HomeMy WebLinkAboutReports - 2023.04.20 - 38145
AGENDA ITEM: Subrecipient Agreement between Oakland County and Honor Community Health
DEPARTMENT: Health & Human Services
MEETING: Board of Commissioners
DATE: Thursday, April 20, 2023 6:00 PM - Click to View Agenda
ITEM SUMMARY SHEET
COMMITTEE REPORT TO BOARD
Resolution #2023-2772
Motion to approve the attached Subrecipient Agreement between Oakland County and Honor
Community Health and authorize the Board Chair to execute this agreement.
ITEM CATEGORY SPONSORED BY
Contract Penny Luebs
INTRODUCTION AND BACKGROUND
Miscellaneous Resolution #22422 approved the FY 2023 United States Department of Agriculture,
Gus Schumacher Nutrition Incentive – Produce Prescription Grant in the amount of $453,000 for the
period September 15, 2022 through September 14, 2025 with the Health Division. A portion of the
grant award, in the amount of $20,000 will be used to reimburse Honor Community Health for
referral services, assisting in participant recruitment, and contributing to the collection of participant-
level core metrics.
The subrecipient agreement has completed the Grant Review Process and a budget amendment is
not required because it was included in the grant acceptance.
BUDGET AMENDMENT REQUIRED: No
Committee members can contact Michael Andrews, Policy and Fiscal Analysis Supervisor at
248.425.5572 or andrewsmb@oakgov.com, or the department contact persons listed for additional
information.
CONTACT
Leigh-Anne Stafford, Director Health & Human Services-APP
ITEM REVIEW TRACKING
Penny Luebs, Board of Commissioners Created -
AGENDA DEADLINE: 04/20/2023 6:00 PM
ATTACHMENTS
1. Grant Review Sign-Off
2. 2023.03.06 Revised FY23 GUS SCHUMACHER NUTRITION INCENTIVE GRANT
PROGRAM sub grant Honor health (1)
COMMITTEE TRACKING
2023-04-11 Public Health & Safety - Recommend to Board
2023-04-20 Full Board - Approve
Motioned by: Commissioner Robert Hoffman
Seconded by: Commissioner Michael Gingell
Yes: David Woodward, Michael Spisz, Michael Gingell, Penny Luebs, Karen Joliat, Kristen
Nelson, Christine Long, Robert Hoffman, Philip Weipert, Marcia Gershenson, Janet Jackson,
William Miller III, Yolanda Smith Charles, Charles Cavell, Brendan Johnson, Ajay Raman (16)
No: None (0)
Abstain: None (0)
Absent: Gary McGillivray, Gwen Markham, Angela Powell (3)
Passed
GRANT REVIEW SIGN-OFF – Health & Human Services / Health Division
GRANT NAME: Prescription for Healthy Oakland
FUNDING AGENCY: United States Department of Agriculture
DEPARTMENT CONTACT: Stacey Smith 248-452-2151
STATUS: Grant Amendment #2 (less than 15%)
DATE: 03/23/2023
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
Corporation Counsel:
Approved. – Heather Lewis (03/22/2023)
PROGRAM YEAR 2023
GUS SCHUMACHER NUTRITION INCENTIVE GRANT PROGRAM
SUBRECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND HONOR HEALTH
Data Universal Numbering System (DUNS) # 041808262
This Agreement is made between Oakland County, a Constitutional Corporation, 1200 North
Telegraph, Pontiac, Michigan 48341 ("County") and Oakland Integrated Healthcare Network d/b/a Honor
Community Health, 461 West Huron, Pontiac, Michigan 48341 ("Subrecipient). The County and
Subrecipient shall be collectively referred to as the “Parties.”
IT IS HEREBY AGREED AS FOLLOWS:
1. Exclusive Agreement. This Agreement, including exhibits attached hereto, constitutes the entire
Agreement between Subrecipient and County for the scope of services on Exhibit A for the term
of this Agreement. The Agreement includes the following documents which are incorporated
herein by reference and are deemed to be part of this contract as if set forth in full herein and, in
the event of inconsistencies between the documents, shall govern in the order listed:
a. This Contract
b. All Provisions required by law to be inserted in this contract whether actually inserted or
not.
2. Term of Agreement. This Agreement will become effective on October 1, 2022, and shall continue
until October 31, 2023. No services shall be provided, and no costs incurred until this Agreement
is fully executed by both parties. This Agreement may be extended or renewed by written
agreement signed by both parties. All provisions of this Agreement shall apply to all services and
all periods of time in which the Subrecipient renders services for the County.
3. Termination of Agreement.
a. With reasonable cause: Either party may terminate this Agreement immediately by giving
written notice of termination to the other party. For purposes of this Agreement,
reasonable cause shall be defined as: a material violation of this Agreement, or any act
or omission by the non-terminating party that exposes the terminating party to liability
for personal injuries or damage to property, real or personal.
b. Without cause: This Agreement will be terminated on 30 days’ written notice by either
party to this Agreement.
4. Services to be Performed. Subrecipient agrees to perform for the County the services listed on
the attached Exhibit A, SERVICES TO BE PROVIDED.
5. Federal Grant Funds. This Agreement designates the provider a subrecipient of the County. This
Agreement is being paid for by Federal grant program funds. Identification of Federal Dollars
Awarded:
CFDA Title: Food Insecurity National Incentive Grants Program
CFDA Number: 10.331
Award Name: Gus Schumacher Nutrition Incentive Grant Program
Award Number (FAIN): 20227042438540
Award Date: 9/27/2022
Federal Agency Name: National Institute of Food and Agriculture/USDA
Awarding Official Contact Information:
Mallory Koenings (202)604-1985 mallory.koenings@usa.gov
Period of Performance: 9/15/2022 -9/14/2025
6. Performance.
a. Subrecipient shall perform the Work as required by and in accordance with the schedule
or time requirements set forth in this Agreement.
b. Failure to complete services as required shall constitute a breach of this Contract.
c. The County shall have the option to allow the Subrecipient to cure a breach of this
Contract (the “Cure Period”). Failure to cure a breach of this Contract within the County
established Cure Period shall allow the County to, without further notice to the
Subrecipient, declare this Contract terminated and proceed with the replacement of the
Subrecipient and the County shall be entitled to all remedies available to it at law or in
equity.
7. Confidentiality. Subrecipient will not disclose or use, either during or after the term of this
Agreement, any proprietary or confidential information of County without County’s prior written
permission except to the extent necessary to perform services on County’s behalf. Proprietary or
confidential information includes:
a. Electronic information including but not limited to IP addresses, user histories, and
content of electronic communications;
b. Information belonging to the County, customers and/or suppliers of County about whom
Subrecipient gained knowledge as a result of Subrecipient’s services to County. This
information may contain any or all of the following: written, printed, graphic, or
electronically recorded materials furnished by County for Subrecipient to use; business
plans, customer lists, vendor lists, operating procedures, trade secrets, design formulas,
know-how and processes, computer programs and inventories, discoveries, and
improvements of any kind. Subrecipient shall not be restricted in using any material that
is publicly available, already in Subrecipient’s possession, or known to Subrecipient
without restriction, or that is rightfully obtained by Subrecipient from sources other than
County. On termination of Subrecipient’s services to County, or at County’s request,
Subrecipient shall deliver to County all materials in Subrecipient’s possession relating to
County’s business.
8. Expenses. Subrecipient shall be responsible for all the Subrecipient’s expenses incurred while
performing services under this Agreement. This includes license fees, memberships and dues;
automobile and other travel expenses; meals and entertainment; insurance premiums;
telephone; all salary/payroll expenses, and other compensation paid to employees or contract
personnel that the Subrecipient hires to complete the work under this Agreement.
9. Materials. Subrecipient will furnish all materials, equipment and supplies used to provide the
services required by this Agreement.
a. Permits and Licenses. Subrecipient declares that Subrecipient has complied with all
federal, state, and local laws requiring business permits, certificates, and licenses
required to carry out the services to be performed under this Agreement.
b. Grantee shall not purchase capital assets or equipment without written approval of the
COUNTY
10. Payment and Terms of Payment. In consideration for the services to be performed by
Subrecipient, County agrees to pay Subrecipient the compensation as set forth on Exhibit B and
at completion of work performed on attached Exhibit A.
11. Independent Contractor Status. The parties agree that Subrecipient is an independent contractor,
and that neither Subrecipient nor Subrecipient’s employees nor contract personnel are, or shall
be deemed to be, employees of County. In its capacity as an independent contractor, Subrecipient
agrees to and represents the following:
a. Subrecipient has the right and does fully intend to perform agreed services during the
term of this Agreement.
b. Subrecipient has the sole right to control and direct the means, manner, and method by
which the services required by this Agreement will be performed.
c. Subrecipient has the right to perform the services required by this Agreement at any place
or location and at such times as Subrecipient may determine.
d. The services required by this Agreement shall be performed by Subrecipient, or
Subrecipient’s employees or contract personnel, and County shall not hire, supervise, or
pay any assistants to help Subrecipient.
e. Neither Subrecipient nor Subrecipient’s employees or contract personnel shall receive
any training from County in the professional skills necessary to perform the services
required by this Agreement.
f. Neither Subrecipient nor Subrecipient’s employees or contract personnel shall be
required by County to devote full time to the performance of the services required by this
Agreement.
g. The Subrecipient does not receive the majority of its annual compensation from County.
h. The parties acknowledge and agree that County is entering into this Agreement with
reliance on the representations made by the Subrecipient relative to its independent
contractor status.
12. Benefits. Subrecipient understands that neither Subrecipient nor Subrecipient’s employees or
contract personnel are eligible to participate in any employee pension, health, vacation pay, sick
pay, or other fringe benefit plan of County.
13. Workers’ Compensation. County shall not obtain workers’ compensation insurance on behalf of
Subrecipient or Subrecipient’s employees. If Subrecipient hires employees to perform any work
under this Agreement, Subrecipient will cover them with workers’ compensation insurance and
provide County with a certificate of workers’ compensation insurance before the employees begin
work.
14. Unemployment Compensation. County shall make no state or federal unemployment
compensation payments on behalf of Subrecipient or Subrecipient’s employees or contract
personnel. Subrecipient will not be entitled to these benefits in connection with work performed
under this Agreement. If a Subrecipient (or Subrecipient’s employee) files a petition for and
receives unemployment compensation from the County, the Subrecipient shall reimburse the
County for the total amount of unemployment compensation awarded to and received by
Subrecipient (or Subrecipient’s employee) or such amount shall be deducted from and be an
offset against the amount of compensation due and payable to Subrecipient by County under this
Agreement.
15. State and Federal Taxes.
a. County will not withhold FICA (Social Security and Medicare taxes) from Subrecipient’s
payments or make FICA payments on behalf of the Subrecipient or the Subrecipient’s
employee or other personnel, or make state or federal unemployment compensation
contributions, or withhold state or federal income tax from or on behalf of the
Subrecipient or the Subrecipient’s employees or other personnel.
b. Subrecipient shall pay all taxes arising from or incurred while performing services under
this Agreement, including all applicable income, FICA, workers compensation, and/or
unemployment taxes. On demand, Subrecipient shall provide County with proof that
such payments have been made.
16. Insurance. Subrecipient, as an independent contractor, agrees to indemnify, defend, and hold
harmless County from any and all liability arising out of or in any way related to Subrecipient’s
performance of services during the term of this Agreement, including any liability resulting from
negligent, grossly negligent, intentional or reckless acts or the acts of the employees or agents of
Subrecipient. Specific insurance is required as set forth in the attached Exhibit C.
17. Dispute. In the event of any dispute or difference of any kind whatsoever, arising out of or in
relation to or in connection with the validity or invalidity, construction, execution, meaning,
operation or effect, change of or breach of this Agreement, which cannot be settled by the
individuals who have executed this Agreement by signature, such dispute or difference shall be
referred to the Parties’ respective CEOs (or equivalents) who shall meet together with a view to
resolving the same within a period of not more than 30 days from the date of the submission. In
the event that Parties’ respective CEOs are unable to amicably resolve such dispute or difference
within a reasonable time, the Parties shall be free to pursue any and all available remedies at
equity or law including binding or non-binding mediation if agreed to by both Parties.
Pending resolution of such dispute or difference and without prejudice to their rights, the Parties
shall continue to respect all their obligations and to perform all their duties under this Agreement.
18. Contractor Representation and Warranty Regarding Federal Excluded Parties List. The
Subrecipient acknowledges that the County is receiving funds from or through the Federal
Government and that such funds may not be used to pay any Contractor on the Federal Excluded
Parties List (EPLS). The Subrecipient represents and warrants to the County that it is not on the
Federal EPLS. If the Subrecipient is in non-compliance at any time during execution or term of
this agreement (including any extensions thereof), the Subrecipient shall be in breach and the
County shall be entitled to all remedies available to it at law or equity, specifically including but
not limited to recovery of all moneys paid to the Subrecipient, all consequential damages
(including the loss of grant funding or the requirement that grant funding be returned), and
attorney fees (including the costs of in-house counsel) sustained as a result of the Subrecipient's
non-compliance with this warranty and representation.
19. Applicable Law.
a. This Agreement will be governed by the laws of the State of Michigan.
b. The Subrecipient shall at all times comply with all applicable local, State and Federal laws,
rules, and regulations applicable to this Contract and the work to be done herewith,
specifically including but not limited to:
i. The Elliott-Larsen Civil Rights Act,
ii. The Americans with Disabilities Act,
iii. Occupational Safety and Health Administration (OSHA) and Michigan OSHA
requirements,
iv. Laws and regulations concerning environmental or pollution matters,
v. Laws and regulations concerning export and/or data security and/or destruction
matters,
vi. Laws, ordinances, rules and regulations that may in any manner affect the safety
of equipment or material used in accordance with this Agreement, those
employed on the work, and the conduct of the work,
vii. The Michigan Iran Economic Sanctions Act, 2012 P.A. 517,
viii. State of Michigan Emergency Rules, Orders, and Directives.
The Subrecipient shall indemnify and hold County harmless against any claim or liability
arising from the violation of any such provisions.
20. Jurisdiction and Venue. The parties consent to the exercise of general personal jurisdiction over
it by the appropriate courts in the State of Michigan. Any action on a controversy that arises
under or in association with this Agreement shall be brought in the Oakland County Circuit Court,
State of Michigan, which both parties agree is a reasonably convenient place for trial of the action.
The parties both agree that their consent in accordance with this Section is not obtained by
misrepresentation, duress, the abuse of economic power, or other unconscionable means.
21. No Partnership. This Agreement does not create a partnership relationship. Neither party may
enter into a contract on behalf of the other party.
22. Partial Invalidity. The partial invalidity of any portion of this Agreement shall not be deemed to
affect the validity of any other provision. In the event that any provision of this Agreement is held
to be invalid, the parties agree that the remaining provisions shall be deemed to be in full fo rce
and effect as if they had been executed by both parties subsequent to the expunction of the
invalid provision.
23. Absence of Waiver. The failure of either party to insist on the performance of any of the terms
and conditions of this Agreement, or the waiver of any breach of such terms and conditions, shall
not be construed as thereafter waiving such terms and conditions, which shall continue and
remain in full force and effect as if no such forbearance or waiver had occurred.
24. Governmental Immunity. County does not waive its governmental immunity by entering into this
Agreement, and fully retains all immunities and defenses provided by law with respect to any
action based upon or occurring as a result of this Agreement.
25. Breach Notification and Recovery. Subrecipient will provide notification without unreasonable
delay when citizens’ personally identifiable information is lost or stolen or there is unauthorized
access or disclosure of non-public data. All communication relating to any of the data breach
situations described in this section shall be coordinated with the County. When Subrecipient or
its subcontractors are liable for the loss, Subrecipient shall bear all costs associated with the
investigation, response and recovery from the breach including but not limited to credit
monitoring services with a term of at least three years, mailing costs, website and toll free
telephone call center services. The County shall not agree to any limitation on liability that
relieves Subrecipient or its subcontractors from their own negligence or to the extent that it
creates an obligation on the part of the County to hold a contractor harmless.
a. Notification of Legal Requests. Subrecipient shall contact the County upon receipt of any
electronic discovery, litigation holds, discovery searches, and expert testimonies related
to, or which in any way might reasonably require access to the data of the County.
Subrecipient shall not respond to subpoenas, service of process, and other legal requests
related to the County without first notifying the County unless prohibited by law from
providing such notice
b. Security Logs and Reports. Subrecipient shall allow the County access to system security
logs that affect this engagement, its data and or processes. This includes the ability for
the County to request a report of the records that a specific user accessed over a specific
period of time.
26. Health Insurance Portability and Accountability Act (HIPAA). To the extent that this act is
pertinent to the services that Subrecipient provides to the County under this Agreement,
Subrecipient assures that it is in compliance with HIPAA requirements, as amended by the Health
Information Technology for Economic and Clinical Health Act (HITECH) under the American
Recovery and Reinvestment Act of 2009, PO 115-5.
27. Modifying the Agreement. This Agreement may be modified only by a writing signed by both
parties.
28. Administration of the Agreement. The person acting for the County in administering this
Agreement (hereinafter referred to as the Project Manager) is:
Carrie Hribar
Planning and Evaluation Supervisor
(248)425-1230 hribarc@oakgov.com
29. Subricipient’s Financial Contact for the Agreement. The person acting for the Subrecipient on the
financial reporting for this Agreement is:
Patti Fournier
248-724-7411 pfournier@honorcommunityhealth.org
30. Notices.
a. All notices and other communication for the parties may be served, mailed, or delivered
at the following addresses:
If to the Subrecipient:
Debra Brinson
Oakland Integrated Healthcare Network d/b/a Honor Community Health
461 W Huron St., Suite 103
Pontiac, MI 48341
If to the County:
Oakland County Health and Human Services
Att. Carrie Hribar
1200 N Telegraph Bldg. 34 East
Pontiac, MI 48341
b. Notice shall be deemed given as follows:
i. If served by personal delivery or certified mail, upon receipt.
ii. If served by US First Class Mail with postage pre-paid, service shall be deemed
given two (2) business days after such mail was deposited with the US Postal
Service assuming the deposit is made before the last posted pick up time at the
place of deposit.
iii. If served by email prior to 4:30 p.m., upon completion of the transmission unless
the party making service learns that the attempted service did not reach the email
address of the intended recipient or is returned as undeliverable. If served after
4:30 p.m., service shall be complete the following business day.
31. Miscellaneous.
a. Force Majeure: Either party shall be excused from performance under this Agreement
for any period of time during which the party is prevented from performing its obligations
hereunder as a result of any Act of God, war, civil disobedience, court order, labor dispute,
or other cause beyond the party's reasonable control. Such non-performance shall not
constitute grounds for default.
b. Titles and Headings: Titles and headings to articles, sections or paragraphs in this
Agreement are inserted for convenience of reference only and are not intended to affect
the interpretation or construction of the Agreement.
c. Anticipatory Breach: If the Subrecipient, at any time before delivery of services, declares
its intent not to perform in accordance with this Agreement, County shall have an
immediate cause of action for breach of this Agreement, and shall be entitled to all
remedies available to it at law or in equity.
d. Assignment and Delegation: Subrecipient may not assign or subcontract any rights or
obligations under this Agreement without County’s prior written approval.
e. No Third Party Benefit: The provisions of this Agreement are for the benefit of the parties
hereto, and not for the benefit of any other person or legal entity.
f. Availability of Funds: Each payment obligation of County is conditioned upon the
availability of government funds appropriated or allocated for the payment of this
obligation. If funds are not allocated and available for continuance of the services
performed herein, either party may terminate this Agreement at the end of the period
for which funds are available. County shall notify the Subrecipient at the earliest possible
time of the services that will or may be affected by the shortage of funds. No penalty
shall accrue to either party in the event this provision is exercised, and neither party shall
be obligated or liable for any further payments due or for any damages as a result of
termination under this Section.
g. This Agreement may be executed in counterparts, each of which shall be deemed an
original, but all of which together shall be deemed to be one and the same agreement. A
signed copy of this Agreement delivered by facsimile, e-mail, or other means of electronic
transmission shall be deemed to have the same legal effect as delivery of an original
signed copy of this Agreement.
h. Other Provisions: The parties hereby incorporate the additional provisions set forth on
Exhibit D.
SIGNATURES APPEAR ON NEXT PAGE
IN WITNESS WHEREOF, David T. Woodward, Chairperson, Oakland County Board of Commissioners,
acknowledges that he has been authorized by a resolution of the Oakland County Board of
Commissioners, and hereby accepts and binds the County to the terms and conditions of this
Agreement.
EXECUTED: ________ DATE_____________________
David T. Woodward, Chairperson
Oakland County Board of Commissioners
IN WITNESS WHEREOF, Debra Brinson, Chief Executive Officer, Oakland Integrated Healthcare Network
d/b/a Honor Community Health, acknowledges that he/she has been authorized to sign this Agreement
on behalf of the responsible governing board or official of the Subrecipient, and hereby accepts and binds
the Subrecipient to the terms and conditions of this Agreement.
EXECUTED:
DATE:__March 6, 2023__
Printed Name: Debra Brinson
Title: Chief Executive Officer
Oakland Integrated Healthcare Network d/b/a Honor Community Health
EXHIBIT A
SERVICES TO BE PROVIDED
Prescription for a Healthy Oakland, a Produce Prescription Program (PPR), is a collaboration project between
Oakland County Health Division (OCHD) and Oakland University (OU) and partnerships have spanned across
clinical and community organizations, including Honor Community Health. For the Gus Schumacher Nutrition
Incentive (GusNIP) PPR grant, Oakland County Health Division will act as the fiduciary and lead for program
planning and implementation.
Honor Community Health will be a primary clinical referral partner, assisting in participant recruitment and
referrals, and contributing to the collection of participant-level core metrics consistent with the grant
proposal (Exhibit E).
Honor will screen their clients for eligibility, refer them to the produce prescription program, and provide
assistance if needed with enrollment. Prescription for Healthy Oakland program eligibility includes being an
Oakland County resident, being enrolled in or eligible for the Supplemental Nutrition Assistance Program
(SNAP) or Medicaid and being able to shop at Prescription for Healthy Oakland vendor locations. The Honor
community health worker will also help grant staff refer program participants to other needed resources
and work with the grant team to promote client retention and participation.
Honor will track referrals to the program and also work with OCHD and OU staff to provide information on
patient outcomes needed for program evaluation. OCHD will reimburse Honor for the hours that the
community health worker spends on grant activities and recruitment as described below.
Honor Community Health is responsible for the following services as part of the Prescription for Healthy
Oakland program:
• Send a representative from the organization to regularly participate in Prescription for
Healthy Oakland partner meetings
• Provide a Community Health Worker to assist with the Prescription for Healthy Oakland
program consistent with
• Screen clients for eligibility for Prescription for Healthy Oakland
• Assist with recruitment and enrollment of clients in Prescription for Healthy Oakland
• Collaborate with Prescription for Healthy Oakland staff to support client retention and
program participation
• Assist with providing and sharing client data for program evaluation purposes at least
quarterly
• Provide information and/or data for program reports
EXHIBIT B
PAYMENT AMOUNTS AND SCHEDULE
The County, under the terms of this Agreement, shall reimburse Subrecipient for actual costs incurred
in delivering Prescription for Healthy Oakland County, services and activities. The total amount of the
reimbursement shall not exceed twenty-thousand, five-hundred dollars ($20,500). Any adjustment to
the total amount of this Agreement must be made in writing and executed by all parties to this
Agreement before the modifications can be implemented
Method of Payment:
1. Maintain all financial records and reports as required by this Agreement and state and federal law
including, but not limited to, time and effort records.
2. In monitoring the day-to-day performance of Subrecipient staff, utilize daily time sheets or time and
effort records to track all daily activities of grant supported staff.
3. The Subrecipient shall prepare and submit a reimbursement invoice to County on a quarterly basis
for all Healthy Oakland County services and activities with allowable expenditures. In charging
expenses to federal grants, adhere to costs principles of 2 CFR 200, Subpart E. Submit statements
requesting reimbursement to:
Carrie Hribar
Planning and Evaluation Supervisor
Oakland County Health Division
Health and Human Services
Phone: (248) 425-1230
Email: hribarc@oakgov.com
4. Subrecipient accepts reimbursement as payment in full.
EXHIBIT C
INSURANCE REQUIRED
The Subrecipient shall notify all insurance agents and companies retained by the Subrecipient that these
insurance requirements shall be included in any Agreement between the Subrecipient and the County.
During this Agreement, the Subrecipient shall provide and maintain, at their own expense, all insurance as
set forth and marked below, protecting the County against any Claims. Claims are defined as any loss;
complaint; demand for relief or damages; lawsuit; cause of action; proceeding; judgment; penalty; costs or
other liability of any kind which is imposed on, incurred by, or asserted against the County or for which the
County may become legally or contractually obligated to pay or defend against, whether commenced or
threatened, including, but not limited to, reimbursement for reasonable attorney fees, mediation,
facilitation, arbitration fees, witness fees, court costs, investigation expenses, litigation expenses, or
amounts paid in settlement.
The insurance shall be written for not less than any minimum coverage herein specified. Limits of insurance
required in no way limit the liability of the Subrecipient.
Primary Coverages
Commercial General Liability Occurrence Form including: (a) Premises and Operations; (b) Products and
Completed Operations (including On and Off Premises Coverage); (c) Personal and Advertising Injury; (d)
Broad Form Property Damage; (e) Broad Form Contractual including coverage for obligations assumed in
this Agreement;
$1,000,000 – Each Occurrence Limit
$1,000,000 – Personal & Advertising Injury
$2,000,000 – Products & Completed Operations Aggregate Limit
$2,000,000 – General Aggregate Limit
$ 100,000 – Damage to Premises Rented to You (formally known as Fire Legal Liability)
Workers’ Compensation Insurance with limits statutorily required by any applicable Federal or State Law
and Employers Liability insurance with limits of no less than $500,000 each accident, $500,000 disease each
employee, and $500,000 disease policy limit.
1. ☒ Fully Insured or State approved self-insurer.
2. ☐ Sole Proprietors must submit a signed Sole Proprietor form.
3. ☐ Exempt entities, Partnerships, LLC, etc., must submit a State of Michigan form WC-337 Certificate
of Exemption.
Commercial Automobile Liability Insurance covering bodily injury or property damage arising out of the use
of any owned, hired, or non-owned automobile with a combined single limit of $1,000,000 each accident.
This requirement is waived if there are no company owned, hired or non-owned automobiles utilized in the
performance of this Agreement.
If the Subrecipient will interact with children, schools, or the cognitively impaired, the Subrecipient must
maintain appropriate insurance coverage related to sexual abuse and molestation liability.
Commercial Umbrella/Excess Liability Insurance with minimum limits of $2,000,000 each occurrence.
Umbrella or Excess Liability coverage shall be no less than following form of primary coverages or broader.
This Umbrella/Excess requirement may be met by increasing the primary Commercial General
Liability limits to meet the combined limit requirement.
Third-Party Employee Theft Insurance Coverage will be required in the minimum amount of the grant with
the County of Oakland named as an additional insured.
Supplemental Coverages – As Needed
1. Professional Liability/Errors & Omissions Insurance (i.e., Consultants, Technology Vendors, Architects,
Engineers, Real Estate Agents, Insurance Agents, Attorneys, etc.) with minimum limits of
$1,000,000 per claim and $1,000,000 aggregate shall be required when the Subrecipient provides
professional services that the County relies upon.
2. Cyber Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be
required when the Subrecipient has access to County IT systems and/or stores County data electronically.
3. Commercial Property Insurance. The Subrecipient shall be responsible for obtaining and maintaining
insurance covering their equipment and personal property against all physical damage.
4. Liquor Legal Liability Insurance with a limit of $1,000,000 each occurrence shall be required when liquor
is served and/or provided by Subrecipient.
5. Pollution Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall
be required when storage, transportation and/or cleanup & debris removal of pollutants are part of the
services utilized.
6. Medical Malpractice Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate
shall be required when medically related services are provided.
7. Garage Keepers Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000
aggregate shall be required when County owned vehicles and/or equipment are stored and/or serviced at
the Subrecipient’s facilities.
8. Other Insurance Coverages as may be dictated by the provided product/service and deemed appropriate
by the County Risk Management Department.
General Insurance Conditions
The aforementioned insurance shall be endorsed, as applicable, and shall contain the following terms,
conditions, and/or endorsements. All certificates of insurance shall provide evidence of compliance with all
required terms, conditions and/or endorsements.
1. All policies of insurance shall be on a primary, non-contributory basis with any other insurance or self-
insurance carried by the County;
2. The insurance company(s) issuing the policy(s) shall have no recourse against the County for subrogation
(policy endorsed written waiver), premiums, deductibles, or assessments under any form. All policies shall
be endorsed to provide a written waiver of subrogation in favor of the County;
3. Any and all deductibles or self-insured retentions shall be assumed by and be at the sole risk of the
Subrecipient;
4. Subrecipient shall be responsible for their own property insurance for all equipment and personal
property used and/or stored on County property;
5. The Commercial General Liability and Commercial Automobile Liability policies along with any required
supplemental coverages shall be endorsed to name the County of Oakland and it officers, directors,
employees, appointees and commissioners as additional insured where permitted by law and policy form;
6. If the Subrecipient’s insurance policies have higher limits than the minimum coverage requirements stated
in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the
Subrecipient under contract.
7. The Subrecipient shall require its contractors or sub-contractors, not protected under the Subrecipient’s
insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or clauses
equal to those required in this Agreement;
8. Certificates of insurance must be provided no less than ten (10) Business Days prior to the County’s
execution of the Agreement and must bear evidence of all required terms, conditions and endorsements;
and provide 30 days’ notice of cancellation/material change endorsement.
9. All insurance carriers must be licensed and approved to do business in the State of Michigan along with
the Subrecipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A - unless
otherwise approved by the County Risk Management Department.
Required Insurance Documentation
1. Certificate of Insurance
The Subrecipient must provide a Certificate of Insurance evidencing the required insurance set forth above
and it shall be attached to this agreement when signed.
EXHIBIT D
ADDITIONAL PROVISIONS
A. Responsibilities – Subrecipient
1. Publication Rights. Where the Subrecipient exclusively develops books, films, or other such
copyrightable materials through activities supported by this agreement, the Subrecipient may copyright
those materials. The materials that the Subrecipient copyrights cannot include service recipient
information or personal identification data. Subrecipient agrees that the federal government reserves a
royalty-free, non-exclusive and irrevocable license to reproduce, publish and use such materials
copyrighted by the Subrecipient and authorizes others to reproduce and use such materials. Copyrighted
materials or modifications bearing acknowledgment of the United States Department of Agriculture
(USDA), and must be pre-approved by USDA prior to reproduction and use. The Subrecipient shall give
recognition to the County in any and all publications papers and presentations arising from the program
and service contract herein
2. Fees. Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report these as
directed. Any under recoveries of otherwise available fees resulting from failure to bill for eligible
services will be excluded from reimbursable expenditures. Guarantee that any claims made to the
County under this Agreement shall not be financed by any sources other than the County under the
terms of this Agreement. If funding is received through any other source, the Subrecipient agrees to
budget the additional source of funds and reflect the source of funding on the Financial Status Report.
3. Reporting. Utilize all report forms and reporting formats required by the County at the effective date of
this agreement, and provide the County with timely review and commentary on any new report forms
and reporting formats proposed for future use.
4. Record Maintenance/Retention. Maintain adequate program and fiscal records and files including
source documentation to support program activities and all expenditures made under the terms of this
agreement, as required. Assure that all terms of the agreement will be appropriately adhered to; and,
that detailed documentation for the project or program identified in this agreement will be maintained
for a period of not less than four (4) years from the date of termination, the date of submission of the
final expenditure report or until litigation or audit findings have been resolved. This Section applies to
Subrecipient, any parent, affiliate, or subsidiary organization of Subrecipient, and any subcontractor that
performs Agreement activities in connection with this Agreement.
5. Audit and Authorized Access. Subrecipient certifies by signing this Agreement that it complies with
regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200 and will provide notice of the
completion of required audits and any adverse findings which impact this subaward as required by parts
200.501-200.521, and will permit upon reasonable notification and at reasonable times, access by
authorized representatives of the County, Federal Grantor Agency, Comptroller General of the United
States and State Auditor General, or any of their duly authorized representatives, to records, files, and
documentation related to this agreement, to the extent authorized by applicable state or federal law,
rule or regulation.
6. Notification of Modifications. Provide timely notification to the County, in writing, of any action by the
Subrecipient, its governing board or any other funding source which would require or result in significant
modification in the provision of services or funding or compliance with operational procedures.
7. Software Compliance. The Subrecipient must ensure software compliance and compatibility with the
County’s data systems for services provided under this agreement including, but not limited to: stored
data, databases, and interfaces for the production of work products and reports. All required data under
this Agreement shall be provided in an accurate and timely manner without interruption, failure or
errors due to the inaccuracy of the Subrecipient’s business operations for processing date/time data.
8. Human Subjects. The Subrecipient will comply with Protection of Human Subjects Act, 45 CFR, Part
46.The Subrecipient agrees to submit all research involving human subjects, which is conducted in
programs sponsored by the County, or in programs which receive funding from or through the State of
Michigan, to the County and to the Institutional Review Board (IRB) of the MDHHS for approval prior to
initiation of the research.
9. Mandatory Disclosures. The Subrecipient must disclose to the County in writing within 14 days of
receiving notice of any litigation, investigation, arbitration, or other proceeding (collectively,
“Proceeding”) involving Subrecipient, a subcontractor, or an officer or director of Subrecipient or
subcontract, or that arises during the term of this Agreement including:
a. All violations of federal and state criminal law involving fraud, bribery, or gratuity violations
potentially affecting the agreement.
b. A criminal Proceeding;
c. A parole or probation Proceeding;
d. A Proceeding under the Sarbanes-Oxley Act;
e. A civil Proceeding involving;
i. A claim that might reasonably be expected to adversely affect Subrecipient’s
viability or financial stability; or
ii. A governmental or public entity’s claim or written allegation of fraud; or
f. A Proceeding involving any license that Subrecipient is required to possess in order to perform
under this Agreement.
10. Conflict of Interest and Code of Conduct Standards.
a. The Subrecipient is subject to the provisions of 1968 PA 317, as amended, 1973 PA
196, as amended, and Title 2 Code of Federal Regulations, Section 200.318 (c) (1) and
(2).
b. The Subrecipient will uphold high ethical standards and is prohibited from:
i) Holding or acquiring an interest that would conflict with this Agreement.
ii) Doing anything that creates an appearance of impropriety with respect to
the award or performance of this Agreement.
iii) Attempting to influence or appearing to influence any County employee
by the direct or indirect offer of anything of value; or
iv) Paying or agreeing to pay any person, other than employees and consultants
working for Subrecipient, any consideration contingent upon the award
of this Agreement.
c. Immediately notify the County of any violation or potential violation of these
standards. This Section applies to Subrecipient, any parent, affiliate, or subsidiary
organization of Subrecipient, and any subcontractor that performs activities in
connection with this Agreement.
11. Non-Discrimination. The Subrecipient agrees not to discriminate against any employee or applicant for
employment or service delivery and access, with respect to their hire, tenure, terms, conditions or
privileges of employment, programs and services provided or any manner directly or indirectly related
to employment, because of race, color, religion, national origin, ancestry, age, sex, height, weight,
marital status, physical or mental disability unrelated to the individual’s ability to perform the duties of
the particular job or position or to receive services.
The Subrecipient further agrees that every subcontract entered into for the performance of any contract
or purchase order resulting herefrom will contain a provision requiring non-discrimination in
employment, service delivery and access, as herein specified binding upon each subcontractor.
12. Anti-Lobbying Act. The Subrecipient will comply with the Anti-Lobbying Act, (31 USC 1352, as revised by
the Lobbying disclosure Act of 1995, being 2 USC 1601 et seq.), and section 503 of the County’s of Labor,
Health and Human Services, and Education, and Related Agencies Appropriations Act (Public Law 104 –
208). Further, the Contractor shall require that the language of this assurance be included in the award
documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants,
loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
13. Debarment and Suspension. The Subrecipient assures that it will comply with federal regulations 45
C.F.R., Part 76 and certifies to the best of its knowledge and belief it:
a. Is not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or agency;
b. Has not within the three-year period preceding this Agreement been convicted of or had a
civil judgment rendered against it for commission of a fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (federal, state or local)
transaction or contract under a public transaction; violation of federal or state antitrust
statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements or receiving stolen property;
c. Is not presently indicted or otherwise criminally or civilly charged by a governmental entity
(federal, state or local) with commission of any of the offenses enumerated in (b) above; and
d. Has not within the three-year period preceding this Agreement had one or more public
transactions (federal, state or local) terminated for cause or default.
This Agreement may be terminated immediately without further liability to County if Subrecipient or an
official or employee of Subrecipient is convicted of any activity referenced in this Section during the term
of this Agreement or any extension thereof.
14. Pro-Children Act. The Subrecipient will comply with Public Law 103-227, also known as the Pro-Children
Act of 1994 (20 USC 6081 et seq.), which requires that smoking not be permitted in any portion of any
indoor facility owned or leased or contracted by and used routinely or regularly for the provision of
health, day care, early childhood development services, education or library services to children under
the age of 18, if the services are funded by federal programs either directly or through state or local
governments, by federal grant, contract, loan or loan guarantee. The law also applies to children’s
services that are provided in indoor facilities that are constructed, operated, or maintained with such
federal funds. The law does not apply to children’s services provided in private residences; portions of
facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable
funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed.
15. Smoke-Free Environment. The Subrecipient also assures that any service or activity funded in whole or
in part through this agreement will be delivered in a smoke-free facility or environment. Smoking shall
not be permitted anywhere in the facility, or those parts of the facility under the control of the
Subrecipient. If activities or services are delivered in facilities or areas that are not under the control of
the Subrecipient (e.g., a mall, restaurant or private site), the activities or services shall be smoke-free.
16. Procurement. The Subrecipient will assure that all purchase transactions, whether negotiated or
advertised, shall be conducted openly and competitively in accordance with the principles and
requirements of OMB Circular A-102 (as revised), implemented through applicable portions of the
associated “Common Rule” as promulgated by responsible federal Contractor(s), or OMB Circular A-110
as applicable, and that records sufficient to document the significant history of all purchases are
maintained for a minimum of three years after the end of the agreement period
17. Hatch Political Activity Act and Intergovernmental Personnel Act. The Subrecipient will comply with the
Hatch Political Activity Act 5 USC 1501-1508 and the Intergovernmental Personnel Act of 1970, as
amended by Title VI of the Civil Service Reform Act, Public Law 95-454, Section 42 USC 4728. Federal
funds cannot be used for partisan political purposes of any kind by any person or organization involved
in the administration of federally-assisted programs.
18. Master Agreement. The Subrecipient will be subject to the master agreement (Comprehensive
Agreement) between the United States Department of Agriculture and the County. In the event of a
conflict between the subcontract and provisions of the master agreement, the provisions of the master
agreement shall prevail.
19. Further Federal Requirements. The funds provided for this subrecipient agreement are provided by a
Federal Grant, the Gus Schumacher Nutrition Incentive Grant Program. As a result, the subrecipient must
abide by the following terms which are a part of the award:
a. Research Terms and Conditions and USDA/NIFA Agency-Specific Terms and
Conditions (May 2022) at http://nifa.usda.gov/terms-and-conditions.
b. General Provisions found in Title 2: 2 CFR Part 400; 2 CFR Part 415; 2 CFR Part 416; 2
CFR Part 418; 2 CFR Part 422; and, Title 7: 7 CFR Part 3430 - all incorporated by
reference and found at:
https://www.nsf.gov/bfa/dias/policy/fedrtc/rtcoverlay_nov20.pdf.
B. Responsibilities - County
1. Notification of Modifications. Notify the Subrecipient in writing of modifications to Federal or State laws,
rules and regulations affecting this agreement.
2. Identification of Laws. Identify for the Subrecipient relevant laws, rules, regulations, policies,
procedures, guidelines and State and Federal manuals, and provide copies of these documents to the
extent they are not otherwise available to the Subrecipient.
3. Modification of Funding. Notify the Subrecipient in writing within thirty (30) calendar days of becoming
aware of the need for any modifications in agreement funding commitments made necessary by action
of the Federal Government, the Governor, the Legislature or the Department of Management and
Budget on behalf of the Governor or the Legislature. Implementation of the modifications will be
determined jointly by the Subrecipient and the County.
4. Monitor Compliance. Monitor compliance with all applicable provisions contained in federal and state
grant awards and their attendant rules, regulations and requirements pertaining to program elements
covered by this agreement.
5. Technical Assistance. Make technical assistance available to the Subrecipient for the implementation of
this agreement, as resources allow.
C. Terms and Conditions
1. Compliance with Applicable Laws. The Subrecipient will comply with applicable federal and state laws,
guidelines, rules and regulations, professional licenses, permits, and certificates in carrying out the terms
of this agreement. The Subrecipient will also comply with all applicable general administrative
requirements such as OMB Circulars covering cost principles, grant/agreement principles, and audits in
carrying out the terms of this agreement.
2. Subcontracts of the Subrecipient. Assure for any subcontracted service, activity or products:
a. Subrecipient may not assign or subcontract any rights or obligations under this Agreement
without County’s prior written approval.
a. That a written subcontract is executed by all affected parties prior to the initiation of any new
subcontract activity. Exceptions may be granted by the County upon written request.
b. That any executed subcontract shall require the Subrecipient to comply with all applicable terms
and conditions of this agreement. In the event of a conflict between this agreement and the
provisions of the subcontract, the provisions of this agreement shall prevail. A conflict between
this agreement and a subcontract, however, shall not be deemed to exist where the subcontract:
i. Contains additional non-conflicting provisions not set forth in this agreement; or
ii. Restates provisions of this agreement to afford the Subrecipient the same or
substantially the same rights and privileges as the County; or
iii. Requires the Subcontractor to perform duties and/or services in less time than that
afforded the Subrecipient in this agreement.
c. That the subcontract does not affect the Subrecipient’s accountability to the County for the
subcontracted activity.
d. That any billing or request for reimbursement for subcontract costs is supported by a valid
subcontract and adequate source documentation on costs and services.
e. That the Subrecipient will submit a copy of the subcontract to the County upon request.
f. That subcontracts in support of programs or elements utilizing funds provided by the County,
the State of Michigan or the federal government in excess of $10,000 shall contain provisions or
conditions that will:
i. Allow the Subrecipient or County to seek administrative, contractual or legal remedies
in instances in which the Subrecipient violates or breaches contract terms, and
provide for such remedial action as may be appropriate.
ii. Provide for termination by the Subrecipient, including the manner by which
termination will be effected and the basis for settlement.
3. Unobligated Funds. Any unobligated balance of funds held by the Subrecipient at the end of the
agreement period will be returned to the County or treated in accordance with instructions provided by
the County. The County has the option to assume no responsibility or liability for costs incurred by the
Subrecipient prior to the signing of this agreement.
4. Final Reporting. Should either party terminate this agreement, within thirty (30) days after the
termination, the Subrecipient shall provide the County with all financial performance, and other reports
required as a condition of the agreement. The County will make payments to the Subrecipient for
allowable reimbursable costs not covered by previous payments, other state or federal programs. The
Subrecipient shall immediately refund to the County funds not authorized for use and any payments
advanced to the Subrecipient in excess of allowable reimbursable expenditures. Any dispute arising as a
result of this agreement shall be resolved in the State of Michigan.
5. Amendments. Any modification of this Agreement or additional obligation assumed by either party in
connection with this Agreement shall be binding only if evidenced in writing, and signed by each party
or an authorized representative of each party.
6. Confidentiality. Both County and Subrecipient shall assure that the health services to and information
contained in medical records of persons served under this Agreement, or other such recorded
information required to be held confidential by federal or state law, rule or regulation, in connection
with the provision of services or other activity under this Agreement shall be privileged communication,
shall be held confidential, and shall not be divulged without the written consent of either the patient or
a person responsible for the patient, except as may be otherwise required by applicable law, or
regulation. Such information may be disclosed in summary, statistical or other form which does not
directly or indirectly identify particular individuals.
7. Relationship of Parties
a. The parties agree that Subrecipient is an independent contractor for the purposes of this
Agreement. Subrecipient shall not be considered an agent or employee of County for any
purpose, and neither the Subrecipient nor its employees are entitled to any of the benefits that
the County provides for its employees. Subrecipient shall not be subject to or covered by any
of the County’s employee handbooks, collective bargaining agreements, or personnel policies.
b. County shall not be responsible for covering Subrecipient under any worker’s compensation
insurance or unemployment compensation insurance plans. Subrecipient represents and
warrants that it:
i. is covered by a worker’s compensation insurance policy procured and paid for by it;
or
ii. has a valid Notice of Exclusion on file with the Michigan Bureau of Workers’ Disability
Compensation; or
iii. is a “sole proprietor” within the meaning of the Michigan Workers’ Disability
Compensation Act and has no employees. Subrecipient shall notify County
immediately if the status of said coverage, notice or sole proprietorship changes.
c. Subrecipient shall have no authority or right to obligate County in any way whatsoever.
Subrecipient shall identify itself as an independent contractor and shall not hold itself out as an
employee or agent of County.
d. County does not agree to use Subrecipient exclusively, and remains free to enter into contracts
for similar or other services with other individuals or entities during the course of this
Agreement.
8. Conflict of Interest. County and Subrecipient are subject to the provisions of Public Act No. 317 of 1968,
as amended (MCL 15.321 et seq., MSA 4.1700 (51) et seq.); and Public Act No. 196 of 1973, as amended
(MCL 15.341 et seq., MSA 4.1700 (71) et seq.).
9. Entire Agreement. This Agreement, together with any affixed schedules and exhibits, shall constitute
the entire agreement between the parties. Any prior understanding, representation or negotiation of
any kind preceding the date of this Agreement shall not be binding upon either party except to the extent
incorporated in this Agreement.
10. Attorney Review. The parties represent that they have carefully read this Agreement and have had the
opportunity to review it with an attorney. The parties affirmatively state that they understand the
contents of this Agreement and sign it as their free act and deed.
EXHIBIT E
GRANT PROPOSAL
GUSNIP PPR Narrative - Oakland County Health Division - Prescription for Healthy Oakland
1. Introduction to Community(ies) to be involved in the Project & the Benefit to the
Community(ies)
Oakland County prides itself on being a great place to live, work, and play, but when you look
closer, not all residents have the same opportunities for good health and well-being. There are
neighborhoods in Pontiac where the average life expectancy is only 66 or in Southfield where it is only 72,
while a neighborhood in Troy that is just 10 miles away has an average life expectancy of 86 (National
Center for Health Statistics, 2018). That’s a 14 to 20-year difference in life expectancy based on where you
live in our county borders.
These areas are also populated with higher concentrations of people of color than other areas of
the county. In the county overall, the white or Caucasian population is 75%, while the Black or African
American population is 14%, Asian people are 8% of the county population, and Hispanic/Latino people
are 4%. When looking at specific geographic areas like cities and census tracts, we see higher
concentrations of people of color in certain areas. The city of Pontiac has a total population of 60,116, and
African Americans make up 49% and Hispanics/Latinos are 16% of the total population. Areas of southern
Oakland County, such as the city of Southfield, has a population of 73,392 with the African American
population making up 70%. The city of Oak Park has a significant African American population at 56% of
its total populations of 29,849 (U.S. Census Bureau, 2020). These areas of the county illustrate the unequal
distribution of racial and ethnic groups in Oakland County, with African American and Hispanic/Latino
populations
concentrated in key cities in the county.
The focus communities also experience poorer health outcomes, higher rates of poverty, lower
access to quality healthcare compared to wealthier, less diverse parts of the county, due in part to
historical and systematic racism. The median household income for Oakland County is
$81,587 (U.S. Census). United Way ALICE data shows that cities within this region have a high percentage
of households that are below the financial threshold to make ends meet, including Oak Park (48%),
Southfield (48%), Pontiac (67%), Waterford (30%), and Auburn Hills (37%), compared to Oakland County,
which has 30% of residents living below the ALICE threshold (Alice 2021 Michigan report, data sheet).
When it comes to access to healthcare, overall, Oakland County appears to have healthy outcomes,
yet, when the data is broken down by community, disparities in health outcome and
access to health care are disproportionately experienced by the communities that will be the primary focus
for the program. In a 2021 needs assessment conducted by Honor Community Health (HCH), survey
respondents indicated that the top three barriers to seeking medical care were lack of insurance, lack of
coverage for necessary services, and lack of affordability of specialty care. In Oakland County overall,
approximately 10% households are uninsured, but when examining within the focused communities,
uninsured rates range from 12.6% in Oak Park to 33% in Pontiac (ACS, 2020). Only Southfield has a similar
rate to Oakland County at 10.3% (ACS, 2020).
Adult residents in these communities also report poor physical health, with Auburn Hills at 10.4%,
Southfield and Waterford communities at 13.4 and 13.1% respectively, Oak Park at 14.2%, Pontiac 18.6%,
and Royal Township at 19% (BRFSS, 2019). Residents in these communities report higher blood pressure
and diabetes rates compared to Oakland County. In Royal Oak Township, approximately 20% adults report
being diagnosed with diabetes. This is both higher than the county rate at 9.9% and state rate at 10.3%
(BRFSS, 2019).
Oakland County also faces challenges with regards to food access. Michigan is the second most
diverse agriculture state behind California. Even with this wealth of fresh produce, food insecurity is still a
concern for residents in Southeastern Michigan. In 2019, approximately 9.8% of Oakland County residents
experienced food insecurity (Feeding America, 2019). There was a 37% estimated increase in food
insecurity in Oakland County from 2019 to 2020, with an estimated 80% jump for child food insecurity
rates (Feeding America, 2021). In 2021, the rates were estimated to have decreased to 12%, which is still
above pre-pandemic rates (Feeding America).
Currently, SNAP participation in some of the program’s target communities is more than 4 times
that of Oakland County on average. While 6.8% of Oakland County residents are enrolled in SNAP,
communities such as Pontiac and Royal Oak Charter Township have 28.9% and 33.7% enrolled respectively.
Other communities such as Oak Park have just over 17% and Southfield has 11.7%, still nearly double and
triple that of Oakland County. School districts in these areas also have high percentages of children that
receive free or reduced lunch, with 79% participation in City of Pontiac School District, 77% participation
in Hazel Park and 77% participation rate in Oak Park school district.
Within Oakland County overall, approximately 12.8% of residents have Medicaid (or other means
tested public coverage). But when communities within the county are examined, this healthcare coverage
disparity grows. Approximately 40.3% of Pontiac residents are enrolled in Medicaid/Means-tested Public
Coverage, 44% in Royal Oak Township, 35% in Hazel Park, 28% in Oak Park, 20% in Southfield, and 17.6%
in Waterford.
Healthy food access was identified as a strategic area to prioritize in OCHD’s 2016 Community
Health Assessment. Only 19.6% Oakland County adults report consuming the recommended amount of
fruits and vegetables (Michigan BRFS, 2015). Oakland County Food Policy Council was formalized in 2017
out of the health assessment process with the mission of creating a fair and culturally friendly food system
in Oakland County that encourages healthy eating. This council has previously written letters of support
on behalf of Oakland University and other collaborative partners to lift programming and environmental-
level changes that align with its mission, most recently on behalf of the prescription program expansion
into the Southeastern county corner.
While all Oakland County residents meeting eligibility criteria will be able to enroll in the program,
HCH, OCHD, and OU will primarily target residents in Pontiac, Southfield, Oak Park, Royal Oak Township
and surrounding communities due reported reduced access to healthy foods, higher rates of household
SNAP participation, and lower household income. All of these factors are correlated with reduced food
security. HCH has 8 primary healthcare clinics located near or within these communities and Oakland
County Health Division operates two health centers in Pontiac and Southfield.
HCH will have medical records and insurance information for all referrals to verify their current
enrollment in Medicaid and/or SNAP benefits, thus confirming eligibility in the program. Other avenues for
screening for eligibility will be for individuals to show proof of Medicaid or SNAP enrollment (ie. benefit
card). Or, since participants need to be SNAP eligible, our team will develop and utilize a brief screening
tool incorporating SNAP eligibility screening questions (eg. gross monthly income, net income, assets). This
can serve as an additional method of screening for eligibility if an individual is not already SNAP enrolled.
HCH will take the lead on referring only eligible participants to enroll after verification takes place.
Prescription for a Healthy Oakland will allow individuals who have previously participated in our
programming, who meet the GusNIP PPR participant eligibility criteria, and
express interest to participate in this future program. Since our PPR programming is in its third iteration,
community interest is piqued and many have expressed continued interest and need. Results from our
programming show a decrease in food insecurity and improved eating behaviors, however systemic
economic challenges exacerbated by the COVID-19 pandemic have created additional burdens and
disparities within our communities. In allowing return participants will give opportunities for additional
evaluation comparisons within and between groups of those who have experienced programming before
vs. new participants. It will also allow our team to compare health outcomes of repeat participants.
A Prescription for Health program will increase healthy food access to vulnerable communities in
Oakland County that have higher rates of poverty, food insecurity, and poor health outcomes. It will
increase food security for people on food assistance or Medicaid, especially focusing on areas that have
higher populations of people of color.
2. Personnel and Resources of the Organizations and Communities Involved in the Project;
Oakland County Health Division (OCHD), Oakland University (OU), and Honor Community Health
will be partnering on the prescription program, with OCHD as the lead applicant and fiduciary. OCHD has a
long history of bringing together community organizations and residents to further understand and address
the health needs of Oakland County residents.
OCHD convenes several coalitions that are focused on a variety of community health issues including
eliminating health disparities and/or serving the needs of disenfranchised populations.
Prescription for a Healthy Oakland was born out of these long-standing collaborative partnerships
and community coalitions. OCHD, OU, and Honor Community Health have partnered through several
collaborative bodies, including Energizing Connections for Healthier Oakland, the Oakland County Food
Policy Council, and the Healthy Pontiac, We Can! Coalition, all of which are composed of a diverse body of
partners including local community members.
The drive to increase access to and consumption of healthy foods is a primary goal of the Food Policy Council
and the Prescription for Healthy Oakland program is a key mechanism for implementation.
OCHD and OU have been collaborating on different iterations of the Prescription for Healthy
Oakland Program over the past five years. A small initial award in 2017 from Blue Cross Blue Shield of
Michigan funded the development, implementation, and evaluation of a pilot Prescription for Health
project within the Pontiac community. Further funding from the
Michigan Health Endowment fund in 2019 expanded participation levels widely and brought on several
additional vendor locations. Finally in 2021, joint funding from Blue Cross Blue Shield of Michigan
Foundation, Michigan Health Endowment Fund, and the W. K. Kellogg Foundation expanded the program
into the Southeast portion of Oakland County, with additional vendor locations in that area. Honor has
been a referral partner since the start of the program.
Honor Community Health is a nonprofit, 501(c)(3) community health center with 16 sites
throughout Oakland County, Michigan – including six integrated primary care sites, one dental site, a mobile
dental bus, four school-based health centers and four school-based empowerment zones. As a federally
qualified health center (FQHC), Honor Community Health provides access to primary, behavioral health,
dental care, and other specialty services to the communities they serve – regardless of insurance status,
place of residence or ability to pay. Over the past two years, OCHD has been implementing the Oakland
Health 360 project with partners Honor Community Health and Oakland Livingston Human Services Agency
(OLSHA). The county’s public health clinics in Pontiac and Southfield now offer comprehensive, integrated
health care and enrollment in social services. By integrating care at OCHD Pontiac and Southfield locations,
partners are directly addressing this shortage, creating a one-stop shop for prevention services, healthcare,
and social service assistance.
Oakland University and faculty from the Department of Interdisciplinary Health and the Master
of Public Health program have long standing partnerships with local communities and have been
intricately involved in community engaged public health work, using community- based participatory
approaches. In addition to past and current PPR programming with OCHD and Honor, faculty serve as
representatives on community coalitions such as the Healthy Pontiac, We Can! coalition, Energizing
Connections for Healthy Oakland, and as evaluation specialists for community programming. Oakland
University also recently led a collaborative community health needs assessment for Honor Community
Health. This collaborative work encompasses community-based participatory approaches in planning,
implementation, and evaluation.
Prescription for a Healthy Oakland came about because of identified needs around food from multiple
stakeholders through coalition and other community work. In planning and development, our team has
engaged our community to identify key program components and operations through a core partner group,
consisting of health division staff, OU faculty, clinical partners, grocery store owners/farmer market staff,
community health navigators, and former
PPR participants. Through extensive and ongoing evaluation, we are working with past and current
program participants to solicit feedback on programming in the areas of recruitment/referral processes,
health education and physical activity needs, additional case management needs, voucher use, vendor
perceptions, and overall needs to improve programming. We anticipate this ongoing evaluation process
will aid in the future development of our PPR and look forward to our continued collaborations with our
partners and stakeholders. Incentives for participating in evaluation are included in the grant budget.
The proposed project staff will include Carrie Hribar, MA - Planning and Evaluation Supervisor,
OCHD. Carrie has worked in public health for 18 years, including nearly 9 with Oakland County. In her role
at OCHD, she has been responsible for community health assessment and improvement planning, strategic
planning, and performance improvement. She has a strong foundation in the social determinants of health
and systems thinking in public health, as well as public health policy. She has been involved with
Prescription for Healthy Oakland since 2019 and will supervise the grant staff and lead grant oversight.
Oakland University Interdisciplinary Health Sciences faculty, Drs. Laurel Dolin Stevenson and
Jennifer Lucarelli, will provide support through planning and evaluation activities. Dr. Stevenson has a
strong background in working with vulnerable and low-resource communities on a variety of health-
related issues and will act as the evaluation lead. She is trained in community-based participatory
practices, program implementation and evaluation methods, and has used these skills to lead
implementation and evaluation projects in Pontiac and the metro-Detroit area. She has worked with the
Health Division to oversee the development, implementation, and evaluation of the pilot Prescription for
a Healthy Oakland program from 2017 to the present time. Dr. Lucarelli will provide additional evaluation
support and brings extensive community-based planning experience. Oakland University will also provide
student support in the form of a Master of Public Health graduate research student and hourly
undergraduate student workers to support daily implementation activities. OU will support time for faculty
to conduct evaluation and voucher contract oversight, as well as an MPH student and undergraduate
students to help with grant activities. OCHD will hire two part-time health educators to work on grant
activities – one senior Health Educator III to serve in a project management role and a Health Educator II
to assist with client management and grant activities.
Honor Community Health will assign a part-time community health worker to recruit grant participants,
assist with enrollment, and conduct data collection and evaluation.
3. Project Goals, Intended Outcomes, and Relationship to GusNIP Produce Prescription Program
Purpose and Priorities
The overarching goal of this project is to create a culture of healthy living with a focus on
reducing barriers to accessing fruits and vegetables, thereby improving nutritional security and healthy
behaviors for eligible individuals in Oakland County. This produce prescription program is designed with
online health education sessions, fruit and vegetable vouchers, optional physical activity components,
and phone check-ins with a health educator that support behavior change to improve fruits and
vegetable consumption and make healthier choices.
Participants will be able to purchase a wide range of culturally appropriate fresh fruits and vegetables
at farmers markets and groceries stores. Health education topics covered will include goal setting,
healthy lifestyles, shopping on a budget, advocating for health, and meal planning.
Goals and objectives focus on these improvements while also attending to process evaluation. Thus,
by the end of the 6-month intervention, an individual will have increased and improved self-efficacy,
attitude, and knowledge around healthy eating as reflected on pre-
/post-program surveys (behavioral/psychosocial determinants). Also indicated on pre-/post- program
surveys, participants will increase fruit and vegetable consumption (behavioral change outcomes at or
above US dietary guidelines). This program will reduce food insecurity of participants as indicated in pre-
/post-program evaluation based on the required measures from the participant-level core metrics USDA
measures of food security. We will have a minimum of 100 adults over the age of 18 enroll and complete
the 6-month intervention.
4. Activities to Achieve the Goal
OCHD, Oakland University, and partners will collaborate to implement another revised round of
Prescription for Healthy Oakland, with rolling enrollment over a 2-year period. There will be a six-month
planning period to complete contracts, MOUs, data sharing agreements, and hire program staff. Program
enrollment will occur over 18 months to two years and 200 individuals will be targeted to enroll in the
program. Prescription for Healthy Oakland has had an approximate 50-60% completion rate, so this will
allow for 100 participants to complete the entire 6 months of programming.
Prescription for Healthy Oakland vouchers have been accepted at both farmers markets and some
independent grocery stores in Central and Southeast Oakland County. Those vendor contracts will be
extended or reestablished with Oakland University at the start of this funding cycle. Additionally, the
Prescription team will continue to look for additional vendor relationships to enhance the program
throughout the grant cycle. A workplan of grant activities is attached as Appendix 1 to this narrative. These
activities have been established by partners as the most effective methods to continue and grow the
program.
5. Relationship to GusNIP Produce Prescription Program Goals and Priorities.
The goals of the GusNIP program are the improvement of dietary health through increased consumption
of fruits and vegetables; the reduction of individual and household food insecurity; and the reduction in
healthcare use and associated costs. Prescription for a Healthy Oakland aligns with Goal 4 of the USDA
Strategic Plan: Make Safe, Nutritious Food Available to All Americans. Specifically, the proposed project
focuses on reducing “food and nutritional insecurity” while “expanding access to and increasing
consumption of healthy and nutritious foods” among racial/ethnic minorities and low-income
communities (USDA Strategic Plan, 2022). The proposed project’s activities support short-term outcomes
around increasing self- efficacy, attitude, knowledge of healthy eating, and reducing environmental and
financial barriers around access to healthy and nutritious food, thus leading to intermediate outcomes
(behavior change and an increase in food and nutritional security), and long-term outcomes/impacts
around improved health status and lower health care costs. Goal 4 also focuses on “innovative methods
of healthy food procurement” with a focus on “equitable opportunities for small businesses,” aligning
with and supporting our partnerships with small, locally owned independent grocery stores and farmers
markets.
6. Evaluation.
Our team has conducted program process, outcome, and impact evaluation for our previous
three PPR iterations using a modified version of the Michigan Farmers Market Association Evaluation
Toolkit and we have worked collaboratively with our community partners in analysis, dissemination, and
data sharing. Our previous data collection plans included pre-/post-program surveys to explore program
outcomes including eating behavior changes, food security, social isolation and loneliness, and perceived
overall mental and physical health. We have collected extensive data on voucher spending across
program duration (high, medium, low
spenders/users of fruit and vegetable incentives), BMI (height/weight), and blood pressure. We have
engaged in process evaluation of program implementation and have conducted extensive qualitative data
collection to explore participants’ perceptions and engagement with our programming. Our evaluation
findings have shown statistically significant improvements in fruit and vegetable consumption, food security,
mental health, self-efficacy around healthy eating, and lower BMI and blood pressure (high spenders/users
of incentives had lower BMI and blood pressure post PPR programming).
The evaluation process for this project will follow the guidelines put forward by the Nutrition
Incentive Hub and in consultation with the GusNIP NTAE Reporting and Evaluation team. We will undergo
IRB review and collaborate with the NTAE to contribute the minimum core data set to the NTAE, while also
renewing our MOUs and Data Use Agreements between each sub-grantee to guarantee each firm will
provide necessary information required for core data set to the NTAE.
Overall process evaluation will take place throughout the duration of the program to document
challenges and successes of implementation. Weekly staff meetings and partner check- ins will take place
to discuss and document implementation issues such as establishing/renewing vendor contracts,
participant recruitment and referrals, retention, evaluation, and voucher
spending/tracking/reimbursements, and other program challenges. We will use this opportunity to modify
and improve our current Program Implementation Manual to support future replication and
documentation of our approach.
Our outcome evaluation will include collection of firm-level metrics for both farm direct and brick
and mortar sites, both of which we have successfully partnered in the past, and participant-level core
metrics and. Firm-level core metrics will include comprehensive site and project information and
incentive program information, as required by the NTAE. This proposal is an expansion on previous PPR
programming, therefore we have established relationships with farmers markets and independently-
owned grocery stores in our county that are familiar with overall programming,
requirements/restrictions, and our payment and reimbursement model. We have used paper vouchers
with unique identification numbers and expirations dates to allow for tracking of participant spending
and redemption and encourage consistent spending throughout the duration of the program. Our
grocery stores provide duplicate receipts for each transaction, giving us details on spending amounts,
dates of purchases, and types of fruits and vegetables
purchased. Having detailed spending information allows for greater oversight and accountability to ensure
vouchers are spent on eligible purchases and it allows for detailed tracking on spending. We have
experienced very few issues in the management of voucher spending (eg. spending on ineligible items)
and have monitored receipt items to promptly address issues as they arise. We have engaged vendors in
cashier training and have a system in place for weekly check-ins, counts of voucher spending, and
reimbursements.
We will utilize Qualtrics to collect pre/post survey data on participant-level core metrics.
Our team has built a website that includes an enrollment section and close-out section where participants
are required to do a pre- and post-program survey, which will be updated to include the NTAE’s core
metrics, questions to assess short-term outcomes around psychosocial determinants of behavior change
(knowledge, attitudes, self-efficacy), and other health care outcomes of interest. We are familiar with and
have collected data using the PSS-4, the Short R- UCLA Loneliness Scale, 6-item Short Form USDA-FSSM,
and USDA dietary intake assessment tool. We will collect data using the aforementioned tools, and in
consultation with our clinical partners and the NTAE, also incorporating in height/weight measures, BP,
number of participant well visits, and number of no-shows to clinic appointments. These latter measures
may change after further consultation with our clinic partners and the NTAE. We will integrate the NTAE
core metrics with the additional questions from a modified version of the Michigan Farmers Market
Association Evaluation Toolkit. This will allow for us to share aggregate data with both the NTAE and our
PPR statewide learning network hosted by the Michigan Farmers Market Association as we continue to
build the body of knowledge around PPRs.
We do not anticipate challenges with IRB review and have had our other program iterations
reviewed and approved by Oakland University’s IRB with few challenges. We anticipate challenges around
timing for review and approval of MOUs and Data Sharing Agreements since each institution for this
project has standard processes of review through multiple offices at set dates. We are requesting a 3-year
grant period to ensure we have a reasonable amount of time for all agreements and contracts to be
finalized.
7. Sustainability
The Prescription for a Healthy Oakland team, composed of Oakland County Health Division, Oakland
University, Honor Community Health, and other community partners continue to work towards
sustainability. The infusion of Federal funds will advance our local capacity building as
we expand our much-needed services to cover Oakland County These funds also support a goal of adding
to the collective knowledge base around PPRs to promote long-term sustainability across Michigan and
our nation. The opportunity to be part of this research will aid in our local capacity building around program
refinement.
Our team is currently working with two major health insurance plans, Blue Cross Blue Shield of
Michigan and Humana, for our southeast Oakland expansion. We are implementing evaluation processes
to investigate healthcare outcomes of interest such as increased consumption of fruit and vegetables,
increased food security, and reduced social isolation and loneliness. While measurement of reduction of
healthcare costs are currently not feasible within the scope of our programming and evaluation, we
continue to advance with this outcome in mind, and look to integrate metrics within evaluation and
programming that support this outcome. We look to other modes of reimbursement, such as other value-
based and social determinants of health/care management payments (Z codes) as method of
sustainability.
Our team is exploring healthcare system investment, private physician or physician organization
reimbursement, and other philanthropic and/or government funding. Our team is part of the Michigan
Farmers Market Association Produce Prescription Learning Network. We will continue efforts with this
group to engage in standardized data collection efforts across Michigan and to support statewide efforts
in sustainability. Oakland University, on behalf of Prescription for a Healthy Oakland, and in collaboration
with Michigan Farmers Market Association, Public Sector Consultants, and Reciprocity, a local technology
firm, has submitted a proposal to Michigan Health Endowment Fund to build a technology platform to
serve the needs of PPRs in management/administration, participant experience, and standardized data
collection (see Business Plan for additional details). This project will continue to advance our local capacity
through a Participant Advisory Council and Steering Committee as we identify continued PPR needs across
Michigan and it will allow us to capitalize on our strengths as well.
Beyond our programming, we continue to see our local food system culture and capabilities
improve. Our vendors and their many staff are informed of our programming and its overarching goals. We
anticipate that implementing a GusNIP-supported PPR will further strengthen our local food system
commitment to this program and to providing high quality, culturally appropriate fruits and vegetables.
We envision that our communities and individuals served will increase capacity to engage in
healthy living, and our programming helps to facilitate a culture of healthy living within households and
communities. We have evidence from past programming that supports improvements in knowledge and
self-efficacy around healthy eating. We also have data that supports improvements in eating behaviors,
food security, and mental health. For historically underserved communities, we believe that this type of
programming, with additional health education and wrap-around services offered by our many partners,
serves to empower communities and promote a culture of health.
8. Non-supplantation.
Prescription for a Healthy Oakland does not currently have funding to operate in central Oakland County
and has limited funds to serve only 50 participants in the southern portion of the county until October
2022. Funding received would allow the current program to grow and concurrently cover two pockets of
health disparity and food insecurity: the central portion of the county in the greater Pontiac area and the
southern portion of the county. Prescription for a Healthy Oakland has not been able to serve these two
areas of need simultaneously due to funding limitations. The current 2022 small-scale program in the
southern portion of the county was privately funded by Blue Cross Blue Shield of Michigan (BCBSM), as
was the program’s initial small-scale, short- term 2018 pilot program in the Pontiac area. The BCBSM
funding previously received, though immensely helpful in kickstarting efforts, has been insufficient to
operate on a scale appropriate for the level of local need. Michigan Health Endowment Fund, which
previously supported the largest scale iteration of our program in central Oakland County from 2021-2022,
has explicitly stated that their focus has shifted and they will no longer be funding individual produce
prescription programs. Our letter of intent in response to MHEF’s most recent RFP was denied for this
reason. There is no currently available source of local funding that could support this program as proposed;
that is, serving 200 individuals across both locations of need. This level of intervention is necessary; our
past and potential future participants need this intervention and deserve dignified care that does not have
to deny them due to lack of funding. Implementing this full-scale intervention will make an immense impact
on food insecurity and health disparities in areas of critical concern through the county. Furthermore, the
successful accomplishment of this county-wide program will demonstrate its necessity, impact, and
establishment as a fundamental community service to potential future funders.
Work Plan - GusNIP Produce Prescription
Program Oakland County Health Division -
Prescription for Healthy Oakland
B. Work plan: Year 1: 2022-
2023
Year 2: 2023-
2024
Year 3: 2024-2025
Key Activities Intended outcomes of
activities
Impact of
activities on
target population
Entity
Responsible
Notes Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug Staffing
Finalize OU, Honor, and
Centro subcontracts and
complete hires
Position descriptions
created, candidates
interviewed, health
educators hired
Indirect OCHD/OU/HC
H
X X
Hire of OCHD Health
Education staff
Position descriptions
created, candidates
interviewed, health
educators hired
Indirect OCHD X X
Program Planning
Assess feedback from
previous prescription
iterations to identify
potential improvements
for next round.
Performance
improvement
opportunities to improve
efficiency and operations
of program
Indirect OCHD/OU/HC
H
X
Revise referral process,
enrollment criteria,
enrollment process, and
consent process
Referral process model,
enrollment criteria,
enrollment process, and
consent process,
Participants
have overview
of program and
consent to
program
OCHD/OU X X X X
Establish/extend vendor
contracts with partners
Completed contracts Indirect OU X X X
Print materials including
voucher booklets and
incentives
Materials and voucher
booklets → program
packets and marketing
Participants
have program
materials and
vouchers for
use
OCHD X X X X X X X X
Update and revise
website w/ new program
information and
enrollment forms
Portal for enrollment,
health education,
evaluation, participant
resources
Participants
have overview
of program and
access to
program
materials and
activities
OCHD/OU X X X
Identify additional health
education and resources
for staff
Supplemental learning
activities and
opportunities
Resources to
enhance
OCHD/OU X X X X X X
Work Plan - GusNIP Produce Prescription Program
Oakland County Health Division - Prescription for
Healthy Oakland
B. Work plan: Year 1: 2022-
2023
Year 2: 2023-
2024
Year 3: 2024-2025
Key Activities Intended outcomes of
activities
Impact of
activities on
target population
Entity
Responsible
Notes Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug program
opportunities
Program Implementation/Evaluation
Hold regular check-in
meetings between core
partners to coordinate
activities and conduce
process evaluation.
Quality improvement
opportunities; enhanced
communication between
partners; and improved
programming for
participants.
Improved
program
delivery
OCHD/OU X X X X X X X X X
Conduct training sessions
with referral sites
Clinic staff trained on
program and referral
process
Clear referral
and enrollment
process for
participants
OCHD/OU/HC
H
X X
Referral and enrollment
process- rolling
Approximately 200
eligible individuals
enrolled in program
Program entry
and information
HCH/OCHD X X X X X
Participant voucher use Participants use
purchased fruits and
vegetables
Increase in
consumption of
fruits and
vegetables →
leads to
intermediate
and long-term
outcomes
Participants X X X X X X
Online health education
sessions- done
asynchronously online
Participants complete
health education sessions
Increase self-
efficacy,
attitudes,
knowledge →
behavior
change → leads
to intermediate
and long-term
outcomes
Participants X X X X X X
Conduct check-ins with
participants
Participants receive
support and review goals
with staff
Participants
receive social
support →
leads to
intermediate
OCHD/OU X X X X X
2
Contract Number:
36
Work Plan - GusNIP Produce Prescription Program Oakland County
Health Division - Prescription for Healthy Oakland
B. Work plan: Year 1:
2022-
2023
Year 2:
2023-
2024
Year 3:
2024-2025
Key Activities Intended outcomes
of activities
Impact of activities
on target population
Entity
Responsible
Notes Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug Sept- Dec Jan- April May- Aug and long-term
outcomes
Post-program
evaluation- rolling
online asynchronously
Participants
close-out
program
Completion of
program support
→ leads to
intermediate
and long-term
outcomes
OCHD/OU X X X X X
Monitoring of program
activities
Ability to revise or
address participants’
or partner needs
Improved program
delivery
OCHD X X X X X X X X
Track and
reimbursement of
produce vendors
Invoices created,
payment sent to
partners
Indirect OU X X X X X X X
Evaluation follow-up
(6- mo, 1-yr, 2-yr→
some outside of
granting period)
Data collected
for program
evaluation,
receive
participant
feedback
Gives voice to
participant
experiences
OU X X X X X X X
Dissemination
Create final
reports (clinic
partners,
community
partners, academic
publications
and conference
presentations,
funders)
Established
program
protocol/guide,
lessons learned
Sustainability of
program in
community
OU/OCHD X X
Contract Number:
37
Research and explore
additional funding
opportunities among
healthcare systems,
philanthropic,
governmental, and other
sources
Program funding
and/or expansion
Sustainability of
program in
community
OU/OCHD X X X X X X X X X
Abbreviations are as follows: Oakland County Health Division (OCHD), Oakland University (OU), Honor Community Health (HCH)