,
which includes salaries, printing, educational supplies, telephone communications and IT operations;
and
WHEREAS Amendment #2 includes American Rescue Plan Act grant funding in the amount of
$20,000, with no grant match required; and
WHEREAS the funding is sufficient to continue two (2) Special Revenue (SR) Full-Time Eligible
(FTE) Public Health Educator III positions (#1060261-00960 and #1060261-07497); and
WHEREAS Amendment #2 to the Interlocal Agreement 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 #2 to the Interlocal Agreement between the County of Oakland and the
Oakland Community Health Network.
BE IT FURTHER RESOLVED to continue two (2) SR FTE Public Health Educator III positions
(#1060261-00960 and #1060261-07497) within the Health Division.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to
execute the Amendment and to approve any extensions or changes, within fifteen percent (15%) of
the original award, which are consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the County to any
future commitment and continuation of the Special Revenue positions in the grant is contingent upon
future levels of grant funding.
BE IT FURTHER RESOLVED that the FY2023 budget is amended as detailed in the attached
Schedule A.
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 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: #2 to the Interlocal Agreement with Oakland County Health Network for
Substance Use Disorder Prevention Services .
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_Substance Use Disorder Prevention (SUDP) #2_Sch.A
2. Grant Review Sign-Off FY22
3. 2022-0215-SUDP #2 OCHD
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 - SUBSTANCE USE DISORDER PREVENTION (SUDP) AMENDMENT #2
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 CCN1060261 RC610313 PRG134795 GRN-0001133 610000 Federal Operating Grants $199,992 $-$-
Total Revenues $199,992 $-$-
E Human Services Grants Health FND11007 CCN1060261 SC730373 PRG134795 GRN-0001133 730000 Contracted Services $178,847 $-$-
E Human Services Grants Health FND11007 CCN1060261 SC732018 PRG134795 GRN-0001133 730000 Travel and Conferences 3,644
E Human Services Grants Health FND11007 CCN1060261 SC750294 PRG134795 GRN-0001133 750000 Material and Supplies 17,501 --
Total Expenditures $199,992 $-$-
GRANT REVIEW SIGN-OFF – Health & Human Services/Health
GRANT NAME FY 2022 Oakland Community Health Network SUD Prevention
FUNDING AGENCY: Oakland Community Health Network
DEPARTMENT CONTACT PERSON: Stacey Smith / (248) 452-2151
STATUS: Grant Amendment #2 (Greater than 15% Variance from Current Award)
DATE: 11/15/2022
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 email and the grant agreement/contract with related documentation) may be requested to be placed on the
agenda(s) of the appropriate Board of Commissioners’ committee(s) for grant acceptance by Board resolution.
DEPARTMENT REVIEW
Management and Budget:
Approved – Sheryl Johnson (11/11/2022)
Human Resources:
Approved by Human Resources. Continues positions with no changes. – Heather Mason (11/10/2022)
Risk Management:
Approved – Robert Erlenbeck (11/10/2022)
Corporation Counsel:
Approved – Heather Lewis (11/14/2022)
OAKLAND COUNTY INTERLOCAL AGREEMENT BETWEEN
OAKLAND COUNTY
AND
OAKLAND COMMUNITY HEALTH NETWORK
FOR
Substance Use Disorder Prevention Services
2022-0215-SUDP #2
The Parties, Oakland County ("County") and Oakland Community Health Network
("OCHN"), agree and acknowledge that the purpose of this Amendment is to modify as
provided herein and otherwise continue the present contractual relationship between
the Parties as described in their current Substance Use Disorder Prevention Services,
("Contract").
In consideration of the mutual promises, representations, assurances, agreements, and
provisions in the Contract and this Amendment, the adequacy of which is hereby
acknowledged by the Parties, the Parties agree to amend the Contract as follows:
1.The Parties acknowledge and agree to FY23 Exhibit I: Financial and Reporting
Obligations, as attached hereto.
2.The Parties acknowledge and agree to FY23 Exhibit II: Scope of Services, as
attached hereto.
3.The Parties acknowledge and agree to Attachment B – Management by Objectives
in Exhibit IV, as attached hereto.
4.The Parties acknowledge and agree to Attachment C – Purchase of Services Polices
for Providers of Prevention Services FY23 in Exhibit IV, as attached hereto.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 1 of 32
For and in consideration of the mutual assurances, promises, acknowledgments,
warrants, representations and agreements set forth in the Contract and this Amendment,
and for other good and valuable consideration, the receipt and adequacy of which is
hereby acknowledged, the undersigned hereby execute this Amendment on behalf of
the OCHN and County and by doing so legally obligate and bind the OCHN and
County to the terms and conditions of the Contract and this Amendment:
OAKLAND COMMUNITY HEALTH NETWORK:
BY: ________________________________ DATE: _______________________
Callana Ollie,
Chief Legal Officer
BY: ________________________________ DATE: _______________________
Anya Eliassen,
Chief Financial Officer
THE COUNTY OF OAKLAND
BY:________________________________ DATE:_______________________
___________________________________,
Chairperson, Oakland County Board of Commissioners
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 2 of 32
OAKLAND COUNTY INTERLOCAL AGREEMENT
BETWEEN
OAKLAND COUNTY
AND
OAKLAND COMMUNITY HEALTH NETWORK
EXHIBIT I: Financial 1 and Reporting Obligations
Health Education SUD Prevention Services
October 1, 2022 – September 30, 2023
Description Budget
FY22 Travel 3,644
Supplies & Materials 11,859
Contractual 178,847
Other 25,641
OCHN Funding 199,992
Local Match 19,999
Total Budget – Health Education 219,991
American Rescue Plan Act Grant (ARPA)
October 1, 2022 – September 30, 2023
Description Budget
FY22 Travel 663
Supplies & Materials 3,650
Contractual 14,409
Other 1,278
Total Budget 20,000
The County shall submit an invoice to the OCHN on a monthly basis, which shall itemize all
amounts due and or owing by OCHN. The monthly invoice must reflect total actual program
expenditures by category. The invoices shall be submitted in a form and format agreed upon by
the Parties.
1 Some or all of the funds provided by OCHN are federal funds. Department of Health and Human
Services/Substance Abuse and Mental Health Services Administration (SAMHSA), CFDA NO. 93.959, Block Grant
for Prevention and Treatment of Substance Abuse. Grant NO. 13 B1 MI SAPT, award phase 2022. Title SAPT
Block Grant sub-recipient relationship, non-research and development project.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 3 of 32
OAKLAND COUNTY INTERLOCAL AGREEMENT
BETWEEN
OAKLAND COUNTY
AND
OAKLAND COMMUNITY HEALTH NETWORK
EXHIBIT II: Scope of Services
1. SUPPORTS AND SERVICES
1.1. The County shall assure for the provision of services for eligible individuals pursuant to
the Contract and this Scope of Services.
1.2. Federal Award Project Description: Support projects for the development and
implementation of prevention activities directed to the diseases of alcohol and drug
abuse.
1.3. The County agrees to provide Health Education Substance Use Prevention Services and
will comply with the Management by Objective requirements in Attachment B and the
terms and conditions in Attachment C.
2. ADMINISTRATIVE RESPONSIBILITIES
2.1. Required Staff Training(s): The County understands that various federal and state rules
and regulations impose specific training requirements on the Parties. The County agrees
that its entire staff will receive all required training(s) as applicable. The County also
agrees to document the completion of applicable training in the personnel file of each
staff.
2.2. Cultural Competency: The County must assure meaningful service for persons with
diverse cultural backgrounds (including, but not limited to religious, ethnical,
geographical, geriatric, socioeconomic, and/or disability). The County shall assess the
population(s) it serves, collaborating with other community agencies (e.g., Council on
Aging) and training staff on any identified cultural issues.
2.3. Relationship with Other Providers (Contractors): The County when practicable shall
collaborate with agencies in the community to the benefit of the consumer. Such
agencies include but are not limited to hospitals, intermediate school district, local
schools, faith-based organizations, courts, law enforcement, community corrections,
substance abuse, Indian Health Services and Tribal Health Centers, Early On and other
early intervention programs that are essential to positive outcomes to our community.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 4 of 32
2.4. Customer Services:
2.4.1. Orientation: The County will provide orientation to newly enrolled Consumers.
Orientation will include information about benefits and services provided by
Oakland County's Office of Substance Abuse Services.
2.4.2. The County will acknowledge receipt of support and for Federal and State funds
from the Michigan Department of Health and Human Services (MDHHS) and/or
Oakland Community Health Network (OCHN) in any articles or publications that
are produced utilizing any such funding.
2.4.3. Grievance: The County will have a policy, procedures and a process to document
the number and nature of grievances and complaints brought to the County.
2.5. Recipient Rights:
2.5.1. The County will, and will require its subcontractors to, at every service site, make
readily available to all employees and staff, and if applicable, will post in a
conspicuous place and/or make available, the following:
2.5.1.1. A summary of all recipient rights guaranteed by the Public Health Code;
2.5.1.2. Post the MDDHS/Office of Recipient Rights (ORR) Reporting Requirements
poster for staff;
2.6. Service Cost Tables Reporting: The County agrees to cooperate with and participate in
OCHN's cost integrity process. The County agrees to develop and submit to OCHN
Service Cost Tables upon request by the OCHN. The County agrees that the rates it
establishes for all procedures listed in the Service Cost Table are based on actual costs
and are representative of current costs incurred and paid by the County.
3. DATA MANAGEMENT
3.1. As to the extent provided for by law the OCHN is the owner of all data related to
consumers pursuant to this agreement including all data entered into the County's
management information system(s), such as, all eligibility and demographic data,
utilization data, claims data, and any other service, administrative or financial
information that has passed through the OCHN's or the County's operation that resides
with the County. Notwithstanding the foregoing, the County is not precluded from
maintaining and utilizing the data identified in this section in support of the services
provided to the consumer and internal County operations.
3.2. The County shall implement tools to prevent unauthorized access and virus protection to
its internal transaction and office system using planning, management, and system
monitoring tools.
3.3. The Parties agree that when transmitting information electronically the national ANSI
and HIPAA compliant standards shall be utilized.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 5 of 32
American Rescue Plan Act Funding (ARPA) – FY23
The purpose of the ARPA Evidenced-Based Prevention Program (EBP) Project is to increase the
capacity of the Oakland Community Health Network (OCHN) provider system to effectively
address the social emotional needs of youth and risks for substance and mental health that was
identified in our needs assessment. OCHN prevention providers received training in the
following EBP, Michigan Model for Health (MMH).
Michigan Model for Health (MMH) is an evidenced-based comprehensive health education
curriculum that targets Pre-K through 12th grade students utilizing a skills-based approach.
Students are taught the knowledge and skills they need to build and maintain healthy behaviors
and lifestyles. It is age-appropriate and provides sequential lessons that focus on the serious
health challenges school-aged children face.
1. Eligibility Requirements
• The County is a current provider or registered vendor of OCHN
• The County staff have experience in interacting with families and teens with knowledge
of social emotional needs of youth.
2. Scope of Service
• The County has attended a training in the program outlined above.
• The County agrees to provide at least eighty (80) outputs of the program each year for the
life of the grant in which they were trained during FY23.
• The County will submit an invoice (ATTACHMENT B 2) for ARPA EBP funded
activity that may include registration cost, travel expenses, and curriculum materials and
facilitator charges. Invoices specific to the ARPA EBP grant (separate from the SAPT
invoice) are sent electronically to Janet Selberg, selbergJ@oaklandchn.org with cc. to
Rachel Rhodes, rhodesr@oaklandchn.org
• The County will provide OCHN with proof of training attendance in the form of a
certificate, sign-in sheet or other document with supervisor signature.
• The County agrees to a site visit and programmatic review.
• The County agrees to monthly reporting for data gathering purposes.
3. Obligations of OCHN
• OCHN, in collaboration with MDHHS, will provide technical assistance to The County
upon request
• OCHN will reimburse The County for registration cost, mileage, curriculum and other
educational materials necessary to conducting the programs including facilitation charges
as outlined in ATTACHMENT B2 of this amendment.
4. Outcomes/ Deliverables
• Provide the OCHN with a participant sign-in sheet with time and date noted for all
sessions of the program
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 6 of 32
• Provide an invoice for ARPA-EBP implementation expenses to OCHN as noted above by
the 10th day of the month following the service month utilizing the Budget Summary &
Billing Pages provided with this agreement (ATTACHMENT B2)- and as delineated in
the Scope of Service
• Provide OCHN with outcome evaluation using the tool provided by the program
developers.
• Enter group information into the Michigan Prevention Database System (MPDS).
5. Technical Assistance
Provided by the SUD Prevention Coordinator, Rachel Rhodes-
rhodesr@oaklandchn.org or 248.452-9850
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 7 of 32
OAKLAND COUNTY INTERLOCAL AGREEMENT
BETWEEN
OAKLAND COUNTY
AND
OAKLAND COMMUNITY HEALTH NETWORK
EXHIBIT IV: Attachments
ATTACHMENT B
Management by Objective
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 8 of 32
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 9 of 32
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 10 of 32
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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Amendment Number 2 of Contract Number 2022-0215-SUDP
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ATTACHMENT B
Management by Objective for ARPA Funding
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 13 of 32
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 14 of 32
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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ATTACHMENT C
OAKLAND COMMUNITY HEALTH NETWORK (OCHN)
SUBSTANCE USE DISORDER SERVICES
PURCHASE OF SERVICE POLICIES
For
PROVIDERS OF PREVENTION SERVICES
FY 2023
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 16 of 32
TABLE OF CONTENTS
I. BUDGETS ................................................................................................................................. 2
Prevention Budget .................................................................................................................. 2
Program Local Match ............................................................................................................ 2
II. BILLING AND PAYMENT ....................................................................................................... 2
Prevention Billing Summary Form ........................................................................................ 2
Billing Summary Page ............................................................................................................ 2
Bill Due Date .......................................................................................................................... 2
Reimbursements ...................................................................................................................... 2
Performance Requirement ...................................................................................................... 2
III. AMENDMENTS AND ALLOCATIONS ................................................................................... 2
Request an amendment ........................................................................................................... 2
Budget amendment .................................................................................................................. 2
Request for Amendment Form.............................................................................................. 2-3
IV. DATA, REPORTING AND RECORD RETENTION…………………………… .. ……...3
Evidence-Based Services Prevention Management by Objectives (MBO) ......................... 3
Reimbursement ........................................................................................................................ 3
Reporting Requirements ......................................................................................................... 3
Electronic Submission ............................................................................................................ 4
Records Retention ................................................................................................................... 4
V. AGENCY AND STAFF REQUIREMENTS ................................................................................... 4
License and Prevention Credential Requirements ............................................................... 4
Criminal Background Checks ................................................................................................ 4
Prevention Directors Meeting ……………………………………………………………………4
VI. CULTURAL COMPETENCY & TRAININGS ...................................................... ….4-5
Cultural Compet ency Plan ..…………………………………………………………………….5
Trauma-Informed Training ...…………………………………………………………………....5
Communicable Disease Training ..………………………………………………………………5
VII. CONFIDENTIALITY…………………………………………………………………………….5-6
VIII. CHOICE POLICY AND PROCEDURE………………….………………………...……….5
The Federal Register ............................................................................................................... 5
Charitable Choice Regulations .............................................................................................. 6
IX. REQUIRED DISCLAIMERS ..................................................................................... 6
Funding Sources Statement ..................................................................................................... 6
Recipient Rights Statement ...................................................................................................... 6
OCHN Logo Requirements .................................................................................................... 6
X. OCHN PREVENTION REVIEW……………………………………………………….6
Programmatic and On-Site Reviews ...................................................................................... 7
Bi-annual Financial Review ................................................................................................... 8
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 17 of 32
OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
2
FY 2022/2023
OCHN Prevention Program Policies and Procedures
I. Budget
A. Prevention programs will submit an annual budget for OCHN-administered funds that
include revenue sources for total substance use disorder prevention programming using
the following forms: Prevention Budget/ Billing Summary and Budget/Billing Pages
(Attachment A .)
B. Programs will provide a 10% local match for all OCHN funding and submit as part of
budget.
C. 90% of prevention expenditures are expected to be directed to programs which are
implemented as a result of an evidence-based decision-making process.
II. Billing and Payment
A. The Prevention Billing Summary Form along with the Prevention Budget Billing Pages
are the source document for billing the OCHN for actual expenditures related to
prevention services provided each month.
B. Payment for services will be based on actual expenses incurred for service delivery. The
Billing Summary page must include the total amount expended for each category
(Travel, Supplies & Materials, Contractual, and Other) for the invoiced month, as well as a
breakout by funding source (i.e. OCHN funds and/or Local Match) The Billing Pages
must contain the monthly charges by line item in each categ ory as identified in the
original budget.
C. Bills are due to OCHN no later than ten (10) days after the close of each service month;
those received after the 10th may not be processed for payment until the following month.
D. Reimbursements will be based on the understanding that a certain level of performance,
measured by outputs (face-to-face, direct service hours engaged with the service
population, or activities outlined in the Preven tion Guidance provided by OROSC and
approved by Prevention Coordinator - ATTACHMENT B) must be met in order to
receive full reimbursement of costs up to the contracted amount at the end of the contract
year.
E. For this agree ment, the performance requirement is defined as 100% of the OCHN-
funded share of the Total Expenditure amount.
III. Amendments and Adjustments to Allocations
A. A program can request an amendment at any time up to the OCHN amendment deadline
of May 12, 2023.
B. A budget amendment with revised budget pages is required when there is a change in a
budget category over $2,000 or 15% of the category, whichever constitutes the greater
amount. The deviation allowance does not authorize new categories or line items within
the category.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 18 of 32
OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
3
C. Request for Amendment Form (Attachment C-1) must be completed and approved by
OCHN before requested changes can be implemented. In order to move 15% or $2,000
(whichever is greater) from one budget category to another, it is nec essary to complete the
Request fo r Amendment Form , including a detailed explanation of the changes and
updated budget summary and billing pages – (email to Kristie Schmiege at
schmiegek @oaklandchn.org or by mail to her attention at 5505 Corporate Dr., Troy, MI
48098. For questions call 248.452.9850). You will receive a determination of approval,
disapproval or pending status within 10 business days or comments/questions if further
clarification is required.
IV. Data, Reporting & Record Kee ping
A. Prevention contractors must provide evidence -based prevention services (as defined in the
Research-based Prevention Protocol of their proposal ).
B. A Prevention Management by Objectives (MBO) Form (Attachment B) describing
specific measurable objectives and assigned number of outputs for each is submitted as
part of the contract and will be reviewed for compliance during the contract year.
C. All OCHN-funded program grantees are required to participate in the collection of State-
required prevention data elements by utilizing the Michigan Prevention Data System
(MPDS) (http://mpds.sudpds.com), a web -based system- including but not limited to:
• Number of direct hours (defined as face to face or output hours)
• Collection of strategies employed (Information Dissemination, Educatio n,
Community-Based , Problem Identification and Referral, Environmental, or
Alternative)
• Population code
• Service population, type and domain
• Service population demographics
• Evidence-based practice
• Funding source
• Program Intervention Name
Outputs delivered during the invoiced month must be entered into the Michigan Data
Prevention System (MPDS) by the 10th of the month following the service month , for on-
time reimbursement.
D. Reimbursement is based on the understanding that a certain level of performance ,
measured by outputs (face-to-face, direct service hours engaged with the target
population, or approved activities outlined in Prevention Guidance Document) must be
met in order to receive full reimbursement of costs, up to the contracted amount.
E. OCHN grantees must submit a monthly and End-of-Year Prevention Program Report
(Attachment C -2) that includes a narrative, data outcome tables and process evaluation
results for all programs/services - no later than ten (10) days following the end of the
reporting period (e-mail to rhodesr@oaklandchn.org ).
F. OCHN grantees must incorporate tobacco prevention activitie s into their programming. A
report of tobacco prevention activities must be completed annually, using the Tobacco
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 19 of 32
OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
4
Activity Report Form (Attachment C-3) – and submitted with the monthly and End-of-
Year Reports (e-mail to rhodesr@oaklandchn.org).
G. All forms and reports must be submitted in electronic form. Failure to submit required
reports in a timely manner to OCHN will result in withholding of payment for services.
H. Program documents related to OCHN -funded prevention services must be retained for a
period of seven (7) years in addition to the present contract year. After a period of three
(3) years post-program completion, providers may store documents electronically.
V. Agency and Staff Requirements
A. All agencies receiving OCHN-administered prevention funds must possess/demonstrate
expertise in substance use prevention. Unless Prevention Programs have been approved by
the Prevention Coordinator, all agencies must possess or have in possession by October 1,
2022, a current State of Michigan substance use prevention license (CAIT, Community
Change, Alternatives, and Information & Training). http://www.michigan.gov/lara/
B. During the period covered by this contract, the provider agency that directly employs or
contracts with the OCHN to provide prevention services is responsible for verifying that
staff who have been employed for a year or more are credentialed or have development
plans and verifying the ongoing certification status of employees. This includes
verification of the credential(s), monitoring staff dev elopment plans, and compliance with
continuing education requirements.
C. As a condition of the contract, Prevention Professionals (commonly described as P rogram
or Prevention Coordinators, Prevention Specialist, or Consultants i.e., those responsible
for the planning, coordination and /or oversight of program implementation) must be
certified by the Michigan Certification Board for Addiction Professional (MC BAP) as one
of the following:
• Certified Prevention Specialist M (CPS-M)
• Certified Prevention Specialist R (CPS-R)
• Certified Prevention Consultant M (CPC -M)
• Certified Prevention Consultant R (CPC-R)
• Certified Health Educator Specialist (CHES)
OR
Must file a certification “Development Plan” with Michigan Certification Board for
Addiction Professionals (MCBAP) within sixty (60) days of the contract start date.
Information on filing a Development Plan may be found at www.mcbap.com. Failure to
comply with credentialing requirement may result in termination of the contract.
D. All providers must conduct yearly criminal background checks on all employees (and
potential employees) employed in programs funded by the OCHN, as a condition of
employment.
E. All providers are expected to attend at least 90% of the scheduled Prevention Directors
meetings. If the Prevention Director is not able to attend, please make arrangements for
someone from the staff at your organization to attend or inform the OCHN Prevention
Coordinator prior to the meeting.
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OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
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F. For all Synar and Coverage Study guidelines please refer to the Policy 30.0 Synar
DYTUR-Procedures.
G. There is a protocol for all media campaigns utilizing SAPT, SOR, and any discretionary
funds. Please refer to the Policy 31.0 Media Campaign Procedures.
VI. Cultural Competency, Trauma Informed Approach to Prevention , & Communicable Disease
A. Providers must submit a cultural competency plan to the OCHN, addressing the following
elements and be able to document same at their annual program review:
• The program must identify and as sess the cultural needs of potential and active
clients based on population served
• The program must identify how access to service s is facilitated for persons with
diverse cultural backgrounds and Limited English Proficiency (LEP) and hearing
impairment
• The program must identify standards for the recruitment and hiring of culturally
competent staff members
• The program must document cultural competency tr aining for provider staff upon
hire and bi-annually (every two years) thereafter for all staff
B. Agencies must document staff training in a trauma-informed approach to Prevention
within the period of the contract . The training must incl ude: an understanding of the
critical nature of trauma in the development of SUD; an understanding of the dimensions
of resiliency; building community capacity and learning strategies to change community
conditions to support individuals, families and communities affected by trauma/adverse
experiences.
C. Agencies must document staff training in cultural competency within the period of the
contract. The training must include basic information on cultural competence for providers
of behavioral health services, helps learners identify how culture aff ects the perception of
others, describe the importanc e of understanding our o wn and other’s culture and values
and how they affect the quality of services for those we serve.
D. Agencies must document staff training in communicable disease within the pe riod of the
contract. The training must include identify transmission methods, symptoms and
treatments for communicable diseases, describe communicable disease prevention
methods, recognize risk factors that increase risk exposure, and identify connections
between communicable disease and sub stance use.
E. Agencies must document staff trai ning in any of the required and updated trainings that
OCHN requests to be in compliance with MDHHS, LARA, and SAMHSA requirements.
VII. Confidentiality
The provider will comply with all Federal requiremen ts contained in 42 CFR, Part 2,
Confidentiality of Alcohol and Drug Abuse Patient Records, Final Rule, June 9, 1987, as well as
any information about alcohol and other drug use obtained by a “program” (42 CFR2.11),
(42CFR2.12b). Information may be disclosed in summary, statistical or other form which does not
directly identify particular individuals. Providers must submit a copy of their confidentiali ty policy
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
6
to OCHN and be able to d ocument at their annual program review.
VIII. Charitable Choice Policy a nd Procedure
A. The Federal Register (45 CFR part 96) contains federal Charitable Choice SAPT block
grant regulations that apply t o prevention and treatment providers/programs. The
regulations require: (1) that the designatio n of religious (faith-based) organizations as such
be based on the organization’s self-identification as religious (or faith-based) and (2) that a
program benefi ciary receiving services from such an organization who objects to the
religious character of a program has a right to notice, re ferral and alternative services
which meet standards of timelines s, capacity, accessibility, and equivalency – and
ensuring contact to this alternative provider.
B. The program is required to comply with all applicable requir ements of the Charitable
Choice regulations. If the program identifies itself as a religious or faith-based
organization, it must provide the federally mandated model notice to all clients. Providers
who are faith-based must notify participants of their ri ght by providing the following
model notice:
No provider of substance abuse services receiving Federal funds
from the U.S. Substance Abuse and Mental Health Serv ices
Administration, including this organization, may discriminate
against you on the basis of religion, a religious belief, a refusal to
hold a religious belief, or a refusal to actively participate in a
religious practice.
If you object to the religious character of this organization, Federal
law gives you the right to a referral to another provi der of substance
abuse services. The referral, and your receipt of alternative services,
must occur within a reasonable period of time after you request
them. The alternative provider must be accessible to you and have
the capacity to provide substance abuse services. The services
provided to you by the alternative provider must be of a value not
less than the value of the services you would have received from thi s
organization.
IX. Required Statement of Funding Sources and Statement of Recipient Rights
Prevention programs that maintain reco rds that include both the recipient’s name and information
regarding his or her substance use, shall provide the recipient wi th a summary of recipient rights
protected by state or federal laws and promulgated rules. Any program announcement, brochure,
or other written communication that describes the program’s substance abuse prevention services
shall state the following:
Recipients of substance abuse prevention services have rights protected by state and
federal laws an d promulgated rules”. For information contact the OCHN Substance
Use Disorder Services, Recipient Rights Coordinator Sherrie Cook, 5505 Corporate
Dr., Troy, MI 48098 or call 248.858.1210
Providers must assure that any program reports, articles and publica tions that result from
information gathered through the use of state, federal or county funds ackn owledge receipt of that
support from the OCHN and/or the appropriate federal agencies by use of the following statement:
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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OCHN PREV CONTRACTS ATTACHMENT C FY 2022/2023
7
Federal, State, and/or County Funding has been provided through the Oakland
Community Health Network Substance Use Disorder Services to support the project
costs.
In addition to the disclaimer above, the promotion of any program, activity, training, or meeting
funded in whole or in part by the OCHN must contain the OCHN logo.
X. Programmatic and Financial Review
OCHN grantees are subject to an annual site review as well as annual scheduled program review
by the OCHN Service Network Analyst. The site review affords OCHN an opportunity to
experience the staff and program in action. The program review looks at compliance with
contractual requirements: licensing requirements, progress toward meeting output and outcome
goals, process and outcome evaluation, certification and background checks on employees,
timeliness and accuracy of billing and reporting, etc.
Grantees are also subject to a complete financial review on a bi -annual basis by the OCHN Fiscal
Analyst. The objectives of the financial review are:
• Verify the reported expenditures have supporting documentation and were allowable
expenses
• Determine whether an agency’s internal controls are adequate to provide reasonable
assurance that funds are managed in compliance with applicable laws and regulations
and/or provisions of the contract
• Confirm the billing was consistent with the contr act bu dget
• Review the agency’s financial audit to determine if there were any significant audit
findings
Prevention contract questions may be addressed to Rachel Rhodes, Prevention Coordinator for OCHN:
rhodesr@oaklandchn.org or (248)452-9850.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 23 of 32
Amending Budget:
Expenditures Proposed Budget Increase/Decrease
Travel 0
Supplies/Materials 0
Contractual 0
Other 0
TOTAL EXPENDITURES 0 0
Source of Funds
Local Match 0
OCHN Funding 0
TOTAL FUNDING 0 0
Approved Not Approved Pended:
Date Comments:
Signature Date
ATTACHMENT C-1
0
Current Budget
REQUEST FOR AMENDMENT
OAKLAND COMMUNITY HEALTH NETWORK
Substance Use Disorder Services
Agency:
Date Requested: Requested by:
Purpose of Amendment:
0
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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ATTACHMENT C-2
OCHN Contract Prev ATTACHMENT C-2 FY 2022/2023
Agency Name:
OAKLAND COMMUNITY HEALTH NETWORK
Substance Use Disorder Services
End-of-Year
Prevention Program Report
End of Year – Due October 13, 2023
Note: The End-of -Year report should contain a summation of activity for the entire year (October-September).
Simply type your responses beneath each question.
1) Describe your service population for the reporting period. Indicate how successful you were in recruiting your
target population. It is not necessary to provide exact numbers…however, please describe what risk categories you
intended to target and if different from your original plan- describe the actual population served. What impact did
this change, if any- have on program/service delivery or outcomes?
2) Refer to your MBO (Management By Objective) form and comment on any services that were not provided as
planned (explain either why you were not able to complete the activity and/or why you did something different
from the original plan.)
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Amendment Number 2 of Contract Number 2022-0215-SUDP
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ATTACHMENT C-2
OCHN Contract Prev ATTACHMENT C-2 FY 2022/2023
3) Describe your program’s overall process evaluation method(s) and the results of your evaluation. (In a process
evaluation items commonly include recruitment procedures and retention rate; number of participants; staff
processing of program activity; participant comments or results of satisfaction surveys.) Describe any ways in
which your process evaluation results will be used to improve the program in the future.
4) Outcome Evaluation: Complete the Attached Outcome Tables for each service/activity listed on your MBO Form.
State your measurable indicator(s) from the MBO Form and provide supporting data to show if the outcome was
achieved. Use as many tables as you need to present results in an organized and logical manner (please number if
using multiple tables.) For activities/services that are implemented as series at multiple locations - you may choose
to state outcomes by grade, school, city, etc. but the provider must include a table with an overall result for a
particular program.
5) Provide supporting documentation.
• Actual data used to calculate outcome results and a description of how the results were determined
• Program flyers or letters used to recruit participants
• Outline or brief description of the program or curriculum
• A copy of evaluation instruments
• Letters of support or news articles generated by the program
Call or email Rachel Rhodes at rhodesr@oaklandchn.org for assistance in collecting, calculating, analyzing and
reporting data.
OAKLAND COMMUNITY HEALTH NETWORK Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 26 of 32
ATTACHMENT C-2
OCHN Contract Prev ATTACHMENT C-2 FY 2022/2023
Substance Use Disorder Services
Prevention Activities FY 2022/2023
Outcomes Table # Example
Program Name: Example Group Designation:
MBO
Activity Target Population Indicator Statement Outcome Results
OCHN
Use
Only
#____
Hispanic parents living in
the Pontiac and Auburn
Hills areas
Hispanic parents who
participate in the Love &
Logic Program (3 hours
per week for 8 weeks) will
experience (a) 7%
increase in positive
parenting attitudes and
interaction with their
children and (b) a 10%
increase in knowledge of
positive parenting
techniques as measured
by the Love & Logic Pre
Post Test that
accompanies the
program.
Auburn Hill Elem Group #1
(a) 15% ▲
(b) 12% ▲
Comments:
Please Note: For activities/services that are implemented in series at multiple locations – you may choose to state
outcomes by grade, school location, city, etc., but please also include a table with an overall result. Copy and create
as many tables as you deem necessary to accurately report your results. Attach supporting data/spreadsheets to
table or at end of report.
OAKLAND COMMUNITY HEALTH NETWORK
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
Page 27 of 32
ATTACHMENT C-2
OCHN Contract Prev ATTACHMENT C-2 FY 2022/2023
Substance Use Disorder Services
Prevention Activities FY 2022/2023
Outcomes Table # 1
Program Name: Group Designation:
MBO
Activity Target Population Indicator Statement Outcome Results
OCHN
Use
Only
#____
Comments:
Please Note: For activities/services that are implemented in series at multiple locations – you may choose to
state outcomes by grade, school location, city, etc., but please also include a table with an overall result. Copy
and create as many tables as you deem necessary as you deem necessary to accurately report results. Attach
supporting data/spreadsheets to table or at end of report.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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ATTACHMENT C-2
OCHN Contract Prev ATTACHMENT C-2 FY 2022/2023
OAKLAND COMMUNITY HEALTH NETWORK
Substance Use Disorder Services
Prevention Activities FY 2022/2023
Outcomes Table # 2
Program Name: Group Designation:
MBO
Activity Target Population Indicator Statement Outcome Results
OCHN
Use
Only
#____
Comments:
Please Note: For activities/services that are implemented in series at multiple locations – you may choose to
state outcomes by grade, school location, city, etc., but please also include a table with an overall result. Copy
and create as many tables as you deem necessary to accurately report results. Attach supporting
data/spreadsheets to table or at end of report.
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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Prevention Monthly Report & MPDS Verification
Month/Year
Reporting Period:
Agency Name:
Total # of records:
Total # people served:
Total # of groups:
Total # of activities:
Total # of units:
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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Activity Name Activity
Date
Activity
Time
Activity
Units Activity Notes Staff Strategy Funding Source
Total Outputs:
Reporting Period:
Month/Year
Prevention Monthly Report Continued
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Amendment Number 2 of Contract Number 2022-0215-SUDP
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Instructions:
Reporting Period:
Month/Year
Specific topic of information
Description of population distributed to:
Estimated Outputs
Description of audience and type of format
Estimated Outputs
Activity
Estimated Outputs
Activity
Estimated Outputs
Specific topic of information
Description of population distributed to:
Estimated Outputs
Description of population distributed to:
Estimated Outputs
Please briefly describe any tobacco use prevention activities your group or organization has undertaken in the past six-month reporting period in each of the following
strategies:
Information Dissemination defined as one-way communication from the source to the intended audience. Examples are social media, multimedia, etc.
Community-Based Activity (Describe activity: examples may include assessing community needs regarding tobacco use; accessing services and funding for tobacco use prevention;
providing trainings on tobacco use prevention, etc.)
Environmental Strategies (Describe activity: examples include any activity undertaken to change the physical, legal, economic, and social processes of a community that are associated
with tobacco use, i.e., establishing tobacco free policies, preventing underage sale of tobacco products to minors, vendor education, changing codes, ordinances, or regulations regarding sale and
use.)
Problem ID & Referral (Describe activity: examples include any activity undertaken to change the physical, legal, economic, and social processes of a community that are associated
with tobacco use, i.e., establishing tobacco free policies, preventing underage sale of tobacco products to minors, vendor education, changing codes, ordinances, or regulations regarding sale and
use.)
Education Educational activities aim to improve critical life and social skills. Type of format (class, series of classes, video, speaker, skills training, etc.)
Alternatives Opportunities for the target population to participate in safe and healthy activities. Ex. are free social & recreational events, youth leadership activities, drop-in centers
3
Oakland Community Health Network
Amendment Number 2 of Contract Number 2022-0215-SUDP
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