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Home My WebLink AboutReports - 2024.02.07 - 40979 AGENDA ITEM: Amendment #2 to the FY 2024 Emerging Threats Local Health Department Agreement from the Michigan Department of Health and Human Services DEPARTMENT: Health & Human Services MEETING: Board of Commissioners DATE: Wednesday, February 7, 2024 6:00 PM - Click to View Agenda ITEM SUMMARY SHEET COMMITTEE REPORT TO BOARD Resolution #2023-3661 Motion to accept Amendment #2 to the Fiscal Year 2024 Emerging Threats Local Health Department Agreement totaling $2,080,502 for the period of October 1, 2023 through September 30, 2024, and authorize the Chair of the Board of Commissioner to execute the agreement; further, amend the FY 2024 budget as detailed in attached Schedule A. ITEM CATEGORY SPONSORED BY Grant Gwen Markham INTRODUCTION AND BACKGROUND The Oakland County Health Division has received Amendment #2 to the Michigan Department of Health and Human Services (MDHHS) Fiscal Year (FY) 2024 Emerging Threats Local Health Department Agreement. The original agreement totaling $6,263,627 was adopted by the Board of Commissioners on September 21, 2023, via Miscellaneous Resolution #23-3306. Amendment #1 increased the funding to $6,438,627; an increase of $175,000. Amendment #2 increases the funding to $8,519,129, a total increase of $2,080,502 and provides increased funding for the Regional Lab, SEWER Network, and COVID Workforce Development programs. POLICY ANALYSIS Acceptance of this grant does not obligate the county to any future commitment and continuation of this program is contingent upon continued future levels of grant funding. BUDGET AMENDMENT REQUIRED: Yes 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 ITEM REVIEW TRACKING Aaron Snover, Board of Commissioners Created/Initiated - 2/7/2024 AGENDA DEADLINE: 02/07/2024 6:00 PM ATTACHMENTS 1. HHS_2024 Emerging Threats_Amend#2_Sch. A 2. Grant Review Sign-Off 3. Amendment #2 ATT III 4. Amendment #2 ATT IV 5. Amendment #2 ATT I 6. Amendment #2 Contract draft COMMITTEE TRACKING 2024-01-31 Finance - Recommend to Board 2024-02-07 Full Board - Adopt Motioned by: None Seconded by: None Yes: None (0) No: None (0) Abstain: None (0) Absent: (0) Oakland County, Michigan HEALTH AND HUMAN SERVICES DEPARTMENT/HEALTH DIVISION - FY 2024 EMERGING THREATS LOCAL HEALTH DEPARTMENT AGREEMENT AMENDMENT #2 Schedule "A" DETAIL R/E Fund Name Division Name Fund # (FND) Cost Center (CCN) # Account # (RC/SC) Program # (PRG) Grant ID (GRN) # Project ID # (PROJ) Region (REG) Budget Fund Affiliate (BFA) Ledger Account Summary Account Title FY 2024 Amendment FY 2025 Amendment FY 2026 Amendment R Human Services Grants Health FND11007 CCN1060201 RC610313 PRG133095 GRN-1004198 610000 Federal Operating Grants $1,414,692 $-$- Total Revenues $1,414,692 $-$- E Human Services Grants Health FND11007 CCN1060201 SC702010 PRG133095 GRN-1004198 702000 Salaries Regular $23,047 $-$- E Human Services Grants Health FND11007 CCN1060201 SC722740 PRG133095 GRN-1004198 722000 Fringe Benefits 18,324 -- E Human Services Grants Health FND11007 CCN1060201 SC730926 PRG133095 GRN-1004198 730000 Indirect Costs (3,554)-- E Human Services Grants Health FND11007 CCN1060201 SC730373 PRG133095 GRN-1004198 730000 Contracted Services 1,000,000 E Human Services Grants Health FND11007 CCN1060201 SC731346 PRG133095 GRN-1004198 730000 Personal Mileage 3,350 E Human Services Grants Health FND11007 CCN1060201 SC732018 PRG133095 GRN-1004198 730000 Travel and Conferences 15,000 E Human Services Grants Health FND11007 CCN1060201 SC731458 PRG133095 GRN-1004198 730000 Professional Services (600,000)-- E Human Services Grants Health FND11007 CCN1060201 SC750294 PRG133095 GRN-1004198 750000 Material and Supplies 958,525 -- Total Expenditures $1,414,692 $-$- R Human Services Grants Health FND11007 CCN1060201 RC610313 PRG133095 GRN-1004197 610000 Federal Operating Grants $555,810 $-$- Total Revenues $555,810 $-$- E Human Services Grants Health FND11007 CCN1060201 SC702010 PRG133095 GRN-1004197 702000 Salaries Regular $(67,978)$-$- E Human Services Grants Health FND11007 CCN1060201 SC722740 PRG133095 GRN-1004197 722000 Fringe Benefits (40,909)-- E Human Services Grants Health FND11007 CCN1060201 SC730926 PRG133095 GRN-1004197 730000 Indirect Costs (9,388)-- E Human Services Grants Health FND11007 CCN1060201 SC731458 PRG133095 GRN-1004197 730000 Professional Services 90,275 -- E Human Services Grants Health FND11007 CCN1060201 SC732018 PRG133095 GRN-1004197 730000 Travel and Conference 3,000 -- E Human Services Grants Health FND11007 CCN1060201 SC750294 PRG133095 GRN-1004197 750000 Material and Supplies 530,810 -- E Human Services Grants Health FND11007 CCN1060201 SC760157 PRG133095 GRN-1004197 760000 Lab Equipment 50,000 -- Total Expenditures $555,810 $-$- R Human Services Grants Health FND11007 CCN1060201 RC615571 PRG133095 GRN-1004179 615000 State Operating Grants $110,000 $-$- Total Revenues $110,000 $-$- E Human Services Grants Health FND11007 CCN1060201 SC731346 PRG133095 GRN-1004179 730000 Personal Mileage $670.00 -$- E Human Services Grants Health FND11007 CCN1060201 SC731388 PRG133095 GRN-1004179 730000 Printing 1,000 -- E Human Services Grants Health FND11007 CCN1060201 SC731458 PRG133095 GRN-1004179 730000 Professional Services 50,830 -- E Human Services Grants Health FND11007 CCN1060201 SC731941 PRG133095 GRN-1004179 730000 Training 50,000 -- E Human Services Grants Health FND11007 CCN1060201 SC732018 PRG133095 GRN-1004179 730000 Travel and Conference 7,500 -- Total Expenditures $110,000 $-$- GRANT REVIEW SIGN-OFF – Health & Human Services / Health Division GRANT NAME: FY 2024 Emerging Threat Local Health Department Agreement AWD00385 FUNDING AGENCY: Michigan Department of Health & Human Services DEPARTMENT CONTACT: Stacey Sledge 248-452-2110 STATUS: Grant Amendment #2 (Greater than 15% of Award) DATE: 01/12/2024 Please be advised that 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 should be placed on the next agenda(s) of the appropriate Board of Commissioners’ committee(s) for grant amendment by Board resolution. DEPARTMENT REVIEW Management and Budget: Approved. – Sheryl Johnson (01/11/2024) Human Resources: Approved. –Hailey Matthews on behalf of Heather Mason (01/05/2024) Risk Management: If the ATT III COVID-19 Mobile Testing section applies, then the insurance provisions must be changed to allow for self-insurance. - Robert Erlenbeck (01/08/2024) Corporation Counsel: CC conducted a legal review of the 2nd Amended Agreement and attachments relevant to the following programs: COVID workforce development, COVID Immunizations, and ELC Contact Tracing, case investigation. Other program assurances within Att 3 either existed in previous agreements or are not applicable to Oakland County at this time. CC received confirmation from S. Sledge, K. Guzeman, and S. Stoddard that they have reviewed the agreement and assurances applicable to their roles, can comply, and have no questions or issues. Heather Lewis– (01/11/2024) ATTACHMENT III MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES LOCAL HEALTH DEPARTMENT AGREEMENT October 1, 2023 – September 30, 2024 Fiscal Year 2024 PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Grantee and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on-site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. Special requirements are applicable for the program elements listed in the attached pages. Attachment IV Reimbursement Chart Program Element: The Program Element indicates currently funded Department programs that are included in the Comprehensive Local Health Department Agreement. Reimbursement Methods The Reimbursement Methods specifies the type of method used for each of the program element/funding sources. Funding under the Comprehensive Local Health Department Agreement can generally be grouped under four (4) different methods of reimbursement. These methods are defined as follows: Performance Reimbursement A reimbursement method by which local agencies are reimbursed based upon the understanding that a certain level of performance (measured by outputs) must be met in order to receive full reimbursement of costs (net of program income and other earmarked sources) up to the contracted amount of state funds prior to any utilization of local funds. Performance targets are negotiated starting from the last year's negotiated target and the most recent year's actual numbers except for programs in which caseload targets are directly tied to funding formulas/annual allocations. Other considerations in setting performance targets include changes in state allocations from past years, local fiscal and programmatic factors requiring adjustment of caseloads, etc. Once total performance targets are negotiated, a minimum state funded performance target percentage is applied (typically 90% unless otherwise specified). If local Grantee actual performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation for cost reimbursement will be reduced equivalent to actual performance in relation to the minimum performance. Fixed Unit Rate Reimbursement A reimbursement method by which local health departments are reimbursed a specific amount for each output actually delivered and reported. ELPHS A reimbursement method by which local health departments are reimbursed a share of reasonable and allowable costs incurred for required Essential Local Public Health Services (ELPHS), as noted in the current Appropriations Act. Grant Reimbursement A reimbursement method by which local health departments are reimbursed based upon the understanding that State dollars will be paid up to total costs in relation to the State's share of the total costs and up to the total state allocation as agreed to in the approved budget. This reimbursement approach is not directly dependent upon whether a specified level of performance is met by the local health department. Department funding under this reimbursement method is allocable and a source before any local funding requirements unless a special local match condition exists. Performance Level If Applicable The Performance Level column specifies the minimum state funded performance target percentage for all program elements/funding sources utilizing the performance reimbursement method (see above). If the program elements/funding source utilizes a reimbursement method other than performance or if a target is not specified, N/A (not available) appears in the space provided. Performance Target Output Measures Performance Target Output Measure column specifies the output indicator that is applicable for the program elements/ funding source utilizing the performance reimbursement method. Output measures are based upon counts of services delivered. Relationship Designation The Subrecipient, Contractor, or Recipient Designation column identifies the type of relationship that exists between the Department and grantee on a program-by-program basis. Federal awards expended as a subrecipient are subject to audit or other requirements of Title 2 Code of Federal Regulations (CFR). Payments made to or received as a Contractor are not considered Federal awards and are, therefore, not subject to such requirements. Subrecipient A subrecipient is a non-Federal entity that expends Federal awards received from a pass- through entity to carry out a Federal program, but does not include an individual that is a beneficiary of such a program; or is a recipient of other Federal awards directly from a Federal Awarding agency. Therefore, a pass-through entity must make case-by-case determinations whether each agreement it makes for the disbursement of Federal program funds casts the party receiving the funds in the role of a subrecipient or a contractor. Subrecipient characteristics include: • Determines who is eligible to receive what Federal assistance; • Has its performance measured in relation to whether the objectives of a Federal program were met; • Has responsibility for programmatic decision making; • Is responsibility for adherence to applicable Federal program requirements specified in the Federal award; and • In accordance with its agreements uses the Federal funds to carry out a program for a public purpose specified in authorizing status as opposed to providing goods or services for the benefit of the pass-through entity. Contractor A Contractor is for the purpose of obtaining goods and services for the non-Federal entity’s own user and creates a procurement relationship with the Grantee. Contractor characteristics include: • Provides the goods and services within normal business operations; • Provides similar goods or services to many different purchasers. • Normally operates in a competitive environment. • Provides goods or services that are ancillary to the operation of the Federal program; and • Is not subject to compliance requirements of the Federal program as a result of the agreement, though similar requirements may apply for other reasons. In determining whether an agreement between a pass-through entity and another non-Federal entity casts the latter as a subrecipient or a contractor, the substance of the relationship is more important than the form of the agreement. All of the characteristics listed above may not be present in all cases, and the pass-through entity must use judgment in classifying each agreement as a subaward or a procurement contract. Recipient A Recipient is for grant agreement with no federal funding. Amendment Schedule Request Due Date Amendment Type Amendment #1 (new projects and end date changes only) NA - Program Only Requests New Projects Only Amendment #2 Tuesday September 19, 2023 Allocation and Budget Category Changes Amendment #3 Monday, January 22, 2024 Allocation and Budget Category Changes Amendment #4 (Final) Monday, May 6, 2024 Allocation and Budget Category Changes Agencies need to request budget category changes to the program office via email by the due date. PROJECT PROGRAM CONTACT EMAIL American Rescue Plan Charisse Sanders sandersc2@michigan.gov Aresnic Water Sampling Laura de la Rambelje delarambeljel@michigan.gov COVID Immunization Amy Mills millsa12@michigan.gov COVID-19 Mobile Testing Brenda Jegede jegedeb@michigan.gov COVID Workforce Development Laura de la Rambelje delarambeljel@michigan.gov ELC Contract Tracing, Investigation, Testing Coord., and Infection Prevention Laura de la Rambelje delarambeljel@michigan.gov ELC Regional Lab Marty Soehnlen soehnlenm@michigan.gov ELC Sewer Network Mary Stobierski stobierskim@michigan.gov Expanding Public Health Workforce Tedra Jackson jacksont7@michigan.gov Lead Response Laura de la Rambelje delarambeljel@michigan.gov Local Public Health Nursing Case Management Expansion Carin Speidel speidelc@michigan.gov PFAS Response (All Locations)Laura de la Rambelje delarambeljel@michigan.gov Regional Lab Workforce Marty Soehnlen soehnlenm@michigan.gov Reopening Schools HRA Joseph Coyle coylej@michigan.gov PROJECT TITLE: American Rescue Plan American Rescue Plan – HFA American Rescue Plan – NFP Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis: The American Rescue Plan (ARP) funding is federal funding issued to assist Home Visiting programs and associated families with the means to respond to immediate needs resulting from the impacts of COVID-19. This funding will assist Home Visiting programs with addressing the impacts of COVID-19 by providing services and supplies to families while also supporting the programmatic costs and training needs of Home Visiting agencies. Reporting Requirements (if different than agreement language): The Local Implementing Agency (LIA) shall submit all required reports in accordance with the Department’s reporting requirements. See the Michigan Department of Health and Human Services’ (MDHHS) Home Visiting Unit (HVU) Guidance Manual for details about what must be included in each report. a. Staffing Changes: Within 10 days of a staffing change, notify the HVU Model Consultant via e-mail and incorporate the change(s) into the budget and facesheet during the next amendment cycle as appropriate. The facesheet identifies the agency contacts and their assigned permissions related to the tasks they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the facesheet changes once the agreement is available to be amended. b. ARP Work Plan: Due annually on June 30 to the HVU Model Consultant for preapproval. Upon approval, upload the Work Plan to Groupsite. See the MDHHS Home Visiting Unit Guidance Manual for requirements related to Work Plan development and reporting. c. Work Plan Reports: Must be uploaded to Groupsite within 30 days of the end of each quarter (January 30, April 30, July 30 and October 30). d. ARP Quarterly Report: This report is unique to ARP funding asking for specific information relating to the allowable uses of ARP funds. These reports will assist the MDHHS Home Visiting Unit in complying with HRSA requirements and are due on the 15th of the month following each calendar quarter. The report template will be provided. All ARP Quarterly Reports should be submitted to the MDHHS Home Visiting Program Analyst. Additional Requirements Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: Arsenic Water Sampling Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis: To protect the health of residents in Middleton, the health department will conduct a sampling event of 20 homes served by private drinking water wells. Using information collected from this initial sampling event, it will be determined if there is a threat to the drinking water source serving the Middleton community. Additional rounds of sampling may be needed based on the testing results. Reporting Requirements (if different than contract language): The agency will submit a report that includes the following information: • background • data evaluation • trends • conclusions • recommendations Eligible expenses Include: • Staff time • lab sampling costs • lab courier • travel costs • printing costs Expenses not listed above must receive prior approval by MDHHS before submission. Any additional requirements (if applicable) Each well will be required to have a well log entered in wellogic. . PROJECT: COVID Immunization Start Date: 10/1/2023 End Date: 6/30/2024 Project Synopsis: This grant should be directed to increase COVID vaccination within Michigan. will be used to support awardee and local Health Department (HD) staffing, communications campaigns, pandemic preparedness, mass vaccination and all COVID-19 vaccine response work. Reporting Requirements (if different than contract language) Completion of the Supplemental Quarterly Workplan Report. Any additional requirements (if applicable) Allowable expenses include staffing, communications, and supplies to support COVID-19 vaccination events, including PPE, vaccine refrigerators, data loggers, vaccine coolers, and indirect costs for COVID-19 related work. Not allowable expenses: vehicles, food, alcoholic beverages, building purchases, construction, capital improvements, entertainment costs, goods and services for personal use, and promotional and/or incentive material. Additional Requirements Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: COVID Workforce Development Start Date: 10/1/2023 End Date: 6/30/2024 Project Synopsis: Funding for COVID-19 Public Health Workforce Development to establish, expand, and sustain a public health workforce, including school nurses Reporting Requirements (if different than contract language) Reporting requirements will be provided at a later date. Any additional requirements (if applicable) Eligible purchases include: • Hiring personnel (including wages and benefits) for roles that may range from senior leadership positions to early career or entry-level positions (including, but not limited to permanent full-time and part-time staff, temporary or term-limited staff, fellows, interns, and contractors or contracted employees). Examples of personnel include professional or clinical staff, disease investigation staff, school nurses and school-based health services personnel, program staff, administrative staff, and any other positions that may be required to prevent, prepare for, and respond to COVID-19. • Purchase of equipment and supplies necessary to support the expanded workforce including personal protective equipment, equipment needed to perform the duties of the position, computers, cell phones, internet costs, cybersecurity software, and other costs associated with support of the expanded workforce (to the extent these are not included in recipient indirect costs). • Administrative support services necessary to implement activities funded under this section, including travel and training (to the extent these are not included in recipient indirect costs). PROJECT: COVID-19 Mobile Testing Start Date: 10/1/2023 End Date: 7/31/2024 Project Synopsis Mobile testing deployment to high-risk areas of need. Walk or drive up testing. Partnerships with community organizations. Eliminate barriers by offering no appointments or prescription. Testing and include vaccinations and health screening. Services include social determinant assessments and linkage to services and care. Reporting Requirements (if different than contract language) Monthly Project Updates Please submit monthly project updates via email to Shronda Grigsby Grigsbys1@michigan.gov and Nina Talarico TalaricoN@michigan.gov no later than the 15th of each calendar month. Quarterly Narrative Progress Reports Submit quarterly narrative progress reports utilizing the template provided via email to Shronda Grigsby at Grigsbys1@Michigan.gov and Nina Talarico TalaricoN@michigan.gov in accordance with the following schedule: Reporting Period Report Due Date October 1 - December 31 January 31 January -March 31 April 30 April 1 - June 30 July 31 October 1 - Septmeber 30 (entire FY) October 31 Any additional requirements (if applicable) A. Ensure that activities implemented under this grant award are in accordance with established MDHHS program standards, as well as State and Federal policy and statutes, including HIPAA. B. Adhere to timelines and work plans, budgets, and staffing plans submitted and approved by MDHHS. Deviations from approved timelines, work plans, budgets and staffing plans must receive advance authorization from MDHHS. Failure to make reasonable progress in program development may result in revocation or reduction of the grant award. C. Collaborate with and build on other MDHHS COVID-19 response programs wherever possible, rather than duplicating or rebuilding efforts. D. Ensure that services and materials are culturally and linguistically appropriate to meet the needs of the respective client populations. E. Utilize results from the Social Vulnerability Index/mortality analysis from the State of Michigan at the census tract level for Southeast Michigan to help identify priority areas for the mobile testing program within high priority census tracts, and share data maps of COVID-19 “hot spots” with MDHHS. F. Assess insurance status of each individual being tested. Bill relevant insurers, including private insurers, Medicaid health plans, and the Health Resources and Services Administration for COVID-19 testing costs when possible. G. Store, refuel, and maintain vehicles to ensure optimum vehicle performance. Take all reasonable precautions to keep vehicles safe against fire, water, and traffic damage, and maintain cleanliness of the vehicles. Submit documentation and billing for storage, fuel, and maintenance reimbursement. H. As part of any vaccination activities, follow all relevant MDHHS protocols, including record and account of all doses of vaccine administered in the Michigan Care Improvement Registry (MCIR) and assuring vaccines are stored at recommended temperatures at all times. 1. Reports from temperature data logger showing temperatures within recommended range may be requested at any time by MDHHS. The terms below are in addition to the standard terms in the County Health Department Agreement, and apply only to this specific project: Insurance Requirements. Grantee, at its sole expense, must maintain the insurance coverage identified below. All required insurance must: (i) Protect the State from claims that arise out of, are alleged to arise out of, or otherwise result from Grantee's performance; (ii) Be primary and non-contributing to any comparable liability insurance (including self-insurance) carried by the State; and (iii) Be provided by a company with an A.M. Best rating of "A-" or better, and a financial size of VII or better. Required Limits Additional Requirements Commercial General Liability Insurance Minimum Limits: $1,000,000 Each Occurrence $1,000,000 Personal & Advertising Injury $2,000,000 Products/Completed Operations $2,000,000 General Aggregate Coverage must not have exclusions or limitations related to sexual abuse and molestation liability. Automobile Liability Insurance Minimum Limits: $1,000,000 Per Accident Policy must include Hired and Non-Owned Automobile coverage. Workers' Compensation Insurance Minimum Limits: Coverage according to applicable laws governing work activities Waiver of subrogation, except where waiver is prohibited by law. Employers Liability Insurance Minimum Limits: $500,000 Each Accident $500,000 Each Employee by Disease $500,000 Aggregate Disease Privacy and Security Liability (Cyber Liability) Insurance Minimum Limits: $1,000,000 Each Occurrence $1,000,000 Annual Aggregate Policy must cover information security and privacy liability, privacy notification costs, regulatory defense and penalties, and website media content liability. Medical Malpractice Insurance Minimum Limits: $1,000,000 Each Occurrence $3,000,000 Annual Aggregate If any required policies provide claims-made coverage, the Grantee must: 1. Provide coverage with a retroactive date before the Effective Date of the Grant or the beginning of Grant Activities; 2. Maintain coverage and provide evidence of coverage for at least three (3) years after completion of the Grant Activities; and 3. If coverage is cancelled or not renewed, and not replaced with another claims- made policy form with a retroactive date prior to the Effective Date of this Grant, Grantee must purchase extended reporting coverage for a minimum of three (3) years after completion of work. Grantee must: 1. Provide insurance certificates to the Grant Administrator, containing the agreement or delivery order number, at Grant formation and within twenty (20) calendar days of the expiration date of the applicable policies; 2. Require that subgrantees maintain the required insurances contained in this Section; 3. Notify the Grant Administrator within five (5) business days if any policy is cancelled; and (iv) waive all rights against the State for damages covered by insurance. Failure to maintain the required insurance does not limit this waiver. This Section is not intended to and is not to be construed in any manner as waiving, restricting or limiting the liability of either party for any obligations under this Grant (including any provisions hereof requiring Grantee to indemnify, defend and hold harmless the State). Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: ELC Contact Tracing, Case Investigation, Testing Coordination, and Infection Prevention Start Date: 10/1/2023 End Date: 7/31/2024 Project Synopsis: For COVID-19 and Mpox funding from ELC Supplemental for Infection Prevention, Case Investigations, and Contact Tracing and Infection Prevention. To gain access to these funds, Local Health Departments (LHDs) must participate in collaborative efforts with MDHHS to improve the knowledge of infection prevention (IP) and control at a local level, therefore improving the quality of care for residents within congregate care settings within Michigan. If the need arises, the funds can also be used to support case investigations, contact tracing, and testing for emerging pathogens. All activities supported under this agreement must have a tie to COVID-19. Reporting Requirements (if different than contract language) *Reporting requirements, if applicable, are noted in the individual sections below. Any additional requirements (if applicable) • Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase. COVID-19 activities must remain the primary purpose of this expansion and MPV is in addition to the approved services provided and within scope. Please ensure these activities are conducted concurrently. MPV ONLY activities are not allowable with COVID-19 funding. • The inability to meet quality standards will elicit the following response from MDHHS related to this funding: a. Technical assistance b. Corrective action/performance improvement plans with MDHHS Related to Case Investigation Quality: • LHD’s will continue to perform high quality case investigation and contact tracing for Department-recommended priorities. Local health departments should focus on interview completion, timeliness, and race and ethnicity completion, as well as effective communication with providers, individuals, the general public, and businesses related to isolation and quarantine. LHD’s shall focus work on outbreak investigations in populations of interest. LHD’s can procure tools to increase case investigation quality (people finding software, communications, printed materials for testing events, EMR access, etc.). • Case investigation data will be reported in MDSS. Allowable expenses include staffing, IT, communications, computers and or phones or other office needs, access to people finding software or EMR, printed materials, outreach, supports to cases for isolation and quarantine (not including wraparound services). Funding cannot be used for clinical care, vaccine administration, or research. Local health departments should ensure staff are trained to conduct culturally competent interviews. Related to Contact Tracing: • Dependent on MDHHS guidance, LHDs will collaborate with MDHHS to assure timely contact notification and education of close contacts (named or associated with an event or outbreak) of a COVID-19 or mpox case. Local health departments should ensure contact tracing for COVID-19 and mpox is culturally competent. Contact tracing data will be documented in OMS (COVID-19) or MDSS (mpox) Related to testing: • LHDs will provide staffing and support for testing activities related to outbreak response. This funding can be used to staff testing or outreach events, shipping and handling of specimens, mobile units, or assure testing strategies are completed. Related to Infection Prevention (i.e. MI-ECHO Project): • Technical assistance can be requested by LHD Infection Prevention personnel including, but not limited to: a. train-the-trainer models b. job shadowing c. assistance with onsite and virtual facility assessments d. pre-and post-visit consultation and follow-up e. cluster/outbreak reporting f. response and containment • The LHD will designate a staff member or members responsible for leading virtual and onsite infection prevention assessments: 1. Proactive IP assessments (preparedness) 2. Assessments in response to an outbreak/cluster • A list of LHD IP team members and contact information will be available to MDHHS. • Team members will participate in a Project kickoff meeting and routinely scheduled coordination calls with MDHHS. • Dedicated LHD staff will complete Project FirstLine Training provided by CDC and/or MDHHS. • Dedicated LHD staff will participate in an APIC training sponsored by MDHHS. • LHDs will conduct ongoing outreach to high-risk settings to assess communicable disease reporting and existing infection prevention resources, policies, practices, processes and provide facilities with best practice recommendations for infection prevention. ** High risk settings include but are not limited to healthcare settings (hospitals, nursing homes, other long term care facilities), jails, prisons, and shelters. • LHDs shall submit ICARs to MDHHS at https://dhhshivstd.iad1.qualtrics.com/jfe/form/SV_0dNux70o256K6B7 This data will be reported to MDHHS in a quarterly survey (Qualtrics/SurveyMonkey): a) # of LHD staff completing Project FirstLine Training b) # of LHD staff completing APIC training c) # of proactive virtual site visits conducted d) # of proactive onsite visits conducted e) # of outbreak/cluster site visits conducted f) # of trainings coordinated by LHD personnel g) # of infection prevention consultations conducted h) # of IP meetings coordinated by the LHD • Allowable expenses include staffing, IT, communications, computers and/or phones or other office needs, travel, PPE, professional development/trainings/conferences for staff, expenses related to hosting events/trainings. • Funding cannot be used for clinical care, vaccine administration, or research. Related to Infection Prevention: MDHHS will serve as a statewide technical assistance provider to LHD personnel for infection prevention expertise, including but not limited to train-the-trainer models, job shadowing, assistance with onsite facility assessments, pre-and post-visit consultation and follow-up, cluster/outbreak reporting, investigation, response, and containment of multidrug resistant organisms. • The LHD will designate a staff member or members responsible for leading onsite infection prevention assessments: o Prevention-based IP assessments (preparedness) o Response-based IP assessments (outbreak/cluster) • A list of relevant LHD team members and contact information will be made available to MDHHS • Team members will participate in routinely scheduled coordination calls with MDHHS • Dedicated LHD staff will complete education provided by MDHHS based on the LHD staff member needs. This will include regular check-in meetings and office hour sessions • Dedicated LHD staff will participate in MDHHS sponsored trainings by the Association for Professionals in Infection Control and Epidemiology • LHDs will conduct ongoing outreach to high-risk settings to assess infectious disease reporting, existing infection prevention resources, policies, practices, and processes and provide facilities with best practice recommendations for infection prevention • LHDs will coordinate, schedule, and complete site visits with MDHHS for both shadowing and leading experiences • LHDs shall submit site visit information to MDHHS at https://mdhhscd.qualtrics.com/jfe/form/SV_73acnAtD2MuHJNI. Related to Case Investigation and Contact Tracing: If the need arises, these funds can also be used to support case investigations, contact tracing, and testing for emerging pathogens – in consultation with MDHHS. For local health departments: • Use staffing to collaborate to conduct contact tracing, contact notification, outreach and mitigation for high-priority settings like schools, jails, dorms, congregate settings, etc. • LHDs will report to MDHHS the number of clusters/outbreaks investigated with supported staff • LHDs should report to MDHHS, on a quarterly basis, which non-COVID-19 conditions were investigated by staff supported under this award. • LHD’s will provide education to contacts on public health recommendations for COVID-19, mpox, or other emerging communicable disease threats. • LHDs will provide information to close contacts such as websites, printed materials, social media, or hotlines. • LHDs will provide timely and medically accurate linkage to treatment or PEP for contacts and cases. • Staffing can be used to support: a. connecting people with supportive services and treatments when indicated b. assisting with expanding public education and outreach c. promoting vaccination — including scheduling and booster reminders d. TPOXX outreach, provider education, and distribution • Staff can be cross trained to support other communicable disease investigation activities such as: a. mpox b. sexually transmitted infection and c. HIV partner services, d. Hepatitis C infection, e. foodborne outbreak response, f. tuberculosis investigations, g. healthcare associated and antibiotic resistant organisms, h. other programs that can benefit from the skills of this highly-trained workforce. • LHDs will support local public health staff impacted by COVID-19 and mpox by providing development and training opportunities, including addressing the physical and behavioral health impact of COVID-19 on the public health workforce. • LHDs will support staff workforce development and training, including conference fees and associated travel. • Allowable expenses include staffing, IT, communications, computers and or phones or other office needs, access to people finding software or EMR, supports to cases and contacts for isolation and quarantine for COVID-19, mpox, and/or other infectious disease threats. • Funding cannot be used for clinical care, vaccine or vaccine administration, or research. For local health departments: • Use staffing to collaborate to conduct infection prevention and outbreak response activities, such as infectious disease mitigation for high-priority settings like skilled nursing facilities, adult foster care, jails, other congregate settings, etc o LHDs will report to MDHHS the number of clusters/outbreaks investigated with supported staff • LHDs will provide education to congregate care and other healthcare setting staff on infection prevention and other public health recommendations for infectious diseases, including COVID-19 and other emerging communicable disease threats • Staffing can be used to support: o training and development of infection prevention and infectious disease response expertise o proactive infection prevention and infectious disease response activities in congregate care and other high impact settings o assisting with expanding infection prevention knowledge in congregate care settings • Staff can be cross trained to support other infectious disease investigation activities such as: o healthcare associated and antibiotic resistant organisms o hepatitis C infection o tuberculosis investigations o foodborne outbreak response o sexually transmitted infections o HIV partner services • LHDs will report to MDHHS, on a quarterly basis, which non-infection prevention- related activities/conditions were investigated by staff supported under this award • LHDs will support local public health staff in infection prevention and infectious disease response expertise by providing development and training opportunities Allowable expenses: • Staffing and contractual staffing • Staffing can support activities related to other infectious diseases, as long as the work incorporates components of COVID-19 (e.g. providing education on COVID- 19 testing, vaccine, or therapeutics) • Staff training and professional development • In- and out-of-state travel to conferences (including registration fees, lodging, meals, etc.) • Investment in IT systems at least partially relevant to COVID-19 • Hardware or software for staff related to COVID-19 • Educational materials, health promotion, and printed or electronic media at least partially related to COVID-19 (stay home when sick, testing, therapeutics, vaccination) • Assistance with case/contact isolation or quarantine expenses related to COVID- 19 Any single procurement of over $4,000 should be vetted with MDHHS prior to purchase. Requests should be sure to include how the purchase is related to COVID-19. Unallowable expenses: • Cannot be used for clinical work • Cannot be used to support research • Cannot be used to purchase vaccine • Cannot be used to recuperate costs of vaccine administration • Cannot be used to purchase of food for meetings, events • Cannot be used to support lobbying activities For additional guidance, please refer to the CDC ELC ED Guidance Document and the CDC ELC ED FAQ. Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: ELC Regional Lab Start Date: 10/1/2023 End Date: 7/31/2024 Project Synopsis ELC Regional Lab funds are dedicated to developing lab, epi, and other public health efforts to modernize and expand testing and response capabilities of pandemics with special emphasis on the responses to COVID-19. The Regional laboratory system is intended to serve as a “hub-and-spoke” model in conjunction with the state public health laboratory to rapidly respond to community needs. Funding is expected in personnel, equipment, overhead (discreationary of county or district needs if in support of public health), and lab supplies/consumables or materials that directly support sampling for return to the lab. Reporting Requirements (if different than contract language) Smay be asked to provide tally counts of testing if not directly available from StarLIMS or to answer occasional question from CDC on capabilities. Any additional requirements (if applicable) Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: ELC SEWER Network Start Date: 10/1/2023 End Date: 7/31/2024 Project Synopsis The State of Michigan SARS-CoV-2 Epidemiology - Wastewater Evaluation and Reporting Network, also known as the SEWER Network, is a wastewater monitoring project that utilizes locally coordinated projects to conduct surveillance for SARS-CoV-2 virus shed into Michigan public sewer systems. The overarching goal of the Michigan SEWER Network is to rapidly detect circulation of SARS-CoV-2 virus within specific communities via wastewater testing. The SEWER Network is designed to support local project participation through the collection, transportation, and testing of wastewater samples, analysis and reporting of results, coordination and communications within local projects and with state agencies, and submission of results to MDHHS and EGLE. The emphasis for this funding is that the funded activities provide useful, timely, and consistent wastewater data to support local COVID-19 public health responses. Reporting Requirements (if different than contract language) All local projects may be required to submit a weekly summary of project activities to MDHHS via email or uploading to the existing Microsoft Teams site for the project. This could include information on sample collection, testing, data reporting and utility, and partner communication. A template for this report will be provided by MDHHS. MDHHS will communicate any changes in reporting requirements to project participants. Quarterly workplan updates will be required from all local projects. Lead agencies who are not local health departments will be required to complete a quarterly workplan report in EGrAMS that details the activities and objectives during that time period. LHD leads for local projects will submit quarterly workplan reports directly to MDHHS project staff. Failure to implement project requirements or submit required financial and performance reports in accordance with this agreement may result in reduction of funds or non- renewal of future contracts. Any additional requirements (if applicable) This agreement reflects the sampling commitments written in the proposal. Any changes in the sampling plan need to be discussed with SEWER Network project staff. Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: Expanding Public Health Workforce Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis The Health Department will hire a ‘Disability Health Specialist’ to provide culturally affirmative and linguistically accessible information, in plain language. They will also provide activities that support public health and well being of people with developmental disabilities. The community coordinator will: • Develop specialized clinical training programs that will help health professionals understand how to work with individuals with disabilities. • Create an ADA guide for health professionals that include the latest regulations and best practices for working with clients with disabilities. Health and wellness education and information: • The Health Department, in partnership with CRIO (ODA), will host community education on health and wellness, customized for the disability population (e.g., hosting a workshop on signing up for ABLE Account, understanding Medicaid/Medicare, SSDI). • Additionally, hosting preventive health education in plain language that is easy to follow • Other activities that support the public health and wellbeing of people with disabilities o Developing training and education to healthcare professionals • Conducting evaluation to identify to identify gaps in services o Advocating for people with disabilities' health and well-being, as well as access to service providers and hospitals o Collaborating with community partners to improve health equity of people with disabilities. Reporting Requirements (if different or in addition to contract language) Required reports include semi-annual federal financial reports (FFR) and annual program reports that include: • Number of full-time equivalents (FTEs), • Type of public health professional(s) hired, and • The activities they are engaged in to advance public health Any additional requirements (if applicable) Participation in this funding opportunity requires any organization directly involved in vaccine administration to follow the CDC COVID-19 Vaccination Program Provider Agreement and the State of Michigan/MDHHS COVID-19 vaccine guidance including (but not limited to): • Maintaining enrollment in the CDC COVID-19 Vaccination Program • Adhering to state vaccine prioritization guidance • Following CDC/ACIP recommendations and clinical considerations • Adhering to CDC/FDA/MDHHS/Manufacturer vaccine storage, handling, and administration directions. Entering administered vaccines into MCIR in the timeframe defined by MDHHS, including completing optional MCIR fields such as race and ethnicity • Following MDHHS, CMS, and HRSA billing guidelines for vaccine administration • Participating in ‘VaccineFinder’ inventory and VAERS reporting, as well as ‘VaccineFinder's’ "Find COVID-19 Vaccines Near You" tool • Providing required patient education materials and vaccine record cards as well as encouraging patients use of v-safe Unallowable Costs/Services: 1. Purchase a vehicle to transport people with disabilities or older adults to vaccination appointments 2. The provision of transportation stipends/vouchers to individuals 3. General equipment purchases for staff who are not involved in public health activities, or for the organization Non-Supplanting Use of Funds Funds MAY NOT supplant existing funds. This means federal funds must be used to supplement existing state or local funds for program activities and may not replace state or local funds that have been appropriated or allocated for the same purpose. Publication Rights All products, including, but not limited to: reports, training manuals, service models, curricula, web sites, electronic information, videotapes, or files, which arise from grant projects funded by the Michigan Developmental Disabilities Council shall contain the following language: “Production of this {Product Type} was supported by Grant {Grant #} from the Michigan Developmental Disabilities Council, awarded pursuant to P.L. 106-402, as amended, the Developmental Disabilities Assistance and Bill of Rights Act, through the Michigan Department of Department of Health and Human Services, the Council’s designated state administering agency.” All dissemination of products, including, but not limited to: reports, training manuals, service models, curricula, electronic information, videotapes, or films produced by grant projects funded by Michigan Developmental Disabilities Council funds, shall be reviewed by the Michigan Developmental Disabilities Council, or its designee, prior to dissemination. PROJECT TITLE: Lead Response Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis: Lead Action Level Exceedance (ALE) response capacity encompasses public outreach, including education on water testing and results, water filter usage, flushing recommendations, and the interim provision of water filtration systems. Activity 1: The Michigan Department of Health and Human Services (MDHHS), through a legislative funding allocation, can provide lead-reducing water filter systems and replacement cartridges if the local water supply cannot provide them, and if the LHD or local unit of government doesn’t have the resources to provide them. Filters from MDHHS can be offered at no cost to low-income households that meet these criteria: Requirement 1: To qualify for a filter, both requirements must be met: o Household receives water from the ALE Community Water Supply o Household has NOT received a water filter from ALE Community Water Supply, the Local Health Department, or the Michigan Department of Health and Human Services. Requirement 2: To qualify for a filter, one requirement must be met: o A child under age 18 lives at the applicant’s address. o A child under age 18 spends a few hours a day and several days a week at the applicant’s address for at least 3 months of the year. o A pregnant woman lives at the applicant’s address. Requirement 3: To qualify for a filter, one requirement must be met: o Household includes a person who receives WIC benefits or Medicaid insurance. o Household attests they can’t afford a filter and replacement cartridges (filters cost about $35 and replacement cartridges cost about $15.) If an eligible household’s water test result is above the action level (AL = 15 ppb) for lead, or the resident’s home is on the public water system experiencing an ALE for lead, a faucet mount filter and 2 replacement cartridges will be offered. A pitcher filter and 3 replacement cartridges may be offered, when necessary (e.g., faucet mount does not fit their faucet). These measures will be provided until a permanent solution can be identified and implemented, as resources allow, or a determination is made by MDHHS Division of Environmental Health that filtration is no longer recommended or advised. Activity 2: Incorporate ALE Ambassadors into dissemination of ALE communication into the community. Activity 3: Assist the MDHHS DEH to promote available lead services (lead inspection, lead abatement and plumbing mitigation) to residents through one-on-one outreach and community events. Through these means, also assist residents in completing the Lead Services Application and submit to MDHHS. Each ambassador shall be responsible for reaching 5-10 households per week to promote lead services and assist in filling out application when possible. Reporting Requirements Activity 1: By Wednesday at noon each week, grantees are required to enter all data collected on the Water Filter Request Forms in the attached Excel file. The file will be submitted to Gabriella Dionise, at dioniseg1@michigan.gov. Activity 2: ALE Ambassadors will assist BCHD and MDHHS with getting messages into the BH community (i.e., messaging about filter use and maintenance, home lead inspections, etc.) Activity 3: On a quarterly basis, BCHD will report the number of households reached to promote lead services. Reports should be sent to MDHHS-DEH-FSO. Additional Requirements: Requesting Funding • Local Health Departments requesting funds for Lead ALE response will provide an estimated budget, as well as a description of expenses on Form DCH-0385(E) and DCH-0386(E). • Lead ALE response funds are not capacity building funds but are limited-term funding to achieve a critical public health response on behalf of the MDHHS for environmental public health needs related to lead in drinking water. Eligible Expenses Include: • Staff time and fringe dedicated to Lead ALE response in association with the interim response. a. Eligible staff activities for Lead ALE response include filtration system distribution, home visits, organizing and hosting town hall meetings or other public education, phone banks, water sample collection or other activities approved by and conducted in collaboration with MDHHS Division of Environmental Health. • Printing materials associated with ALE response; • Mileage associated with lead ALE response and MDHHS-provided training; • Lead and copper analysis fees for health departments with certified drinking water laboratories when costs are in alignment with the Michigan Department of Environment, Great Lakes, and Energy’s (EGLE) Drinking Water Laboratory fees ($26/sample). • Other items as need is determined, such as public meeting venue rental or phone bank expenses. • Blood Lead Screening regardless of age and/or insurance status for Benton Harbor City residents. Other expenses that are not on this list must receive prior approval by DEH before submission to Division of Local Health Services. Any deviation or amendment to existing Lead ALE response projects requires DEH approval. Local Health Departments submit all budget requests to DEH Community Engagement Unit. Ineligible Expenses Include: • Training • Association membership fees • Travel not associated with direct Lead ALE service delivery. Providing Interim Filtration Systems When distributing water filters to residents, health departments will obtain a signed Water Filter Request Form from each resident. A site-specific form will be provided as a fillable PDF. Health Departments may choose to type resident’s information into the fillable PDF or print off the form. Residents will complete Page 1 of the form, and health department staff (or their designees) will complete Page 2 of the form. Grantees are requested to maintain hard copies of the Water Filter Request Forms for audit purposes. Completion of the Water Filter Request Form is NOT intended to be a barrier to the provision of filtration systems for households with pregnant women and children under age 18. ** A note here: sometimes the filter distributions happen at CE events that are not run by LHDs, in that case, Lakecia holds onto the PDF forms. PROJECT: Local Public Health Nurse Case Management Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis The purpose of this project is to fund nursing case management support for children 6-16 years of age with elevated lead levels in Berrien County, as well as children under 6 years of age with an elevated blood lead level who are not enrolled in a Medicaid Health Plan in Berrien County. This project also supports funding to InterCare FQHC, as needed, for reimbursement blood lead sample analysis at $7.00 each. Finally, this project supports efforts to increase blood lead testing within Berrien County, with high priority to Benton Harbor. This funding can support Berrien County in identifying barriers to blood lead testing, reduction strategies for these identified barriers and methods to increase access to blood lead testing, focusing messaging on blood lead testing for children and pregnant persons. Reporting Requirements (if different than contract language) N/A Any additional requirements (if applicable) Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. PROJECT: PFAS (Per- and Polyfluoroalkyl Substances) Response Start Date: 10/1/2023 End Date: 9/30/2024 Project synopsis: The Michigan Department of Health and Human Services (MDHHS) Division of Environmental Health (DEH), in conjunction with local health departments, works to implement drinking water recommendations in communities with residents on private residential wells which have been or potentially are impacted by releases of PFAS to the environment. Local health departments are eligible for PFAS Response funding when filtration or another alternate source of drinking water is recommended as a health protective measure. PFAS response encompasses the components below: • Public education and outreach including, but not limited to, the health effects of exposure to PFAS, drinking water testing results, and information on and distribution of certified drinking water filter. • Interim provision of certified water filtration systems or an alternate source(s) of water to impacted residents until a determination is made by MDHHS DEH that the interim provision is no longer recommended. • Follow-up with residents who have received a certified water filter to offer free replacement filter cartridges every six months. Local health departments requesting funds for PFAS response will provide an estimated budget as well as a description of expenses on forms DCH-0385E and -0386E. PFAS Response funds are not capacity building funds but are limited-term funding to achieve a critical public health response on behalf of MDHHS DEH for environmental public health needs related to PFAS. Eligible expenses include: • Water filters certified for PFAS reduction. • Installation of certified water filters by a plumber licensed in the State of Michigan. • Replacement water filter cartridges provided per the filter manufacturer’s instructions and the residents’ water usage, e.g., every 800 gallons of filtered water for the Aquasana AQ-5300+ Claryum 3-Stage Max Flow. • Alternate water such as water coolers/dispensers or bottled water, as need is determined and approved by MDHHS DEH. • Mileage. • Supplies. • Staff time and fringe dedicated to PFAS response. Required staff activities for PFAS response include: o Distribution of certified water filtration systems and replacement cartridges. o Coordination of water filter installation by a licensed plumber when requested by the resident. o Provision of semi-annual filter replacement cartridge offers and reminders. These offers and reminders are made to residents previously provided with water filters until a determination is made by MDHHS DEH that the interim provision is no longer recommended. o Documentation of water filter and replacement cartridge distribution. o Data entry and submission to MDHHS DEH. • When necessary, staff activities may include: o Bottled water distribution. o Home visits. o Organizing and hosting town hall meetings or other public education. o Water sample collection support when requested by MDHHS DEH. • Other items as need is determined such as public meeting venue rental or phone bank expenses. • Indirect costs. Expenses not on this list must receive prior approval by MDHHS DEH before submission. Any deviation from or amendment to existing PFAS response projects requires MDHHS DEH approval. Local health departments submit all budget requests to MDHHS DEH for approval. Application for funds in subsequent fiscal years is expected where there is an ongoing interim recommendation for water filtration or use of an alternate water source. Ineligible expenses include: • Training. • Association membership fees. • Travel not associated with direct PFAS service delivery. • The cost to remove filters unless the water filter is found to be defective and requires replacement. Acknowledgement of Receiving or Declining Water Filter Form When providing a water filter to a resident, grantees will ensure residents complete the Acknowledgement of Water Filter Receipt form, or similar acknowledgment form based on the grantee’s legal review, including the resident’s signature. The forms will be retained by the grantees. • Please note that an acknowledgement form is NOT intended to be a barrier to provision of water assistance. Reporting requirements: By the first Wednesday of each month, grantees are required to submit: • Site-specific, updated tracking forms including: o Site name. o Resident’s name, address, contact information. o Water filter or alternate water type provided. o Water filter or alternate water quantity distributed. o Filter replacement cartridges distributed. o Date of each distribution. o Filter declination. o Dates filter replacement cartridge reminders were made. o Staff name. • Site-specific updated information on number of bottles of water distributed. Submit tracking forms to MDHHS DEH via email to MDHHS-dehresponse@michigan.gov with the subject line: PFAS Alternate Water Tracker – (add reported month). Any additional requirements: N/A PROJECT: Regional Lab Workforce Start Date: 10/1/2023 End Date: 09/30/2024 Project Synopsis The Regional laboratory system is intended to serve as a “hub-and-spoke” model in conjunction with the state public health laboratory to rapidly respond to community needs. Regional Lab Workforce funds are dedicated to support laboratory staff and associated personnel costs. Reporting Requirements (if different than contract language) NA Any additional requirements (if applicable) NA PROJECT: Reopening Schools HRA Start Date: 10/1/2023 End Date: 7/31/2024 Project Synopsis The Michigan Department of Health and Human Services (MDHHS) is offering a voluntary program to provide rapid antigen testing to educators, staff, and students at public and private schools. In addition, MDHHS is providing funds to school districts that have indicated the need for additional technical support with the intent to participate in testing programs, among other factors. Funding provided will support hiring health resource advocates (HRAs). Individuals serving in the role as an HRA will provide front- line support for COVID-19 testing and reporting, help districts identify emerging COVID- 19 related health concerns, and amplify best health practices. Reporting Requirements (if different than contract language) Bi-Monthly reports by school district to include the following (additional information may be requested): 1. Total enrollment 2. PCR tests conducted 3. Antigen tests conducted 4. Total positive cases 5. # HRAs hired 6. Qualitative feedback on: • barriers • successes • lessons learned • verification of funding use for HRA positions Reports should be submitted via email to MDHHS-HRAreporting@michigan.gov. For any, additional questions or concerns can be submitted to MDHHS- COVIDTestingSupport@michigan.gov. Funding may only be used for hiring an HRA(s). The funding shall not be used for any other purpose beyond hiring and/or funding an HRA(s), which may include supporting existing positions. These funds must also be accompanied by a plan to conduct COVID- 19 testing in school settings. Additional Requirements Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation, to support program activities and all expenditures made under the terms of this Agreement, as required. The Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than seven years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. This section applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. FOOTNOTES: FY 2023/2024 a) Refer to Plan and Budget Framework for element definitions. b) Refer to master comprehensive agreement and program and budget instructions package for further explanation of applicability of these reimbursement methods. c) Negotiated starting from the average of the past two complete years' actual number where available. d) Calculated by multiplying the "Total Performance Expectation" column by the ratio of the elements total State funding (DCH 0410, Line 24) to "Total Expenditures” DCH 0410, Line 17). Prior to calculation, adjustments will be made for unallowable cost, equipment funded by local funds and MDHHS reimbursement not performance based (I.E., fixed unit rate, staffing). e) Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column. f) Refer to master comprehensive agreement and budget instructions package for further explanation regarding these designations. 1. CSHCS Care Coordination A. Case Management 1. Maximum of six (6) services per year 2. Reimbursement - $201.58 per service provided face-to-face in the home setting. 2. CARE COORDINATION A. LEVEL I PLAN OF CARE 1. Annual Plan of Care in the home or home-like setting that requires the Care Coordinator to travel to a non-LHD site - $150 2. Annual Plan of Care over the telephone -$100 B. LEVEL II CARE COORDINATION 1. Level II Care Coordination is reimbursed at $30.00 per unit 2. A maximum of 15 units per beneficiary per eligibility year will be reimbursed. (2) Reimbursement Chart for Fixed Rates Body Art $303.43 / appl. annual license prior to July1 $151.72/ appl. annual license after July 1 $136.53 / appl. temporary license $303.43 / appl. renewal prior to December 1 $455.15 / appl. renewal after December/1 $30.33 / duplicate license CSHCS-Medicaid Elevated Blood Lead Case Management $201.58 per home visit, for up to 6 home visits Fetal Infant Mortality Review (FIMR) Case Abstractions $270.00 per case, not to exceed the maximum set for each Grantee Immunization Nurse Education $200 per session except Vaccines Across the Lifespan, which is to be reimbursed at $250 per session, upon completion and submission of Provider Contracts and Report Forms. Reimbursement can only be made for one in-service module session per physician clinic site per year. Immunization VFC (only) Provider Site Visits $175 per site visit, not to exceed the maximum set for each individual Grantee Immunization Combined VFC/QI Provider Site Visits $350 for a Combined VFC/QI site visit or Birthing Hospital visit. Informed Consent $50 per woman served, for each woman that expressly states that she is seeking a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an abortion and is provided the services. SIDS (FIMR Interviews) $125 for each family support visit. A maximum of six (6) visits per infant death is reimbursable Statewide Lead Case Management $204.58 per home visit. A maximum of six (6) visits per home. $100 per community health worker visit, A maximum of 2. (3) Allocation to be reflected in individual programs during budgeting process. (4) Funding Source (not a single element). Hearing and Vision are single elements. (5) Subject to Statewide Maintenance of Effort requirement for Title X. (6) State funding is first source (after fees and other earmarked sources). (7) Fixed unit rate subject to actual costs. (8) The performance reimbursement target will be the base target caseload established by MDHHS. (9) Subject to a match requirement (hard or in-kind) of $1 for each $3 of MDHHS agreement funding for Coordination. (10) Fixed rate limited to contract amount. (11) Up to six (6) visits per family. (12) Non-categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum of $2,000 annually. (13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Semi-annual FPAR data will be used to determine total Title X users. (14) Public Health Emergency Preparedness (PHEP) funding BP1 must be expended by June 30 and is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) column for this program element. (15) Public Health Emergency Preparedness (PHEP) funding for October 1–June 30, and July 1–September 30, is subject to a 10% match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must submit a three-month budget and a quarterly Financial Status Report (FSR) column for this program element. (16) Project meets the Research and Development criteria as defined by Title 2 CFR, Section 200.87. (17) Not Applicable (18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements. NOTE: Some footnotes may not apply to this agency. ATTACHMENT I MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Local Health Department Agreement October 1, 2023- September 30, 2024 Fiscal Year 2024 INSTRUCTIONS FOR THE ANNUAL BUDGET INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES TABLE OF CONTENTS Page INTRODUCTION ............................................................................................................................ 1 MINIMUM BUDGETING REQUIREMENTS ................................................................................... 1 REIMBURSEMENT CHART ........................................................................................................... 2 LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES .............................................................................................................................. 3 BUDGET PREPARATION DETAIL……………………………………………………………………....3 General Information…………………………………………………………………………………3 Expense Line-Item Detail…………………………………………………………………………..4 Source of Funds……………………………………………………………………………..…….15 SPECIAL BUDGET and REPORTING INSTRUCTIONS…………………………………………….18 1. Public Health Emergency Preparedness (PHEP) .................................................... 19 2. WIC ......................................................................................................................... 19 3. Family Planning ..................................................................................................... 21 4. Breast and Cervical Cancer ................................................................................... 22 5. WISEWOMAN……………………………………………………………………………...24 5. Medicaid Outreach Activities Reimbursement Procedures ..................................... 24 Medicaid…………………………………………………………………………………..25 Nurse Family Partnership Services Medicaid Outreach…………………………….25 CSHCS Medicaid Outreach…………………………………………………………….26 6. Immunization 317 and VFC Allowable Expenditures .............................................. 29 1 INTRODUCTION The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs’ funding and Essential Local Public Health Services (ELPHS) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. The MI E-Grants System is an on-line application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Grantee. The system is designed to accommodate any number of local program elements including those unique to a particular local Grantee. Applications, including budget forms, are completed for all program elements, regardless of the reimbursement mechanism, including Agency administration(s) fee for service program elements, categorical program elements, performance- based program elements and Medicaid Outreach associated program elements. Budget entry is required for each major expenditure and source of fund categories for which costs/funds are identified. MINIMUM BUDGETING REQUIREMENTS Cost Principles Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Federal Block Grant Funds Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (other than minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal 2 funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. Expenditure and Funding Source Breakdown For purposes of development, analysis and negotiation activities must be budgeted at the individual expenditure and funding source category level on the Annual Budget for Local Health Services. Special Budget Requirements for Certain Categorical Program Elements The Annual Budget for Local Health Services is completed in the MI E-Grants System through the application budget to include details for all program elements (excluding Administration and Grantee Support). See special budget and reporting section below section. Local MCH Local MCH funds can be used to support the health of women, children, and families in communities across Michigan. Funding addresses one or more Title V Maternal and Child Health Block Grant national and state priority areas and/or a local MCH priority need identified through a needs assessment process. Priority areas are developed into Local MCH Work Plans which are described in the Annual Local MCH Plan. These funds are to be budgeted as a funding source in two project categories. The Local MCH projects need to be budgeted separately. Please note only two LMCH project titles can be used: • MCH – Children • MCH – All Other These funding sources cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of expenditures, and evidence is provided that the expenditures satisfy all funding requirements. Local health departments are encouraged to select only one to two performance measures and delve deeper into the strategies in an effort to “move the needle.” REIMBURSEMENT CHART The Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures for each program/element having a performance reimbursement option. In addition, the chart also provides the subrecipient, contractor, or recipient designations, as in prior years. The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by 3 Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Research and development (R&D) means all research activities, both basic and applied, and all development activities that are performed by non-Federal entities. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. LOCAL ACCOUNTING SYSTEM STRUCTION OF ACCOUNTS / COST ALLOCATION PROCEDURES As in past years, no additional accounting system detail is being required beyond local uniform accounting procedures prescribed by the Michigan Department of Treasury, Local Financial Management System requirements, documentation requirements of categorical program funding sources and any local requirements. Some agencies may already have separate cost centers in their accounting system to directly identify costs and related funding of required services, but such breakdowns are not essential to being able to meet minimum reporting requirements if proper allocation procedures are used and adequate documentation is maintained. All allocations must have clearly measurable bases that directly apply to the amounts being allocated, must be documented with work papers that will provide an adequate audit trail and must result in a representative reporting of costs and funding for affected programs. More specific guidance can be found in Title 2 CFR, Part 200 Appendix V State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans and the brochure published by the Department of Health and Human Services entitled “A Guide for State, Local and Indian Tribal Governments: Cost Principles and Procedures for Developing Cost Allocation Plans and Indirect Cost Rates for Agreements with the Federal Government. BUDGET PREPERATION DETAIL 1. Budgeted expenditures are to be entered for each program element, project, or group of services by applicable major category. 4 2. The Budget should reflect all planned expenditures and revenues associated with the program. Funding source revenues include Federal funding sources, fees and collections, local, state, and other sources. 3. When developing the budget, it is important to note that total program expenditures must equal total program revenues. 4. Although a Grantee’s budget is approved, it does not mean expenses are approved. Reported expenses are subject to audit and must comply with Federal regulations, the terms of the agreement, and other policy impacting the allowability of expenses. Certain expenses may require prior approval, which should be in writing from MDHHS. 5. It is the Grantee’s responsibility to ensure budgeted expenses comply with Federal regulations, the terms of the agreement, and other policy impacting the allowability of expenses, and have documented prior approval, as needed, when the budget is submitted for review. EXPENSE LINE- ITEM CATEGORIES 1. Salaries and Wages a. This category includes compensation paid to permanent and part-time employees on the payroll of the Grantee who work in the program. Is reasonable for the services rendered and conforms to the established written policy of the Grantee consistently applied to both Federal and non-Federal activities. b. This category may include the cost of leave/paid time off (e.g., vacation, sick, holiday, bereavement, military) or the cost of leave/paid time off may be included as a fringe benefit, based on the Grantee’s written policy. See Section 2, Fringe Benefits. Leave/paid time off cannot be included in both categories and must be consistently budgeted and expensed for all Federally and non-Federally funded programs and activities of the Grantee. c. This category does not include personnel hired on a private contract basis or through a personnel service, contractual services, or professional fees. Consulting services, professional fees or personnel hired on a private contracting basis should be included in Contractual – Professional Services. d. Charges to salaries and wages must be based on records that accurately reflect the work performed. The records must: 5 1) Reflect the total activity for which the employee is compensated by the non-federal entity, not to exceed 100 percent. 2) Encompass federally assisted and all other activities compensated by the non- federal entity on an integrated basis but may include the use of subsidiary records as defined in the non-federal entity’s written policy. 3) Support the distribution of the salaries or wages among specific activities or cost objectives if the employee works on more than one federal or non-federal program; an indirect cost activity and a direct cost activity; more than one indirect activity which are allocated using different distribution bases; or an allowable and unallowable activity. e. See Title 2 CFR 200.430 for salaries and wages regulations. 2. Fringe Benefits a. Fringe benefits include, but are not limited to, the costs of leave/paid time off (e.g., vacation, sick, holiday, bereavement, military), employee insurance (e.g., employer paid portion of health, dental, vision, life), pensions, employer contribution to a retirement account, bonuses, health stipends in lieu of health insurance, unemployment, workers compensation, social security. b. The cost of leave/paid time off, and other taxable income (e.g., bonuses, health stipends in lieu of health insurance) may be included in salaries/wages, . See Item 1 above. It cannot be included in both categories and must be consistently budgeted and expensed for all Federally and non-Federally funded programs and activities of the Grantee. c. The cost of fringe benefits is allowable provided they are reasonable and are required by law, or a Grantee-employee agreement or established in the Grantee’s written policy. d. Fringe benefit costs must be equitably allocated to all activities (Federal award activity and non-Federal award activity). e. See Title 2 CFR 200.431 for fringe benefit regulations. 3. Employee Travel and Training a. This category includes the cost of travel and training for full and part-time employees working in the program. 6 b. This category does not include travel and training costs for personnel hired on a private contract basis or through a personnel service, for contractual services, or for volunteers. c. This category includes the cost of mileage, lodging, per diem, meals, tips, modes of transportation, approved registration fees for conferences, seminars, and other types of training related to the program. d. The costs must be consistent with the Grantee’s written policy and procedures to be allowable. e. See Title 2 CFR 200.474 for travel expense requirements. 4. Supplies and Materials a. This category includes consumable and short-term items costing less than five thousand dollars ($5,000). b. Examples include office supplies, office furniture, computers, computer software, printers, printing, postage, janitorial supplies, educational supplies, medical supplies, etc. according to the requirements of the program. c. This category does not include the cost of supplies and materials related to operating a shelter or other emergency housing. d. Purchases of materials and supplies must be charged at the actual price, net of applicable credits. e. For budgeting purposes, when the Supplies and Materials line item budget will not exceed 10 percent of the total budgeted grant expenses, specific detail will not be required. Detail is required only when the Supplies and Materials line item budget will exceed 10 percent. 5. Subawards – Subrecipient Services a. This category includes the cost of an agreement (subaward) between the Grantee and another organization for the purpose of carrying out a portion of the Grant program. A subaward is a subrecipient relationship. b. See below to differentiate between a subrecipient and a contractor. SUBRECIPIENT AND CONTRACTOR DETERMINATION FACTORS Title 2 CFR 200.331states that a pass-through entity (in this case the Grantee) must make case by case determinations whether an agreement it makes for the disbursement of Federal funds casts the party receiving the funds in the role of a subrecipient or contractor. 7 In determining whether an agreement casts the role of party receiving the Federal funds from the Grantee as a subrecipient or contractor, the substance of the relationship is more important than the form of the agreement. All characteristics listed below may not be present in all cases and the Grantee must use judgement when determining if the agreement is a subaward or a procurement contract. Subrecipient Characteristics A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. Characteristics of a subrecipient include: 1. In accordance with its agreement, uses the Federal awards to carry out a public purpose specified in authorizing statute, as opposed to providing goods and services for the benefit of the pass-through entity. 2. Is responsible for adherence to applicable Federal program requirements specified in the Federal award. 3. Has responsibility for programmatic decision making. 4. Determines who is eligible to receive what Federal assistance. 5. Has its performance measured in relation to whether objectives of the Federal program are met. Contractor Characteristics A contract is for the purpose of obtaining goods or services for the non-Federal entity’s own use and creates a procurement relationship with the contractor. Characteristics of a contractor include: 1. Provides goods and services within normal business operations. 2. Provides similar goods and services to many different purchasers. 3. Normally operates in a competitive environment. 4. Provides goods or services that are necessary to support the operation of the Federal program. 5. Is not subject to compliance requirements of the Federal program as a result of the agreement although similar requirements may apply of other reasons. 6. Contractual – Professional and Personnel Services 8 a. This category includes the costs of professional and personnel services rendered by members of a particular profession or possess a certain skill set and are not employees of the Grantee. b. This category includes the costs of services such as accounting, auditing, payroll, consulting, services, contract employees, etc. c. Grantees generally hire contract employees in place of part-time or full-time staff because of the need for specialized skills or budgetary reasons. d. The Grantee is not responsible for taxes, social security, workers compensation, unemployment, health benefits, sick or vacation time for contract employees. e. Travel expenses may be included when it is part of the contract terms between the Grantee and the contractor. f. Training expenses may be included when it is part of the contract terms between the Grantee and the contractor. 7. Communications a. This category includes the cost of telephone services (cell and/or land lines), hotline, data lines, internet services, cloud services, copy machine, and website necessary for the operation of the program. b. The cost of certain telecommunication and video surveillance services or equipment are prohibited in accordance with Title 2 CFR 200.216. c. For budgeting purposes, when the Communications line item budget will not exceed 10 percent of the total budgeted grant expenses, specific detail will not be required. Detail is required only when the Communications line item budget will exceed 10 percent. 8. Grantee Rent Expense a. This category includes the cost of rent/leases by the Grantee for space related to the operation of the program. b. This category does not include the cost of client rent assistance or equipment rentals/leases. 9. Space Expenses a. This category includes costs to maintain a facility related to the operation of the program. Costs include electricity, heating and air conditioning, maintenance and repairs, lawncare 9 and snowplowing, janitorial services, insurance, security system, depreciation (when the space is owned by the Grantee), etc. b. These costs must be allocated equitably to all Federal and non-Federal activities related to the space. c. Shelter Expenses – The costs associated with operating a shelter. Includes such things as rent or depreciation, insurance, utilities, maintenance and repairs, snow removal, lawn care, trash removal, security system etc. 10. Capital Expenditures – Equipment and Other a. Capital Expenditures – Equipment 1) Equipment is defined as an article of non-expendable property having a useful live of more than one year and acquisition cost of $5,000 or more per unit. Items with an acquisition cost of less than $5,000 classified as supplies and materials. 2) The cost of single a single unit or piece of equipment includes the necessary accessories and installation costs. 3) When the Grantee’s definition and threshold differs from the definition above, the Grantee will budget and report only those equipment purchases of $5,000 or more, on the Capital Expenditures – Equipment and Other line item. 4) Equipment purchases must have prior written approval from MDHHS if the item will be expensed in the year of purchase. The approved Budget does not qualify as prior written approval. When equipment purchases are not expensed in the year of purchase, the Grantee may only expense the deprecation calculated in accordance with its written policy. b. Capital Expenditures – Other 1) This category includes capital outlay for capital assets other than equipment. 10 CAPITAL ASSETS AND DEPRECIATION Title 2 CFR 200.1 defines capital assets as tangible or intangible assets used in operations having a useful life of more than one year which are capitalized in accordance with Generally Accepted Accounting Principles and includes: • Land, buildings (facilities), equipment, and intellectual property (including software) whether acquired by purchase, construction, manufacture, exchange, or through a lease accounted for as financial purchase under GASB or a finance lease under FASB. Additions, improvements, modifications, replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially increase their value or useful life. Title 2 CFR 200.439(b) includes the following rules of allowability for equipment and other capital expenditures. 1. Capital expenditures for general purpose equipment, building, and land are unallowable as direct charges, except with the prior written approval of the Federal awarding agency or the pass-through entity. 2. Capital expenditures for special purpose equipment are allowable as direct costs, provided that items with a cost of $5,000 or more have prior written approval of the Federal awarding agency or the pass-through entity. 3. Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life are unallowable as a direct cost except with prior written approval from the Federal awarding agency or the pass-through entity. 4. When approved as a direct charge, capital expenditures will be charged in the period in which the expenditure is incurred. 5. The unamortized portion of any equipment written off as a result of a change in capitalization levels may be recovered by continuing to claim the otherwise allowable depreciation on the equipment or by amortizing the amount to be written off over a period of years negotiated with the Federal cognizant agency for indirect cost. 6. Cost of equipment disposal is allowable if the non-Federal entity is instructed by the Federal awarding agency to otherwise dispose or transfer the equipment. 7. Equipment and other capital assets are unallowable as indirect costs. Title 2 CFR 200.1 defines capital assets as tangible or intangible assets used in operations having a useful life of more than one year which are capitalized in accordance with Generally Accepted Accounting Principles and includes: 11 • Land, buildings (facilities), equipment, and intellectual property (including software) whether acquired by purchase, construction, manufacture, exchange, or through a lease accounted for as financial purchase under GASB or a finance lease under FASB. • Additions, improvements, modifications, replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially increase their value or useful life. 11. Client Assistance – Rent a. This category includes the cost of rental assistance provided for eligible clients in accordance with the program requirements. b. The Grantee must account for rental assistance separate from all other client assistance. 12. Client Assistance – All Other a. This category includes the costs of providing assistance for eligible clients in accordance with program requirements. The guidance below is not meant to be comprehensive, and some costs may not be allowable for a particular program. It is the Grantee’s responsibility to budget and report expenses in accordance with the program requirements. b. Examples include: 1. Gift Cards/Prepaid Cards/E-Cards/Store Cards/Vouchers – The cost various types of purchase cards (e.g., gas, phone, food), vouchers (e.g., laundry vouchers for a local laundromat), and public transportation cards/tokens, etc. in accordance with program requirements. 2. Transportation – The cost of taxis, Uber, Lyft, etc. for eligible clients when necessary for the health and safety for eligible clients in accordance with program requirements. 3. Utilities – The costs associated with heat, electricity, water, etc. for eligible clients in accordance with program requirements. 4. Personal Care – The costs associated with food, formula, clothing, diapers, toiletries, medication, medical equipment, etc. for eligible clients in accordance with program requirements. 5. Safety – The cost of changing windows and doors or locks, cost of short-term alternative housing (e.g., hotel due to shelter capacity), security cameras, assistance for 12 obtaining long-term housing for a victim (regardless of distance, based on safety needs) etc. for eligible clients in accordance with program requirements. 6. Other – The cost of assistance not specifically identified above for eligible clients in accordance with program requirements . 13. Other Expenses a. This cost category includes expenses not previously identified on other line items purchased for the operation of the program. b. If the Grantee will claim the DeMinimis Indirect rate, the Grantee’s accounting records must clearly identify the following excluded expenses which are included as Other Expenses for budget and FSR purposes and excluded when determining Total Modified Direct Costs. 1. Charges for Patient Care – Medical, social, and educational services to patients relating to prevention, diagnosis, and treatment. Includes medical fees, laboratory, pharmacy, and other health inpatient care, home care services, treatments, professional and consultation fees and related travel costs, transportation of patients including accompanying parents or guardians (or other escort), and for sundry related support such as meals and housing. 2. Participant Support Costs – Direct costs for such items for stipends or subsistence allowances, travel allowances, and registration fees paid to or on behalf of participants or trainees (not employees) in connection with conferences or training projects. 2 CFR 200.201 3. Tuition Remission – Refers to ways that a college or university pays tuition costs for students. Includes tuition waivers and tuition payments. Does not include tuition reimbursement for employees when the Grantee offers tuition reimbursement as an employee fringe benefit. 4. Scholarships and Fellowships – A scholarship is generally an amount paid or allowed to a student at an educational institution for the purpose of study. A fellowship grant is generally an amount paid or allowed to an individual for the purpose of study or research. www.irs.gov c. This cost category does not include indirect expenses which are included below. 13 14. County / City Central Services a. These are costs associated with central support activities of the local governing unit allocated to the local health department accordance with Title 2 CFR, part 200. 15. General and Administrative Indirect Expenses These cost categories are used to distribute costs of general administrative operations that have not been directly charged to individual subrecipient programs. The Indirect Cost expenditures distribute administrative overhead costs to each program element, project, or service grouping. Two separate local rates may apply to the agreement period (i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter part. Indirect costs are not allowed on programs elements designated as vendor relationship. An indirect rate proposal and related supporting documentation must be retained for audit in accordance with records retention requirements. In addition, these documents are reviewed as part of the Single Audit, subrecipient monitoring visit, or other State of Michigan reviews. Following is further clarification regarding indirect rate and/or cost allocation approval requirements to distribute administrative overhead costs, in accordance with Title 2 CFR Part 200 (formerly Circular A-87 2 CFR Part 225, Appendix E), for Local Health Departments budgeting indirect costs: 1. Local Health Departments receiving more than $35 million in direct Federal awards are required to have an approved indirect cost rate from a Federal Cognizant Agency. If your Local Health Department has received an approved indirect rate from a Federal Cognizant agency, attach the Federal approval letter to your MI E-Grants Grantee Profile. 2. Local Health Departments receiving $35 million or less in direct Federal awards are required to prepare indirect cost rate proposals in accordance with Title 2 CFR and maintain the documentation on file subject to review. 3. Local Health Departments that received approved indirect cost rates from another State of Michigan Department should attach their State approval letter to their MI E-Grants Grantee Profile. 4. Local Health Departments with cost allocation plans should reflect these allocations in the Other Cost Distributions budget category. 5. As a Subrecipient of federal funds from MDHHS, a Local Health Department that has never received a negotiated indirect cost rate, your Local Health Department may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) based on Title 2 CFR part 200 requirements. MTDC includes all direct salaries and wages, fringe benefits, supplies and materials, travel, services, and contractual expenses up to the first $25,000 of each contract. MTDC excludes all equipment, capital expenditures, charges for patient care, rental costs, tuition remission, 14 scholarships and fellowships, participant support costs, and portions sub contractual and/or subaward expenses in excess of $25,000 per contract. Attach a current copy of the letter stating the applicable indirect costs rate or calculation information justifying the de minimis rate calculation to you MI E-Grants Grantee profile. Detail on how the indirect costs was calculated must be shown on the Budget Detail Schedule. The amount of Indirect Cost should be allocated to all appropriate program elements with the total equivalent amount reflected as a credit or minus in the Administration projects. County-City Central Services Cost Allocation Plan a. This category includes the allocation of central services costs allocated to the program. b. Central service departments are within the county or city government that exist to provide support services to other operating departments within that unit of government. c. Examples of central service departments include finance, accounting, facilities maintenance, information technology, human resources, purchasing, motor pools, etc. d. All costs and data used the distribute the costs included in the plan must be supported by formal accounting and other records that support the propriety of the costs assigned to Federal awards. e. Each central service cost allocation plan is required to be certified by the local government. f. See Title 2 CFR Part 200 Appendix V, State/Local Governmentwide Central Service Cost Allocation Plans for specific requirements. Other Indirect Cost Distributions a. This category includes various contributing activity costs to appropriate program areas based on a documented allocation methodology in accordance with Title 2 CFR 200. b. This category is generally associated with governmental entities that utilize a City-County Central. c. Use to distribute various contributing activity costs to appropriate program areas based upon activity counts, time study supporting data or other reasonable and equitable means. An example of Other Cost Distributions is nursing supervision. The distribution process permits costs reflected in a single program element to be subsequently distributed, perhaps only in part, to other programs or projects as appropriate. If an allocation is made, the charges must be reflected in the appropriate program element and the offsetting credit reflected in the 15 program element being distributed. There must be a documented, well-defined rationale and audit trail for any cost distribution or allocation based upon Title 2 CFR, Part 200 Cost Principles Local Health Departments using the cost distribution or cost allocation must develop the plan in accordance with the requirements described in Title 2 CFR, Part 200. Local Health Departments should maintain supporting documentation for audit in accordance with record retention requirements. The plan should include a Certification of Cost Allocation plan in accordance with Title 2 CFR, Part 200 Appendix V. The cost allocation plan documentation is not required to be submitted unless specifically requested. d. Cost associated with the Essential Local Public Health Services (ELPHS), Maternal and Child Health (MCH) Block Grant and Fixed Fee may be budgeted in the associated program element and distributed to the associated projects. e. Federal Provided Vaccine Value should be reported on a separate line and clearly identified. SOURCE OF FUNDS Source of funds are to be entered for each program element, project, or group of services by applicable major category as follows. 1. MDHHS Comprehensive Funding (Federal and/or State dollars) provided by MDHHS for this grant agreement. 2. Fees and Collections – 1st and 2nd Party a. 1st party funds received from private payers, including patients, source users, and any member of the general public receiving services. b. 2nd party funds received from organizations, private or public, who might reimburse services for a group or under a special plan. c. Revenues will be reported when earned (accrual basis of accounting) or when received (cash basis of accounting). 3. Fees and Collections – 3rd Party a. 3rd Party funds received from private insurances, Medicaid, Medicare, or other applicable titles of the Social Security Act directly related to the cost of providing patient care or other services. 16 b. Revenues will be reported when earned (accrual basis of accounting) or when received (cash basis of accounting). 4. Local Funds All local support in the appropriate element, project, or service group column. This may include local property tax, and other local revenue. Does not include fees. 5. Federal or State (Non MDHHS) Funds provided to directly to the Grantee from the State of Michigan or the Federal government (other than MDHHS) to support the program. 6. Other Funding provided by foundation grants, United Way grants, private donations, fund-raising, charitable contributions, etc. that provide support to the program. 7. In-Kind Match Represents the value of donated services (e.g., accounting, legal, medical, etc.), donated materials and supplies, donated space, etc. that support the program. 8. MDHHS Fixed Unit Rate Select the type of fee-for-services from the lookup button to correspond with the program element. 9. MCH Funding This section includes all the funding projected to be due under Comprehensive Agreement specific to the CMH eligible program elements. Please note: the MI E-Grants System validates the MCH budgeted funds across the appliable program elements to assure the agreement does not exceed the MCH allocation. 10. Required Match – Local Funds projected to be local contribution for programs that have a match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) 17 12. Federal Medicaid Outreach (Please note: to be used only for Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership Medicaid Outreach program elements.) Funds projected to be received from the federal government for allowable Medicaid Outreach activities. This amount represents the anticipated 50% federal administrative match of local contributions. 13. Federally Provided Vaccines The projected value of federally provided vaccines. 14. Local Non-ELPHS (Local funds budgeted for the following expenditures) 1. Expenditures for services not designated as required and allowable for ELPHS funding (e.g., medical examiner and inpatient maternity services); expenditures determined not to be reasonable; and expenditures in excess of the maximum state share of funds available. 2. Any losses arising from uncollectible accounts and other related claims. Under-recovery of reimbursable expenditures from, or failure to bill, available funding sources that would otherwise result in exclusions from ELPHS funding, if recovered. 3. However, no exclusion is required where the local jurisdiction has made and documented a decision to have local funds underwrite: a. The cost of uncollectible accounts or bad debts incurred in support of providing required or allowable health services. An example of this condition would be for services provided to indigents who are billed as a matter of procedure with little chance for receipt of payment. b. Potential recoveries or under-recoveries from other sources for the principal purpose of providing required and allowable health services at free or reduced cost to the public served by the Grantee. An example would be keeping fees for services at a reduced level for the benefit of the people served by the Grantee while recognizing that to do so limits recovery from third parties for the same types of services. 4. Contributions to a contingency reserve or any similar provisions for unforeseen events. 5. Charitable contributions and donations. 6. Salaries and other incidental expenditures of the chief executive of a political subdivision (i.e., county executive and mayor). Legislative expenditures, such as, salaries and other incidental 18 expenditures of local governing bodies (i.e., county commissioners and city councils). Do not enter board of health expenses. 7. Expenditures for amusements, social activities and other incidental expenditures related to, such as, meals, beverages, lodging, rentals, transportation, and gratuities. 8. Fines, penalties, and interest on borrowings. 9. Capital Expenditures - Local capital outlay for purchase of facilities and equipment (assets) are excluded from ELPHS funding. 15. Other Non- ELPHS Funds budgeted from sources other than state, federal and local appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local substance abuse coordinating grantee, local area on aging grantees). 16. Federal Cost Based Reimbursement Funds received from Federal Cost Based Reimbursement must be budgeted and reported in the program in which they were earned. See MCBR Budget and FSR MDHHS Guidance for reporting requirements. SPECIAL BUDGET AND REIMBURSEMENT PROCEDURE INSTRUCTIONS Certain elements are supported by federal or other categorical program funds for which special budgeting requirements are placed upon grantees and subgrantees. Element Federal or Other Funding Contractor Public Health Emergency Preparedness U.S. Department of Health & Human Services, Centers for Disease Control WIC U.S. Department of Agriculture, Food & Nutrition Service Family Planning U.S. Department of Health & Human Services, Public Health Service Breast and Cervical Cancer U.S. Department of Health & Human Services, Centers for Disease Control 19 CSHCS Outreach & Advocacy Michigan Department of Health & Human Services Medicaid Outreach Activities Centers for Medicare and Medicaid Services In general, subgrantee budgets must provide sufficient budget detail to support grantee budget requests and be in a format consistent with grantor Contractor requirements. Certain types of costs must receive approval of the federal grantor Contractor and/or the grantee prior to being incurred. 1. Public Health Emergency Preparedness Local Health Departments will receive the initial FY 23/24 allocation of the CDC Public Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period October 1, 2023 through June 30, 2024. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE Local Health Department program elements: • Public Health Emergency Preparedness (PHEP) (October 1 – June 30) • Public Health Emergency Preparedness (PHEP)– Cities of Readiness (October 1 –June 30) • Laboratory Services - Bioterrorism (October 1 – September 30) 2. WIC Special Budget Requirements WIC licensing MOUs are in the show documents section in the EGrAMS system for review. The following local budget breakdowns are required to fulfill WIC grant application budget requirements each fiscal year: • Salaries & Fringe Benefits • Automated Management Systems • Space Utilization Costs • Equipment • Supplies • Communications & Travel • All Other Direct Costs • Indirect Costs • All Funding Sources by Type The WIC cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget form in the MI E-Grants System. 20 Agencies receiving WIC-USDA Infrastructure grants must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. Agencies receiving WIC-USDA Breastfeeding Peer Counselor funds must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR and comply with special reporting requirements. • Costs Allowable Only With Prior Approval - The following costs are allowable only with prior review/approval of the Michigan Department of Health & Human Services as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR Part 246, and USDA-WIC Administrative Cost Handbook 3/86). Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Automated Information Systems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B. Capital Expenditures of $2,500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C. Management Studies - performed by agencies or departments other than the local Grantee or those performed by outside consultants under contract with the local Grantee. D. Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1. Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Grantee level. F. Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out-of-service training over extended periods of time. G. Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H. Non-Fringe Insurance and Indemnification Costs 21 All charges to WIC must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. 3. Family Planning Special Budget Requirements The following local budget breakdowns are required to fulfill Family Planning grant application budget requirements each fiscal year: • Salaries & Wages • Fringe Benefits • Travel • Equipment • Supplies • Contractual • Construction • All Other Direct Costs • Indirect Costs • All Funding Sources by Type The Family Planning cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget in the MI E-Grants System. • Costs Allowable Only With Prior Approval - The following costs are allowable only with prior review/approval of MDHHS. Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Alterations and Renovations - to change the interior arrangements or other physical characteristics of existing facilities or installed equipment, to the extent that such changes cost more than $1,000 each. B. Audiovisual Materials and Activities - acquired, produced, presented, or disseminated to the general public. C. Consultant Contracts for General Support Services - including equipment and supplies, that will cost in excess of $25,000 or 10% of the total direct cost budget (whichever is greater). D. Equipment - including general purpose and special equipment (e.g., air conditioning) costing $5,000 or more per unit. E. Insurance - contributions to a reserve for a self-insurance program. 22 F. Public Information Service Costs – for the cost of providing public information services. G. Publication and Printing Costs - for the cost of publications. H. Capital Expenditures - for land or buildings. I. Indemnification Against Third Parties Costs - insurance against potential liabilities. J. Mass Severance Pay - involving grant-supported personnel. K. Organization/Reorganization Costs - allocable to the program. L. Overtime Premium - involving grant-supported personnel. M. Patient Care Costs – re-budgeting out of or reduction in patient care costs (considered a change in scope). N. Professional Services - in connection with Patent/Copyright Infringement Litigation. O. Trailers or Modular Units – for costs of trailers and modular units. P. Transfers Between Construction and Non-construction - for approved construction funds. Q. Transfers Between Indirect and Direct Costs - for amounts awarded for indirect costs to absorb increases in direct costs. R. Transfers for Substantive Programmatic Work - to a third party, by contracting, or any other means used for the actual performance of substantive programmatic work. All charges to Family Planning must be necessary, reasonable, allowable, and allocable, for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule and 2 CFR, Part 215 (OMB Circular A-110) 4. Breast and Cervical Cancer Control Coordination Program Special Budget Requirements The Breast and Cervical Cancer Control Navigation Program (BC3NP) budget is to be developed based on specific responsibilities of Local Health Departments (LHDs) participating in the Breast and Cervical Cancer Control Navigation Program. LHDs agreeing to participate in the program fall into two categories: LHDs agreeing to participate as Local Coordinating Agencies (LCAs) and LHDs agreeing to participate as Local Community Partners (LCPs). A. LHDs agreeing to participate as Local Coordinating Agencies (LCAs) – LCAs are responsible in assuring implementation of all program requirements and policies and 23 procedures. This includes client outreach and recruitment into BC3NP to achieve yearly targeted caseload allocations, financial monitoring of program expenses and claims for provision of client clinical services, obtaining results of client services and entry of client data into the program’s secure statewide database to monitor timeliness and completeness of care delivery and authorize payment for services, and assuring appropriate providers are contracted with the program to provide screening and diagnostic services to enrolled clients. Only coordination expenses will be reimbursed through the Comprehensive Agreement. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCA and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing clinical services claims to the MDHHS Cancer Prevention and Control Section. The Coordination amount of $205-$210 per woman is based on achievement of a target caseload established for each LCA by MDHHS. Requirements. Each LCAs target caseload is evaluated yearly based on the BC3NP Tiered Program Performance requirements. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. B. LHDs agreeing to participate as Community Partners (LCPs) – LCPs are responsible for implementing strategies to identify and recruit clients eligible for the BC3NP, enroll clients into the program, and arrange for provision of screening and diagnostic clinical services through contracted providers. LCPs will obtain results of all clinical services provided to BC3NP clients and send this information to MDHHS for data entry into the secure program’s statewide database. Information entered into the database will be reviewed by MDHHS staff to evaluate timeliness and completeness of care delivery and authorize payment for services. MDHHS staff will oversee financial monitoring of program expenses and claims for provision of client clinical services. LCPs will be awarded a base award (to be determined yearly by MDHHS) that is to be used to implement strategies to recruit a minimum target caseload of BC3NP women established for these agencies by MDHHS. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCP and/or direct service providers with contracts or letters of agreement with the LCP will be responsible for billing clinical service claims to the MDHHS Cancer Prevention and Control Section. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. For specific billing requirements refer to the most recent BC3NP Participation Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates refer to the current fiscal year Unit Cost Reimbursement Rate Schedule for the BC3NP issued in August of each fiscal year. The above referenced documents are available at https://michigan.gov/BC3NP 24 5. The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) budget is to be developed in the following way: 1. WISEWOMAN Coordination and Screening should be used to budget costs associated with coordination of the program and delivery of the initial screening and risk reduction counseling to WISEWOMAN participants. This includes collecting answers to health intake questions, WISEWOMAN screening services (height, weight, body mass index, 2 blood pressure readings, total cholesterol, HDL cholesterol, and fasting glucose or A1C), and delivery of risk reduction counseling. 2. All Direct Service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreements with the LCA will be responsible for billing Direct Service claims to the MDHHS Cancer Prevention and Control Section. This includes follow- up fasting lipid panel, fasting glucose, A1c, and one diagnostic exam. No Direct Services expenses will be reimbursed through the Comprehensive Agreement. The Coordination and Screening amount is $150 per woman based on a target caseload established by MDHHS. 3. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 95% caseload performance requirement for this project. For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and other Program instructions for the WISEWOMAN Program issued in August of each fiscal year. The above referenced documents are available at www.michigan.gov/ wisewoman. 6. Medicaid Outreach Activities and Reimbursement Procedures Medicaid Outreach Activities that are funded by local dollars and meet federal requirements are eligible for reimbursement at a 50% federal administrative match rate. Local Health Departments must maintain proper documentation of the activities performed and those activities must conform with the activities outlined in MSA Bulletin 05-29. Medicaid Outreach Activities funding is a subrecipient relationship. 25 Budget Preparation A. Medicaid Outreach Activities Complete the MI E-Grants application and budget forms for the application Medicaid Outreach Activities that occur during the fiscal year: 10/1-09/30. Reimbursable activities included in the budget must conform to the requirements as specified in the MSA Bulletin 05-29. Complete the MI E-Grants application and budget forms for this program. 1. Expenditure Category Tab Enter the expenditures budgeted for the fiscal year 10/1-9/30 Expenses budgeted for each of the listed expenditure categories are allowable and must be specific to the Medicaid program as described in MSA Bulletin 05-29. Outreach activities must not be part of direct service. Expenditures must be reflected in the cost allocation plan. 2. Source of Funds Tab Budget the amount expected from the federal government for allowable Medicaid Outreach Activities. Federal Medicaid Outreach represents the anticipated 50% federal administrative match of local contributions. Budget the local contribution. Required Match - Local represents the 50% matching local contribution for Medicaid Outreach activities. These two amounts must match. 3. Sources of Local Funds Types Local Health Departments may utilize their county appropriation, any earned income, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the Health Department as a source for matching funds. Other state and/or federal grant awards for Medicaid Outreach must be recorded on the appropriate line as indicated in the Comprehensive Budget Instructions - Attachment I. B. Nurse-Family Partnership Outreach Expenditures related to Nurse-Family Partnership Medicaid Outreach should be reflected under one program element. The budget should reflect the entire fiscal year period: 10/1- 09/30. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD Nurse-Family Partnership program has been applied. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 26 2. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution in Required Match – Local. Federal Medicaid Outreach and Required Match – Local must equal each other. Additional local contribution related to service provision for non- Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds – Other. 3. Sources of Local Fund Types Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non- state/non-federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the Health Department as a source for matching funds. C. CSHCS Medicaid Outreach Complete the MI E-Grants application and budget forms for the application titled CSHCS Medicaid Outreach for the timeframe: 10/01-09/30. Expenditures related to CSHCS Medicaid Outreach should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1-09/30. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD CSHCS program has been applied. A table containing each health jurisdiction Medicaid Participation Rate is located in the MI E-Grants site. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution. Federal Medicaid Outreach and Required Match – Local must equal each other. Additional local contribution that is not eligible for the 50% federal match should be reported on the Local Funds – Other line. 27 3. Sources of Local Fund Types Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non- state/non-federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the health department as a source for matching funds to be used at the discretion of the health department as a source for matching funds. 4. Comprehensive CSHCS Outreach and Advocacy and Case Management/Care Coordination Funds Should be reported in a separate program element. Indirect Costs There are three (3) options for indirect costs. They are: 1. an approved federal or state indirect rate; 2. a 10% de minimis rate; or 3. a cost allocation/distribution plan Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go to VI. Form Preparation, L. Indirect Cost, on page 5 of this document. Cost Allocation Certification The Cost Allocation Certification remains on file with the Department until there is a change in the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS- Medicaid-Outreach), the local health department must: 1) submit a copy of the revised cost allocation plan with the budget request; and 2) complete a revised cost allocation methodology certification. Both documents are to be attached to a Detailed Budget line in EGrAMS. Financial Status Report (FSR) – LHDs seeking 50% federal administrative match must request reimbursement by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through MI E-Grants. A. Quarterly and Final FSR LHDs must reflect the actual Medicaid Outreach expenses incurred on the quarterly and final FSR. Actual expenses incurred must be specific to Medicaid Outreach as defined by the MSA Bulletin 05-29 and not part of a direct service. All expenses should be supported by an approved methodology and appropriate support documentation. 28 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match for Medicaid Outreach. 2. Required Match - Local Should be used to report the local match for Medicaid Outreach. Both the federal and local amounts must match. 3. Source of Funds Category Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds – Other). Total Source of Funds must equal Total Expenditures. B. Nurse-Family Partnership Medicaid Outreach – Quarterly and Final FSRs For Quarters 1-3, LHDs must reflect the actual Medicaid Outreach expenses incurred in a separate program element titled Medicaid Outreach. Actual expenses incurred for each of the listed expenditure categories are allowable but must be specific to Medicaid Outreach as defined by MSA Bulletin 05-29 and not part of a direct service. Expenses should be supported by a time study or other federally approved methodology. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Both lines should equal. Additional local contribution related to service provision for non-Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Category 29 Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds – Other). C. CSHCS Medicaid Outreach – Final FSR CSHCS Medicaid Outreach billing may occur before the final FSR through the MI E-Grants system after Comprehensive Agreement CSHCS Outreach and Advocacy funds have been fully expended. Local contributions eligible for the Medicaid Outreach match should be cost distributed to the CSHCS Medicaid Outreach program element from the CSHCS Outreach and Advocacy program element and reported as indicated below. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Additional local contribution that is not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Category Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I. 4. Comprehensive CSHCS Outreach and Advocacy and Care Coordination Should be billed as separate program element. 7. Immunization 317 and VFC Allowable Expenditures Please reference the Immunization VFC and 317 Allowable expenditures chart located in the documents section in EGrAMS. The information is provided from the “Immunization Program Operations Manual” (known as the IPOM), published by CDC. DRAFT12/27/2023 Contract #: 20240194-01 Amendment Number: 2 to the Between Michigan Department of Health and Human Services and County of Oakland hereinafter referred to as the "Local Governing Entity" on Behalf of Health Department Oakland County Department of Health and Human Services/ Health Division AMENDMENT PURPOSE AND JUSTIFICATION 1.The purpose of this amendment is to: 1. Add/revise information in Attachment I - Annual Budget Instructions; 2. Add/revise information in Attachment III - Program Specific Assurance and Requirements; and 3. Incorporate Attachment IV- Funding/Reimbursement Matrix as revised for the Essential Local Public Health Service (ELPHS) and categorical budget details, output measures and performance criteria. 4. Increase the Department's agreement amount from $6,438,627 to $8,519,129, as shown on the Attachment B budget pages. 2.Amendment Revisions: The following are the additions/revisions to Attachment I and III A) The following projects include additions/revisions as highlighted in Attachment I - Annual Budget Instructions: No Change B) The following projects include additions/revisions as highlighted in Attachment III - Program Specific Assurance and Requirements: Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 1 of 15 DRAFT12/27/2023 1. COVID Workforce Development - New 2. ELC Contact Tracing, Case Investigation, Testing Coordination, and Infection Prevention 3. COVID Immunization Following are adjustments to funding levels of the Local Health Department agreement as reflected in Attachment IV: Budget line item changes are reflected in the attached budgets for the following elements: Project Title Current Amount Amended Amount New Project Amount COVID Workforce Development 0 110,000 110,000 ELC Regional Lab 500,000 555,810 1,055,810 ELC Sewer Network 909,057 1,414,692 2,323,749 Total Comprehensive Funding 1,409,057 2,080,502 3,489,559 Performance Level Adjustments N/A Budget category Adjustments It is understood and agreed that all other conditions of the original agreement remains the same. Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 2 of 15 DRAFT12/27/2023 3.Signing this amendment The individual or officer sigining this amendment certifies by his or her signature that he or she is authorized to sign this amedment on behalf of the reponsible governing board official or agency. Signature Section For Oakland County Department of Health and Human Services/ Health Division Andrea Powers Administrator ___________________________________________________________________ Name (please print) Title For the Michigan Department of Health and Human Services Christine H. Sanches 11/17/2023 ___________________________________________________________________ Christine H. Sanches, Director Date Bureau of Purchasing Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 3 of 15 DRAFT12/27/2023 Attachments Attachment I - Instructions for the Annual Budget Attachment III - Program Specific Assurances and Requirements Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 4 of 15 DRAFTContract # Date: 12/27/2023MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESATTACHMENT IV - Emerging Threats- Local Health Department- 2024CONTRACT MANAGEMENT SECTIONOakland County Department of Health and Human Services/ Health Division Program Element/Funding Source(a)MDHHSSourceFed/StFundingAmountReimbursementMethod(b)PerformanceTargetOutputMeasurementTotal (c)PerformExpectState (d)FundedTargetPerformState Funded MinimumPerformancePercentNumber (e)Contractor /Subrecepient(f)American Rescue PlanReg. Alloc.F216,336Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientCOVID ImmunizationReg. Alloc.F1,387,989Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientCOVID Workforce DevelopmentReg. Alloc.F110,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientELC Contract Tracing,Investigation, Testing Coord., andInfection PreventionReg. Alloc.F3,188,658Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientELC Regional LabReg. Alloc.F500,000Actual CostReimbursementN/AN/AN/AN/AN/ARecepientELC Sewer NetworkReg. Alloc.F909,057Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientPFAS Response - AirportReg. Alloc.S60,390Actual CostReimbursementN/AN/AN/AN/AN/ARecepientPFAS Response - Falk RdReg. Alloc.S1,197Actual CostReimbursementN/AN/AN/AN/AN/ARecepientRegional Lab WorkforceReg. Alloc.F175,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientTOTAL MDHHS FUNDING6,548,627*SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENTAttachment IV NotesEmerging Threats- Local Health Department- 2024, Date: 12/27/2023________________________________________________________________________________________________________________Page: 5 of 15 DRAFTContract # Date: 12/27/2023 Project Budgets 1 Program Budget Summary PROGRAM / PROJECT Emerging Threats- Local Health Department- 2024 / ELC Regional Lab DATE PREPARED 12/27/2023 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2023 To : 7/31/2024 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 2 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 67,978.00 67,978.00 2 Fringe Benefits 40,909.00 40,909.00 3 Cap. Exp. for Equip & Fac.100,000.00 100,000.00 4 Contractual 0.00 0.00 5 Supplies and Materials 19,000.00 19,000.00 6 Travel 3,000.00 3,000.00 7 Communication 0.00 0.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)259,725.00 259,725.00 Total Program Expenses 490,612.00 490,612.00 TOTAL DIRECT EXPENSES 490,612.00 490,612.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 9,388.00 9,388.00 Total Indirect Costs 9,388.00 9,388.00 TOTAL INDIRECT EXPENSES 9,388.00 9,388.00 TOTAL EXPENDITURES 500,000.00 500,000.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 6 of 15 DRAFTContract # Date: 12/27/2023 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 MDHHS Comprehensive 500,000.00 500,000.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 500,000.00 500,000.00 0.00 0.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 7 of 15 DRAFTContract # Date: 12/27/2023 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Medical Technologist Notes : Position # P00015845 J McChristian 1.0000 67978.000 0.000 FTE 67,978.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT AND LONG TERM DISABILITY 0.0000 60.180 67978.000 40,909.00 3 Cap. Exp. for Equip & Fac. Equipment - Lab 0.0000 0.000 0.000 100,000.00 4 Contractual 5 Supplies and Materials Materials and Supplies 0.0000 0.000 0.000 19,000.00 6 Travel Mileage 0.0000 0.000 0.000 1,000.00 Conferences 0.0000 0.000 0.000 2,000.00 Total for Travel 3,000.00 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Professional Services 0.0000 0.000 0.000 159,725.00 Equipment Maintenance 0.0000 0.000 0.000 100,000.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 8 of 15 DRAFTContract # Date: 12/27/2023 Line Item Qty Rate Units UOM Total Total for All Others (ADP, Con. Employees, Misc.)259,725.00 Total Program Expenses 490,612.00 TOTAL DIRECT EXPENSES 490,612.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 9,388.00 Total Indirect Costs 9,388.00 TOTAL INDIRECT EXPENSES 9,388.00 TOTAL EXPENDITURES 500,000.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 9 of 15 DRAFTContract # Date: 12/27/2023 1 Program Budget Summary PROGRAM / PROJECT Emerging Threats- Local Health Department- 2024 / ELC Sewer Network DATE PREPARED 12/27/2023 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2023 To : 7/31/2024 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 2 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 93,907.00 93,907.00 2 Fringe Benefits 48,654.00 48,654.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 153,527.00 153,527.00 6 Travel 0.00 0.00 7 Communication 0.00 0.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)600,000.00 600,000.00 Total Program Expenses 896,088.00 896,088.00 TOTAL DIRECT EXPENSES 896,088.00 896,088.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 12,969.00 12,969.00 Total Indirect Costs 12,969.00 12,969.00 TOTAL INDIRECT EXPENSES 12,969.00 12,969.00 TOTAL EXPENDITURES 909,057.00 909,057.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 10 of 15 DRAFTContract # Date: 12/27/2023 2 Program Budget - Source of Funds SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Source of Funds Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Federally Provided Vaccines 0.00 0.00 0.00 0.00 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 Required Match - Local 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Local Non-ELPHS 0.00 0.00 0.00 0.00 Other Non-ELPHS 0.00 0.00 0.00 0.00 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 MDHHS Comprehensive 909,057.00 909,057.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 0.00 0.00 0.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 909,057.00 909,057.00 0.00 0.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 11 of 15 DRAFTContract # Date: 12/27/2023 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Epidemiologist Notes : Position # 07258 M. Swain 0.2500 92241.000 0.000 FTE 23,060.00 Supervisor Notes : Laboratory Supervisor Position # 00399 B. Carter 0.1000 106316.000 0.000 FTE 10,632.00 Chief PH Notes : Position # 11973 K. Snowden 0.2500 111632.000 0.000 FTE 27,908.00 Administrator Notes : Administrator PH Position # 14250 K..Guzman 0.2500 129227.000 0.000 FTE 32,307.00 Total for Salary & Wages 93,907.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT AND LONG TERM DISABILITY 0.0000 51.811 93907.000 48,654.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Materials and Supplies 0.0000 0.000 0.000 153,527.00 6 Travel Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 12 of 15 DRAFTContract # Date: 12/27/2023 Line Item Qty Rate Units UOM Total 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Professional Services - Entech 0.0000 0.000 0.000 600,000.00 Total Program Expenses 896,088.00 TOTAL DIRECT EXPENSES 896,088.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% of Salaries 0.0000 0.000 0.000 12,969.00 Total Indirect Costs 12,969.00 TOTAL INDIRECT EXPENSES 12,969.00 TOTAL EXPENDITURES 909,057.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 13 of 15 DRAFTContract # Date: 12/27/2023 Summary of Budget PROGRAM / PROJECT Emerging Threats- Local Health Department- 2024 / Emerging Threats- Local Health Department- 2024 DATE PREPARED 12/27/2023 CONTRACTOR NAME Oakland County Department of Health and Human Services/ Health Division BUDGET PERIOD From : 10/1/2023 To : 9/30/2024 MAILING ADDRESS (Number and Street) 1200 N. Telegraph Rd. 34 East BUDGET AGREEMENT Original Amendment AMENDMENT # 2 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 420,343.00 420,343.00 2 Fringe Benefits 229,483.00 229,483.00 3 Cap. Exp. for Equip & Fac.100,000.00 100,000.00 4 Supplies and Materials 332,817.00 332,817.00 5 Travel 45,200.00 45,200.00 6 Communication 20,520.00 20,520.00 7 All Others (ADP, Con. Employees, Misc.)5,243,691.00 5,243,691.00 Total Program Expenses 6,392,054.00 6,392,054.00 TOTAL DIRECT EXPENSES 6,392,054.00 6,392,054.00 INDIRECT EXPENSES Indirect Costs 1 Cost Allocation Plan / Other 46,573.00 46,573.00 Total Indirect Costs 46,573.00 46,573.00 TOTAL INDIRECT EXPENSES 46,573.00 46,573.00 TOTAL EXPENDITURES 6,438,627.00 6,438,627.00 SOURCE OF FUNDS Category Total Amount Cash Inkind 1 Fees and Collections - 1st and 2nd Party 0.00 0.00 0.00 0.00 2 Fees and Collections - 3rd Party 0.00 0.00 0.00 0.00 3 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00 4 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 14 of 15 DRAFTContract # Date: 12/27/2023 5 Federally Provided Vaccines 0.00 0.00 0.00 0.00 6 Federal Medicaid Outreach 0.00 0.00 0.00 0.00 7 Required Match - Local 0.00 0.00 0.00 0.00 8 Local Non-ELPHS 0.00 0.00 0.00 0.00 9 Local Non-ELPHS 0.00 0.00 0.00 0.00 10 Local Non-ELPHS 0.00 0.00 0.00 0.00 11 Other Non-ELPHS 0.00 0.00 0.00 0.00 12 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00 13 MDHHS Comprehensive 6,438,627.00 6,438,627.00 0.00 0.00 14 MCH Funding 0.00 0.00 0.00 0.00 15 Local Funds - Other 0.00 0.00 0.00 0.00 16 Inkind Match 0.00 0.00 0.00 0.00 17 MDHHS Fixed Unit Rate 0.00 0.00 0.00 0.00 TOTAL 6,438,627.00 6,438,627.00 0.00 0.00 Emerging Threats- Local Health Department- 2024, Date: 12/27/2023 __________________________________________________________________________ Page: 15 of 15