HomeMy WebLinkAboutReports - 2024.03.14 - 41061
AGENDA ITEM: Amendment #2 to the Michigan Department of Health and Human Services Fiscal
Year 2024 Local Health Department Agreement
DEPARTMENT: Health & Human Services
MEETING: Board of Commissioners
DATE: Thursday, March 14, 2024 9:30 AM - Click to View Agenda
ITEM SUMMARY SHEET
COMMITTEE REPORT TO BOARD
Resolution #2024-3808
Motion to approve Amendment #2 to the FY 2024 Local Health Department (Comprehensive)
Agreement for funding in the amount of $2,122,575 for the period of October 1, 2023 through
September 30, 2024 and the subrecipient agreement with Remembering Cherubs; further, authorize
the Chair of the Board of Commissioner to execute the amendment and subrecipient agreement;
further, authorize the expansion of the County Fleet by one (1) Class C Recreational Vehicle;
further, amend the FY 2024 budget as detailed in the attached Schedule A.
ITEM CATEGORY SPONSORED BY
Grant Penny Luebs
INTRODUCTION AND BACKGROUND
The Oakland County Health Division has received Amendment #2 to the FY 2024 Local Health
Department (Comprehensive) Agreement. The original agreement totaling $12,096,246 was
adopted by the Board of Commissioners on September 21, 2023, via Miscellaneous Resolution #23-
3305. Amendment #1 increased the funding to $12,189,775, an increase of $93,529. Amendment
#2 increases the funding to $14,312,350, a total increase of $2,122,575. Amendment #2 provides
one-time funding in the amount of $120,000 to purchase a Class C Recreational Vehicle for mobile
outreach services provided through the Harm Reduction Support Services program. The vehicle will
allow the Health Division to increase Harm Reduction efforts including Sexual Transmitted Infection,
Hepatitis C, and HIV testing. The addition of the Class C Recreational Vehicle requires an addition
of one (1) department vehicle to the County Fleet. A portion of the $12,189,775 grant award totaling
$23,529, will be used to reimburse Remembering Cherubs for providing support, guidance, and
educational materials in the immediate aftermath of pregnancy loss or infant death.
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 - 3/14/2024
AGENDA DEADLINE: 03/14/2024 9:30 AM
ATTACHMENTS
1. Grant Review Sign-Off
2. Amendment #2 ATT I (1)
3. Amendment #2 ATT III (1)
4. Amendment #2 ATT IV (1)
5. Amendment #2 Draft Contract
6. FINAL FY2024 Remembering Cherubs Subaward Agreement_1.16.24
7. HHS_2024 Health LHD_Amend#2_Sch. A
COMMITTEE TRACKING
2024-03-05 Public Health & Safety - Forward to Finance
2024-03-06 Finance - Recommend to Board
2024-03-14 Full Board - Adopt
Motioned by: Commissioner Philip Weipert
Seconded by: Commissioner Linnie Taylor
Yes: David Woodward, Penny Luebs, Karen Joliat, Kristen Nelson, Christine Long, Robert
Hoffman, Philip Weipert, Gwen Markham, Angela Powell, William Miller III, Yolanda Smith
Charles, Charles Cavell, Ajay Raman, Ann Erickson Gault, Linnie Taylor (15)
No: None (0)
Abstain: None (0)
Absent: Michael Spisz, Marcia Gershenson, Brendan Johnson, Michael Gingell (4)
Passed
GRANT REVIEW SIGN-OFF – Health & Human Services / Health Division
GRANT NAME: FY 2024 Local Health Department (Comprehensive) Agreement
FUNDING AGENCY: Michigan Department of Health & Human Services
DEPARTMENT CONTACT: Stacey Sledge 248-452-2151
STATUS: Grant Amendment #2 (greater than 15% of award amount)
DATE: 02/05/2024
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) should be requested to 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 (01/30/2024)
Human Resources:
Approved by Human Resources. No position impact - Heather Mason (01/29/2024)
Risk Management:
Approved. Contract allows for governmental self-insurance and waives additional insured requirement. --Robert
Erlenbeck (02/05/2024)
Corporation Counsel:
Approved. I have no legal issues with the documents provided. - Bradley Benn (01/30/2024)
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
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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
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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
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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.
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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:
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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.
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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.
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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
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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
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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.
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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:
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• 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
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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.
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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,
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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
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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.
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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.)
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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
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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.
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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
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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.
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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
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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
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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.
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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)
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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.
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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.
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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
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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.
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.
Many program specific assurances and other requirements are defined within the referenced
documents including Minimum Program Requirements established for the following program
elements as of October 1, 2006:
1. Breast and Cervical Cancer Control
2. Clinical Laboratory
3. CSHCS
4. EGLE Drinking Water and Onsite Wastewater Management
5. Family Planning
6. Food ELPHS
7. Hearing ELPHS
8. HIV/STD Prevention Treatment
9. MDHHS Essential Local Public Health Services (ELPHS)
10. Michigan Care Improvement Registry
11. Vision ELPHS
12. WIC
For Fiscal Year 2024, special requirements are applicable for the remaining 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 Title Name EMAIL
Administration Projects Laura de la Rambelje delarambeljel@michigan.gov
Adolescent STI Screening Christopher Stickney stickneyc@michigan.gov
Body Art Fixed Fee Seth Eckel eckels1@michigan.gov
Breast & Cervical Cancer Control (BCCCP) Coordination Polly Hager hagerp@michigan.gov
Child and Adolescent Health Center Program Expansion (All locations)Kim Kovalchick kovalchickk@michigan.gov
Child and Adolescent Health Center Construction (All locations)Kim Kovalchick kovalchickk@michigan.gov
Childhood Lead Poisoning Prevention Carin Speidel speidelc@michigan.gov
Children's Special Hlth Care Services (CSHCS) Care Coordination Kelly Schoenherr-Gram Gramk2@michigan.gov
Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy Kelly Schoenherr-Gram Gramk2@michigan.gov
CLPP Lead Expansion Carin Speidel speidelc@michigan.gov
Community Blood Lead Testing Carin Speidel speidelc@michigan.gov
CSHCS Medicaid Elevated Blood Lead Case Mgmt Carin Speidel speidelc@michigan.gov
CSHCS Medicaid Outreach Kelly Schoenherr-Gram Gramk2@michigan.gov
CSHCS Vaccine Initiative Kelly Schoenherr-Gram Gramk2@michigan.gov
Eastern Equine Encephalitis Virus Surveillance Project Mary Grace Stobierski stobierskim@michigan.gov
Eat Safe Fish Christopher Finch finchc2@michigan.gov
EEEH-All Locations Taggert Doll dollt@michigan.gov
EGLE Drinking Water and Onsite Wastewater Management Jeremy Hoeh hoehj@michigan.govg g p @ gg
Emerging Threats - Hepatitis C Seth Eckel eckels1@michigan.gov
Empowering Youth Today Robyn Corey coreyr1@michigan.gov
Ending the HIV Epidemic Implementation Christopher Stickney stickneyc@michigan.gov
Family Planning Services Deanna Charest charestd@michigan.gov
Fetal Alcohol Spectrum Disorders Community Projects Keyonie James jamesk17@michigan.gov
Fetal Infant Mortality Review (FIMR) Case Abstraction Nicholas Drzal drzaln@michigan.gov
FFPSA HV Expansion Charisse Sanders sandersc2@michigan.gov
FIMR Interviews Nicholas Drzal drzaln@michigan.gov
Food ELPHS Adam Christenson christensona@michigan.gov
Gonococcal Isolate Surveillance Project Christopher Stickney stickneyc@michigan.gov
Grief and Bereavement Nicholas Drzal drzaln@michigan.gov
Harm Reduction Capacity Expansion Seth Eckel eckels1@michigan.gov
Harm Reduction Support Services Seth Eckel eckels1@michigan.gov
Hearing ELPHS Jennifer Dakers dakersj@michigan.gov
HIV & STI Testing and Prevention Christopher Stickney stickneyc@michigan.gov
HIV / STI Partner Services Christopher Stickney stickneyc@michigan.gov
HIV Care Coordination Christopher Stickney stickneyc@michigan.gov
HIV Data to Care Christopher Stickney stickneyc@michigan.gov
HIV Housing Assistance Christopher Stickney stickneyc@michigan.gov
HIV Linkage to Care Christopher Stickney stickneyc@michigan.gov
HIV PrEP Clinic Christopher Stickney stickneyc@michigan.gov
HIV PrEP Mobile Clinic Christopher Stickney stickneyc@michigan.gov
HIV Prevention Christopher Stickney stickneyc@michigan.gov
HIV Prevention - Forest Community Health Annalisa Gancer GancerA@michigan.gov
HIV Ryan White Part B Christopher Stickney stickneyc@michigan.gov
HIV Ryan White Part B MAI Christopher Stickney stickneyc@michigan.gov
Housing Opportunities for People Living with HIV/AIDS Jessica Altenbernt altenberntj@michigan.gov
Immunization Action Plan (IAP)Heidi Loynes loynesh@michigan.gov
Immunization Action Plan Pilot Heidi Loynes loynesh@michigan.gov
Immunization Fixed Fees Heidi Loynes loynesh@michigan.gov
Immunization Vaccine Quality Assurance Heidi Loynes loynesh@michigan.gov
Infant Safe Sleep Nicholas Drzal drzaln@michigan.gov
Informed Consent Laura de la Rambelje delarambeljel@michigan.gov
Integrating MPOX into STI Clinics Christopher Stickney stickneyc@michigan.gov
Laboratory Services Bio Marty Soehnlen soehnlenm@michigan.gov
Lactation Consultant Nicholas Drzal drzaln@michigan.gov
Lead Hazard Control Courtney Wisinski wisinskic@michigan.gov
Lead Health and Safety Courtney Wisinski wisinskic@michigan.gov
Local Health Department (LHD) Sharing Support Laura de la Rambelje delarambeljel@michigan.gov
Maternal Infant Erly Chd Home Visiting Initiative Rural Local Home Visiting Grp3 Charisse Sanders sandersc2@michigan.gov
Maternal Infant Erly Childhood Home Visiting Initiative Local Home Visiting Grp Charisse Sanders sandersc2@michigan.gov
MCH - All Other Trudy Esch EschT@michigan.gov
MCH - Children Trudy Esch EschT@michigan.gov
MDHHS-Essential Local Public Health Services (ELPHS)Laura de la Rambelje delarambeljel@michigan.gov
Medicaid Outreach Carrie Tarry tarryc@michigan.gov
MI Adolescent Pregnancy & Parenting Program Hillary Brandon brandonh@michigan.gov
MI Home Visiting Initiative Rural Expansion Grant Charisse Sanders sandersc2@michigan.gov
MIECHVP Healthy Families America Expansion Charisse Sanders sandersc2@michigan.gov
Minority Health Community Capacity Building Initiatve Brenda Jegede jegedeb@michigan.gov
MRC STTRONG 10/1 - 5/31 Janis Tipton jegedeb@michigan.gov
Nurse Family Partnership Medicaid Outreach Charisse Sanders sandersc2@michigan.gov
Nurse Family Partnership Services Charisse Sanders sandersc2@michigan.gov
Oral Health - Kindergarten Assessment Christine Farrell farrellc@michigan.gov
Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 Janis Tipton tiptonj2@michigan.gov
Public Health Emergency Preparedness (PHEP) 7/1- 9/30 Janis Tipton tiptonj2@michigan.gov
Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 Janis Tipton tiptonj2@michigan.gov
Public Health Emergency Preparedness (PHEP) CRI 7/1 - 9/30 Janis Tipton tiptonj2@michigan.gov
Public Health Infratstructure Laura de la Rambelje delarambeljel@michigan.gov
Regional Perinatal Care System Deanna Charest charestd@michigan.gov
SDOH Hub Pilot Ninah Sasy sasyn@michigan.gov
SDOH Planning Ninah Sasy sasyn@michigan.gov
SEAL! Michigan Dental Sealant Christine Farrell farrellc@michigan.gov
Sexual Violence Prevention Jennifer DeLaCruz delacruzj@michigan.gov
Sexually Transmitted Infection (STI) Control Christopher Stickney stickneyc@michigan.gov
Statewide Lead Case Managment - Fixed Fee Carin Speidel speidelc@michigan.gov
STI Specialty Services Christopher Stickney stickneyc@michigan.gov
Substance Use Home Visiting Charisse Sanders sandersc2@michigan.gov
Taking Pride in Prevention Kara Anderson andersonk10@michigan.gov
Telehealth Family Planning Steve Utter utters@michigan.gov
Tobacco Control Grant Program Julia Hitchingham hitchinghamj@michigan.gov
Tobacco Use Reduction for People Living with HIV Julia Hitchingham hitchinghamj@michigan.gov
Transforming Youth Suicide Prevention Jennifer DeLaCruz delacruzj@michigan.gov
Tuberculosis (TB) Control Peter Davidson davidsonp@michigan.gov
Vector-Borne Surveillance & Prevention Mary Grace Stobierski stobierskim@michigan.gov
Vision ELPHS Rachel Schumann schumannr@michigan.gov
West Nile Virus Community Surveillance Mary Grace Stobierski stobierskim@michigan.gov
WIC Breastfeeding Cecilia Hutson hutsonc1@michigan.gov
WIC Migrant Cecilia Hutson hutsonc1@michigan.gov
WIC Resident Services Cecilia Hutson hutsonc1@michigan.gov
Wisewoman Polly Hager hagerp@michigan.gov
PROJECT TITLE: Adolescent Sexually Transmitted Infection (STI) Screening
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and
health care cost. Adolescents and young adults experience elevated rates of infection
in Michigan and across the country. Individuals 15-24 years of age will be screened for
chlamydia and gonorrhea at the following Oakland County sites:
1. Oakland County Main Jail
2. Oakland County Work Release
3. Oakland County Community Sites where Priority Population Gathers
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit
Report
Quarterly report of screening
and treatment activity Quarterly 15 days after the
end of the quarter
Email to MDHHS
contract liaison
GRANTEE SPECIFIC REQUIREMENTS
Utilizing the identified project sites:
1. Test at least 100 adolescents and young adults per month, using NAAT tests for
gonorrhea and chlamydia.
2. Collect race, gender, age, test result, and treatment date for all tests.
3. Refer clients for further health evaluation if indicated.
4. Provide client centered risk reduction plan, promoting abstinence.
5. Treat all positives on site if possible.
6. Contact positive clients that are released prior to treatment with treatment options
in community.
7. Promote self-notification of partners.
8. Develop one annual slide set highlighting year end data by demographic variable
including trend data.
9. Continue to promote awareness of prevalence of STIs within adolescent and
young adult populations.
Participate in MDHHS convened meetings regarding chlamydia and gonorrhea
screening as requested.
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in
the BHSP SHOARS system. These roles must match what the agency has listed
for these roles in the EGrAMS system. If you have access related questions,
contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-
SUPPORT@michigan.gov
PROJECT: Body Art Fixed Fee
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
This agreement is intended to establish a payment schedule to the Grantee, following
notification of a completed inspection and recommendation for issuance of license.
The intent is to help offset costs related to the licensing of a body art facility, when
fees are collected from the respective Grantee’s jurisdiction in accordance with
Section 13101-13111 of the Public Health Code, Public Act 149 of 2007, which was
updated on December 22, 2010 and is now Public Act 375.
Reporting Requirements (if different than contract language)
The Department will reimburse the Grantee on a quarterly basis according to the
following criteria:
Facility License for 2023 Reimbursement Rates
1. Initial annual license for a Body Art Facility prior to July 1
• $303.43 (50% of state fee)
2. Initial annual license for a Body Art Facility on or after July 1
• $151.72 (50% of state fee)
3. Issue a temporary license for a Body Art Facility
• $136.53 (75% of state fee)
4. License renewal prior to or on December 1
• $303.43 (50% of state fee)
5. License renewal after December 1
• $455.15 (50% of state fee + 50% late fee penalty)
6. Duplicate license
• $30.33
Facility License for 2024 Reimbursement Rates
1. Initial annual license for a Body Art Facility prior to July 1
• $317.69 (50% of state fee)
2. Initial annual license for a Body Art Facility on or after July 1
• $158.85 (50% of state fee)
3. Issue a temporary license for a Body Art Facility
• $142.95 (75% of state fee)
4. License renewal prior to or on December 1
• $317.69 (50% of state fee)
5. License renewal after December 1
• $476.54 (50% of state fee + 50% late fee penalty)
6. Duplicate license
• $31.76
Payment will be made for those body art facilities that have applied and paid in full to the
Department, following notification of a completed inspection and recommendation for
issuance of license. Please note that the fees in the list above are based on 2023 and
2024 license reimbursement rates and are subject to change with the Consumer Price
Index.
Any additional requirements (if applicable)
The Grantee is authorized to enforce PA 375 and conduct an inspection of all body art
facilities under its jurisdiction, investigate complaints, and enforce licensing regulations
and requirements. The Grantee must complete a Body Art Facility Inspection Report
[DCH-1468 (07-09)], as provided by the Department, or other report form approved by
the Department that meets, at minimum, all standards of the state inspection report.
Only body art facilities that have applied for licensure should be inspected. All body art
facilities must be inspected annually. Initial licenses will only be released from the
Department following notification of a completed inspection and upon recommendation
by the Grantee.
Completed inspection reports should be signed by the facility owner and
recommendation for licensure should be forwarded to the Department within two to four
weeks following the inspection. Reports should be entered via the online interface.
PROJECT: Breast and Cervical Cancer Control Navigation Program
Start Date: 10/1/2023
End Date: 6/30/2024
Project Synopsis
The BC3NP (Breast and Cervical Cancer Control Navigation Program) provides
individualized assistance to low-income women, < 250% FPL, in overcoming barriers
that may impede their access to receiving breast and cervical cancer services.
Services are provided to uninsured and underinsured women enrolled in the program.
Women identified for priority enrollment in the program are those women in hard-to-
reach populations, such as minorities, particularly African American, Hispanic, Asian
American, Arab American, Native American and LGBTQ women.
Breast and/or cervical screening and diagnostic services are reimbursed for uninsured
and underinsured low-income women enrolled through the program that meet the
following criteria:
• Age 21-64; self-referred, referred from a BC3NP provider or a non-BC3NP
provider and requires cervical cancer screening and/or diagnostic services for
an identified cervical screening abnormality.
• Age 40-64; self-referred, referred from a BC3NP provider or a non-BC3NP
provider and requires breast cancer screening and/or diagnostic services for an
identified abnormality.
• Age 21-39; referred from either a BC3NP or non-BC3NP provider with an
abnormal breast finding requiring diagnostic follow-up to rule out or confirm a
breast cancer diagnosis.
Reporting Requirements (if different than contract language)
Instructions for use of MBCIS, a statewide database, will be provided to agencies that
contribute data to this database. The CPCS will exchange relevant program reports with
appropriate contractors through encrypted email or a secure file transfer system.
Any additional requirements (if applicable)
For specific BC3NP requirements, refer to the most current BC3NP Policies and
Procedures or visit www.michigan.gov/BC3NP.
PROJECT: Child Adolescent Health Center Construction
Star Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Grants are provided to newly funded child and adolescent health centers for the
purposes of completing necessary construction and covering start-up costs of the
centers.
Reporting Requirements (if different than contract language)
NA
Any additional requirements (if applicable)
NA
PROJECT: Child and Adolescent Health Center Program Expansion
Start Date: 10/1/2022
End Date: 9/30/2023
Project Synopsis:
A major role of the CAHC program is to provide a safe and caring place for children
and adolescents to receive needed medical care and support, learn positive health
behaviors, and prevent diseases, resulting in healthy youth who are ready and able to
learn and become educated, productive adults. CAHCs assist eligible children and
adolescents with enrollment in Medicaid and provide access to Medicaid preventive
services.
Reporting Requirements (if different than contract language)
A. The Grantee shall submit the following reports on the following dates:
• Quarterly Program Data Report: Due 30 days after the end of the reported quarter
• Annual Program Narrative: Due 30 days after the end of the grant period
B. Any such other information as specified in the Statement of Work, Attachment A shall
be developed and submitted by the Grantee as required by the Contract Manager.
C. Reports and information shall be submitted to the Contract Manager as follows:
• Quarterly Program Data Report: via the Child and Adolescent Health Center Clinical
Reporting Tool located at Clinical Reporting Tool (knack.com)
• Annual Program Narrative: email
D. The Contract Manager shall evaluate the reports submitted as described in Attachment
C, Items A. and B. for their completeness and adequacy.
E. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by Contract Manager.
Any additional requirements (if applicable)
Funding Eligibility
To be eligible for funding, all applicants must provide signed assurance that referrals for
abortion services or assistance in obtaining an abortion will not be provided as part of the
services (MCL §388.1766). For programs providing services on school property, signed
assurance is required that family planning drugs and/or devices will not be prescribed,
dispensed or otherwise distributed on school property as mandated in the Michigan School
Code (MCL §380.1507). Applicants must assure compliance with all federal and state laws
and regulations prohibiting discrimination and with all requirements and regulations of MDE
and MDHHS.
Target Populations to be Served
Proposals should focus on the delivery of health services to ages 5-21 years at school-based
sites, and 10-21 years at school-linked sites, in geographic areas where it can be
documented that health care services that are accessible and acceptable to children and
adolescents require enhancement or do not currently exist. The children (birth and up) of the
adolescent target population may also be served where appropriate. Funding may be used
to provide clinical services to students receiving special education services up to 26 years
of age.
Technology
Successful applicants are required to have an accessible electronic mail account (email) to
facilitate ongoing communication. All successful applicants will be added to a CAHC program
list serve, which is the primary vehicle for communication from the State.
Successful applicants must have the necessary technology and equipment to support billing
and reimbursement from third party payers. Refer to Reference A, Minimum Program
Requirements which describes the billing and reimbursement requirements for all grantees.
Training
At least one staff member is required to attend a yearly Michigan Department of Health and
Human Services CAHC Annual Meeting in the fall, as announced by the MDHHS team.
Unallowable Expenses
The following costs are not allowed with this funding:
• The purchase or improvement of land
• Fundraising activities
• Political education or lobbying, including membership costs for advocacy or lobbying
organizations
• Indirect costs
The following restrictions are in effect for this funding:
• Funds may not be used to refer a student for an abortion or assist a student in
obtaining an abortion (MCL §388.1766).
• Funds may not be used to prescribe, dispense or otherwise distribute a family
planning drug or device in a public school or on public school property (MCL
§380.1507).
• Funding may not be used to serve the adult population (ages 22 years and older),
with the exception of students up to 26 years of age who are receiving special
education services.
• Funds may not be used to supplant or replace an existing program supported with
another source of funds or for ongoing or usual activities of any organization involved
in the project.
MINIMUM PROGRAM REQUIREMENTS
CHILD AND ADOLESCENT HEALTH CENTERS
CLINICAL AND ALTERNATIVE CLINICAL MODELS
ELEMENT DEFINITION:
Services provided through the Child and Adolescent Health Center Program are
designed specifically for children and adolescents ages 5 through 21 years and are
aimed at achieving the best possible physical, intellectual, and emotional health status.
The infants and young children of adolescents can also be served through this program.
Included in this element are school-based health centers; and school-linked adolescent-
only health centers (which serve only adolescents between the ages of 10 through 21
years) designed to provide comprehensive primary care, psychosocial and mental
health services, health promotion/disease prevention, and outreach services.
MINIMUM PROGRAM REQUIREMENTS:
1. The health center shall provide a range of health and support services based on
a needs assessment of the target population/community and approved by the
community advisory council. The services shall be of high quality, accessible, and
acceptable to youth in the target population. Age-appropriate prevention
guidelines and screening tools must be utilized.
a) Clinical services shall include, at a minimum: primary care including health
care maintenance, immunization assessment and administration using the
MCIR, care of acute and chronic illness; confidential services including mental
health services, STI diagnosis and treatment and HIV counseling and testing
as allowed by state and/or federal law; health education and risk reduction
counseling; and referral for other services not available at the health center.
(See Attachment 1: Services Detail).
b) Each health center shall implement one evidence-based intervention with
fidelity or clinical intervention in the approved focus areas as determined
through needs assessment data (For approved focus areas, see
Attachment 2: Focus Areas).
2. Clinical services provided, including mental health services, shall meet the
recognized, current standards of practice for care and treatment for the
population served.
3. The health center shall not provide abortion counseling, services, or make
referrals for abortion services.
4. The health center, if on school property, shall not prescribe, dispense, or otherwise
distribute family planning drugs and/or devices.
5. The health center shall provide Medicaid outreach services to eligible youth and
families and shall adhere to Child and Adolescent Health Centers and Programs
outreach activities as outlined in MSA 04-13.
6. If the health center is located on school property, or in a building where K-12
education is provided, there shall be a current interagency agreement defining
roles and responsibilities between the sponsoring agency and the local school
district.
Written approval by the school administration and local school board exists for the
following:
a) Location of the health center
b) Administration of a needs assessment process to determine priority health
services for the population served; which includes, at a minimum, a risk
behavior survey for adolescents served by the health center c) Parental consent policy
d) Services rendered in the health center
7. The health center shall be located in a school building or an easily accessible
alternate location.
8. The health center shall be open during hours accessible to its target population, and
provisions must be in place for the same services to be delivered during times when
school is not in session. Not in session refers to times of the year when schools are
closed for extended periods such as holidays, spring breaks, and summer vacation.
The school-based health center shall designate specific hours for services to be
provided to adolescents only (when the center serves both children aged 5 to 10 and
adolescents), and a policy shall exist to this effect. These provisions shall be posted
and explained to clients.
Clinical Centers: The health center shall provide clinical services a minimum of five
days per week. Total primary care provider clinical time shall be at least 30 hours per
week. Total primary care provider clinical time shall be at least 30 hours per week over
five days. Full time (or full time equivalent) mental health counseling and/or services
must be provided as part of this program a minimum of five days per week. Hours of
operation must be posted in areas frequented by the target population.
Alternative Clinical Centers: The health center shall provide clinical services a
minimum of three consistent days per week. Total primary care provider clinical time
shall be at least 24 hours per week. Mental health counseling and/or services must
be provided as part of this program at least 24 hours per week over at least three
days. Hours of operation must be posted in areas frequented by the target
population.
The health center shall have a written plan for after-hours and weekend care, which
shall be posted in the health center including external doors and explained to clients.
An after-hours answering service and/or voicemail with instructions on accessing
after-hours care is required.
The health center shall have a licensed physician, nurse practitioner or physician
assistant that serves as Medical Director. A nurse practitioner or physician assistant
serving as Medical Director of a health center should have clinical supervision by a
physician and follow all legal requirements.
9. The health center staff shall operate within their scope of practice as
determined by certification and applicable agency policies:
a) The center shall be staffed by a certified nurse practitioner (FNP, PNP), licensed
physician, or a licensed physician assistant working under the supervision of a
physician. Nurse practitioners must be a Family Nurse Practitioner (FNP) or
Pediatric Nurse Practitioner (PNP); must be certified or eligible for certification in
Michigan; accredited by an appropriate national certification association or board;
and have a current, signed collaborative practice agreement with the medical
director or designee. Physicians and physician assistants must be licensed to
practice in Michigan.
b) The health center must be staffed with a minimum of a licensed Masters level
mental health provider (i.e. counselor or Social Worker). Appropriate
supervision must be available.
10. The health center must establish a procedure that doesn’t violate
confidentiality for communicating with the identified Primary Care Provider
(PCP), based on criteria established by the provider and the Medical
Director.
11. The health center shall implement a continuous quality improvement plan for
medical and mental health services. Components of the plan shall include, at a
minimum:
a) Practice and record review shall be conducted at least twice annually by an
appropriate peer and/or other staff of the sponsoring agency, to determine that
conformity exists with current standards of care. A system shall also be in place
to implement corrective actions when deficiencies are noted. A CQI Coordinator
shall be identified. CQI meetings, that include staff of all disciplines working in
the health center, shall be held at least quarterly. These meetings shall include
discussion of reviews, client satisfaction survey and any identified clinical issues.
b) Completing, updating, or having access to a needs assessment process
conducted within the last three years to determine the health needs of the
population served including, at a minimum, a risk behavior survey for
adolescents.
c) Conducting a client satisfaction survey at a minimum annually.
12. A local community advisory council shall be established and operated as follows:
a) A minimum of two meetings per year
b) The council must be representative of the community and include a broad
range of stakeholders such as school staff c) One-third of council members must be parents of school-aged children/youth d) Health care providers shall not represent more than 50% of the council
e) The council must approve the following policies and the health center must
develop applicable procedures:
1. Parental consent policy
2. Requests for medical records and release of information that include the
role of the non-custodial parent and parents with joint custody
3. Confidential services as allowed by state and/or federal law
4. Disclosure by clients or evidence of child physical or sexual abuse, and/or
neglect
f) Youth input to the council shall be maintained through either membership
on the established advisory council; a youth advisory council; or through
other formalized mechanisms of involvement and input.
13. The health center shall have space and equipment adequate for private physical
examinations, private counseling, reception, laboratory services, secured
storage for supplies and equipment, and secure paper and/or electronic client
records. The physical facility must be barrier-free, clean, and safe.
14. The health center staff shall follow all Occupational Safety and Health Act
guidelines to ensure protection of health center personnel and the public.
15. The health center shall conform to the regulations determined by the Department
of Health and Human Services for laboratory standards.
16. The health center shall establish and implement a sliding fee scale, which is not a
barrier to care for the population served. Clients must not be denied services
because of inability to pay. CAHC funding is in place to support overall program
operations including provider time; agencies are responsible to offset any
outstanding balances for direct health services to avoid collection notices and/or
referrals to collection agencies for payment.
17. The health center shall establish and implement a process for billing Medicaid,
Medicaid Health Plans and other third-party payers.
18. The billing and fee collection processes do not breach the confidentiality of the client.
19. Revenue generated from the health center must be used to support health center
operations and programming.
CHILD AND ADOLESCENT HEALTH CENTERS CLINICAL AND
ALTERNATIVE CLINICAL MODELS
Attachment 1: Services Detail
The following health services are required (*or recommended) as part of the Child
and Adolescent Health Center service delivery plan:
PRIMARY CARE SERVICES
• Well child care
• EPSDT screenings and exams
• Comprehensive physical exams
• Risk assessment/other screening
• Laboratory services
1. CLIA Waived testing
2. Specimen collection for outside lab testing
• *Other diagnostic, screening and/or preventive services
1. Hearing and vision screening
2. Tympanometry
3. Preventive oral applications
4. Spirometry
5. Pulse oximetry
6. Telehealth capabilities
7. Office microscopy
MENTAL HEALTH
SERVICES
• Mental Health services provided by a Master’s level mental health provider.
ILLNESS/INJURY CARE
• Minor injury assessment/treatment and follow up
• Acute illness assessment/ treatment and follow up &/or
referral CHRONIC CONDITIONS CARE
• Includes assessment, diagnosis and treatment of a new condition
• Maintenance of existing conditions based on need,
collaborations with PCP/specialist or client/parental request
• Chronic conditions may include: asthma, diabetes, sickle cell,
hypertension, obesity, metabolic syndrome, depression, allergy, skin
conditions or other specific to a population
IMMUNIZATIONS
• Screening and assessment utilizing the MCIR and other data
• Complete range of immunizations for the target population utilizing
Vaccine for Children and private stock
• Administration of immunizations
• Appropriate protocols, equipment, medication to handle vaccine
reactions HEALTH EDUCATION
STI & HIV EDUCATION, COUNSELING, & VOLUNTARY TESTING
• Education appropriate for age, other demographics of the target
population, and needs assessment data
• Risk assessment, historical and physical assessment data informs individualized
care
• CAHC-trained HIV counselor/tester is on site
• Testing for and treatment of STI and testing and referral for HIV treatment is
on site “CONFIDENTIAL SERVICES” AS DEFINED BY MICHIGAN AND/OR
FEDERAL LAW
• Confidential services are those services that may be obtained by minors
without parental consent
• Confidential services include: mental health counseling, pregnancy
testing & services, STI/HIV testing and treatment, substance use disorder
counseling and treatment, family planning (excluding contraceptive
prescription/distribution on school property).
REFERRAL
• PCP, specialists, dental services, community agencies, etc.
CHILD AND ADOLESCENT HEALTH CENTERS CLINICAL AND
ALTERNATIVE CLINICAL MODELS
and SCHOOL WELLNESS PROGRAMS
Attachment 2: Focus Areas
Each year, health centers and SWPs should review their needs assessment data to
determine priority health issues that are of such significance to their target population to
warrant an enhanced “focus” for the upcoming year. Each center is required to
implement one evidence-based program or clinical intervention to begin to address the
needs within the selected focus area(s).
FOCUS AREAS
• ALCOHOL/TOBACCO/OTHER DRUG PREVENTION
• HIV/AIDS/STI PREVENTION
• NUTRITION AND PHYSICAL ACTIVITY
• PREGNANCY PREVENTION
• SUICIDE PREVENTION
• TRAUMA
• VIOLENCE PREVENTION
• DEPRESSION/ANXIETY
• ASTHMA
Focus areas are meant to provide services above and beyond what would typically be
provided in comprehensive primary care. It is expected that each of these focus areas
will be a part of comprehensive primary care already, but intervention selected for the
focus area requirement should be significantly beyond typical care. Strategies should be
intensive, evidence-based, and include appropriate evaluation methods to assess
impact and progress on meeting focus areas.
PROJECT: Childhood Lead Poisoning Prevention
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
MDHHS CLPPP’s mission is “to prevent childhood lead poisoning across the state
through surveillance, outreach and health services”. This grant provides local health
departments the opportunity to prevent and address lead poisoning within their
communities, with support of CLPPP. The overall goal of the grant is to increase testing
for children under the age of 6, specifically capillary to venous testing rates.
Reporting Requirements (if different than contract language)
1. Workplan – submitted according to due dates set by CLPPP
2. Quarterly Reports – submitted no later than thirty (30) days after the close of the
quarter.
Grantee Specific Requirements
• Identify target areas with lower testing rates, with the assistance of CLPPP and
quarterly data reports provided to the LHDs.
• Provide a workplan with a detailed overview of how your LHD plans to increase
testing rates within the grantee focus area, and explanation of target
audience/locations. Metrics for success should be strategic, measurable,
ambitious, realistic, time-bound, inclusive, and equitable. Planning for the
workplan should be done in coordination with CLPPP. CLPPP will provide
recommended activities to the grantees.
• Conduct a quarterly review of the workplan and grant activity progress. Submit a
quarterly report to CLPPP with progress made, as well as revisions needed for
the workplan.
• Attend meetings with CLPPP and other grantees as scheduled.
• Ensure all communication materials that are developed and distributed by the
grantee are approved by CLPPP if MDHHS funds are used.
PROJECT: CLPP Lead Expansion
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
MDHHS CLPPP’s mission is “to prevent childhood lead poisoning across the state
through surveillance, outreach and health services”. The goal of this pilot is to maximize
the number of children less than six years of age protected from lead poisoning and the
number of City of Detroit childcare facilities where lead hazards are controlled. This
goal should be accomplished through targeted lead testing and hazard controls efforts,
expanded education and outreach, and enhancing nursing and environmental services
to children with an EBLL 3.5-19 mcg/dL, residing in the 6 high risk zip codes in the City
of Detroit.
Grantees could achieve this goal through:
1) Targeted lead testing and hazard controls efforts, this can include:
• Lead education in early childhood care centers (daycares, Early Head Start, Head
Start)
• Lead inspection risk assessments in licensed childcare centers
2) Expanded education and outreach, this can include:
• Providing lead testing on site at early childcare centers
• Providing referrals to other essential health services (WIC, IMMS, Vision/Hearing
screening)
3) Enhancing nursing and environmental services to children with an EBLL 3.5-
19mcg/dL, residing in the 6 high risk zip codes in the City of Detroit, this can include:
• Non-Medicaid children – providing nursing case management home visits
• Coordinate lead inspection risk assessments for children with an ebll, residing in this
zip code
Reporting Requirements (if different than contract language)
• Provide a workplan with a detailed overview of how your LHD plans to expand
education, NCM and linkage to care within the grantee focus area, and explanation
of target audience/locations
• Submit quarterly reports
CLPPP support will include:
a. Nursing and Public Health Consultant technical assistance as requested
b. miclppp.org website with educational materials re: testing, cleaning
c. Online training module for health care providers
Any additional requirements (if applicable)
Attend quarterly call/in-person meetings
Ensure all communication materials that are developed and distributed by the grantee
are approved by CLPPP if MDHHS funds are used.
Grantees Focus Area:
• Detroit Health Department – City of Detroit
PROJECT: Community Blood Lead Testing
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
In response to the decrease in blood lead testing due to COVID-19 and the impact on
pediatric visits and WIC agency closure, there is a necessity to support local health
departments to facilitate innovative strategies in their jurisdictions to ensure access to
and completion of blood lead testing for children to identify lead exposure. It is
imperative that there is a community-based approach to blood lead testing. This pilot
funding is to support local health departments in planning for implementation of
strategies to increased blood lead testing of children <6 years old within their
jurisdiction. This planning will follow the ABC Building Blocks for Community Blood Lead
Testing, comprised of assessing, bolstering, and coordinating.
Grantees could achieve this goal through:
1) Assess current state of blood lead testing in the jurisdiction, this can include:
• Survey community partners and local health department to determine where
blood lead testing is taking place
• Identify gaps in blood lead testing availability
• Identify barriers to accessing blood lead testing
• Identify Medicaid Health Plans (MHPs) serving the community
• Identify Partners for promotion of lead testing
2) Bolster current testing efforts, this can include:
• Conduct provider education regarding recommendations for blood lead testing at
existing access points
• Conduct public education about existing testing options, targeting children less
than 6 years old
• Enhance access to existing local access points for blood lead testing by reducing
identified barriers to testing
3) Coordinate a testing plan, this can include:
• Work with Medicaid Health Plans to identify children due for screening and
perform targeted outreach
• Identify a plan for a “safety net” option for free testing for uninsured, those whose
insurance will not cover testing, those falling outside our target groups, or
communities needing timely access to testing
• Reporting Requirements (if different than contract language)
• Provide a workplan with a detailed overview of how your LHD will demonstrate
functional “safety net” option and ability to increase access to testing as needed
• Submit quarterly reports
• CLPPP support will include:
• ABC Building Blocks for Community Blood Lead Testing Plan one pager
• Sample workplan for grantee to complete including a checklist of recommend
community partners
• Nursing and Public Health Consultant technical assistance as requested
• Identify ALE communities within jurisdiction and provide appropriate educational
resources
Any additional requirements (if applicable)
• Attend quarterly call/in-person meetings
• Ensure all communication materials that are developed and distributed by the
grantee are approved by CLPPP if MDHHS funds are used.
Grantees Focus Areas:
• District Health Department #4
• Ingham County Health Department
• Jackson County Health Department
• Kalamazoo County Health and Community Services Department
PROJECT: CSHCS Care Coordination
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis
Beneficiaries enrolled in CSHCS with identified needs may be eligible to receive Care
Coordination Services as provided by the local health department. In addition,
beneficiaries with either CSHCS, CSHCS and Medicaid, or Medicaid only (no CSHCS)
may be eligible to receive Case Management services if they have a CSHCS medically
eligible diagnosis, complex medical care needs and/or complex psychosocial situations
which require that intervention and direction be provided by the local health department.
LHD staff includes registered nurses (RNs), social workers, or paraprofessionals under
the direction and supervision of RNs. Services are reimbursed on a fee for services
basis, as specified in Attachment IV Notes.
Reporting Requirements (if different than contract language)
Case Management and Care Coordination services within a specific Case Management
role cannot be billed during the same LHD billing period, which is usually a fiscal quarter.
Care Coordination and Case Management Logs are submitted electronically via the
Children’s Healthcare Automated Support Services (CHASS) Billing Module to the
Contract Manager. Quarterly logs must be submitted with the financial status report.
Annual Narrative Progress Report
A brief annual narrative report is due by November 15 following the end of the fiscal year.
The reporting period is October 1 – September 30. The annual report will be submitted to
the Department and shall include:
• Summary of successes and challenges
• Technical assistance needs the Grantee is requesting the Department to address
• Brief description of how any local MCH funds allocated to CSHCS were used (e.g.
CSHCS salaries, outreach materials, mailing costs, etc.), if applicable
• The unduplicated number of CSHCS eligible clients assisted with CSHCS
enrollment.
• The unduplicated number of CSHCS clients assisted in the CSHCS renewal
process.
Definitions
Unduplicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment
is defined as:
Number of CSHCS eligible clients the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete the CSHCS enrollment process during the
fiscal year. This assistance includes, but is not limited to, helping the family obtain
necessary medical reports to determine clinical eligibility, completing the CSHCS
Application for Services, completing the CSHCS financial assessment forms, etc.
Assistance does not include mailed letters to the family.
Unduplicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process
is defined as:
Number of CSHCS enrollees the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete and/or submit documents required for the
Department to make a determination whether to continue/renew CSHCS coverage during
the fiscal year. “Assisted” may also include collaboration with the client’s Medicaid Health
Plan. Assistance does not include mailed letters to the family.
Any additional requirements (if applicable)
Case Management services address complex needs and services and include an initial
face-to-face encounter with the beneficiary/family. Case Management requires that
services be provided in the home setting or other non-office setting based on family
preference. Beneficiaries are eligible for a maximum of six billing units per eligibility year.
Services above the maximum of six require prior approval by MDHHS. To request
approval, the LHD must submit an exception request, including the rationale for additional
services, to MDHHS. Limitations on the need for and number of Case Management
service units are set by MDHHS and must be provided by a specific Case Management
role, in accordance with training and certification requirements.
Staff must be trained in the service needs of the CSHCS population and demonstrate skill
and sensitivity in communicating with children with special needs and their families.
Care Coordination is not reimbursable for beneficiaries also receiving Case Management
services during the same LHD billing period, which is usually a calendar quarter. In the
event Care Coordination services are no longer appropriate and Case Management
services are needed, the change in services may only be made at the beginning of the
next billing period.
PROJECT: CSHCS Medicaid Elevated Blood Lead Case Management
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The local health department will complete in-home elevated blood lead (EBL) case
management (CM) services, with parental consent, for children less than age 6 in their
jurisdiction enrolled in Medicaid with a blood lead level equal to or greater than 3.5
µg/dL as determined by a venous test. EBL CM will be conducted according to the
“Case Management Guide for Children with Elevated Blood Lead Levels” that is
provided by the Childhood Lead Poisoning Prevention Program (CLPPP), Michigan
Department of Health and Human Services (MDHHS). For each child eligible for EBL
CM, efforts to contact the family to provide CM services and specific services provided
must be documented in the child’s electronic record in the Healthy Homes and Lead
Poisoning Prevention Surveillance System (HHLPSS) database.
Reporting Requirements (if different than contract language)
Quarterly FSR and FSR Supplemental Attachment
Submit request for reimbursement through EGrAMS based on the “fixed unit rate”
method. The fixed rate for case management services is $201.58 per home visit, for up
to 6 home visits. Additionally, a FSR supplemental attachment form is required to be
uploaded in EGrAMS that specifies the number of children and home visits for which
reimbursement is being requested on. The FSR and the FSR supplemental attachment
form must be submitted no later than thirty (30) days after the close of the quarter.
Quarterly Case Management Logs
A complete spreadsheet of CM activities is due quarterly, submitted electronically
through the CLPPP’s secure DCH-File Transfer Site available through MiLogin, using a
template provided by CLPPP. The quarterly spreadsheet must be submitted no later
than thirty (30) days after the close of the quarter.
Annual Report
An annual report is required covering the reporting period for the fiscal year is October 1
– September 30. The format and due date for the submission will be determined by
CLPPP, and communicated to the local health departments.
Reporting Time Period Due dates for quarterly spreadsheet, FSR,
and supplemental form
October 1 – December 31 January 31
January 1 – March 31 April 30
April 1 – June 30 July 30
July 1 – September 30 October 20
Any additional requirements (if applicable)
The local health department shall:
• Have CM conducted by a registered nurse trained by MDHHS CLPPP. To be
reimbursed for a home visit, the visit must be completed by a registered nurse.
• Sign up for the DCH-File Transfer Site available through MiLogin. This site will be
used for data sharing of confidential information.
• Have an agreement with all Medicaid Health Plans in their jurisdiction that allows
for sharing of Personal Health Information.
• Identify and initiate contact with families of all Medicaid-enrolled children with
EBLLs.
• Complete case management activities according to the MDHHS CLPPP Case
Management Guide.
• Document all required case management activities in the child’s electronic file in
the HHLPPS database. Required documentation includes an initial home visit
form, follow-up visit forms, dates of chelation therapy, and plan of care.
PROJECT: CSHCS Medicaid Outreach
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis
Local Health Departments may perform Medicaid Outreach activities for
CSHCS/Medicaid dually enrolled clients and receive reimbursement at a 50% federal
administrative match rate based upon their CSHCS Medicaid dually enrolled caseload
percentage and local matching funds.
Reporting Requirements (if different than contract language)
See Attachment I for specific budget and financial requirements.
Any additional requirements (if applicable)
N/A
PROJECT TITLE: CSHCS Outreach and Advocacy
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
Local Health Departments (LHDs) throughout the state serve children with special health
care needs in the community. The LHD acts as an agent of the CSHCS program at the
community level. It is through the LHD that CSHCS succeeds in achieving its charge to
be community-based. The LHD serves as a vital link between the CSHCS program, the
family, the local community and the Medicaid Health Plan (as applicable) to assure that
children with special health care needs receive the services they require covering every
county in Michigan.
LHD is required to provide the following specific outreach and advocacy services:
• Program representation and advocacy
• Application and renewal assistance
• Link families to support services (e.g. The Family Center, CSHCS Family Phone Line,
the CSHCS Family Support Network (FSN), transportation assistance, etc.)
• Implement any additional MPR requirements
• Care coordination
• Budget and Agreement Requirement and Grantee
• Submission of all documents via the document management portal, as required
Reporting Requirements (if different than agreement language):
Annual Narrative Progress Report
A brief annual narrative report is due by November 15 following the end of the fiscal year.
The reporting period is October 1 – September 30. The annual report will be submitted to
the Department and shall include:
• Summary of successes and challenges
• Technical assistance needs the Grantee is requesting the Department to address
• Brief description of how any local MCH funds allocated to CSHCS were used (e.g.
CSHCS salaries, outreach materials, mailing costs, etc.), if applicable
• The unduplicated number of CSHCS eligible clients assisted with CSHCS
enrollment.
• The unduplicated number of CSHCS clients assisted in the CSHCS renewal
process.
Definitions
Unduplicated Number of CSHCS Eligible Clients Assisted with CSHCS Enrollment
is defined as:
Number of CSHCS eligible clients the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete the CSHCS enrollment process during the
fiscal year. This assistance includes, but is not limited to, helping the family obtain
necessary medical reports to determine clinical eligibility, completing the CSHCS
Application for Services, completing the CSHCS financial assessment forms, etc.
Assistance does not include mailed letters to the family.
Unduplicated Number of CSHCS Clients Assisted in the CSHCS Renewal Process
is defined as:
Number of CSHCS enrollees the Grantee provided one-on-one (in person or via
telephone) substantial assistance to complete and/or submit documents required for the
Department to make a determination whether to continue/renew CSHCS coverage during
the fiscal year. “Assisted” may also include collaboration with the client’s Medicaid Health
Plan. Assistance does not include mailed letters to the family.
Any additional requirements (if applicable):
Relationship between Grantees and Medicaid Health Plans:
The Grantee must establish and maintain care coordination agreements with all Medicaid
Health Plans for CSHCS enrollees in the Grantees service area. Grantees and the
Medicaid Health Plans may share enrollee information to facilitate coordination of care
without specific, signed authorization from the enrollee. The enrollee has given consent
to share information for purposes of payment, treatment and operations as part of the
Medicaid Beneficiary Application.
Care coordination agreements between Grantees and the Medicaid Health Plans will be
available for review upon request from the Department.
The agreement must address all the following topics:
• Data sharing
• Communication on development of Care Coordination Plan
• Reporting requirements
• Quality assurance coordination
• Grievance and appeal resolution
• Dispute resolution
• Transition planning for youth
PROJECT: CSHCS Vaccine Initiative
Start Date: 10/01/2023
End Date: 06/30/2024
Project Synopsis
Local Health Departments are eligible to receive funding to support efforts to increase
vaccination rates among children with disabilities and special health care needs, along
with parents and family members of children with special health care needs. Eligible
activities include incorporating the promotion of adherence to MDHHS vaccination
guidelines into existing interactions and communications with CSHCS families,
accommodations for serving children with special needs into existing or established
community vaccination efforts, and additional vaccination outreach and promotion efforts
focused on child populations with special needs. Eligible activities should include a focus
on vaccinations for COVID-19 but can also include a broader focus on adherence to
recommended pediatric vaccination schedules. Children with disabilities and special
health care needs includes children enrolled in CSHCS but can also include children with
special health care needs that are not enrolled in or medically eligible for CSHCS.
Reporting Requirements (if different than contract language)
Annual Narrative Progress Report
With Final FSR, please submit a brief narrative with the following information:
1. Describe how these funds have been used to promote vaccinations among
children with special needs and their family members. When feasible, include a
list of events or activities that have been supported with these funds, a total for the
number of events or activities, and an estimate of the number of families reached
through these activities.
2. Describe any local partnerships or collaborations used to reach families for
vaccinations, including partnerships with health care providers and/or provider
organizations. Please note any challenges or successes.
3. Describe any innovative or unique methods used to reach families with a child with
special health care needs to promote or encourage adherence to recommended
vaccination guidelines.
Any additional requirements (if applicable)
N/A
PROJECT: Eastern Equine Encephalitis Virus Surveillance
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Conduct county-level mosquito surveillance to determine the presence and abundance of
EEEV vectors and virus in various habitat locations. This information will be used to
inform future surveillance efforts at the county level. If EEEV positive mosquitoes are
found, LHD’s will be able to provide early warning of increased EEE risk in their area.
Additionally, the funding will support the creation of subject matter expertise at the local
level regarding surveillance for EEEV and build capacity for future EEEV prevention and
control activities.
Reporting Requirements (if different than contract language)
The recipient shall submit weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe@michigan.gov) and
Rachel Wilkins (rwilkins3@michigan.gov) at the MDHHS EZID Section. A final report on
all activities completed is due by October 15.
Any additional requirements (if applicable)
Funding is to be used to support personnel, mosquito trapping equipment and supplies,
and travel related to conducting mosquito surveillance in areas with historic cases of EEE
virus or suitable habitat for the EEE vector mosquitoes, and to submit appropriate
mosquito species to the MDHHS BOL for pathogen testing. When EEE virus is identified,
the grantee will communicate to the community about the increasing risk for EEE virus
infection and actions to take to prevent mosquito bites.
EEE Vector Surveillance:
To support local public health jurisdictions with known historical EEEV risk to conduct a
survey for EEEV vector mosquitoes Culiseta melanura and Coquillettidia perturbans.
Funded counties will work with MDHHS EZID staff to:
1) Identify suitable habitat for these mosquito species using land survey and other
data.
2) Select 5 sampling (for example, sites near a previous EEE human and/or animal
case or those with suitable habitat for the vector mosquito species)
3) Conduct trapping for 2 nights/week from June 20-Sept. 9 (12 weeks)
4) Sort and identify species collected.
5) Submit target species to MDHHS BOL for pathogen testing.
The Department’s Emerging & Zoonotic Infectious Diseases (EZID) Section will provide
the Grantee with the following support:
• Training for staff associated with the project (Spring 2022)
• Trapping equipment necessary to collect mosquitoes
• Pathogen testing of mosquito pools for EEE virus provided by MDHHS Bureau of
Laboratories
• Entomologic and epidemiologic support to guide trapping efforts
PROJECT: Eat Safe Fish
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The Grantee will collaborate with the Department and the EPA Region V Saginaw
Community Information Office to deliver a uniform message for the Saginaw River and
connected waters regarding the fish and wild game consumption advisories within the tri-
county area (Midland, Saginaw, and Bay).
Reporting Requirements (if different than contract language)
1. Track and report output measures.
2. Write and submit quarterly reports and an annual report to the Department.
• Submit draft quarterly reports within 15 days after the end of each quarter.
• Annual reports upon request.
Any additional requirements (if applicable)
1. The grantee will develop a plan to distribute that message using existing health
department programs, the medical community, special events, and community
service providers to communicate with the at-risk population.
2. The grantee will get approval from the Department program manager and for any
changes to the Saginaw and Bay County Cooperative Agreement Scope of Work
including budget and budget narratives.
3. The grantee will provide appropriate staff to fulfill the following objectives and
outputs as detailed:
• Comply with the Saginaw and Bay County Cooperative Agreement budget and
budget narratives as describe in the scopes of work provided to the BCHD
program manager as applicable from October 1 to September 30.
• Provide 30 hours of health education and community outreach per week.
• Conduct health education and community outreach in Saginaw, Midland, and Bay
Counties. Activities will include, but not be limited to, internal BCHD distribution,
health care provider outreach, and key event participation.
• Track hours to comply with cost recovery requirements.
• Development, Printing, and Distribution of Outreach Materials and implementation
of Display Booth.
• Identify, track, and record of materials distributed at additional locations within
Midland, Bay, and Saginaw Counties.
• Make payment for the replacement of signage on the Tittabawasse and Saginaw
Rivers.
• Conduct Capacity Building in Saginaw, Midland and Bay Counties
• Actively seek out new community partners in Saginaw, Midland and Bay Counties.
• Participate in bi-monthly SBCA teleconference.
• Provide Presentation of display booth at select community events in coordination
with EPA Region V Saginaw Community Information Office.
• Conduct Outreach though existing BCHD Programs such as WIC, Immunizations,
programs for young mothers, or other programs reaching the target population.
• Assist the EPA Region V Saginaw Community Information Office with community
outreach.
• Outreach to Health Care Providers.
PROJECT: EGLE Drinking Water and Onsite Wastewater Management
Start Date: 10/1/2023
End Date: 09/30/2024
Project Synopsis
State funding for ELPHS shall support, and the Grantee shall provide for, all of the following
required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as amended,
Part 24 and Act No. 336, of 1998 Section 909:
Infectious/Communicable Disease Control
Sexually Transmitted Disease
Immunization
On-Site Wastewater Treatment Management
Drinking Water Supply
Food Service Sanitation
Hearing
Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee’s cost allocation plan.
• ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment and Improvement, Public Policy Development,
Health Services Administration, Quality Assurance, Creating and Maintaining a
Competent Work Force and Local Public Health Accreditation. These services may
be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
• First and second party fees earned in each required service program may be used
only in that required service program.
• State ELPHS funding is subject to local maintenance of effort compliance.
Distribution of state ELPHS funds shall only be made to agencies with total local
general fund public health services spending in fiscal year (FY) 2023 of at least
the amount expended in FY 92/93. To be eligible for any of the State funding
increases from FY 94/95 through FY 2023, the FY 92/93 Local Maintenance of
Effort Level must be met.
Reporting Requirements (if different than contract language)
All final amendment ELPHS funding shift request memos need to be submitted no
later than May 1.
• Please send the official memo to request ELPHS funding shifts by email to Laura
de la Rambelje (DelaRambeljeL@michigan.gov) and copy Carissa Reece
(ReeceC@Michigan.gov).
Any Additional Requirements (if applicable)
• Assure the availability and accessibility of services for the following basic health
services: Prenatal Care; Immunizations; Communicable Disease Control; Sexually
Transmitted Disease (STD) Control; Tuberculosis Control; Health/Medical Annex of
Emergency Preparedness Plan.
• Fully comply with the Minimum Program Requirements for each of the required
services.
• Grantee will be held to accreditation standards and follow the accreditation process
and schedule established by the Department for the required services to achieve
full accreditation status. Grantees designated as “not accredited” may have their
Department allocations reduced for Departmental costs incurred in the assurance
of service delivery. The accreditation process is based upon the Minimum Program
Standards and scheduled on a three-year cycle. The Minimum Program Standards
include the majority of the required Department reviews. Some additional reviews,
as mandated by the funding agency, may not be included in the Program
Standards and may need to be scheduled at other times.
Onsite Wastewater Management
The Grantee shall perform the following services for private single- and two-family
homes and other establishments that generate less than 10,000 gallons per day of
sanitary sewage:
• Maintain an up-to-date regulation for on-site wastewater treatment systems
(Systems). The regulation shall be supplemented by established internal policies
and procedures. Technical guidance for staff that defines site suitability
requirements, the basis for permit approval and/or denial, and issues not specifically
addressed by the regulation shall be provided.
• Evaluate all parcels to determine the suitability of the site for the installation of
initial and replacement Systems in accordance with applicable regulation(s).
These evaluations shall be conducted by a trained sanitarian or equivalent and
shall consist of a review of the permit application for the installation of a System
and a physical evaluation of the site to determine suitability.
• Accurately record on the permit to install the initial or replacement System or on an
attachment to the permit the site conditions for each parcel evaluated including soil
profile data, seasonal high-water table, topography, isolation distances, and the
available area and location for initial and replacement Systems. The requirement
for identifying a replacement System applies to issuance of new construction
permits only.
• Issue a permit, prior to construction, in accord with applicable regulation(s) for
those sites that meet the criteria for the installation of a System. The permit shall
include a detailed plan and/or specification that accurately define the location of the
initial or replacement System, System size, other pertinent construction details, and
any documented variances.
• Provide and keep on file formal written denials, stating the reason for denial, for
those applications where site conditions are found to be unsuitable.
• Conduct a construction inspection prior to covering each System to confirm that the
completed System complies with the requirements of the permit that has been
issued. Maintain, on file, an accurate individual record of each inspection
conducted during construction of each system. In limited circumstances where
constraints prohibit staff from completing the required construction inspection in a
timely manner, an effective alternate method to confirm the adequacy of the
completed System shall be established. The effective alternative method shall be
utilized for no more than ten (10) percent of the total number of final inspections
unless specific authorization has been granted by the State for other percentage.
The results of all such inspections or an alternate method shall be clearly
documented.
• Maintain an organized filing system with retrievable information that includes
documentation regarding all site evaluations, permits issued or denied, final
inspection documentation, and the results of any appeals.
• Conduct review and approval or rejection of proposed subdivisions, condominiums
and also land divisions under one acre in size for site suitability according to the
statutes and Administrative Rules for Onsite Water Supply and Sewage Disposal
for Land Divisions and Subdivisions.
• Utilize the State’s “Michigan Criteria for Subsurface Sewage Disposal” (Criteria) for
Systems other than private single- and two-family homes that generate less than
10,000 gallons per day. Systems treating less than 1,000 gallons per day may be
approved in accordance with the Grantee’s regulation. Advise the State prior to
issuance of a variance from the Criteria. Variances are only to be issued by the
Director of Environmental Health of the Grantee after consultation with the State.
Appeals of any decision of the Grantee pursuant to the Criteria including systems
treating less than 1,000 gallons evaluated in accordance with the Grantee’s
regulation shall only be made to the State.
• Maintain quarterly reports that summarize the total number of parcels evaluated,
permits issued, alternative or engineered plans reviewed, and number of appeals,
number of inspections during construction, number of failed systems evaluated,
and number of sewage complaints received and investigated for each residential
(single and two-family homes) and non-residential properties. The report forms
EQP2057a.1 (Non-Residential) and EQP2057b.1 (Residential) are available on the
EGLE website. All quarterly reports are to be submitted directly to EGLE, to the
address noted on the form, within fifteen (15) days following the end of each
quarter.
• Review all engineered or alternative System plans. Conduct adequate
inspections during the various phases of construction to ensure proper installation.
• Collect data at the time of permit issuance when a System has failed to document
the System age, design, site conditions, and other pertinent factors that may have
contributed to the failure of the original System. Evaluations shall record
information indicated on the EGLE Onsite Wastewater Program Residential and
Non-Residential Information forms. The results for all failed Systems evaluated
shall be maintained in a retrievable file or database and summarized in an annual
calendar year data report. Annual summaries of failed system data shall be
provided to EGLE for input into the state-wide failed system database. The EGLE
Onsite Wastewater Program Residential and Non-Residential Information forms
shall be provided to the State no later than February 1st of the year following the
calendar year for which the data has been collected.
• Provide training for staff involved in the Program as necessary to maintain
knowledge of current regulations and internal policies and procedures and to keep
staff informed of technological improvements and advancements in Systems.
• Establish and maintain an enforcement process that is utilized to resolve violations
of the Local Entity and/or State’s rules and regulations.
• Maintain complaint forms and a filing system containing results of complaint
investigations and documentation of final resolution. Investigate and respond to all
complaints related to onsite wastewater in a timely manner.
Drinking Water:
The Grantee shall perform the following services including but not limited to:
• Perform water well permitting activities, pre-drilling site reviews, random
construction inspections, and water supply system inspections for code compliance
purposes with qualified individuals classified as sanitarians or equivalent.
• Assign one individual to be responsible for quarterly reporting of the data and to
coordinate communication with the assigned State staff. Reports shall be submitted
no later than fifteen (15) days following the end of the quarter on forms provided by
the State. The report form EQP2057 (07/2019) is available on the EGLE website.
All quarterly reports are submitted directly to the EGLE address noted on the form.
• Perform Minimum Program Requirements (MPRs) activities and associated
performance indicators. These are available on the EGLE website. Guidance
regarding the MPRs and indicators is available in the “Local Health Department
Guidance Manual for the Private and Type III Drinking Water Supply Systems.”
The guidance manual is available online at Michigan.gov/WaterWellConstruction.
PROJECT: Food Service Sanitation (FOOD ELPHS)
Start Date: 10/1/2023
End Date: 09/30/2024
Project Synopsis
State funding for ELPHS shall support and the Grantee shall provide for all the following
required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000, as
amended, Part 24 and Act No. 336, of 1998 Section 909:
Infectious/Communicable Disease Control
Sexually Transmitted Disease
Immunization
On-Site Wastewater Treatment Management
Drinking Water Supply
Food Service Sanitation
Hearing
Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee’s cost allocation plan.
• ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment & Improvement, Public Policy Development,
Health Services Administration, Quality Assurance, Creating & Maintaining a
Competent Work Force and Local Public Health Accreditation. These services
may be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
• First- and second-party fees earned in each required service program may be
used only in that required service program.
Reporting Requirements (if different than contract language)
All final amendment ELPHS funding shift request memos need to be submitted
no later than May 1st.
• Please send the memo to Laura de la Rambelje
(DelaRambeljeL@michigan.gov) and copy Carissa Reece
(ReeceC@michigan.gov)
Food Service Establishment Licensing
• Provide updates to MDARD on the 1st and 15th of each month, as necessary to:
• Provide a list of food service establishments approved for licensure/license
issued.
• Provide a list of food service establishment licenses that have not been
approved for licensure and are considered voided or deleted.
• Return the actual licenses to MDARD that are to be voided or deleted.
• Return renewal license applications and licenses that require correction.
Mark the corrections on the renewal application.
Temporary Food Establishment Licensing
Provide updates to MDARD on the 1st and 15th of each month, as necessary, to
provide:
• A copy of each temporary food establishment license issued.
• A list of lost or voided licenses by license number.
Any additional requirements (if applicable)
Food Service Establishment Licensing
• Accept responsibility for all licenses specified in the “Record of Licenses
Received.”
• Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Temporary Food Establishment Licensing Upon receipt, sign and return the “Record of Licenses Received” to MDARD.
Issue licenses in accordance with the Michigan Food Law 2000, as amended.
Make every effort to issue temporary food establishment licenses in numerical order.
Michigan Department of Agriculture and Rural Development (MDARD) Agrees to:
Food Service Establishment Licensing
• Furnish pre-printed food service establishment license applications and pre-
printed licenses to the Grantee for each licensing year (May 1 through April 30)
using previous year active license data.
• Provide a count of all licenses sent to the Grantee titled “Record of Licenses
Received.”
• Reprint any licenses requiring correction and send corrected copies to the
Grantee.
• Bill the local health department for state fees upon notification by Grantee that
the license has been approved and issued.
Temporary Food Service Establishment Licensing
• Furnish blank temporary food service license application forms (forms FI-231, FI-
231A) and blank Combined License/Inspection forms (FI-229) upon request from
the local health department.
• Furnish a “Record of Licenses Received” with each order of Combined
Licenses/Inspection forms.
• Periodically reconcile temporary food service establishment licenses sent to
the Grantee with the licenses that have been issued (copy returned to MDARD).
• Bill the local health department for state fees upon notification by the
Grantee that the license has been approved and issued.
PROJECT TITLE: ELPHS Hearing and Vision
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The Hearing and Vision Programs screen over 1 million preschool and school-age
children each year. Screening services are conducted in schools, Head Start, and
preschool centers by local health department (LHD) hearing and vision
technicians. Children who fail their vision screening are referred to a licensed eye
doctor for an exam and treatment. Follow-up is conducted by the LHD to confirm that
the child gets the care that they need. Children who do not pass their hearing screening
are referred to their primary care physician, audiologist, or Ear, Nose, and Throat
physician for diagnosis, treatment, and recommendations.
Reporting Requirements (if different than agreement language):
Upon completion of the FY24 contract, grantees must submit a School-Based Hearing
and Vision Program Annual Narrative Progress Report to MDHHS-Hearing-and-
Vision@michigan.gov and cc: respective Program Consultants (Jennifer Dakers,
dakersj@michigan.gov and Rachel Schumann, schumannr@michigan.gov
The report must include:
1. Successes-accomplishments of the program/technician(s)
2. Challenges- issues that created difficulty in managing the program and/or
performing screening services.
3. Technical Assistance Needs- request support from the Hearing and/or Vision
Consultant.
4. Additional Feedback-questions in this section will change annually based on
relevant/current program topics/issues.
• Annual Narrative Report must be approved by the MDHHS Hearing & Vision
Coordinators for their respective programs.
• MDHHS will provide a template for reporting.
• Each Local Health Department (coordinators and technicians) should keep an
ongoing log of Successes and Challenges to compile and share at the end of the
fiscal year.
• Final reports are submitted by the grantee to MDHHS. The reports are due 30
days after the end of the fiscal year.
For questions regarding these reports, please contact:
Jennifer Dakers, MDHHS Hearing Consultant, dakersj@michigan.gov
Rachel Schumann, MDHHS Vision Consultant, schumannr@michigan.gov
Any additional requirements (if applicable):
Grantees must adhere to established Minimum Program Requirements for School-
Based Hearing & Vision Services as outlined in the Michigan Local Public Health
Accreditation Program 2019 MPR Indicator Guide.
PROJECT: MDHHS Essential Local Public Health Services (ELPHS)
Start Date: 10/1/2023
End Date: 09/30/2024
Project Synopsis
State funding for ELPHS shall support and the Grantee shall provide for all of the
following required services in accordance with P.A. 368, of 1978 and P.A. 92 of 2000,
as amended, Part 24 and Act No. 336, of 1998 Section 909:
Infectious/Communicable Disease Control
Sexually Transmitted Disease
Immunization
EGLE Drinking Water and Onsite Wastewater Management
Food Service Sanitation
Hearing
Vision
• State funding for ELPHS can support administrative cost for the eight required
services including allowable indirect cost, or a Grantee’s cost allocation plan.
• ELPHS funding can also be used to fund other core health functions including:
Community Health Assessment & Improvement, Public Policy Development,
Health Services Administration, Quality Assurance, Creating & Maintaining a
Competent Work Force and Local Public Health Accreditation. These services
may be budgeted separately as part of the Administrative Budget element.
• Net allowable expenditures are the authorized actual/allowable expenditures
(total costs less specified exclusions). Available funding is also limited by state
appropriations.
• First and second party fees earned in each required service program may be
used only in that required service program.
• State ELPHS funding is subject to local maintenance of effort compliance.
Distribution of state ELPHS funds shall only be made to agencies with total local
general fund public health services spending in FY 20/19 of at least the amount
expended in FY 92/93. To be eligible for any of the State funding increases from
FY 94/95 through FY 22/23, the FY 92/93 Local Maintenance of Effort Level must
be met.
Reporting Requirements (if different than contract language)
1. Local maintenance of effort reports are due:
• Projected Current Fiscal Year – October 30
• Prior Fiscal Year Actual – March 31
2. A final statewide cost settlement will be performed to assure that all available
ELPHS funds are fully distributed and applied for required services.
2. Each LHD will be required to complete the MDHHS ELPHS Detail report at the
end of Quarter 2 and Quarter 4.
Any additional requirements (if applicable)
All final amendment ELPHS funding shift request memos need to be submitted no
later than May 1st.
• Please send the memo to Laura de la Rambelje
(DelaRambeljeL@michigan.gov) and copy Carissa Reece
(ReeceC@michigan.gov)
• Assure the availability and accessibility of services for the following basic health
services: Prenatal Care; Immunizations; Communicable Disease Control;
Sexually Transmitted Disease (STD) Control; Tuberculosis Control;
Health/Medical Annex of Emergency Preparedness Plan.
• Fully comply with the Minimum Program Requirements for each of the required
services.
• Grantee will be held to accreditation standards and follow the accreditation
process and schedule established by the Department for the required services to
achieve full accreditation status. Grantees designated as “not accredited” may
have their Department allocations reduced for Departmental costs incurred in the
assurance of service delivery. The accreditation process is based upon the
Minimum Program Standards and scheduled on a three-year cycle. The
Minimum Program Standards include the majority of the required Department
reviews. Some additional reviews, as mandated by the funding agency, may not
be included in the Program Standards and may need to be scheduled at other
times.
PROJECT: Emerging Threats – Hepatitis C
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Funds are provided to grantees to increase local capacity to make improvements in
hepatitis C virus (HCV) testing, case follow-up, and linkage to care. Progress will be
tracked by monitoring case completion rates and HCV linkage to care within the MDSS
and evaluating HCV testing volumes submitted by grantees through STARLIMS.
Reporting Requirements (if different than contract language)
• Grantees will keep a log of MDSS IDs on client interactions and linkage to care
progress for submission to the MDHHS Viral Hepatitis Unit on a quarterly basis.
• Grantees will participate on semi-routine group conference calls and/or 1:1
technical assistance check in calls to discuss best practices and identify barriers.
• Grantees will collect and submit specimens to the MDHHS Bureau of Laboratories
for HCV testing through their public health clinics.
Target Requirements
Grantees will meet the following objectives for Hepatitis C, Chronic follow-up:
Target 1: Interview attempted on 90% of Hepatitis C, Chronic cases within 30 days of
referral date.
Target 2: Interview completed on 50% of Hepatitis C, Chronic cases within 60 days of
referral date.
Target 3: Hepatitis C RNA test result on 50% of Probable Hepatitis C, Chronic cases
within 90 days of referral date.
Violation Monitoring:
The inability to meet the metrics will elicit the following response from MDHHS related to
this funding:
• Technical assistance
• Corrective action/performance improvement plans with MDHHS
• Reallocation of funds.
Any additional requirements (if applicable)
• Grantees will document process for carrying out the HCV project during the
current pandemic
• Grantees will document best practices or protocols for HCV case investigation and
linkage to care
• Grantees will document pathways to link patients to medical care
• Grantees may collaborate with the State Viral Hepatitis Unit for assistance
• Grantees can submit HCV specimens to the MDHHS Bureau of Laboratories at no
cost to them or the client
PROJECT: EMPOWERING YOUTH TODAY
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The purpose of this project is to implement a comprehensive, evidence-based positive
youth development program focusing on sexual risk avoidance for youth 10-15 years of
age.
Reporting Requirements
The Grantee shall submit the following reports and data via the appropriate reporting
mechanism on the dates specified below:
Report Time Period Due Date Submit To
Work Plan
October 1 - December 31 January 30
Email to MDHHS
Coreyr1@michigan.gov
January 1 - March 31 April 15
April 1 - June 30 July 30
July 1 - September 30 October 15
Program
Narrative
October 1 - December 31 January 30
Email to MDHHS
Coreyr1@michigan.gov
January 1 - March 31 April 15
April 1 - June 30 July 30
July 1 - September 30 October 15
Local Match
Report
October 1 - December 31 January 30
Email to MDHHS
Coreyr1@michigan.gov
January 1 - March 31 April 15
April 1 - June 30 July 30
July 1 - September 30 October 15
Participant
Level Data
(Youth)
October 1 - December 31 January 5
REDCap
https://chc.mphi.org
January 1 - March 31 April 5
April 1 – June 30 July 5
July 1 - September 30 October 5
Program
Level Data
(Performance
Measures)
October 1 - September 30
(MPHI will open this data
section in REDCap in June)
July 15* REDCap
https://chc.mphi.org
*Due date dependent upon federal requirements
PROJECT TITLE: Ending the HIV Epidemic Implementation
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The purpose of this project is to implement activities to support the objectives of the
CDC PS20-2010 Ending the HIV Epidemic in Wayne County. The purpose of these
objectives is to reduce the incidence of HIV in and improve the overall health and well-
being of residents of Wayne County.
Reporting Requirements:
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) Report submission
Counseling, Testing, and referrals
Quality Control Reports Monthly 10th of the following
month Department Staff
Daily Client Logs Monthly 10th of the following
month Department Staff
Test Kit Inventory Log Monthly 10th of the follow
month Department Staff
HIV Testing
Proficiencies Bi- annually Reviewed during
site visits Department Staff
HIV Testing
Competencies Annually
Sent to MDHHS
before the end of
the fiscal year
Department Staff
EMR testing** Monthly By the 10th of the
following month Department Staff
Non-Reactive Results As needed Within 7 days of test APHIRM
Reactive Results As needed Within 24 hours of
test APHIRM
Case Report Forms
As needed in
the event of a
reactive result
Adult Case Report
Form Directions
LMS
MDHHS Surveillance
Partner Services & Linkage to Care (as applicable)
Linkage to Care and
Partner Services
Interview***
As needed Within 30 days of
service APHIRM
Internet Partner
Services (IPS) and Ongoing Within 30 days of
service APHIRM
Partner Services
Interview****
Disposition on Partners
of HIV Cases Ongoing Within 30 days of
service APHIRM
Evidence Based Risk Reduction Activities (as applicable)
SSP Data Report, Quarterly 10th of the following
month
Syringe Utilization
Platform (SUP)
Clinical HIV/STI services (as applicable)
340b PrEP Prescription
Log Weekly Every Friday by the
close of business
DCH File Transfer –
MDHHS-340B PrEP PT
ADT*****
Billing Revenue Report Quarterly
10th of the following
month
Department Staff
STI 340B
Utilization/Inventory
Report,
Quarterly
Within 10 days after
the end of the
quarter
Log into
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will be
transferred automatically
to ScriptGuide/BHSP
*CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social
Marketing data; Evidence based intervention data; other prevention services and activities,
if applicable
** Aggregated testing data
***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was
interviewed by Partner Services within 30 days of diagnosis)
****(e.g. client identify dating apps used to meet partners), if applicable
*****https://milogintp.michigan.gov
Reporting Requirements:
A. The Grantee will clean-up missing data by the 10th day after the end of each
calendar month. Grantee must report required variables as outlined by National
HIV Monitoring and Evaluation (NHM&E) and MDHHS.
B. Any such other information as specified in the Statement of Work, Attachment A
shall be developed and submitted by the Grantee as required by the Bureau of
HIV and STI Programs (BHSP).
C. The Quality Control and Daily Client Logs may be sent to the Contract Manager
via:
Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS
CTR inbox (MDHHS-HIV-CTR@michigan.gov)
Fax - (517) 241-5922
Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
D. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by BHSP.
E. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
Any additional Requirements:
Publication Rights
1. When issuing statements, press releases, requests for proposals, bid solicitations
and other documents describing projects or programs funded in whole or in part
with Federal fund, the Grantee receiving Federal funds, including but not limited to
State and local governments and recipients of Federal research grants, shall
clearly state:
a. The percentage of the total costs of the program or project that will be
financed with Federal funds.
b. The dollar amount of Federal funds for the project or program.
c. Percentage and dollar amount of the total costs of the project or program
that will be financed by non-governmental sources.
2. The Grantee will submit all educational materials (e.g., brochures, posters,
pamphlets, and videos) used in conjunction with program activities to BHSP for
review and approval prior to their use, regardless of the source of funding used to
purchase these materials. Materials may be emailed to: MDHHS-
HIVSTIoperations@michigan.gov.
Grant Program Operation
1. The Grantee will participate in BHSP needs assessment and planning activities,
as requested.
2. The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, etc. The Grantee is highly encouraged to
participate in other training offerings and information-sharing opportunities,
network detection response and interventions in collaboration with BHSP
opportunities provided by BHSP.
3. Each employee funded in whole or in part with federal funds must record time
and effort spent on the project(s) funded. The Grantee must:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. Denote accurately the percent of effort to the project. The percent of effort
may vary from month to month, and the effort recorded for funds must match
the percentage claimed on the FSR for the same period.
d. Submit a budget modification to BHSP in instances where the percentage of
effort of contract staff changes (FTE changes) during the contract period.
e. If there are any changes in staff or agency operations, please email MDHHS-
SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov.
4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with
guidelines and standards issued by BHSP and:
a. Provide medical oversight letter/agreement signed by a licensed physician is
necessary to collect specimens and order HIV antibody/antigen, HIV
genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C
testing. According to Part 15 of the Public Health Code MCL 333.17001(j),
‘practice of medicine’ is defined as
i. “the diagnosis, treatment, prevention, cure, or relieving of a human
disease, ailment, defect, complaint, or other physical or mental condition,
by attendance, advice, device, diagnostic test, or other means, or offering,
undertaking, attempting to do, or holding oneself out as able to do, any of
these act”.
b. Conduct quality assurance activities, guided by written protocol and
procedures. Protocols and procedures, as updated and revised Quality
assurance activities are to be responsive to: Quality Assurance for Rapid HIV
Testing, MDHHS. See “Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals.”
i. Ensure provision of Clinical Laboratory Improvement Amendments (CLIA)
certificate.
ii. Report discordant test results to BHSP
Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the
MDHHS CTR inbox (MDHHS-HIV-CTR@michigan.gov)
Fax - (517) 241-5922
iii. Ensure that staff performing counseling and/or testing with rapid test
technologies has completed, successfully, rapid test counselor certification
course or Information Based Training (as applicable), test device training,
and annual proficiency testing.
iv. If conducting blood draws, the grantee must conduct the packaging and
shipping training via Bureau of Laboratories. BashoreM@michigan.gov
v. Ensure that all staff and site supervisors have completed, successfully,
appropriate laboratory quality assurance training, blood borne pathogens
training and rapid test device training and reviewed annually.
vi. Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
vii. To maintain active test counselor certification, each HIV test counselor
must submit one competency per test device per year to the appropriate
departmental staff.
5. If conducting SSP, the grantee will develop programs using MDHHS guidance
documents and will address issues such as identification and registration of
clients, exchange protocols, education, and trainings for staff, and referrals.
a. Grantees will participate on monthly or quarterly conference calls to discuss
best practices and identify barriers.
6. If conducting PS, the Grantee will comply with guidelines and standards issued
by the Department. See “Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals.” The Grantee must:
a. Provide Confidential PS follow-up to infected clients and their at-risk partners
to ensure disease management and education is offered to reduce
transmission.
b. Effectively link infected clients and/or at-risk partners to HIV care and other
support services.
c. Work with Early Intervention Specialist to ensure infected clients are retained
in HIV care.
d. If applicable,
i. Procure TLO or a TLO-like search engine.
ii. Ensure staff that are utilizing TLO or TLO-search engine complete the
TLO training to maintain and understand the confidential use of the
system.
iii. Effectively utilize the Internet Partner Services (IPS) Guidance to provide
confidential PS follow-up to at-risk partners named by infected clients who
were identified to have been met through the use of dating apps.
iv. Ensure staff and site supervisors successfully complete the Internet
Partner Services Training.
v. Ensure staff conducting Internet Partner Services participant in monthly,
bi-monthly meetings, webinars or calls to discuss best practices and
identify barriers.
7. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
8. Funds generated by this program must be utilized to support the program,
including to hire a Mid-level provider, supporting staff, and program materials to
provide Pre-Exposure Prophylaxis (PrEP) services.
9. Any funds included in this agreement above must be re-invested in HIV/STI PrEP
services. This could mean improving, enhancing, and/or expanding your current
HIV/STI services or adding new services to improve patient health outcomes for
HIV/STI.
10. Any revenue or income generated via billing from this agreement must be
reinvested into this project.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State of
Michigan.
Software Compliance
1. The Grantee and its subcontractors are required to use APHIRM (formerly
Evaluation Web) to enter HIV client and service data into the centrally managed
database on a secure server.
2. The Grantee and its subcontractors are required to use APHIRM to enter PrEP
Cascade Data into the centrally managed database on a secure server.
3. The Grantee and its subcontractors are required to use APHIRM to enter EBI/
PrEP program data into the centrally managed database on a secure server.
4. The Grantee and its subcontractors are required to use APHIRM (formerly
Partner Services Web) to enter Partner Services interview, linkage to care data,
and identified dating apps through the use of Internet Partner Services (IPS)
where appropriate.
5. The Grantee and its subcontractors are required to use SHOARS to request
amendments, supplies, data, technical assistance and to register for trainings.
6. New staff needing access to APHIRM are required to submit the APHIRM user
request form through SHOARS.
7. The Grantee shall notify MDHHS immediately via email at MDHHS-SHOARS-
SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov of APHIRM users who
are separated from the agency for deactivation.
Mandatory Disclosures
1. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
2. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
3. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of, or
a defendant in, legal action. This includes, but is not limited to, events or notices
related to grievances by service recipients or Grantee or subcontractor
employees.
4. Any staff vacancies funded for this project that exceed 30 days.
a. All notifications should be made to BHSP by MDHHS-
HIVSTIoperations@michigan.gov.
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in
the BHSP SHOARS system. These roles must match what the agency has listed
for these roles in the EGrAMS system. If you have access related questions,
contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-
SUPPORT@michigan.gov .
3. TA will be provided, as requested, on the implementation of the HIV Prevention
program. This may include issues related to: APHIRM, Programs, Budget/Fiscal,
Grants and Contracts, Risk Reduction Activities, Training, or other activities
related to carrying out HIV prevention activities.
4. Training and TA will be provided in support of implementation of HIV testing as a
standard of care and use of rapid HIV tests.
Compliance with Applicable Laws
1. The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
PROJECT: Expanding, Enhancing Emotional Health (All Locations)
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The E3 program funds mental health staff in schools to provide one on one therapy and
small group therapy.
Reporting Requirements (if different than contract language)
The grantee shall submit all required reports in accordance with the Michigan Department of Health and Human Services’ (the Department’s) reporting requirements. These reports shall be submitted via E-GrAMS as described in the Department’s boilerplate language. Work plans will be submitted annually, attached to the original grant application at the beginning of the year. Quarterly work plan reports will be submitted, attached to the FSR, within 30 days of the end of the quarter. Work plans and work plan reports can also be submitted via e-mail to your appropriate E3 consultant: Gina Zerka: zerkag@michigan.gov or Mario Wilcox: wilcoxm7@michigan.gov MDHHS staff will evaluate all reports for completeness and adequacy.
All data previously reported will be submitted quarterly. The due dates are as follows:
a. Q1: Due January 30th,
b. Q2: Due April 30th,
c. Q3: Due July 30th and
d. Q4: Due September 30th.
All data shall continue to be entered into the Clinical Reporting Tool (CRT). See below for data definitions. The grantee shall permit the Department or its designee to visit and make an evaluation of the project as determined by the Contract Manager.
Number of Unduplicated Users (clients) by Demographic Designation per quarter
Definition of an Unduplicated User:
An unduplicated user is an individual who has presented themselves to the E3 Program
for service with the mental health provider (minimum Master’s prepared and licensed
mental health provider), and for whom a record has been opened. Opening a record
includes documenting an assessment, diagnosis and treatment plan. Once per year, the
user is counted to generate the number of unduplicated clients utilizing the E3 services
for that year.
Age Range Female Male Total
0-4
5-9
10-17
18-21
Number of Unduplicated Users (clients) by Race per quarter
White
Black/African-American
Asian
Native Hawaiian or Pacific Islander
American Indian or Alaskan Native
More than One Race
Number of Unduplicated Users (clients) by Ethnicity per quarter
Arab/Chaldean
Hispanic or Latino
Definition of a Visit:
A visit is a significant encounter between an E3 provider and a new (unduplicated) user
or established (duplicated) user. Each visit should be documented as appropriate to the
visit and provider (i.e., visits include an assessment, diagnosis and treatment plan
documented in the medical record and/or other documentation appropriate to the visit). A
user will likely have multiple visits per year.
Total Visits by Provider Type per quarter:
*Mental Health Provider must be minimum Master’s prepared and licensed. Mental
Health Provider visits are counted as “face to face” contacts.
*Telehealth Visits can be tele-conferencing and tele-phonic. Telehealth visits should be
counted when using this mechanism during visit.
Note: Telehealth visits should be counted only once, as a Telehealth visit.
Do not count as a visit with BOTH the mental health provider AND a Telehealth visit.
Visits by Type per quarter:
Count the visit by type of session provided. If the client was seen individually, count as an
individual visit. If the client was seen in a therapeutic group, count as a group visit. If a
client receives both individual and therapeutic group services, count both visit types.
QUALITY INDICATORS REPORT DEFINITIONS
For each of the following Quality Measures, report the YTD NUMBER each quarter.
Each quarter, your data will likely be equal to or greater than, the previous quarter. Note
that this is different than the quarterly reporting elements, where data is reported by
quarter for that specific quarter only.
Number of Unduplicated Clients Ages 10-21 Years with an Up-to-Date Depression
Screen:
Report the number of unduplicated clients up-to-date with depression screening. This
information could come directly from a behavioral health screener or risk assessment, so
the number screened (flagged) for depression may equal or be very close to the number
of behavioral health screeners and/or risk assessments completed. (Note this is not the
same as a depression assessment conducted by a provider.) Do not double count
clients who were screened (flagged) for depression using behavioral health screen or risk
assessment and who also completed a specific depression screening tool (e.g., Beck’s,
PHQ-9, etc).
Number of Clients Age 12 and Up with a Positive Depression Assessment
(Diagnosis of Depression):
Report the number of clients (age 12 and older) with a diagnosis of depression according
to the score on the depression screening tool and psychosocial assessment by the
provider. Exclude the following: a) those who are already receiving documented care
elsewhere, and b) those who are referred out of the E3 site for treatment.
Number of Clients Age 12 and Up with a Diagnosis of Depression who have
Documented, Appropriate Follow-Up:
Report the number of clients from the denominator who receive treatment at the E3 site
who have all of elements of an appropriate follow-up plan: a) had a psycho-social
assessment completed by 3rd visit (includes suicide risk assessment/safety plan), b) had
a treatment plan developed by 3rd visit, c) treatment plan reviewed @ 90 days (for those
on caseload for 90+ days), and d) screener re-administered at appropriate interval to
determine change in score.
For the following two quality measures, please note that you are NOT expected to
administer BOTH a behavioral health screen AND a risk assessment to each client. You
only need to administer one tool or the other as appropriate for age, developmental level
and need. Please report the number of behavioral health screens and/or risk
assessments provided to your clients:;.
Number of Unduplicated Clients Ages 5-21 Years with at least one Behavioral
Health Screen in the annual year:
Report the number of clients that receive a Behavioral Health Screen as appropriate for
age and developmental level. Examples of appropriate screening tools (to use) include
but are not limited to Pediatric Symptoms Checklist (17 or 34), Strength and Difficulties
Questionnaire.
Number of Unduplicated Clients with an Up-to-Date Risk Assessment / Anticipatory
Guidance:
Report the number of clients that are complete with an annual risk assessment or
anticipatory guidance, as appropriate for age and developmental level. This may include
clients that are UTD because they completed the risk assessment/anticipatory guidance
in a previous fiscal year but are being seen in the E3 site in the current fiscal year.
BILLING REPORT DEFINITIONS
Reported on annual basis only, as requested:
Enter the dollar amount in claims submitted for services provided during the current
fiscal year (October 1- September 30), regardless of whether or not the claims were paid
during the fiscal year.
Enter the dollar amount received in revenue during the current fiscal year (October 1-
September 30), regardless of whether or not revenue resulted from claims filed during the
fiscal year.
For each of these entries, you will be entering data by:
• Medicaid Health Plan/Medicaid (from a drop-down menu)
• Commercial
• Self-Pay
• Other
Note that the Estimated Percent of Claims Paid and Unpaid (based on dollar amount, not
on number of claims) and Payor Mix will be auto-totaled.
5 Most Common Reasons for Rejection of Submitted Claims:
Select the five most common reasons for rejection of submitted claims from the
dropdown menu according to best-fit category.
DIAGNOSES AND PROCEDURE CODES AND FREQUENCY
Reported on annual basis only, as requested:
Mental Health Problem Diagnoses – Top 5 diagnoses from the mental health provider
CPT codes – Top 5 CPT codes - both the code and the name of procedure
End of the Year/ Fall Narrative:
In addition to the quarterly data reporting. All E3 sites are required to submit an End of
Year/Fall Narrative Report. This report will focus on the Continues Quality Improvement
requirement as indicated in the Minimum Program Requirements document. The report
template will be given to E3 program sites by their assigned Program Consultant.
Completed Fall Narratives will be emailed to the assigned Program Consultant.
• Due on October 30 each year
MINIMUM PROGRAM REQUIREMENTS
October 1, 2023 - September 30, 2024
The E3 program shall be open and provide a full-time or full time equivalent mental health
provider in one school building year-round. Services shall: a) fall within the current,
recognized scope of mental health practice in Michigan and b) meet the current,
recognized standards of care for children and/or adolescents.
Services provided by the mental health provider are designed specifically for children and
adolescents ages 5 through 21 years and are aimed at achieving the best possible social
and emotional health status. This is done by providing comprehensive mental health
services which include screening, assessment, treatment, follow up and referral.
Services
1. A minimum caseload of 50 clients (users) must be maintained annually.
2. In addition to maintaining a client caseload, the following services may be provided
and must be reflective of the needs of the school:
a. treatment groups using evidence-based curricula and interventions;
b. school staff training and professional development relevant to mental health;
c. building level promotion, such as school climate initiatives, bullying prevention,
suicide prevention programs, etc
d. classroom education related to mental health topics
e. case management to and partnerships with other private/public social service
agencies
3. An up-to-date Behavioral Health Screen and/or Risk Assessment will be completed
for unduplicated users at least once in the annual year.
4. The use of an Electronic Medical Records system is required.
Assurances
5. These services shall not supplant existing school services. This program is not meant
to replace current special education or general education related social work activities
provided by school districts. This program shall not take on responsibilities outside of
the scope of these Minimum Program Requirements (Individualized Educational
Plans, etc.).
6. Services provided shall not breach the confidentiality of the client.
7. The E3 program shall not provide abortion counseling, services, or make referrals for
abortion services.
8. The E3 program, if on school property, shall not prescribe, dispense, or otherwise
distribute family planning drugs and/or devices.
9.
Staffing/Clinical Care
10. The E3 site staff shall operate within their scope of practice as determined by
certification and applicable agency policies: The mental health provider shall hold a
minimum master’s level degree in an appropriate discipline and shall be licensed to
practice in Michigan. Clinical supervision must be available for all licensed providers.
For those providers that hold a limited license working towards full licensure,
supervision must be in accordance to licensure laws/mandates and be provided by a
fully licensed provider of the same degree.
11. The E3 program shall be open during hours accessible to its target population.
Provisions must be in place for the same services to be delivered during times when
school is not in session. Not in session refers to times of the year when schools are
closed for extended periods such as holidays, spring breaks, and summer vacation.
These provisions shall be posted and explained to clients. The mental health provider
shall have a written plan for after-hours and weekend care, which shall be posted in
the center including external doors and explained to clients. An after-hours answering
service and/or answering machine with instructions on accessing after-hours mental
health care is required. If services are not able to continue during periods of not in
session, a written plan must be communicated to MDHHS for approval. If children or
adolescents are being seen from outside of the targeted site, a policy shall exist to
this effect. Provisions shall be explained to clients.
Administrative
12. There shall be a current signed interagency agreement defining the roles and
responsibilities of the sponsoring agency and the local school district/building. This
agreement must state a plan will be in place for transferring clients and/or caseloads if
the agreement is discontinued or expires. Written approval by the school
administration (ex: Superintendent, Principal) and school board exists for the
following:
a. location of the E3 program within the school building;
b. parental and/or minor consent policy; and
c. services rendered through the E3 program.
13. The mental health provider or contracting agency shall establish and implement a
process for billing Medicaid, Medicaid Health Plans and other third party payors for
services rendered. Any revenue generated must be used to sustain the E3 program
and its services. E3 shall establish and implement a sliding fee scale, which is not a
barrier to health care for adolescents. No student will be denied services because of
inability to pay. E3 funding is in place to support overall program operations including
provider time; agencies are responsible to offset any outstanding balances for direct
mental health services to avoid collection notices and/or referrals to collection
agencies for payment. The billing and fee collection processes do not breach the
confidentiality of the client.
14. Policies and procedures shall be implemented regarding proper notification of
parents, school officials, and/or other health care providers when additional care is
needed or when further evaluation is recommended. Policies and procedures
regarding notification and exchange of information shall comply with all applicable
laws e.g., HIPAA, FERPA and Michigan statutes governing minors’ rights to access
care.
15. Implement a continuous quality improvement plan for mental health services.
Components of the plan shall include, at a minimum:
a. ongoing record reviews by peers (at least twice annually) to determine that
conformity exists with current standards of practice. A system shall be in place to
implement corrective actions when deficiencies are noted;
b. conducting a client satisfaction survey/assessment at least once annually.
c. continuous quality improvement team: A CQI Coordinator shall be identified. CQI
meetings, that include all staff associated with E3 program, shall be held at least
quarterly. These meetings shall include discussion of reviews, client satisfaction
survey and any identified clinical issues.
16. The E3 program must have the following policies as a part of overall policies and
procedures:
a. parental and/or minor consent;
b. custody of individual records, requests for records, and release of information
that include the role of the non-custodial parent and parents with joint custody;
c. confidential services; and
d. disclosure by clients or evidence of child physical or sexual abuse, and/or
neglect.
Physical Environment
17. The E3 program shall have space and equipment adequate for private counseling,
secured storage for supplies and equipment, and secure paper and electronic client
records. The physical facility must be youth-friendly, barrier-free, clean and safe.
PROJECT: Family Planning Program
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis
The Michigan Family Planning Program assists individuals and couples in planning and
spacing births, preventing pregnancy, and seeking preventive health screenings. On-
site clinical services are delivered through a statewide network of local health
departments, hospital-based health systems, and federally qualified health centers. The
program prioritizes serving low-income individuals, adolescents, and un/underinsured
individuals. Michigan’s Family Planning Program serves as a safety net with providers
who have been a reliable and trusted source of care, and in many cases the only
regular source of health care and health education for Michiganders. Referrals to other
medical, behavioral health, and social services are provided to clients, as needed.
Services are charged based on ability to pay. No one is denied services due to inability
to pay.
Reporting Requirements (if different than contract language)
Each grantee shall submit the required reporting on the following dates:
Report Time Period Due Date to
Department Submit To
FPAR Year-End
Report
Aggregate
Tables 1-15
(Calendar Year
2023)
January 1 – December 31 January 12
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit@
michigan.gov
FPAR 2.0 Data
Reports
Encounter-
Level (Calendar
Year 2024)
January 1 – March 31
January 1 – June 30
January 1 – September 30
April 12
July 12
October 11
MILogin via Family
Planning Transfer Area
FPAR 2.0
Family Planning
Encounters
(Table 13) &
Family Planning
Revenue
Report (Table
14) (Calendar
January 1 – June 30 July 12
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit@
michigan.gov
Year 2024)
Annual Health
Care Plan October 1 – September 30 September 13
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit@
michigan.gov
Teen/Adult
Consumer
Survey
October 1 – March 31 April 19
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit@
michigan.gov
Medicaid Cost-
Based
Reimbursement
Tracking Form
October 1 – September 30 November 30 EGrAMS with Final
Financial Status Report
Each grantee shall indicate the following project outputs:
Target Measure Total Performance
Expectation
MDHHS State Agreement
Minimum Performance Expected
Unduplicated Number of
Title X Clinic Users
Percent Number
95%
Any additional requirements (if applicable)
1. Each grantee must serve a minimum of 95% of contracted caseload to access its
total amount of allocated funds. Each grantee’s Family Planning Annual Report
(FPAR) data will be used to monitor contracted caseload performance. Year-end
FPAR will be used to assess whether grantee has met their minimum contracted
caseload requirement.
2. Each grantee will be required to adhere to federal statue and regulations for Title X
Family Planning Programs, including legislative mandates, Executive Orders,
Department of Health & Human Services (HHS) grant administration regulations,
HHS grant policy statements, and any applicable appropriations acts.
3. Each grantee will be required to adhere to the current version of the Michigan Title X
Family Planning Program Standards & Guidelines Manual.
4. Each grantee will provide MDHHS a minimum of 30 days advance notice of any
service site (i.e., clinic) changes, including any deletions, additions, or changes to
the name, location, street address and email, services provided on-site, and contact
information for the service site. Service site changes can be sent to grantee’s
agency consultant.
5. Each grantee will be required to participate in program planning and evaluation,
including the completion of an Annual Health Care Plan as stipulated by MDHHS, in
non-competitive funding years, including but not limited to, project progress report,
clinic operations and services provided, and upcoming fiscal year work plan.
6. Each grantee will ensure that low-income individuals (i.e., ≤100% of federal poverty
level) are given priority to receive family planning services.
7. Each grantee will provide family planning clients with a broad range of acceptable
and effective medically approved family planning methods, including natural family
planning, and services, including pregnancy testing and counseling, assistance to
achieve pregnancy, basic infertility services, sexually transmitted infection (STI)
services, preconception health services, and adolescent-friendly health services.
8. Each grantee will provide family planning services on a voluntary basis, without
coercion to accept services or any particular method of family planning, and without
making acceptance of services a prerequisite to eligibility for, or receipt of, any other
services, assistance from, or participation in any another program offered by
grantee.
9. Each grantee will inform all staff participating in the Family Planning project that they
may be subject to prosecution if they coerce or try to coerce any person to undergo
an abortion or sterilization procedure.
10. Each grantee will provide confidential family planning and related preventive health
services to minors and will not require written consent of parents or guardians for the
provision of services to minors. Grantee will not notify parents or guardians before or
after a minor has requested and/or received family planning services, without the
consent of the minor.
11. Each grantee will encourage family participation in the decision of minors to seek
family planning services and must provide counseling to minors on how to resist
efforts that coerce minors into engaging in sexual activities.
12. Each grantee will comply with all state mandated reporting laws related to child
abuse and neglect; abuse, neglect, and exploitation of vulnerable adults; and human
trafficking. Confidentiality cannot be invoked to circumvent requirements for
mandated reporting.
13. Each grantee will provide family planning services in a manner that is client-
centered, culturally and linguistically appropriate, inclusive and trauma-informed;
protects the dignity of the individual and ensures equitable and quality service
delivery.
14. Each grantee will provide family planning services without regard to race, sex,
religion, age, national origin, color, height, weight, marital status, number of
pregnancies, gender identification or expression, sexual orientation, partisan
considerations, sex characteristics, disability or genetic information that is unrelated
to the person’s circumstances.
15. Each grantee will not provide abortion as a method of family planning and will have
written policy that no Title X funds are used to provide abortion as a method of family
planning.
16. Each grantee will provide pregnancy testing and client-centered counseling to all
clients in need of this service and will offer pregnant clients, if requested, neutral,
factual, information and non-directive counseling on prenatal care and delivery;
infant care, foster care, or adoption; and pregnancy termination.
17. Each grantee will offer services on a sliding fee scale, based on the current Federal
Poverty Guidelines, for individuals with a family income between 100% and 250% of
the federal poverty level to assure services are billed based on ability to pay. No one
can be denied services due to inability to pay.
18. Each grantee will ensure no charges will be made for services provided to low-
income clients (i.e., ≤100% of federal poverty level) except when that payment will
be made by a third-party, which is authorized to or is under legal obligation to pay
this charge. Donations are permissible from eligible clients, as long as clients are not
pressured to make one and donations are not a prerequisite to family planning
services or supplies.
19. Each grantee where there is legal obligation or authorization for third-party
reimbursement, including public or private sources, all reasonable efforts must be
made to obtain third-party payment without application of any discounts. Where the
cost of services is to be reimbursed under Title XIX, XX, or XXI of the Social Security
Act, a written agreement with the title agency is required.
20. Each grantee will have a schedule of fees designed to recover the reasonable cost
of providing services for clients whose income exceeds 250% of federal poverty
level based on an analysis of the costs of providing services and identification of
other factors used to determine the fee schedule is reasonable.
21. Each grantee will convene a Family Planning Advisory Committee or similar body,
which will be broadly comprised of the population and/or community served to allow
participation in, the development and review of program policy and practices,
implementation, and evaluation of the project by others in the community
knowledgeable about the community's needs for family planning services and will
meet at least once a year.
22. Each grantee will establish and implement planned activities to provide community
education programs to facilitate awareness and access to family planning services
and encourage participation by diverse persons in the communities served.
23. Each grantee will convene an Information and Education Committee comprised of at
least five members who are broadly representative of the population and/or
community served that meets at least once a year to review (i.e., consider the
suitability) and approve all informational and educational materials, print or
electronic, prior to distribution.
24. Each grantee will provide for orientation and in-service training for all family planning
project personnel.
25. Each grantee will provide family planning services without the imposition of any
residency requirement or requirement that the client be referred by a physician.
26. Each grantee will provide that family planning medical services will be performed
under the direction of a clinical services provider with special training or experience
in family planning.
27. Each grantee will have written clinical protocols that are in accordance with
nationally recognized standards of care and Providing Quality Family Planning
Services recommendations that are reviewed and signed annually by the directing
clinical services provider overseeing the Family Planning project.
28. Each grantee will offer client-centered care on-site and/or by referral, meaning care
that is respectful of, and responsive to, individual client preferences, needs, and
values; client values guide all clinical decisions.
29. Each grantee will offer education on HIV and AIDS, risk reduction information, and
either on-site testing or provide a referral for this service.
30. Each grantee will operate in accordance with federal and state laws regarding the
provision of pharmaceuticals, including but not limited to, security and record
keeping for drugs and devices.
31. Each grantee will operate its project in accordance with federal and state laws and
guidelines regarding the provision of laboratory services related to family planning
and preventive health.
32. Each grantee will address clients’ social determinants of health to the extent feasible
through the coordination of referral arrangements for other health care, related social
services, and counseling.
33. Each grantee will have a current list of social services agencies and medical referral
resources that is reviewed and updated annually.
34. Each grantee will provide for emergency medical management to address
emergency situations.
35. Each grantee will establish a medical record for all clients who receive clinical
services, including but not limited to, pregnancy testing, counseling, and emergency
contraception. Medical records must comply with HIPAA privacy and security
standards and document quality care standards.
36. Each grantee will have a quality assurance system in place for ongoing evaluation of
family planning services, including a tracking system for clients in need of follow-up
or continued care, quarterly medical audits per clinician to determine conformity with
agency protocols, quarterly chart audits/record monitoring to determine the accuracy
of medical records, and a process to implement corrective actions for deficiencies.
37. Each grantee assures that if family planning services are provided by contract or
other similar arrangements with actual providers of services, services will be
provided in accordance with a plan, which establishes rates and method of payment
for medical care. These payments must be made under agreements with a schedule
of rates and payment procedures maintained by grantee. Grantee must be prepared
to substantiate these rates are reasonable and necessary.
38. Each grantee will comply with all Office of Population Affairs (OPA) Family Planning
Annual Report (FPAR) requirements, as well as MDHHS required FPAR elements,
for the purposes of monitoring and reporting performance.
39. Each grantee will have a data collection system in place to assure accurate FPAR
reporting, and will be responsible for updating their system, as needed, to be in
compliance with OPA and MDHHS FPAR data collection and reporting standards
and deadlines.
40. Each grantee will use FPAR to identify program disparities and to the extent
feasible, will implement quality improvement techniques and/or use program
promotion, community outreach, or other community-based strategies to address
identified disparities.
41. The funds appropriated in the current State Public Health Appropriations Act for
pregnancy prevention programs shall not be used to provide abortion counseling,
referrals or services, unless contradicts Title X of the Public Health Service Act, 42
U.S.C. § 300 et seq.
42. Funding awards were made in compliance with 2002 Public Act (PA) 360 MCL §
333.1091. Grantees qualify as priority family planning providers who do not engage
in any activities outlined in 2002 PA 360 MCL § 333.1091.
43. Each grantee will provide that all services purchased for project participants will be
authorized by the project director or their designee on the project staff.
44. Each grantee will have a separate budget for its Family Planning project and
maintain a financial management system that meets the standards specified in 45
CFR Part 75.
45. Each grantee assures all project expenditures comply with 45 CFR Part 75 and are
expended solely for the purpose of delivering Title X Family Planning Services and
that any Family Planning revenue earned will be invested back into program
operations and reported as earned program income for financial reporting.
46. Each grantee will comply with the MDHHS Medicaid Cost-Based Reimbursement
(MCBR) reporting requirements and attach the MCBR Tracking Form to their final
financial status report. The MCBR Tracking Form must be completed in its entirety
and include Family Planning MCBR and Other Medicaid MCBR financial information
for all programs.
47. Grantee’s funding cannot be used for fundraising activities and/or political education
or lobbying, including membership costs for advocacy or lobbying organizations.
48. Grantee’s funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT TITLE: Fetal Alcohol Spectrum Disorder Community Project
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
Grantees will collaborate with the Department to assist local communities with evidence-
based activities, to implement alcohol screening and prevent prenatal alcohol exposure
among women of reproductive age and to refer affected children, birth to 18 years of age,
and their families to an FASD Diagnostic Center for evaluation and intervention for the
purpose of improving care and services for women, infants and families.
Reporting Requirements (if different than agreement language):
The Grantee will collect data using the project evaluation/data tracking forms to monitor
the FASD community program effectiveness and report service numbers.
The Grantee will collect data using the FASD Workplan Narrative Report (A) and the
Data Evaluation Report (B) provided, to monitor the FASD community program
effectiveness.
The Grantee shall submit FASD Workplan report and the Data Evaluation Report
electronically to the MDHHS FASD Program Contact Person on dates specified below.
a. Grantee must provide documentation that FASD services are tracked for all
direct and enabling services provided, including individuals screened, and
referred through the FASD community project.
b. Any such other information as specified in the Statement of Work shall be
developed and submitted by the Grantee as required by the Contract Manager.
c. The Grantee shall permit the Department or its designee to visit and to make
an evaluation of the projects as determined.
FASD Report Guidance
Report Time Period Due Date Submit To
A
FASD
Work Plan
Narrative
Report
October 1 - December 31 January 30 Email to
cruzk2@michigan.gov
January 1 - March 31 April 30
April 1 - June 30 July 30
July 1 - September 30 October 30
B
FASD
Data
Evaluation
Report
October 1 - March 31 April 30
Email to
cruzk2@michigan.gov April 1 – September 30 October 30
FASD Quarterly Meetings
The Grantee will participate in quarterly Technical Assistance calls with MDHHS FASD
Program staff according to the schedule below. Technical Assistance calls are an
opportunity for FASD funded projects to share expertise, best practices and promote
collaboration for FASD program effectiveness.
FASD Technical Assistance Calls
January 16
April 16
July 16
October 16
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Case Abstraction
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis:
Qualified individuals will perform medical record case abstraction for Fetal Infant
Mortality Review to include the following:
• Utilize the FIMR Sampling Plan for case selection template provided.
• Review of medical records involved in fetal and infant death to include, but not
limited to hospital, prenatal, emergency, and medical examiner’s records.
• Interact with other agencies and service providers involved in infant’s death
(Child Protective Services, local health department, law enforcement).
• Develop de-identified case summaries from the above abstracted information,
as well as the FIMR interview.
• Attend the review team meetings to facilitate the presentation of the cases and
develop recommendations, utilizing the Michigan FIMR CRT Recommendation
Form and Michigan FIMR Log of Local Recommendations.
• Utilize the Michigan FIMR Health Equity Toolkit and/or other resources for
training FIMR CRT members on equity, bias, diversity, and inclusion.
• Enter cases into the National Fatality Review Case Reporting System (FIMR
database) at the National Center for Fatality Review and Prevention.
• Present FIMR findings and recommendations to local FIMR Community Action
Team (CAT) annually, at a minimum, to develop action plans.
Reporting Requirements (if different than agreement language):
Quarterly progress reports following the template provided. Quarterly reports are due
the 15th of the month following the end of the quarter and are submitted to Audra
Brummel, State coordinator, via email at brummela@michigan.gov.
Reporting Time Period Due Date
1st Quarter October 1 – December 31 January 15
2nd Quarter January 1 – March 31 April 15
3rd Quarter April 1 – June 30 July 15
4th Quarter July 1 – September 30 October 15
Any additional requirements (if applicable):
Each completed case abstraction will be compensated at $270.00 per case.
• FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
Maximum Program Reimbursement:
Grantee Maximum Reimbursement Amount
Berrien County Health Department $ 4,050
Calhoun County Public Health Department $ 3,240
Detroit Health Department $ 2,700
Genesee County Health Department $ 4,115
Ingham County Health Department $ 3,240
Jackson County Health Department $ 3,240
Kalamazoo County Health and Community
Services Department
$ 6,480
Kent County Health Department $ 12,150
Macomb County Health Department $ 4,050
Public Health Muskegon County $ 2,700
Oakland County Department of Health and
Human Services/Health Division
$ 6,480
Saginaw County Health Department $ 4,860
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Interviews
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis:
Conduct Fetal Infant Mortality Review (FIMR) interviews with the intent of informing the
FIMR case abstraction process and informing the infant mortality reduction efforts both
locally and statewide.
Reporting Requirements (if different than agreement language):
Mid-year progress report and final report using the FIMR interviews template, which will
address what was learned about preventability at the individual, clinical care, health
system, community, and policy level are due April 15 and a final report due October 15
by submission to Audra Brummel, State coordinator, via email at
brummela@michigan.gov.
Any additional requirements (if applicable):
• Each completed FIMR interview will be compensated at $125.00 per interview. A
maximum of 6 visits are reimbursable per fetal/infant death up to the contract
allocation.
• FIMR team recommendations and information will be used to inform the State of
Michigan infant mortality reduction efforts.
• Utilize the following Michigan FIMR Network resources:
a) Michigan FIMR Network Maternal/Family Interview Guide
b) FIMR Case Review Team (CRT) Recommendation Form and the Log of
Local FIMR Recommendations
c) Michigan FIMR Network Health Equity Toolkit
Additional Requirements for Detroit Health Department (DHD) and Kent County
Health Department (KCHD) only:
• At least 1 MMMS next of kin interviews will be completed by September 30, 2024.
Each completed MMMS next of kin interview will be compensated at $250.00 per
interview. A maximum of 6 visits are reimbursable per case up to the contract
allocation.
• The MMMS next of kin interview will follow the FIMR methodology and the
Michigan FIMR Interview Guide questionnaire with additional questions relevant to
maternal deaths.
• Use of consent forms, questionnaire, and template for collecting interview
summaries provided.
• The DHD and KCHD FIMR Interviewers will be invited to MMMS Maternal
Mortality Review Committee (MMRC) meetings when an interview is completed to
provide an overview and additional details on the interview.
Maximum Program Reimbursement:
Grantee Maximum Reimbursement Amount
Berrien County Health Department $ 1,875
Calhoun County Public Health Department $ 1,500
Detroit Health Department $ 6,750 – FIMR
$ 2,000 – MMMS
Ingham County Health Department $ 2,500
Jackson County Health Department $ 1,250
Kalamazoo County Health and Community
Services Department
$ 2,250
Kent County Health Department $ 1,250 – FIMR
$ 1,000 - MMMS
Macomb County Health Department $ 1,500
Public Health Muskegon County $ 625
Oakland County Department of Health and
Human Services/Health Division
$ 2,000
PROJECT TITLE: FFPSA (Family First Prevention Services Act) HV
Expansion
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The FFPSA project is a national initiative being implemented in Michigan to support the
prevention of the placement of children into foster care. FFPSA support Positive Parenting
Programs such as evidence-based home visiting models. Each HV Model is implemented in
accordance with the standards and tenants of that particular model.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with the
Department’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. 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. In addition to other data required by MDHHS, LIAs are required to record and submit
ongoing funding tracking data used for federal billing and reporting through REDCap by
Thursday each week. This data includes:
• Family demographic information (including MiSACWIS IDs)
• Referral information and status
• Enrollment date
• FFPSA eligibility change dates
• Closure date if family has exited home visiting services
e. HVU and FFPSA data collection requirements due in REDCap and appropriate model
data system by the 5th business day of each month. HFA programs must use Home
Visiting On-Line (HVOL), and NFP programs must use Flo for all model and other
MDHHS required data.
f. Quality Improvement Reporting:
• Documentation of a QI team will be submitted with the quarterly Work Plan Report.
• Documentation of QI activities will be submitted with the quarterly Work Plan Report.
• Annual summary of QI activities will be submitted to the Model Consultant by April 30.
g. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the CoIIN’s schedule. Participating LIAs are required to use the HV
CoIIN site to complete monthly submissions of PDSA cycles and required data (the
frequency of data collection may vary).
Reports (a-g) shall be submitted as described above. Additional guidance concerning data
collection and Quality Improvement is provided in the MDHHS Home Visiting Unit Guidance
Manual.
Grantee Specific Requirements:
Home visitors funded through Family First Prevention Services Act will serve families referred
from local Child Welfare agencies, in proportion to their FFPSA FTE.
HFA: 13 FFPSA families per 1.0 FTE
NFP: 25 FFPSA families per 1.0 FTE
PAT: 12-16 (monitoring for 14) families per 1.0 FTE
MOU
LIAs are required to work with MDHHS to complete a Memorandum of Understanding with
MDHHS to establish expectations for the relationship that is being built between child welfare
and the home visiting program. Healthy Families America (HFA) LIAs will need to submit the
HFA’s Child Welfare Protocol application to HFA National. They will also need to work with their
assigned Child Welfare Service Analyst to obtain the signature of their local DHHS office on a
letter of support. Both need to be completed before an HFA LIA can enroll any families under
FFPSA or the Child Welfare Protocol.
Maintain Fidelity to the Model
The LIA shall adhere to the Home Visiting model Best Practice Standards or Model Elements. In
addition, all Healthy Families America affiliates shall comply with the requirements of the Central
Administration for the Multi-Site State System (also known as “The State Office”) housed within
the Michigan Public Health Institute.
Comply with MDHHS Program Requirements
The LIA shall operate the program with fidelity to the requirements of MDHHS based on the
agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home Visiting
Unit Guidance Manual. The LIA will fulfill these requirements while strengthening efforts
towards health and racial equity through staff education, programmatic data evaluation and
client supportive services.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS Home
Visiting Unit Guidance Manual for requirements related to PA 291.
Staffing
The LIA’s home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement within 90
days of a MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Unit
Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures as described in the MDHHS Home Visiting Unit Guidance Manual.
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and the Michigan Public Health Institute
(MPHI) with regards to program development and monitoring (including annual site visits either
in-person or virtual), training, support and technical assistance services. See the MDHHS Home
Visiting Guidance Unit Manual for requirements related to program monitoring, quality
assessment, support and TA.
Professional Development and Training:
All of the LIA’s program staff associated with this funding will participate in professional
development and training activities as required by both the model and the Department.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to professional
development and training activities.
Supervision:
The LIA shall adhere to the HV Model supervision requirements:
• HFA: Weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro-rated as
allowed by the Best Practice Standards.
• NFP: LIA shall adhere to the NFP supervision requirements.
Written policies and procedures shall specify how reflective supervision is included in, or added
to, that time to ensure provision for each home visitor at a minimum of one hour per month.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall build a relationship with their local DHHS office. LIAs are expected to use the
referral response form to inform the DHHS worker for their assigned FFPSA families of the
enrollment date, referral status within two weeks of referral, and if a home visitor has not been
able to connect with a family in two weeks, and referral closure date. After FFPSA eligible
families have enrolled, LIAs are expected to use the monthly update form to provide the DHHS
worker for their assigned FFPSA families with family level updates. LIA will coordinate with
DHHS when approaching annual review for any enrolled FFPSA families.
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have lived experience.
The LIA shall participate in the Local Leadership Group (LLG) (if it is not the community
advisory committee) or, if none, the Great Start Collaborative.
The LIA shall participate in the Regional Perinatal Quality Collaborative.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to engagement
with community partners.
Data Collection:
The LIA shall comply with all model and MDHHS HVU data training, collection, entry, and
submission requirements. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to data collection.
Quality Improvement (QI):
The LIA shall participate in all HV Model quality initiatives including research, evaluation, and
continuous quality improvement.
The LIA shall participate in all state and local Home Visiting QI activities as required by MDHHS.
Required activities include, but are not limited to:
• Developing and maintaining a QI team
• Participating in QI activities during the fiscal year.
• Consulting with QI coaches
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to QI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using grant
agreement funds, they must follow the requirements outlined in the MDHHS Home Visiting Unit
Guidance Manual.
PROJECT TITLE: Gonococcal Isolate Surveillance Project
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
This project will monitor trends in antimicrobial susceptibilities in N. gonorrhoeae via
collection and submission of required specimens and data to the Centers for Disease
Control and Prevention. Patient demographics and specimen phenotypes, particularly
for non-susceptible specimens, will be characterized, and genetic markers associated
with antimicrobial resistance will be identified and monitored using remnant NAATS.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to
Submit Report
Submit clinical and
demographic data to CDC Monthly 4 weeks after end of
month Via SAMS
Complete and submit shipping
manifest Monthly First Monday of the
following month
Paper copy
with isolates,
and electronic
FTP report to
ARLN
Collect and submit N.
gonorrhea isolates Monthly First Monday of the
following month Ship to ARLN
Collect and submit remnant
NAAT samples for gonorrhea-
positive isolates above
Monthly 4 weeks after end of
month
Ship directly to
CDC STD-
LRRB
Complete and submit annual
progress report Annually
90 days after end of
grant period, or as
defined by CDC
Collaborate
with
kentj3@michig
an.gov
The number of culture
specimens collected, and
number of presumptive positive
GC forwarded to CDC and their
designated laboratories for
further testing.
Quarterly January 15, April 15,
July 15, October 15
Written report
submitted to
kentj3@michig
an.gov;
Demographic and behavioral
data to MDHHS for clients with
GC positive isolates utilizing
the CDC required format.
Quarterly January 15, April 15,
July 15, October 15
Written report
submitted to
kentj3@michig
an.gov;
Report of any specimen that
exceeds the alert criteria:
Ceftriaxone MIC ≥ 0.125 µg/ml
Cefixime MIC ≥ 0.25 µg/ml
Azithromycin MIC ≥ 2.0 µg/ml
Immediate Per high-resistance
specimen
Phone or email
to Jim Kent
517-243-4932,
kentj3@michig
an.gov
GRANTEE REQUIREMENTS
Grant Program Operation
1. Monitor trends in antimicrobial susceptibilities in N. gonorrhoeae.
2. Characterize patients with gonorrhea (GC), particularly those infected with N.
gonorrhoeae that are not susceptible to recommended antimicrobials.
3. Phenotypically characterize antimicrobial-resistant isolates to describe the
diversity of antimicrobial resistance in N. gonorrhoeae.
4. For male STI clinic patients suspected of having GC, collect a NAAT sample
during the same visit as the urogenital sample collected above.
5. For the first 25 clients with positive isolates, submit culture specimens to CDC
assigned Regional Laboratory for further testing; and associated demographic
and behavioral data to the CDC and MDHHS at agreed intervals.
6. For the first 25 clients with positive isolates, submit residual NAAT specimens
directly to CDC molecular laboratory.
7. Monitor and track clinic totals including:
a. Number of men with urethral sample collected and tested for gonorrhea
(positive and negative)
b. Number of gonococcal isolates submitted to Region Laboratory
c. Number of isolates found by Regional Laboratory to be non-viable or
contaminated.
d. Percentage of monthly isolate batches shipped to Regional Laboratory within
one week after the end of the month
e. Percentage of monthly demographic data transmissions submitted to CDC
within one month after the end of the month
f. Percentage of collected isolates that include a) age, b) gender of sex partner,
c) HIV status, d) antibiotic use, and d) treatment
g. Number of remnants NAAT samples submitted to CDC
h. Number of remnants NAAT testing positive, negative, or equivocal
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in
the BHSP SHOARS system. These roles must match what the agency has listed
for these roles in the EGrAMS system. If you have access related questions,
contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-
SUPPORT@michigan.gov
PROJECT TITLE: Grief and Bereavement
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis:
LHD will address the critical need for support immediately following the death of a
mother and/or infant, as well as provide linkages to ongoing support of grieving
families and communities.
Program requirements include:
• Establish a partnership comprised of at least one birthing hospital, on
Community-Based Organization (CBO), and one hospice provider/ palliative
care program to serve as a team to create local and sustainable bereavement
support network.
• Strengthen relationships between organizations that work with bereaved
families.
• Establish institutional policies and procedures for responding to a maternal
death, pregnancy loss, and infant death by connecting families to available
resources.
• Enhance grief and bereavement services for families.
• Enhance grief and bereavement hospital policies and/ or procedures.
Reporting Requirements (if different than agreement language):
Mid-year progress report and final report, using the template provided, are due April 30
and a final report due October 31. Reports are submitted to Audra Brummel, State
coordinator, via email at brummela@michigan.gov.
Any additional requirements (if applicable):
• Identify at least one person who will serve as project lead.
• At least one representative from the project team will participate in the following
quarterly teleconference meetings where a short informational presentation/
updates on project activities.
1. October 2
2. January 8
3. April 4
4. July 8
PROJECT: Harm Reduction Capacity Expansion
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within their jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Any additional requirements (if applicable)
• Grantees will participate on monthly conference calls to discuss the state of SSP
in Michigan, share successes, challenges, and best practices.
• Funds may not be used to buy sterile needles or syringes.
• Grantees must establish relationships to link clients to care for substance use
disorder treatment.
• Grantees must be able to provide clients with Narcan / naloxone.
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
• Technical assistance is available upon request.
PROJECT: Harm Reduction Support Services
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Grantees and subrecipients of these funds are authorized by the State of Michigan to
distribute syringes for the purposes of preventing the transmission of communicable
diseases. These dollars will be used by the grantee to plan and implement syringe
service programs within their jurisdictions. Grantees will develop policies and protocols
following best practice guidance with respect to client registration, supply disposal and
supply distribution, education of participants, staff training, referral to substance use
treatment, referral or testing for infectious diseases, and provision of naloxone for
overdose prevention.
Reporting Requirements (if different than contract language)
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Any additional requirements (if applicable)
• Grantees will participate on monthly conference calls to discuss the state of SSP
in Michigan, share successes, challenges, and best practices
• Funds may be used to purchase syringes and other sterile works for injecting
substances.
• Grantees must establish relationships to link clients to care for substance use
disorder treatment.
• Grantees must be able to provide clients with Narcan / naloxone.
• If sites are performing HIV and/or HCV testing, grantees should establish
relationships to link clients to care for HIV and/or HCV follow-up testing and
treatment.
• If sites are not performing HIV and or/HIV testing, grantees should establish
relationships to refer clients to HIV and/or HCV testing.
• Technical assistance is available upon request.
PROJECT TITLE: HIV/STI Testing and Prevention
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The City of Detroit bares a disproportionate burden of reported sexually transmitted
infection, including HIV. As a complement to public health clinical services, the Detroit
Health Department provides community level education and awareness building, along
with targeted screening activities to ensure additional access to service for early case
detection and linkage to care.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit Report
Activity Report Quarterly 30 days after the end
of the quarter
Email to MDHHS HIV and STI
contract liaisons
Any additional requirements (if applicable):
1. In partnership with MDHHS, provide technical assistance and capacity building to
ensure the Public Health STD Clinic adheres to MDHHS and CDC screening,
diagnostic and treatment recommendations and guidelines.
2. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
a. Ensure timely entry of client encounter information into Aphirm
3. Conduct community awareness building activities to increase STI and HIV
knowledge, including points of access for service.
4. By September 30, distribute MDHHS determined allocation worth of condoms,
lube, dental dams, and display equipment/materials.
5. By September 30, distribute HIV Prevention advertising/marketing materials.
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in the
BHSP SHOARS system. These roles must match what the agency has listed for
these roles in the EGrAMS system. If you have access related questions, contact
MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov
PROJECT TITLE:
HIV/AIDS Linkage to Care Project
HIV Care Coordination
HIV Data to Care
HIV Housing Assistance
HIV Ryan White Part B
HIV Ryan White Part B MAI
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The above projects provide a comprehensive system of HIV primary medical care,
essential support services, and medications for consumers with HIV who are newly
diagnosed, not engaged in care, and uninsured and underserved. The projects provide
funding to provide care and treatment services to achieve positive health outcomes;
reduce HIV transmission among hard-to-reach populations; eliminate barriers
(transportation, housing, insurance, access/knowledge of access to medical care, stigma-
related mental health issues, etc.) to accessing care through a combination of referrals
and linkage to Ryan White Service providers and other community services.
Reporting Requirements:
Reports and information shall be submitted to the Bureau of HIV/STI Programs (BHSP).
Please refer to the table for where to submission dates and types of reports.
Report Period Due Date(s) How to Submit
Report
All Agencies: Ryan White
services delivered to HIV-
infected and affected
clients
Monthly 10th of the
following month
Enter into
CAREWare
All Agencies: Ryan White
Services Report (RSR)
Annual Generally,
Grantee
submission will
open in early
February and
close early March
Submission to
HRSA through
Electronic
Handbook (EHB)
All Ryan White federally
funded agencies
providing at least one
Annual (if
applicable)
December 31st Will be reviewed at
Site Visit
Report Period Due Date(s) How to Submit
Report
core medical service:
Quality Management Plan
All Ryan White federally
funded agencies:
Complete and submit at
least one Plan-Do-Study-
Act worksheets correlated
to Quality Management
Plan
Annual (if
applicable)
As completed
over contract year
Email report to
MDHHS-
HIVSTIoperations
@michigan.gov
All Agencies: FY24 actual
expenditures by service
category, program income,
and administrative costs
through the RW Reporting
Tool
Monthly Thirty days after
the end of the
budget period
Attached to
monthly FSR
All Ryan White federally
funded agencies: RW
Form 2100 and RW Form
2300
Annually December 31st Complete in
EGrAMS Agency
Portal
To complete the Ryan White Services Report (RSR), a Health Resources and Services
Administration (HRSA) required annual data report, the Grantee must assure that all
CAREWare data is complete, cleaned, and entered into the HRSA Electronic Handbook.
RSR submission requirements include:
1. The RSR shall have no more than 5% missing data variables.
2. Exact dates for the Grantee submission will be provided by the Department each
reporting year.
3. The Department validates the data within the Grantee’s RSR submission before
receipt by HRSA.
4. Data in CAREWare must be checked and validated every quarter.
*The Grantee shall permit the BHSP or its designee to conduct site visits and to formulate
an evaluation of the project.
Any additional requirements:
Publication Rights
When issuing statements, press releases, requests for proposals, bid solicitations and
other documents describing projects or programs funded in whole or in part with Federal
money, the Grantee receiving Federal funds, including but not limited to State and local
governments and recipients of Federal research grants, shall clearly state:
1. The percentage of the total costs of the program or project that will be financed with
Federal money.
2. The dollar amount of Federal funds for the project or program.
3. Percentage and dollar amount of the total costs of the project or program that will
be financed by non-governmental sources.
Fees
The Grantee must establish and implement a process to ensure that they are maximizing
third party reimbursements, including:
1. Requirement, in agreement, that the Grantee maximize and monitor third party
reimbursements.
2. Requirement that Grantee document, in client record, how each client has been
screened for and enrolled in eligible programs.
3. Monitoring to determine that Ryan White is serving as the payer of last resort,
including review of client records and documentation of billing, collection policies
and procedures, and information on third party contracts.
4. Grantee must adhere to the National Monitoring Standards for Ryan White Part B
Grantees: Program and the National Monitoring Standards for Ryan White
Grantees: Fiscal; and bill for services that are billable in accordance with the above.
5. Ensure appropriate billing, tracking, and reporting of program income to support
appropriate use for program activities.
6. Program income is added to funding provided by the State of Michigan for the
budget period and used to advance eligible program objectives.
7. Provide a report detailing the expenditure and reinvestment of program income in
the program (template will be provided by MDHHS).
Grant Program Operation
1. The Grantee must adhere to the Ryan White HIV/AIDS Program (RWHAP)
National Monitoring Standards for RWHAP Part B Recipients.
2. The Grantee will participate in the Department needs assessment and planning
activities, as requested.
3. The Grantee will participate in regular Grantee meetings which may be face-to-face,
teleconferences, webinars, trainings, etc. The Grantee is highly encouraged to
participate in other training offerings and information-sharing opportunities provided
by the Department.
4. The Grantee is responsible for ensuring that staff retain minimum educational
requirements for staff positions and are proficient in Ryan White-funded service
delivery in their respective roles within the organization. Ensure that Ryan White
funded staff receive MDHHS required case management training within one (1) year
of hire.
5. Each employee funded in whole or in part with federal funds must record time and
effort spent on the project(s) funded. The Grantee must:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. Denote accurately the percent of effort to the project. The percent of effort may
vary from month to month, and the effort recorded for Ryan White funds must
match the percentage claimed on the Ryan White FSR for the same period.
d. Submit a budget modification to the Department in instances where the
percentage of effort of contract staff changes (FTE changes) during the contract
period.
6. The Grantee must submit all details on advertising campaigns (print and social
media) completed via the quarterly workplan progress report submission in
EGrAMS.
7. The Grantee must include the following language in all Client Consent and Release
of Information forms used for services in this agreement:
“Consent for the collection and sharing of client information to
providers for persons living with HIV under the Ryan White Program
provided through (grantee name) is mandated to collect certain
personal information that is entered and saved in a federal data
system called CAREWare. CAREWare records are maintained in an
encrypted and secure statewide database. I understand that some
limited information in the electronic data may be shared with other
agencies if they also provide me with services and are part of the same
care and data network for the purpose of informing and coordinating
my treatment and benefits that I receive under this Program. The
CAREWare database program allows for certain medical and support
service information to be shared among providers involved with my
care, this includes but is not limited to health information, medical
visits, lab results, medications, case management, transportation,
Housing Opportunities for Persons with AIDS (HOPWA) program,
substance abuse, and mental health counseling. I acknowledge that if
I fail to show for scheduled medical appointments, I may be contacted
by an authorized representative of (grantee name) in order to re-
engage and link me back to care.”
8. The Grantee must notify the Continuum of Care Unit staff at MDHHS-
HIVSTIoperations@michigan.gov within 7 business days if a core medical or
support service category is added or removed from the Ryan White services
previously approved by BHSP. An approval from BHSP is required prior to the
change being implemented.
9. The Grantee must adhere to security measures when working with client information
and must:
a. Not email individual health information either internally or externally.
b. Keep all printed materials in locked storage cabinets in locked rooms.
c. Provide written documentation of annual Security and Confidentiality training for
all staff regarding the Health Insurance Portability Accountability Act (HIPAA),
the Health Information Technology for Economic and Clinical Health (HITECH),
and the Michigan Public Health Code.
d. Maintain the standards of CDC’s Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs.
CDC Website:
https://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelin
es.pdf.
10. The Grantee will complete the collection of all required data variables and clean-up
any missing data or service activities by the 10th day after the end of each calendar
month.
11. Subrecipient quality management program should:
a. Include: leadership support, dedicated staff time for QM activities, participation
of staff from various disciplines, ongoing review of performance measure data
and assessment of consumer satisfaction.
b. Include consumer engagement which includes, but is not limited to, agency-level
consumer advisory board, participation on quality management committee,
focus groups and consumer satisfaction surveys.
c. Include conduction of at least one quality improvement (QI) project throughout
the year, using the Plan-Do-Study-Act (PDSA) method to document progress.
This QI project must be aimed at improving client care, client satisfaction, or
health outcomes.
12. If the Grantee is federally funded for Ryan White services (one of which is a core
medical service), the Grantee will develop and/or revise a Quality Management Plan
(QMP) annually, to be kept on file at agency. QM Plans must contain these eleven
components:
• Quality statement
• Quality infrastructure
• Annual quality goals
• Capacity building
• Performance measurement
• Quality improvement
• Engagement of stakeholders
• Procedures for updating the QM plan
• Communication
• Evaluation
• Work Plan
13. Grantee quality management activities should:
a. Incorporate the principles of continuous quality improvement, including agency
leadership and commitment, staff development and training, participation of
staff from all levels and various disciplines, and systematic selection and
ongoing review of performance criteria, including consumer satisfaction; and
b. Include consumer engagement which includes, but is not limited to, agency-
level consumer advisory board, participation on quality management
committee, focus groups and consumer satisfaction surveys.
14. In accordance with continuous quality improvement principles, the Grantee shall
conduct at least one quality improvement project throughout the year, using the
Plan-Do-Study-Act method to document progress.
15. The Grantee must consult and adhere to the Policy Clarification Notice (PCN) #16-
02 established by Health Resources and Services Administration (HRSA). PCN
#16-02 describes the core medical and support services that HRSA considers
allowable uses of Ryan White grant funds and the individuals eligible to receive
those services. A copy of the revised PCN 16-02 is available at this link.
HRSA Unallowable Costs:
*An expanded list of “unallowable” grant costs is available in the PCN 16-02.
a. HRSA RWHAP funds may not be used to make cash payments to intended clients
of HRSA RWHAP-funded services. This prohibition includes cash incentives and
cash intended as payment for HRSA RWHAP core medical and support services.
Where a direct provision of the service is not possible or effective, store gift cards,
vouchers, coupons, or tickets that can be exchanged for a specific service or
commodity (e.g., food or transportation) must be used.
b. Off-premises social or recreational activities (movies, vacations, gym memberships,
parties, retreats)
c. Medical Marijuana
d. Purchase or improve land or permanently improve buildings
e. Direct cash payments or cash reimbursements to clients
f. Clinical Trials: Funds may not be used to support the costs of operating clinical trials
of investigational agents or treatments (to include administrative management or
medical monitoring of patients)
g. Clothing: Purchase of clothing
h. Employment Services: Support employment, vocational rehabilitation, or
employment-readiness services.
i. Funerals: Funeral, burial, cremation, or related expenses
j. Household Appliances
k. Mortgages: Payment of private mortgages
l. Needle Exchange: Syringe exchange programs, Materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether homosexual or
heterosexual
m. International travel
n. The purchase or improvement of land
o. The purchase, construction, or permanent improvement of any building or other
facility
p. Pets: Pet food or products
q. Taxes: Paying local or state personal property taxes (for residential property, private
automobiles, or any other personal property against which taxes may be levied).
r. Vehicle Maintenance: Direct maintenance expense (tires, repairs, etc.) of a
privately-owned vehicle or any additional costs associated with a privately-owned
vehicle, such as a lease, loan payments, insurance, license or registration fees
s. Water Filtration: Installation of permanent systems of filtration of all water entering
a private residence unless in communities where issues of water safety exist.
t. It is unallowable to divert program income (income generated from charges/ fees
and copays from Medicare, Medicaid, other third-party payers collected to cover RW
services provided) toward general agency costs or to use it for general purposes.
u. Pre-Exposure Prophylaxis (PrEP) HIV/AIDS BUREAU POLICY 16-02
v. Non-occupational Post-Exposure Prophylaxis (nPEP).
w. General-use prepaid cards are considered “cash equivalent” and are therefore
unallowable. Such cards generally bear the logo of a payment network, such as
Visa, MasterCard, or American Express, and are accepted by any merchant that
accepts those credit or debit cards as payment. Gift cards that are cobranded with
the logo of a payment network and the logo of a merchant or affiliated group of
merchants are general-use prepaid cards, not store gift cards, and therefore are
unallowable.
* HRSA RWHAP recipients are advised to administer voucher and store gift card programs
in a manner which assures that vouchers and store gift cards cannot be exchanged for
cash or used for anything other than the allowable goods or services, and that systems are
in place to account for disbursed vouchers and store gift cards.
Personnel Systems Access/Transfer/Terminations
1. New staff needing access to CAREWare are required to submit the CAREWare user
request form through SHOARS.
2. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS
designated personnel in writing of any personnel transfers or terminations of
personnel who possess information system privileges within CAREWare or MIDAP
online data systems within 24 hours of change.
a. The Grantee shall notify MDHHS immediately via email at MDHHS-
HIVSTIoperations@michigan.gov of CAREWare users who are separated from
the agency for deactivation.
Record Maintenance/Retention
1. The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program
activities and expenditures, under the terms of this agreement, for clients residing
in the State of Michigan.
2. The Grantee will maintain client files and charts from last date of service plus seven
(7) years. For minors, Grantee will maintain client files and records from last date of
service and until minor reaches the age of 18, whichever is longer, plus seven (7)
years.
Software Compliance
1. The Grantee and its subcontractors are required to use the HRSA-supported
software CAREWare to enter client and service data into the centrally managed
database on a secure server. The Grantee must:
a. Enter all Ryan White services delivered to HIV-infected and affected clients.
b. Enter all data by the 10th of the following month.
c. Successfully create, run, and document the results of their HRSA RSR report in
CAREWare in order to receive relevant support from data managers by the 10th
of the following month. Documentation is to include with identifying information
omitted:
i. Missing records as depicted in the RSR Viewer module in
CAREWare
ii. A list of alert, warning, and error messages as depicted in the RSR
Validation Report module in CAREWare
iii. Efforts or decisions (including collaboration with MDHHS) to resolve
missing data or error messages as applicable
d. Complete collection of all required data variables and the clean-up of any
missing data or service activities by the 10th of the following month.
2. The Grantee must establish written procedures for protecting client information kept
electronically or in charts or other paper records. Protection of electronic client-level
data will minimally include:
a. Regular back-up of client records with back-up files stored in a secure location.
b. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
c. Use of virus protection software to guard against computer viruses.
3. Provide annual training to staff on security and confidentiality of client level data and
sharing of electronic data files according to MDHHS policies concerning sharing and
Secured Electronic Data.
4. New staff needing access to CAREWare are required to submit the CAREWare user
request form through SHOARS.
5. As required by NIST SP 800-53 Details - PS-7e, the Grantee must notify MDHHS
designated personnel in writing of any personnel transfers or terminations of
personnel who possess information system privileges within CAREWare or MIDAP
online data systems within 24 hours of change.
a. The Grantee shall notify MDHHS immediately via email at MDHHS-
HIVSTIoperations@michigan.gov of CAREWare users who are separated from
the agency for deactivation.
6. The Grantee shall as be required by HRSA submit the Ryan White HIV/AIDS
Program Services Report (RSR) for the previous calendar year. The Grantee is
required to use the HRSA Electronic Handbook (EHB) portal for their submission:
a. The Grantee shall acquire access to their agency’s Grant Contract Management
System (GCMS) and their Provider Report prior to January when notified by
HRSA of the required federal report.
b. The Grantee is required to provide access to all staff and personnel responsible
for reviewing and completing the RSR.
c. The Grantee as per HRSA standards and compliance are mandated to require
relevant staff members to update their EHB account passwords as dictated by
HRSA email notifications.
d. The Grantee is mandated to update or add contact information for staff
responsible for completing and/or submitting the RSR and to notify MDHHS of
any changes in personnel immediately.
e. The Grantee shall correspond with MDHHS staff including data management
users to compare units of service provided to the funded services listed on the
EHB.
f. The Grantee shall notify MDHHS immediately if there are any discrepancies
between the funding sources and services listed for their agency’s report on the
Electronic Handbook (EHB) and their agency’s contracts and records.
g. The Grantee shall in these circumstances contact Ryan White Data Support by
email or by phone number (1-888-640-9356) between the hours of 10 am – 6:30
pm Eastern Standard Time (EST) on weekdays regarding the HRSA EHB GCMS
and/or RSR:
i. Issues with account lockouts, lost credentials, or account creation
ii. Issues with accessing the GCMS through the HRSA EHB
iii. Issues with accessing the Provider Report through the HRSA
iv. Technical issues regarding functionality of the EHB portal
h. The Grantee shall attend webinars and instructional sessions to answer
questions about the RSR; Grantee shall utilize tools provided by data
management users to check on the accuracy and completeness of their client
level data (CLD) on a monthly basis leading up to the RSR. These include but
are not limited to:
i. TargetHIV/DISQ webinars regarding the RSR
ii. HRSA produced documentation and manuals on RSR reporting
requirements for the calendar year
iii. Manuals on utilizing CAREWare for completing the RSR
iv. PowerPoint presentations on aspects of the RSR
v. Staff invitations to Teams meetings and breakout sessions to
answer questions regarding the RSR
vi. CAREWare custom reports and financial reports designed to
assess:
• The number of eligible clients
• The number of eligible clients that need to be marked as such
• Services provided by the Grantee
• CLD on ZIP codes, ethnicity, and other features
vii. Emails from MDHHS staff regarding the above but also including:
• Updates on HRSA reporting requirements
• New information provided from HRSA
• Other resources HRSA is providing/will provide
i. The Grantee shall after notification from MDHHS staff including data
management users implement needed corrections and additions to CLD in
CAREWare to ensure compliance with HRSA federal reporting standards.
Mandatory Disclosures
1. The Grantee will provide immediate notification to the Department, in writing, in the
event of any of the following:
a. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
b. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of, or
a defendant in, legal action. This includes, but is not limited to, events or notices
related to grievances by service recipients or Grantee or subcontractor
employees.
c. Any staff vacancies funded for this project that exceed 30 days. All notifications
should be made to BHSP by MDHHS-HIVSTIoperations@michigan.gov.
Technical Assistance
1. Technical assistance (TA) may be requested on the implementation of the Ryan
White program. This may include issues related to: CAREWare, Quality
Management, Ryan White B services, Budget/Fiscal, Grants and Contracts, ADAP,
or other activities related to carrying out Ryan White activities.
2. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
3. Grantee must register an Authorized Official and Program Manager in the BHSP
SHOARS system. These roles must match what the agency has listed for these
roles in the EGrAMS system. If you have access related questions, contact MDHHS-
SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov.
ASSURANCES
Compliance with Applicable Laws
1. The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Public
Health Service (PHS) Act.
3. The Grantee should have procedures to protect the confidentiality and security of
client information.
PROJECT TITLE:
HIV Prevention
HIV Prevention- Forest Community Health
HIV PrEP Clinic
HIV PrEP Mobile Clinic
HIV/STI Partner Services
HIV & STI Testing and Prevention
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The Purpose of this project is to implement a comprehensive HIV surveillance and
prevention program. Funding aim to Prevent new HIV infections, Improve HIV-related
health outcomes of people with HIV, Reduce HIV-related disparities and health
inequities, This funding supports coordinated efforts that address the HIV epidemic
including; implementation of integrated HIV/STI Services including referral and linkage
to appropriate services, social marketing campaigns, community mobilization efforts and
other evidence based risk reduction activities where feasible and appropriate and in
accordance with current CDC guidelines and recommendations.
Reporting Requirements:
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) Report submission
Counseling, Testing, and referrals
Quality Control Reports Monthly 10th of the following
month Department Staff
Daily Client Logs Monthly 10th of the following
month Department Staff
Test Kit Inventory Log Monthly 10th of the follow
month Department Staff
HIV Testing
Proficiencies Bi- annually Reviewed during
site visits Department Staff
HIV Testing
Competencies Annually
Sent to MDHHS
before the end of
the fiscal year
Department Staff
EMR testing** Monthly By the 10th of the
following month Department Staff
Non-Reactive Results As needed Within 7 days of test APHIRM
Reactive Results As needed Within 24 hours of
test APHIRM
Case Report Forms
As needed in
the event of a
reactive result
Adult Case Report
Form Directions
LMS
MDHHS Surveillance
Partner Services & Linkage to Care (as applicable)
Linkage to Care and
Partner Services
Interview***
As needed Within 30 days of
service APHIRM
Internet Partner
Services (IPS) and
Partner Services
Interview****
Ongoing Within 30 days of
service APHIRM
Disposition on Partners
of HIV Cases Ongoing Within 30 days of
service APHIRM
Evidence Based Risk Reduction Activities (as applicable)
SSP Data Report, Quarterly 10th of the following
month
Syringe Utilization
Platform (SUP)
Clinical HIV/STI services (as applicable)
340b PrEP Prescription
Log Weekly Every Friday by the
close of business
DCH File Transfer –
MDHHS-340B PrEP PT
ADT*****
Billing Revenue Report Quarterly
10th of the following
month
Department Staff
STI 340B
Utilization/Inventory
Report,
Quarterly
Within 10 days after
the end of the
quarter
Log into
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will be
transferred automatically
to ScriptGuide/BHSP
*CDC/MDHHS required activities including: Condom Distribution Data, if applicable; Social
Marketing data; Evidence based intervention data; other prevention services and activities,
if applicable
** Aggregated testing data
***(e.g. client attended a medical care appointment within 30 days of diagnosis, and was
interviewed by Partner Services within 30 days of diagnosis)
****(e.g. client identify dating apps used to meet partners), if applicable
*****https://milogintp.michigan.gov
1. The Grantee will clean-up missing data by the 10th day after the end of each
calendar month. Grantee must report required variables as outlined by National
HIV Monitoring and Evaluation (NHM&E) and MDHHS.
2. Any such other information as specified in the Statement of Work, Attachment A
shall be developed and submitted by the Grantee as required by the Bureau of
HIV and STI Programs (BHSP).
3. The Quality Control and Daily Client Logs may be sent to the Contract Manager
via:
a. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS
CTR inbox (MDHHS-HIV-CTR@michigan.gov)
b. Fax - (517) 241-5922
c. Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
4. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by BHSP.
5. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
Any additional Requirements:
Publication Rights
1. When issuing statements, press releases, requests for proposals, bid solicitations
and other documents describing projects or programs funded in whole or in part
with Federal fund, the Grantee receiving Federal funds, including but not limited to
State and local governments and recipients of Federal research grants, shall
clearly state:
a. The percentage of the total costs of the program or project that will be
financed with Federal funds.
b. The dollar amount of Federal funds for the project or program.
c. Percentage and dollar amount of the total costs of the project or program
that will be financed by non-governmental sources.
2. The Grantee will submit all educational materials (e.g., brochures, posters,
pamphlets, and videos) used in conjunction with program activities to BHSP for
review and approval prior to their use, regardless of the source of funding used to
purchase these materials. Materials may be emailed to: MDHHS-
HIVSTIoperations@michigan.gov.
Grant Program Operation
1. The Grantee will participate in BHSP needs assessment and planning activities,
as requested.
2. The Grantee will participate in regular Grantee meetings which may be face-to-
face, teleconferences, webinars, etc. The Grantee is highly encouraged to
participate in other training offerings and information-sharing opportunities,
network detection response and interventions in collaboration with BHSP
opportunities provided by BHSP.
3. Each employee funded in whole or in part with federal funds must record time
and effort spent on the project(s) funded. The Grantee must:
a. Have policies and procedures to ensure time and effort reporting.
b. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
c. Denote accurately the percent of effort to the project. The percent of effort
may vary from month to month, and the effort recorded for funds must match
the percentage claimed on the FSR for the same period.
d. Submit a budget modification to BHSP in instances where the percentage of
effort of contract staff changes (FTE changes) during the contract period.
e. If there are any changes in staff or agency operations, please email MDHHS-
SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov.
4. If conducting HIV testing using rapid HIV testing, the Grantee will comply with
guidelines and standards issued by BHSP and:
a. Provide medical oversight letter/agreement signed by a licensed physician is
necessary to collect specimens and order HIV antibody/antigen, HIV
genotype, HIV incidence, syphilis, gonorrhea, chlamydia, and hepatitis C
testing. According to Part 15 of the Public Health Code MCL 333.17001(j),
‘practice of medicine’ is defined as
i. “the diagnosis, treatment, prevention, cure, or relieving of a human
disease, ailment, defect, complaint, or other physical or mental condition,
by attendance, advice, device, diagnostic test, or other means, or offering,
undertaking, attempting to do, or holding oneself out as able to do, any of
these act”.
b. Conduct quality assurance activities, guided by written protocol and
procedures. Protocols and procedures, as updated and revised Quality
assurance activities are to be responsive to: Quality Assurance for Rapid HIV
Testing, MDHHS. See “Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals.”
i. Ensure provision of Clinical Laboratory Improvement Amendments (CLIA)
certificate.
ii. Report discordant test results to BHSP
Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the
MDHHS CTR inbox (MDHHS-HIV-CTR@michigan.gov)
Fax - (517) 241-5922
iii. Ensure that staff performing counseling and/or testing with rapid test
technologies has completed, successfully, rapid test counselor certification
course or Information Based Training (as applicable), test device training,
and annual proficiency testing.
iv. If conducting blood draws, the grantee must conduct the packaging and
shipping training via Bureau of Laboratories. BashoreM@michigan.gov
v. Ensure that all staff and site supervisors have completed, successfully,
appropriate laboratory quality assurance training, blood borne pathogens
training and rapid test device training and reviewed annually.
vi. Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
vii. To maintain active test counselor certification, each HIV test counselor
must submit one competency per test device per year to the appropriate
departmental staff.
5. If conducting SSP, the grantee will develop programs using MDHHS guidance
documents and will address issues such as identification and registration of
clients, exchange protocols, education, and trainings for staff, and referrals.
a. Grantees will participate on monthly or quarterly conference calls to discuss
best practices and identify barriers.
6. If conducting PS, the Grantee will comply with guidelines and standards issued
by the Department. See “Applicable Laws, Rules, Regulations, Policies,
Procedures, and Manuals.” The Grantee must:
a. Provide Confidential PS follow-up to infected clients and their at-risk partners
to ensure disease management and education is offered to reduce
transmission.
b. Effectively link infected clients and/or at-risk partners to HIV care and other
support services.
c. Work with Early Intervention Specialist to ensure infected clients are retained
in HIV care.
d. If applicable,
i. Procure TLO or a TLO-like search engine.
ii. Ensure staff that are utilizing TLO or TLO-search engine complete the
TLO training to maintain and understand the confidential use of the
system.
iii. Effectively utilize the Internet Partner Services (IPS) Guidance to provide
confidential PS follow-up to at-risk partners named by infected clients who
were identified to have been met through the use of dating apps.
iv. Ensure staff and site supervisors successfully complete the Internet
Partner Services Training.
v. Ensure staff conducting Internet Partner Services participant in monthly,
bi-monthly meetings, webinars or calls to discuss best practices and
identify barriers.
7. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
8. Funds generated by this program must be utilized to support the program,
including to hire a Mid-level provider, supporting staff, and program materials to
provide Pre-Exposure Prophylaxis (PrEP) services.
9. Any funds included in this agreement above must be re-invested in HIV/STI PrEP
services. This could mean improving, enhancing, and/or expanding your current
HIV/STI services or adding new services to improve patient health outcomes for
HIV/STI.
10. Any revenue or income generated via billing from this agreement must be
reinvested into this project.
Record Maintenance/Retention
The Grantee will maintain, for a minimum of five (5) years after the end of the grant
period, program, fiscal records, including documentation to support program activities
and expenditures, under the terms of this agreement, for clients residing in the State of
Michigan.
Software Compliance
1. The Grantee and its subcontractors are required to use APHIRM (formerly
Evaluation Web) to enter HIV client and service data into the centrally managed
database on a secure server.
2. The Grantee and its subcontractors are required to use APHIRM to enter PrEP
Cascade Data into the centrally managed database on a secure server.
3. The Grantee and its subcontractors are required to use APHIRM to enter EBI/
PrEP program data into the centrally managed database on a secure server.
4. The Grantee and its subcontractors are required to use APHIRM (formerly
Partner Services Web) to enter Partner Services interview, linkage to care data,
and identified dating apps through the use of Internet Partner Services (IPS)
where appropriate.
5. The Grantee and its subcontractors are required to use SHOARS to request
amendments, supplies, data, technical assistance and to register for trainings.
6. New staff needing access to APHIRM are required to submit the APHIRM user
request form through SHOARS.
7. The Grantee shall notify MDHHS immediately via email at MDHHS-SHOARS-
SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov of APHIRM users who
are separated from the agency for deactivation.
Mandatory Disclosures
1. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
2. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
3. Any event occurring or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of, or
a defendant in, legal action. This includes, but is not limited to, events or notices
related to grievances by service recipients or Grantee or subcontractor
employees.
4. Any staff vacancies funded for this project that exceed 30 days.
a. All notifications should be made to BHSP by MDHHS-
HIVSTIoperations@michigan.gov.
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in
the BHSP SHOARS system. These roles must match what the agency has listed
for these roles in the EGrAMS system. If you have access related questions,
contact MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-
SUPPORT@michigan.gov .
3. TA will be provided, as requested, on the implementation of the HIV Prevention
program. This may include issues related to: APHIRM, Programs, Budget/Fiscal,
Grants and Contracts, Risk Reduction Activities, Training, or other activities
related to carrying out HIV prevention activities.
4. Training and TA will be provided in support of implementation of HIV testing as a
standard of care and use of rapid HIV tests.
Compliance with Applicable Laws
1. The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
PROJECT TITLE: Housing Opportunities for Persons with AIDS (HOPWA)
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The purpose of this project is to increase housing stability, reduce the risk of
homelessness, and increase access to care and support for low-income individuals living
with HIV/AIDS and their families
Reporting Requirements (if different than agreement language):
Subrecipients must submit required program data through HMIS. It is expected that data
entry into HMIS will be completed within15 days of the event requiring data entry (entry
into the program; end of the operating year; changes in participant status regarding
benefits, income, programs provided, household size, location of housing, and so on as
described by HMIS guidelines). It is expected that data in HMIS be complete, up-to-date,
and without errors or omissions by July 31 (or the first business date immediately
following July 31) of each year.
Any assistance needed for HMIS data entry or reporting should be directed to the
MDHHS HMIS Analyst:
Scott Clark, MPA, MSA
ClarkS15@Michigan.gov
517-284-8013
The subrecipient must submit the Consolidated Annual Performance and Evaluation
Report (CAPER) each grant term prior to July 31st. All requirements for reporting are
outlined in the HOPWA program manual. Please contact Lynn Nee, HOPWA Program
Specialist, from the Housing and Homeless Services Division with any questions about
reporting requirements.
Lynn Nee
HOPWA Program Specialist
Housing and Homeless Services
NeeL@michigan.gov
517-275-2791
Any additional requirements (if applicable)
The subrecipient shall undertake, perform, and complete activities and services for the
program as outlined in the Program Manual provided by the Michigan Department of
Health and Human Services (MDHHS) Housing and Homeless Services Division. The
grantee is expected to adhere to all applicable federal and state laws, regulations, and
notices.
PROJECT: Immunization Action Plan
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Offer immunization services to the public.
• Collaborate with public and private sector organizations to promote childhood,
adolescent and adult immunization activities in the county including but not limited
to recall activities.
• Educate providers about vaccines covered by Medicare and Medicaid.
• Provide and implement strategies for addressing the immunization rates of special
populations (i.e., college students, educators, health care workers, migrant
workers, long term care centers, detention centers, homeless, tribal communities,
and childcare employees).
• Develop and implement strategies to improve jurisdictional and LHD immunization
rates for children, adolescents, and adults.
• Ensure clinic hours are convenient and accessible to the community, operating
both walk-in and scheduled appointment hours.
• Coordinate immunization services with WIC, Family Planning, and STI programs.
• Collaboratively work with regional MCIR staff to ensure providers are using MCIR
appropriately.
• Develop strategies to identify and target local pocket of need areas.
Reporting Requirements (if different than contract language)
1. Develop an Immunization Action Plan (IAP) and submit it by the due date
established by the Division of Immunization.
2. Submit IAP reports by the due dates established by the Department.
Any additional requirements (if applicable)
1. Ensure that VFC providers submit a VFC online re-enrollment form in MCIR by
April 1st.
2. Adhere to federal and state requirements regarding the use of programmatic
funds.
3. Adhere to requirements set forth in the Omnibus Budget Reconciliation Act of
1993, section 1928 Part IV – Immunizations and the most current CDC Vaccines
for Children Operations Manual, Michigan Resource Book for VFC Providers, and
documents that are updated throughout the year pertaining to the Vaccines for
Children (VFC) Program.
4. Ensure that federally procured vaccine is administered only to eligible children and
is properly documented per VFC guidelines.
• The VFC Program provides VFC vaccine to eligible children through 18 years
of age who meet at least one of the following criteria: American Indian or
Alaskan Native, Medicaid eligible, uninsured or under-insured. Underinsured
children are eligible to receive VFC vaccine only through a Federally Qualified
Health Center (FQHC), Rural Health Clinic (RHC) or under an approved
deputization agreement.
5. Ensure state-supplied vaccines provided in the jurisdiction are administered only
to eligible clients as determined by the state. This program allows for the
immunization of select populations who are underinsured and not served at a
FQHC, RHC, or a public health immunization clinic affiliated with a FQHC as
defined by current state program requirements.
6. Ensure that all providers receiving vaccine from the state screen children for VFC
eligibility.
7. Fraud or abuse of federally procured vaccine must be monitored and reported.
8. Adhere to all Federal and Michigan Laws pertaining to immunization administration
and reporting including reporting to the MCIR, VAERS and schools and daycare
reporting
9. Coordinate the submission of immunization data from schools and childcare
centers in your jurisdiction and follow-up with programs providing incomplete or
inaccurate data. Assure compliance levels are adequate to protect the public.
10. Provide education to the parents of children seeking a non-medical exemption in
your jurisdiction.
11. Monitor any provider receiving federally procured vaccine including but not limited
to VFC/QI site visit.
12. Ensure on-site attendance of at least 1 LHD immunization program staff to two (2)
Immunization Action Plan (IAP) meetings each year.
13. Implement the following Perinatal Hepatitis B program activities to prevent the
spread of Hepatitis B Virus (HBV) from mother to newborn:
• Verify pregnancy status on all hepatitis B surface antigen (HBsAg) positive
pregnant women of childbearing years (10-60 years of age.)
• Ensure HBsAg positive pregnant women are reported to the Perinatal Hepatitis
B case manager and according to the Public Health Code.
• Coordinate Perinatal Hepatitis B case management activities between local
health department, provider, and Perinatal Hepatitis B Case Manager to:
Ensure that all infants, born to women who are HBsAg positive
receive hepatitis B vaccine and hepatitis B immune globulin
(HBIG) within 12 hours of life, a complete hepatitis B vaccine
series with post vaccination serology testing and program support
services.
Ensure that all susceptible household and sexual contacts
associated with HBsAg positive women receive appropriate
testing, vaccination, and support services.
Ensure birthing hospitals are able to offer hepatitis B vaccine to
all newborns prior to hospital discharge by enrolling them in the
Universal Hepatitis B Vaccination Program for Newborns.
14. Surveillance of vaccine preventable disease (VPD) activities
• Conduct active surveillance when indicated (i.e. during an outbreak) and contact
hospitals, laboratories, and/or other providers on a regular basis.
PROJECT: Immunization Fixed Fee (VFC, AVP and QI Site Visits)
Start Date: 10/01/2023
End Date: 9/30/2024
Project Synopsis
The format of the site visit will be based on the completed site visit questionnaires, the
CDC-PEAR and CDC-IQIP database systems reviewed at the most recent Fall IAP
meeting, web-training with MDHHS VFC and QI coordinators, in-person training with
Field Reps and the site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the appropriate
database as required by CDC (PEAR and QI database system) within 10 days of the site
visit by the individual who conducted the site visit. VFC site visit documentation must be
entered online within PEAR during the time of the site visit.
Reporting Requirements (if different than contract language)
All reimbursement requests should be submitted on the quarterly Comprehensive
Financial Status Report (FSR).
• The submission should include, as an attachment, detail all the visits during the
quarter using the current spreadsheet information provided by the Department.
Any additional requirements (if applicable)
• The rate of reimbursement is $175 for a VFC Enrollment, AVP Only visit, or VFC
Only visit, $100 for a VFC Unscheduled Storage and Handling Visit, $350 for a
Combined VFC/QI site visit or Birthing Hospital visit, and $200 for a QI Only visit.
A VFC Enrollment visit is required for all new VFC enrolled provider sites.
Unannounced Storage and Handling Visits are not required but when performed,
must occur in conjunction with Immunization Education Sessions required for VFC
Providers that experience a loss exceeding a VFC dollar amount of $2500. These
visits can only be completed if eligible according to current CDC requirements
(e.g., visits cannot be performed for providers who have any visit that is either in
“In Progress” or “Submitted” status). Notify MDHHS VFC staff for approval prior to
performing these visits. MDHHS VFC will monitor the number of Unannounced
Storage and Handling visits performed and, if necessary, may limit the allowable
number of those that can be performed.
• All LHD staff involved with any site visits must complete the Department site visit
training webinar, presented by the Department VFC and QI Coordinator, prior to
conducting any site visits. Annual VFC and QI visit guidance and review materials
will be provided to each LHD at the IAP Meetings and consult will be conducted by
the Department Immunization Field Representative for each Grantee.
• Data from the CDC PEAR and CDC IQIP databases regarding the number and
type of site visits will be used to reconcile the agency request for reimbursement.
For additional detail on the program requirements, refer to the Resource Guide for
Vaccine for Children Providers and the current Department site visit guidance
documents, as well as other current guidance provided by the
Department/Immunization Program in correspondence to Immunization Action
Plan (IAP), Immunization Coordinators, or through health officers.
• Every VFC visit performed for a QI-eligible provider may receive a QI visit within
the same site visit cycle. This may be performed as either a Combined VFC-QI
visit or separate VFC Only and QI Only visit, according to current MDHHS
guidelines. A QI visit can only be conducted within a cycle in which a VFC visit has
also been conducted for the same provider. LHDs must conduct a QI visit on a
least 25% of VFC providers annually.
• Local health departments must complete an in-person VFC or VFC/QI site visit for
every VFC provider at minimum, every 24-months, using the date of their previous
visit as a starting point. Site visits will vary in time an average of 1 hour for QI and
2 hours for VFC Compliance and must not exceed the two-year time frame.
Annual visits are encouraged but must not be conducted sooner than 11 months
from the previous site visit date.
• Combined VFC/QI site visits will be conducted using MCIR QI reports and QI tools
developed by the Department. All VFC and QI follow-up activities and outstanding
issues must be completed within CDC guidelines.
• Detroit Department of Health and Wellness Promotion Immunization Program is
required to complete visits annually to 100% of the VFC providers in accordance
with the SEMHA Quality Assurance Specialist (QAS) contractual obligations,
including the completed site visit questionnaires and the CDC-PEAR and the
CDC-IQIP database systems reviewed at the most recent Fall IAP meeting, web-
training with MDHHS VFC and QI coordinators, in-person training with Field Reps
and the current site visit guidance documents (VFC and QI) provided by the
department and the CDC. All site visit information shall be entered into the
appropriate database as required by CDC (PEAR and QI database system) within
10 days of the site visit by the individual who conducted the site visit. VFC site visit
documentation must be entered online within PEAR during the time of the site
visit.
PROJECT: Immunization Vaccine Quality Assurance
Start Date: 10/01/2023
End Date: 9/30/2024
Project Synopsis
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
1. Follow-up on vaccine losses and replacement for compromised vaccines for
immunization providers within the jurisdiction.
2. Monitor and approve all temperature logs, doses administered reports and ending
inventory reports received from participating VFC providers within the jurisdiction.
3. Monitor and approve vaccine orders for participating VFC providers within the
jurisdiction.
4. Act as the Primary Point of Contact (PPOC) for VFC providers within the
jurisdiction.
5. Provide education and intervention on inappropriate use of publicly purchased
vaccine.
6. Follow-up on VFC site visit non-compliance issues.
7. Assist VFC providers within the jurisdiction on issues related to balancing vaccine
inventories.
8. Assist with the redistribution of short-dated vaccine for providers within the
jurisdiction.
9. Assist with the equitable allocation of vaccines to providers in the jurisdiction
during a vaccine shortage.
PROJECT TITLE: Infant Safe Sleep
Start Date: 10/1/2023
End Date: 09/30/2024
Project Synopsis:
Local health departments will provide safe sleep educational activities, conduct safe
sleep community outreach/awareness efforts and engage community leaders to guide
programming.
Reporting Requirements (if different than agreement language):
1. LHD will attach the completed “Infant Safe Sleep Mini-Grant Work Plan” to the
indirect cost line of the budget for review and approval by the Infant Safe Sleep
program prior to the start of the fiscal year.
2. Prior to the submission of the proposed work plan, LHD will participate in an in-
person or virtual meeting with all mini-grantees facilitated by the Infant Safe Sleep
Program to review current data, discuss infant safe sleep best practices and answer
any questions related to mini-grant requirements.
3. LHD will submit the “Infant Safe Sleep Mini-Grant Work Plan and Reporting
Document” quarterly with the “Summary of Work Completed” and “Outputs” columns
completed and the “Community Engagement Questions” answered. It must be
attached to the indirect cost line of each quarterly FSR (Q1, Q2, Q3) and to the final
FSR.
4. LHD will participate in a monthly meeting (in-person, virtual or call) with the Infant
Safe Sleep Program to review progress, provide updates and coordinate activities
statewide. LHD will participate in more frequent calls if requested by program staff.
Any additional requirements:
1. LHD will designate a staff person to serve as the contact with the Infant Safe Sleep
Program.
2. Grantee must provide safe sleep educational activities, conduct safe sleep
community outreach/awareness efforts and engage community leaders to guide
programming.
3. Programming must adhere to the policy statement titled “SIDS and Other Sleep-
Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping
Environment” issued by the American Academy of Pediatrics or any subsequent
updates to that policy statement.
4. Activities must:
a. Be data driven and focus on communities or populations that experience a
high rate of sleep-related infant death and disparity. Input and feedback from
families at highest risk for sleep-related infant death must be utilized.
b. Be culturally appropriate based on the communities served.
c. Support families and encourage open and nonjudgmental conversations with
families about infant sleep practices, including risk reduction strategies.
5. Grantee must participate in and/or coordinate a local advisory team or regional group
(such as the county’s Regional Perinatal Quality Collaborative) to coordinate efforts
to promote infant safe sleep and reduce infant deaths related to unsafe sleep
environments. Grantee must make efforts to ensure membership represents a
diverse community of stakeholders and includes the following on the advisory team:
a. Community partners that can address social determinates of health including
partners that can meet resource needs of families and partners that work
further upstream.
b. Community members, such as families, parents and caregivers
6. Activities of the grantee must align with the Mother Infant Health and Equity
Improvement Plan to address preventable infant deaths and disparities through
evidence-based infant safe sleep program activities.
7. Funds may be used for the purchase of demonstration and/or educational items,
however, grantee is encouraged to use department-provided educational materials
when possible. Additionally, a maximum of 7% of the funding may be used for
giveaway items that are directly related to infant safe sleep such as cribs, pack and-
plays, and/or sleep sacks. A maximum of 5% of the funding may be used for
advertising, including billboards, bus signage and the purchase of radio, TV, and/or
print media.
8. Grantee must adhere to the approved work plan. Deviations to the work plan must
be approved by the Program Coordinator.
Program Coordinator
Colleen Nelson
nelsonc7@michigan.gov
517-243-1796
PROJECT: Informed Consent
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The Department will provide funding for local health departments that provide assistance
to patients as set forth in MCL 333.17015. Specifically, funding will be granted for serving
patients who—prior to seeking abortion services elsewhere—expressly request a
pregnancy test for the purposes of (1) confirming a pregnancy, and (2) determining the
probable gestational stage of a confirmed pregnancy.
Funding will be provided at the fixed rate of $50 per patient served.
Reporting Requirements (if different than contract language)
The number of services, rate per service, and total amount due must be noted as a funding
source, under the element where the staff providing the services are funded, on the FSR
through the MI E-Grants system.
Any additional requirements (if applicable)
The following requirements apply to all Grantees, whether the Grantee operates a Family
Planning Clinic or not:
1. When a patient states that they are planning to seek an abortion and requests a
pregnancy test to comply with the current requirements under MCL 333.17015, the
Grantee will provide the following:
a. A pregnancy test; and
b. A completed "Verification of Pregnancy and Gestational Age" form (if
pregnancy is confirmed).
2. The Grantee must destroy the individual “informed consent” files containing
identifying information (Name, Address, etc.) after 30 days.
3. When a patient seeks a pregnancy test and does not explicitly state that they are
doing so for the purpose of obtaining an abortion, the Grantee should direct them
to a Family Planning Clinic or to their primary care provider for a pregnancy test
(rather than provide services under this program). Services to comply with MCL
333.17015 should not be provided to a patient in a Title X funded family planning
clinic.
PROJECT TITLE: Integrating Mpox into STI Clinics
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis:
This funding is to support local health departments in integrating mpox into routine STI
care. Activities may include: Amending or planning and assessing barriers to modifying
clinical procedures to incorporate mpox education and plans for risk assessment and
vaccination into clinic flow and practice. LHDs should also consider vaccination for mpox
post exposure prophylaxis for partners. Local Health Departments should promote
availability of mpox testing and vaccination on website and social media sites, conduct an
analysis of clinic's capacity to expand services to include mpox testing, treatment, and
vaccination including staffing and EMR requirements. Local health departments shall
think broadly about vaccines including Flu, COVID, HPV, Hep B, Hep A.
Reporting Requirements (if different than agreement language):
1. How does your program plan to integrate mpox into routine STI and HIV clinical
care?
2. Please Select what mpox services your STI clinic provides (check all that apply)
Testing
Treatment
Vaccination
3. How many mpox vaccines have you provided in the STI clinic this quarter?
4. How many patients have you seen this quarter?
5. How many people have you referred to another clinic at the health department for
mpox vaccine this quarter?
6. Please describe the equitable approaches implemented by your program in this
reporting period (please confirm period in header above) to increase education
and vaccine coverage among populations disproportionately affected by mpox?
7. Where are you with incorporating mpox into routine care?
Not Started
On Track/In Progress
Off Track
Complete
8. Share any comments, updates, success, challenge or other relevant details
related to these activities?
All above reporting requirement must be emailed to Malasha Duncan at
duncanm5@michigan.gov and Kathryn Macomber at macomberk@michigan.gov by
January 10th 2024 April 10th 2024, July 10th 2024 & October 10th 2024
Any additional requirements (if applicable):
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in the
BHSP SHOARS system. These roles must match what the agency has listed for
these roles in the EGrAMS system. If you have access related questions, contact
MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov
PROJECT: Laboratory Services Bio
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
As part of the emergency preparedness and response efforts, the regional laboratories
have been designated as partner organizations that assist with testing, transport, and
communications related to biothreat agents or other evolving infectious agent issues.
Reporting Requirements (if different than contract language)
Provide the Bureau of Laboratories records and reports as required, at least once per
year or upon special request.
Any additional requirements (if applicable)
Meet established standards of performance and objectives in the following areas:
Public Health Emergency Preparedness:
• Maintain a current list of contact information for local community hospital
laboratories to facilitate communication.
• Facilitate response with local community hospital laboratories in preparation for and
during public health threats.
• Coordinate and facilitate specimen collection and transport with facilities within
jurisdiction. This may include specimen packaging and shipping and coordination
with the courier service.
• Provide 24/7 contact information to hospital partners and BOL.
• Participate in and provide support for Department PHEP exercises with community
hospital laboratories within jurisdiction.
• The Grantee will designate one staff member as a liaison to the Bureau of
Laboratories. Each Grantee must designate appropriate staff to take part in LIMS
training activities.
• Provide information on specimen submission to local health jurisdictions to assure
that specimens are submitted to the BOL LRN laboratory, or other appropriate LRN
laboratory as determined by the Department.
PROJECT: Lactation Consultant
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The Lactation Consultant project provides lactation support to persons living in Flint and
the surrounding areas. All activities must support and promote human milk feeding.
Reporting Requirements (if different than contract language)
1. In anticipation of the FY24 contract, grantees must submit a Lactation Consultant
work plan to McDonaldE1@michigan.gov by 9/1/2023. The work plan must
include:
a. Outcome objectives (a minimum of 2) for improved breastfeeding rates in
Genesee County.
b. Activities under each objective that include a specific outcome measure.
For example, “Will hold 4 community coalition meetings by September 30.”
c. The person responsible and deliverable quantifiable outcomes for each
activity.
2. Changes to the work plan throughout the year can occur with prior approval from
the MDHHS.
3. All activities, as specified in the initial approved work plan, shall be implemented.
Workplan Report Due Dates:
Work plan reports must be submitted quarterly or as requested by MDHHS. The reports
are due 30 days after each quarter and year end and include the following timeframes:
a. Initial work plan due August 1, 2023.
b. First quarter (covering period October 1 through December 31) is due January
30.
c. Second quarter report (covering period January 1 through March 31) is due
April 30.
d. Third quarter report (covering period April 1 through June 30) is due July 30.
e. Fourth quarter report (covering period July 1 through September 30) is due
October 30.
Any additional requirements (if applicable)
PROJECT: Lead Hazard Control
Start Date: 10/01/2023
End Date: 9/30/2024
Project Synopsis
The LHCCD grant funds local communities to provide residential lead hazard control
(LHC) services within their communities per the Medicaid Children’s Health Insurance
Program State Plan Amendment. The purpose is to provide LHC services to eligible
households with a Medicaid-enrolled child to reduce lead exposure in children. The
program consists of outreach, education, identification of sources of lead, as well as
remediation of lead hazards within the home that contribute to elevated blood lead
levels. The grant allows grantees to establish a tailored, high quality, and sustainable
lead hazard control program that best serves the residents in their community.
Reporting Requirements (if different or in addition to contract language)
A. Grantees must complete and submit monthly Enrollee Engagement Protocol
Tracking Reports via secured MDHHS File Transfer Protocol (FTP) system by
the 15th of each month for the prior month’s activity.
B. Grantees must complete and submit MDHHS-LSS Monthly Monitoring Reports
via secured FTP by the 15th of each month for the prior month’s activity. The
method of reporting may change following the MiCLEAR application
implementation.
C. Quarterly Financial Status Reports in EGrAMS are due by the 30th of the month
following the end of the quarter. Grantees shall provide applicable general
ledgers attached to the quarterly Financial Status Report in an Excel or PDF
format for reconciliation, review and analysis.
D. Grantees must submit quarterly Work Plan reports via FTP by the 15th of the
month following the end of each quarter, as specified in the Grant Agreement.
Work Plan will include projected benchmarks for applications received/approved,
lead inspection risk assessments as well as lead abatement projects completed.
E. Grantees must have at least one representative participate in additional
monitoring and information conference calls as requested by LLSD.
F. Any other information as specified in the Statement of Work, shall be developed
and submitted by the Grantee as required by the Contract Manager.
G. Reports and information shall be submitted through the Lead Hazard Control
Community Development File Transfer Protocol (LHCCD FTP) shared area and
EGrAMS. The method of reporting may change following the MiCLEAR
application implementation.
H. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by Contract Manager.
Any additional requirements (if applicable)
A. Ensure compliance with laws, regulations, licensing requirements, protocols,
and guidelines for all funded activities under this RFP. Work must be conducted
by firms and persons certified according to the Michigan Lead Abatement Act
and/or EPA 40 CFR 745 possessing certification as lead abatement firms, EPA
certified renovation firms, risk assessors, inspectors, abatement supervisors,
abatement workers or certified renovators (for workers and supervisors
performing non-abatement work), as applicable to each unit’s scope of work.
Any abatement activities conducted under this program require a properly
certified abatement firm, certified abatement supervisor, certified abatement
worker credentialing. Any activities or other renovation activities not performed
during abatement activities under this program requires a properly certified EPA
renovation firm using only EPA-certified renovators. Each project will have a
clearance performed at the end of the abatement work and at the end of the
project. Compliance with the following is required for all sub-contractors, sub-
grantees, sub-recipients, and their contractors:
U.S. Department of Housing and Urban Development (HUD): 24 CFR 35
U.S. Occupational Safety and Health Administration (OSHA): 29 CFR
1910.1025,
29 CFR 1926 (Lead Exposure in Construction)
U.S. Environmental Protection Agency (EPA): 40 CFR 745
U.S. EPA, National Environmental Policy Act - Tier II Environmental
Review: 29 CFR Part 50-58.
National Historic Preservation Act. The National Historic Preservation Act
of 1966 (54 U.S.C. §300101) and the regulations at 36 CFR Part 800
apply to the lead-hazard control or rehabilitation activities that are
undertaken pursuant to this RFP.
State of Michigan regulations, including the Michigan Lead Abatement Act
(MCL 333.5451-333.3477), Lead Hazard Control Administrative Rules
(R325.99101-R325.99409), and Article 24 of Public Act 299 of 1980, as
amended, regarding residential building, maintenance, and alteration
contractor licensing and regulations.
Local regulations as applicable.
B. Applicants applying as a consortium must identify all partners, one Lead
Applicant, and Authorizing Official in their proposal. Identify the geographic
region each consortium partner is serving and their role.
C. Create an Enrollee Engagement Prioritization Plan that specifies how you will
adhere to the minimum requirements in the Enrollee Engagement Protocol.
Grantees must ensure that prioritized at-risk eligible households receive
adequate outreach for equitable inclusion and enrollment.
i. Grantees shall maintain a documented Enrollee Engagement Prioritization
Plan for their community, prioritizing the most at-risk families (e.g.
pregnant women, children with EBLs, age of child, housing stock, etc.).
Upon completion of a Data Use Agreement, MDHHS-LSS will provide
Grantees with a monthly Medicaid enrollee and Elevated Blood Lead
Level (EBLL) report for their geographic region to support this activity.
ii. Grantee’s plan shall include enough potential participants to attain
benchmarks. Conversely, Grantee’s plan must be targeted to avoid a
lengthy backlog of applicants.
iii. Once a Grantee has contacted a potential enrollee, the engagement
protocol shall be followed until an application is received or they are
disengaged according to the disengagement protocol.
iv. Grantee enrollee engagement must include application completion
assistance, if needed.
v. Grantee’s plan shall address how an applicant backlog will be tracked and
monitored if there are more applicants than they can serve.
vi. If Grantee doesn’t have a backlog, all eligible applicants shall be served
regardless of their prioritization status.
vii. If Grantee plans to use a partner to oversee or conduct their Enrollee
Engagement Prioritization Plan and Tracking, they must identify the
partner, agreements they have in place, and how PII and PHI data are
shared and protected.
viii. If Grantee proceeds with an application that does not follow their Enrollee
Engagement Prioritization Plan, Grantee must document the justification in
their project file.
D. Ensure lead abatement requirements are followed including:
i. A lead abatement supervisor is required for each lead abatement job and
must be present at the job site while all abatement work is being done. This
requirement includes set up and clean up time. The lead abatement supervisor
must ensure that all abatement work is done within the limits of federal, state,
and local laws.
ii. Services may be rendered to eligible physical structures and include the
surrounding land up to the property line.
iii. Services must be coordinated with water service line removal that occurs
outside of the property line.
iv. A certified lead inspector or risk assessor, who is independent of the abatement
company, shall perform clearance testing after abatement work is completed
and at the end of the project.
v. All laboratories selected for use in the lead-based paint hazards and
evaluation reports shall hold and maintain an accreditation to the ISO/IEC
17025:2005 standard, through an appropriate accreditation body, to
conduct lead testing services. The laboratory must be recognized by the
U.S. Environmental Protection Agency (EPA) National Lead Laboratory
Accreditation Program (NLLAP) for the analyses performed under this
contract, and shall, for work under this grant, use the same analytical
method used for obtaining the most recent NLLAP recognition. Additionally,
the laboratory must employ individuals, who perform the testing and review
and report out results, which meet the MDHHS Civil Service requirements
for staffing capabilities, which can be found below.
Grantee has two analytical laboratory options, which are to either (1) identify the
laboratory they plan to use; submit documentation of compliance with the
requirements stated in the RFP; (2) use the MDHHS Trace Metals Laboratory.
Copies of the chain-of-custody and sample results must be included within the
EBL EI or Lead Inspection/Risk Assessment report.
vi. Ensure water sampling protocols are followed in compliance with the EPA Lead
and Copper Rule and the MDHHS-LSS Residential Lead Hazard Control-Lead
in Water Protocol. A Michigan Department of Environment, Great Lakes and
Energy Certified Drinking Water Laboratory for Lead and Copper must be used.
All water samples must be analyzed within fourteen (14) days of collection. It is
recommended that all water samples be delivered to the approved laboratory
within ten (10) days of collection. Copies of the chain-of-custody and sample
results must be included within all Lead Hazard Control Environmental
Investigation, Clearance and Addendum reports.
vii. All residences designated within a Historic Preservation District must adhere to
state and local historical preservation requirements.
viii. The LSS – Local Lead Services and Development Unit (LLSD) is responsible
for conducting the Tier I Environment Review through the issuance of a public
notice in the form of a press release. Grantees are required to complete site
specific Tier II Environmental Reviews in accordance with U.S. EPA National
Environmental Policy Act, 24 CFR 50-58. Grantees must complete the required
Tiered Environmental Review Checklist for each project. The following
components shall be included in the review and adhered to:
a. Airport Runway Clear Zones and Clear Zones Disclosures
b. Coastal Barrier Resources Act
c. Coastal Zone Management
d. Flood Insurance
e. Flood Plain Management
f. Wetland Protection
g. Wild and Scenic Rivers
h. Clean Air Act
i. Contaminated and Toxic Substances
j. Endangered Species
k. Farmlands Protection
l. Explosive and Flammable Operations
m. Environmental Justice
E. Applicants must complete minimum work plan requirements, identify specific
program objectives and activities to be accomplished in a work plan. Objectives
should relate to the identified target community needs and be SMART (specific,
measurable, appropriate, realistic, and time-based). Each objective must have a
minimum of one related activity.
F. The following minimum objectives and activities shall be included in Applicant’s work
plan:
Objective: Education & Engagement
Activity: Adhere to Enrollee Engagement Protocol while utilizing
Program Prioritization Plan
Responsible Staff: [Please include responsible entity/individual who is
also listed in Budget section]
Date Range:
Expected Outcome: Receive and approve XX applications.
Measurement: Number of applications received/approved and families
contacted.
Objective: Investigations
Activity: Complete XX EBL/LIRA investigations including water
sampling according to MDHHS Water Protocol
Responsible Staff: [Please include responsible entity/individual who is
also listed in Budget section]
Date Range:
Expected Outcome: XX completed EBL/LIRA investigations
Measurement: Number of EBL/LIRA reports received
Objective: Abatement
Activity: Complete and clear XX abatement projects
Responsible Staff: [Please include responsible entity/individual who is
also listed in Budget section]
Date Range:
Expected Outcome: XX projects completed/cleared
Measurement: Number of projects completed/cleared
G. Collaboration and coordination requirements include:
i. If MDHHS-LSS-Lead Safe Home Program (LSHP) receives an application from
a Medicaid resident in a Grantee community, LSHP and the LLSD will
determine who shall be responsible for serving the applicant. LLSD will work
with Grantees to coordinate referrals.
ii. Services performed must be part of a coordinated plan that ensures abatement
activities of the eligible residential unit align with the community’s water service
line replacement plan (if applicable). The Grantee must replace the service line
if water test results are above acceptable limits. Applicants must include their
coordination plan as part of their proposal.
iii. MDHHS-LSS encourages collaboration and coordination to meet the
requirements of this RFP with other non-profit: communities, agencies, and
partners (such as childhood lead poisoning prevention programs, health
agencies, community development agencies, weatherization assistance
agencies, fair housing organizations, code enforcement agencies, community-
based organizations, faith-based organizations, financial institutions, or other
philanthropic entities).
iv. Grantees are required to enter into formal arrangements, such as
memorandums of understanding or similar contractual agreements, with service
delivery organizations receiving funds.
H. All high-cost projects exceeding $70,000 require MDHHS approval prior to
abatement.
I. Control/Elimination Strategies. All lead-based paint hazards identified in eligible
housing units and in common areas of multifamily housing enrolled in this Medicaid
CHIP program must be controlled or eliminated in accordance with the Michigan
Lead Abatement Act.
J. Data Collection and Use. Grantees must collect, maintain, assure data integrity, and
provide to MDHHS-LSS the data necessary to document, report, and evaluate
program outputs and outcomes. Grantees must document how PII or PHI data will
be securely shared with partnering entities, including the following components:
i. Data source, purpose, and use
ii. Specific data elements (e.g., age, gender, etc.)
iii. Time periods (e.g. October 1, 2020 through September 30, 2021)
iv. Identify what data transfer medium will be used (e.g., electronic through
secured FTP, hard copy via facsimile, encrypted email, etc.)
v. Identify who will have access to the data (e.g., project director, intake
specialist, etc.), and how access will be controlled.
vi. Identify how you will receive authorization from participants to share data with
any subcontractors or partners. Include how you will share the authorized data
with subcontractors or partners, and ensure those accessing data agree to the
same restrictions and conditions.
vii. Identify where data will be stored and how access will be restricted to
authorized individuals (e.g. encrypted or password protected)
viii. Identify how data will be retained in secured storage once the program is
completed to comply with records retention. Include how the data is destroyed
at conclusion of the retention period.
ix. Grantees are required to immediately notify LLSD if a staff member who has
access to FTP or Michigan Comprehensive Lead Abatement and Registry
(MiCLEAR) is no longer employed with the agency and/or permitted to have
access to PHI. LLSD will revoke their access immediately.
K. Grantee shall enter and maintain program and project data in an MDHHS online
application, MICLEAR.
L. Grantee must obtain Data Use Agreement with LLSD if the program is sharing
protected health information.
M. Lead-Based Paint and Lead Hazard Identification. A complete lead-based paint
inspection, lead hazard risk assessment, EBL environmental investigation (for
children with a blood level ≥5 µg/dL), and lead in water sampling
assessment/evaluation will be conducted; either separate reports or a combined
report is required for all properties enrolled under this program. Presumption of the
presence of lead-based paint or lead hazards is not permitted. Paint inspections and
risk assessments must follow the procedures as defined in the Michigan Lead
Abatement Act and HUD Guidelines for the Evaluation and Control of Lead-Based
Paint Hazards in Housing investigation, abatement and clearance. Lead in water
sampling must be conducted in accordance with MDHHS-LSS Residential Lead
Hazard Control-Lead in Water Protocol.
i. Individuals performing EBL/Lead Inspection Risk Assessments
and/or water sampling must use MDHHS approved Lead Hazard
Control Environmental Investigation, Clearance and Addendum
report templates.
N. Demolition. In rare cases, a portion of the housing unit or structure with lead
hazards may be determined to be of so little value, unfit for occupancy, or in a state
of extreme disrepair that pursuing lead hazard control may not be cost effective.
Partial demolition and removal of contaminated materials, soil, etc. is a covered
service only if pre-approved in writing by MDHHS-LSS.
O. Minimal residential rehabilitation is allowed to the extent that this work extends the
life of the lead abatement work done consistent with HUD guidelines, including
activities that are specifically required in order to carry out effective hazard control,
and without which the hazard control could not be completed, maintained, and
sustained, as defined by HUD Policy Guidance Number 2008-02
P. Notification Requirements. All lead-based paint testing results, summaries of lead-
based paint hazard control treatments, and clearances must be provided to the
owner of the unit, together with a notice describing the owner’s legal duty to disclose
the results to tenants and buyers in accordance with 24 CFR 35.88 of the Lead
Disclosure Rule. Applicants must ensure that this information is provided in a
manner that is effective for persons with disabilities (24 CFR 8.6) and those persons
with limited English proficiency (LEP) will have meaningful access to it (see
Executive Order 13166). Applicant files must contain verifiable evidence of providing
lead hazard evaluation and control reports to owners and tenants, such as a signed
and dated receipt. Applicants must also describe how they will provide owners with
lead hazard evaluation and control information generated by activities under this
program, so that the owner can comply with the Lead Disclosure Rule (24 CFR part
35, subpart A, or the equivalent 40 CFR part 745, subpart F), the Lead Safe
Housing Rule (24 CFR part 35, subparts B–R), and the EPA’s Renovation, Repair,
and Painting (RRP) Rule (see 40 CFR part 745 and
http://www2.epa.gov/lead/renovation-repair-and-painting-program).
Q. Procurement Requirements. Recipients must follow State of Michigan or established
grantee policies and procedures.
R. Temporary Relocation. Costs for the temporary relocation for residents required to
vacate housing during abatement activities must be controlled and reasonable for
the area. MDHHS-LSS expects that the lead hazard control work and temporary
relocation will take ten (10) days or less, unless pre-approved by MDHHS-LSS.
Rental unit landlords shall identify alternate relocation for residents during
abatement, if available.
S. If an X-ray fluorescent (XRF) instrument is used, all risk assessors must possess
current training, certification and licensing in the use of the XRF equipment under
appropriate federal, state or local authority.
T. Waste Disposal must adhere to the requirements of the Michigan Lead Abatement
Act, appropriate local, state, and federal regulatory agencies, and HUD Guidelines.
U. Written Policies and Procedures. Grantees will be required to develop written
policies and procedures to comply with the requirements of this RFP within the first
sixty (60) days of the new award. MDHHS-LSS Lead Safe Home Program will
provide Grantees with a minimum set of procedures to be followed. The policies and
procedures must describe how your program will handle items such as, but not
limited, to:
i. Enrollee Engagement Prioritization Plan and Tracking, including a plan for
targeted outreach, prioritization, maintenance of a backlog, documentation, and
reporting.
ii. Workforce development related to lead hazard control
iii. Processing program applications, validating unit eligibility, prioritization, and
selection
iv. All phases of lead hazard evaluation and control, including risk assessments,
inspections, water sampling, reporting, abatement and clearance,
development of specifications for contractor bids
v. Resident temporary relocation
vi. Procurement of abatement contractor
vii. Quality assurance of program data collection and data entry
viii. Financial controls
ix. Quality assurance abatement Plan
V. Grantees are required to retain all project records in a secured location for five (5)
years after project closeout.
W. Program administrative costs are recommended to not exceed ten percent (10%) of
the award for payments of reasonable administrative costs related to planning and
executing the project, preparation/submission of LLSD reports, etc. Administrative
costs are the reasonable, necessary, allocable, and otherwise allowable costs of
general management, oversight, and coordination of the proposal (i.e., program
administration). Administrative costs must be outlined in the budget narrative. If
administrative costs exceed ten percent (10%), justification must be provided.
X. The Grantee can choose to use one of the approved methods outlined below in their
budget. In any method, grantee must provide appropriate documentation of proof.
i. Federal approved rate
ii. State approved rate
iii. Cost allocation plans
iv. De minimis rate: If the Grantee does not have an existing approved
indirect rate above and grantee elects to charge indirect costs, they
must use a 10% de minimis rate in accordance with Title 2 Code of
Federal Regulations (CFR) Part 200. De Minimis Rate cannot
exceed 10% and de minimis calculation form must be completed and
attached.
Y. The Grantee is responsible for assuring that general as well as
environmental/pollution insurance is obtained by certified abatement contractor
and/or abatement firm. Contractor and/or firm will provide the program with a copy
of its current insurance certificate, which will name the property owner and the
State of Michigan as additionally insured. The appropriate pollution/environmental
coverage requirements as stated above will be included in the certificate. The
certificate must be received prior to the issuance of a purchase order.
Z. Eligibility of Expenses
i. Roofs: Medicaid CHIP abatement project is eligible for roof
replacement when roof is beyond minimal rehab and repairable
condition. Documentation is needed stating that roof disrepair would
affect the integrity of the lead hazard control work being completed
on the property.
ii. Multi-Units: Multi-family rental properties are eligible and follows
compliance with HUD policy 5-66.
iii. Public Housing: Following HUD policy, properties that are HUD
voucher based/tenant-based are eligible for lead abatement
services. However, project-based housing owned by HUD is not
eligible for the Medicaid CHIP grant.
iv. Consent Decree: Following HUD policy, properties that have an
existing consent decree on the property are not eligible for the
Medicaid CHIP grant.
v. Demolition: In rare cases, a portion of the residential unit or
accessory structure with lead hazards may be determined to be unfit
for occupancy or in a state of extreme disrepair that pursuing lead
hazard control may not be cost effective or feasible. Partial
demolition and removal of contaminated materials, soil, etc. is a
covered service only if pre-approved by MDHHS-LSS and the
following CMS guidelines are adhered to:
i. Conduct clearance testing of the site and soil upon
completion of the project to make sure that the demolition did
not create new hazards.
ii. Attest that certified professionals are contracted to work on
the demolition to guarantee that it is conducted safely to
protect neighboring structures and residents.
iii. Obtain consent from the resident and property owner for the
demolition, to ensure all parties are in agreement.
vi. Dumpsters: Dumpsters or storage containers/pods are an allowable
expense for households where there are extreme hoarding issues
that would prevent contractors and inspectors from performing Lead
Hazard Control work.
vii. Fire Protection: Medicaid CHIP enrolled properties are eligible to
receive carbon monoxide detectors and smoke alarms based on
local code.
viii. Minimal Rehabilitation: Minimal residential rehabilitation is allowed to
the extent that this work extends the life of the lead abatement work
done consistent with HUD guidelines, including activities that are
specifically required in order to carry out effective hazard control, and
without which the hazard control could not be completed,
maintained, and sustained, as defined by HUD Policy Guidance
Number 2008-02.
ix. Relocation: Temporary relocation expenses are eligible when family
is required to vacate home during abatement activities. When
possible, the State rate for hotels should be used.
x. Fire Protection: Medicaid CHIP LLSD enrolled properties are eligible
to receive carbon monoxide detectors and smoke alarms based on
local code.
xi. Equipment: Any purchase or lease of equipment having a per-
unit cost in excess of $5,000 must be pre-approved by MDHHS
including the purchase or lease of X-ray fluorescence (XRF)
analyzers.
xii. Lead Certifications: Payment of professional certifications and
licenses are eligible which includes securing and maintaining
required certification and licenses for identification, remediation,
and clearance of lead and other housing-related health and
safety hazards.
xiii. Resident blood lead testing and analysis are not eligible services or
costs.
xiv. Costs of case management are not eligible services or costs.
DD. Grantee agrees to follow asbestos recommendations and protocols as
prescribed by the MDHHS Lead Services Section.
EE. MDHHS Local Lead Services and Development Unit will complete quarterly
reviews of EBL/LIRA reports, specifications, site visits, MICLEAR file audits,
benchmarks of abatement projects completed, and financial expenditures. If
significant findings are concluded from quarterly reviews including but not limited
to failure to meet projected benchmarks or adhering to reporting requirements,
grantee will develop a Plan of Action. If Plan of Action does not achieve projected
results in specified amount of time, grantee must revise portions of contract
including benchmarks and/or total contract award in next amendment cycle. After
previous measures are implemented and grantee still fails to comply with grant
requirements, MDHHS reserves the right to rescind grant award and/or amend
total contract award amount.
PROJECT: Lead Health and Safety
Start Date: 11/01/2023
End Date: 09/30/2024
Project Synopsis
Health and Safety Supplemental funding is available to address emergent issues affecting
habitability within homes located in the Local Lead Services’ (LLS) Lead Hazard Control
Program service areas. The Health and Safety Supplemental funding complements lead work
provided through LLS. These hazards must be non-lead related and must present an
immediate threat to occupants’ health and/or safety.
Reporting Requirements (if different than contract language)
Grantees shall provide their detailed general ledger attached to the quarterly Financial
Status Report in an Excel or PDF format for review and analysis.
Any additional requirements (if applicable)
1. Grantee must adhere to following eligibility criteria:
a. The property must be located in a LLS grantee service area.
b. Applicant must be eligible and enrolled in a grantee lead hazard control program.
c. Applicant must be receiving Lead Hazard Control work through grantee’s Medicaid
Child Health Insurance Program (CHIP) funding.
2. The Health & Safety work can be completed before or after abatement. If the Health &
Safety work is subcontracted, the subcontractors cannot be on site during lead
abatement activities unless lead abatement certified.
3. Grantee’s can use Health & Safety funds to provide the following services listed below or
repair the following components/hazards outlined by LLS.
a. Foundation repair
b. Water or sewage backup repair
c. Furnace repair or replacement
d. Water Heater repair or replacement
e. Pest control
f. Working electricity
g. Mold and asbestos remediation
h. Identified repairs to address any other immediate threats to occupants’ health
and/or safety where the property owner does not have available resources to
address it themselves.
4. Michigan Department of Health & Human Services (MDHHS) is under no obligation to
provide these funds on every enrolled LLS project. Grantees must implement
prioritization plan when disseminating Health & Safety funds.
5. MDHHS holds no claim beyond providing these services that the home is free of
structural, mechanical, electrical, or other hazards or deficiencies or that the home
meets any implied warranty of habitability. MDHHS is not responsible for providing
general residential inspections for health and safety violations and is not responsible
for identification, repair or notification of additional health and safety hazards.
6. Investigator must complete initial Health & Safety Assessment on MDHHS provided
report template.
7. Investigator must complete Health & Safety re-assessment on MDHHS provided
report template and include pictures of work completed.
8. Investigator and/or Grantee Program Manager will send initial report and re-
assessment report to homeowner/landlord.
9. Health & Safety assessment reports and addendums will be uploaded in MICLEAR
database system for specific property address. Financial Expenditures associated
with Health & Safety funding will be entered in MICLEAR as well.
10. Grantee is responsible for overseeing internal Quality Assurance Plan and ensure
Health & Safety work completed is to comply with local codes regulations.
PROJECT: Local Health Department Sharing
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Local health departments participating in the project will utilize funds to support activities
pertinent to the exploration, preparation, planning, implementing, and improving sharing
of local health department services, programs or personnel.
Reporting Requirements (if different than contract language)
Grantees will receive notification of reports along with reporting templates. Reporting is
twice per year based on reporting dates required by the CDC.
Any additional requirements (if applicable)
Local health departments must submit a continuation workplan and budget for
continuation funding of the project “Local Health Department Collaboration and
Exploration of Shared Approach to Delivery of Services,”
Eligible Activities:
• Meeting activities, including time and travel costs
• Cost of research activities
• Supplies and presentation materials
• Professional services related to the project
• IT cost related to service sharing (grant funds may not be used to reimburse
equipment costs)
PROJECT TITLE: Local Maternal Child Health (LMCH)
MCH -Children
MCH – All Other
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis: Local Maternal Child Health (LMCH)
LMCH funding is made available to local health departments to support the health of
women, children, and families in communities across Michigan. Funding addresses one
or more Title V Maternal and Child Health Block Grant national and state priority areas
and/or a local MCH priority need identified through a needs assessment process. Local
health departments complete an annual LMCH plan, and a year end report. Target
populations are women of childbearing age, infants, and children aged 1-21 years and
their families, with a special focus on those who are low income. The LMCH allocated
funds are to be budgeted as a funding source in two project categories.
LMCH
Local Maternal and Child Health (MCH)
ESCMCH MCH - Children
OTHERMCHV MCH – All Other
Reporting Requirements (if different than agreement language):
1. The LMCH Plan submission and due date will be communicated through a
notification mailing. The department will provide the format for the LMCH Plan.
The LMCH Plan, approved by the department, is to be uploaded with the budget
application into EGrAMS. The Plan and Plan amendments, if needed, need to be
approved in advance of the budget application and budget amendment.
2. The LMCH Year-End Report submission and due date will be communicated
through a notification mailing. The department will provide the format for the LMCH
Year-End Report. The Local MCH Year-End Report, approved by the department,
is to be uploaded in EGrAMS with the final FSR. The Year-End Report must be
approved in advance of the final FSR.
Any additional requirements (if applicable):
1. Local MCH funding must be used to address the unmet needs of the maternal
child health population and based on data and need(s) identified through the
Local Health Department community health assessment process.
2. Activities and programs supported with Local MCH funds must be evidence-
based/informed. Exceptions must be submitted in writing and pre-approved by
MDHHS.
3. Local MCH funding cannot be used under the WIC element, except in extreme
circumstances where a waiver is requested in advance of the expenditures and
evidence is provided that the expenditures satisfy all funding requirements.
4. Local MCH funds may not be used to supplant available/billable program income
such as Medicaid or Healthy Michigan Plan fees or additional funding under the
Medicaid Cost-Based Reimbursement process.
5. Local Health Departments should leverage program generated income, especially
third-party payers (Medicaid, private insurers) before utilizing LMCH MCH block
grant funds. LMCH funds are to be used for those services that cannot be paid for
through other sources or for gap filling services. Third party fees should be listed
in other funding sources. If no 3rd party fees are listed, an explanation must be
noted.
6. The approved LMCH Plan allocation table and the budget application MCH
source of funds must match. If an agency needs to move funds between projects,
an amended LMCH Plan must be approved in advance of the budget amendment
request period. Any specified expenditure in the LMCH Plan must be detailed in
the budget (e.g. incentives).
7. The LMCH program follows the same principle on budget transfers and
adjustments outlined in the comprehensive agreement. The comprehensive
agreement allows for budget transfers and adjustments of $10,000 or 15%,
whichever is greater. However, if the transfer or adjustment is greater than the
$10,000 or 15%, OR there are any changes made to any of the children
performance measures an amended LMCH Work Plan and budget will be
required.
8. LMCH is unable to accept cost distributions from MDHHS-ELPHS due to the
nature of the block grant and LMCH reporting requirements. LMCH will continue
to accept other cost distributions as in the past (such as Family Planning, CSHCS
Outreach and Advocacy, VQA, IAP, and Lead Prevention).
9. LMCH has adopted Title 2 Code of Federal Regulations 200 Cost principles.
PROJECT TITLE: Maternal Infant and Early Childhood Home Visiting
Initiative Local Home Visiting Group
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to increased opportunities for coordination and
collaboration of home visiting programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The LLG shall submit all required reports in accordance with the Department’s reporting
requirements.
a. Staffing Changes: Within 10 days of a staffing change, notify the State LLG
Coordinator via e-mail and incorporate the change(s) into the budget and facesheet
during the next amendment cycle as appropriate. The facesheet identifies the
agency contacts and their assigned permissions related to the tasks they can
perform in E-GrAMS. The assigned Project Director in E-GrAMS can make the
facesheet changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval from the State LLG
Coordinator. Upon approval, upload the Work Plan to Groupsite. See the Michigan
Department of Health and Human Services’ (MDHHS) Home Visiting Guidance Manual for
requirements related to Work Plan development and reporting.
c. Work Plan Reports: Must be uploaded to Groupsite within 30 days of the end of
each quarter (January 30, April 30, July 30, and October 30).
d. See the MDHHS Home Visiting Guidance Manual for specific Continuous Quality
Improvement (CQI) reporting requirements.
e. The Grantee shall permit the Department or its designee to visit, either in person
or virtually, and make an evaluation of the project as determined by the Contract
Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the State LLG Coordinator or Groupsite.
Any additional requirements (if applicable):
Comply with MDHHS Home Visiting Program Requirements:
The Grantee shall operate the LLG with fidelity to the requirements of MDHHS as
outlined in the MDHHS Home Visiting Unit Guidance Manual.
1. The LLG will work with the State LLG Coordinator and the Michigan Public Health
Institute (MPHI) Quality Improvement Consultant. See the MDHHS Home Visiting
Guidance Manual for details.
2. The LLG will achieve the following deliverables to create and sustain a local home
visiting system:
a. Convene and build a local home visiting collaborative body by ensuring the
recruitment and participation of both required and strongly encouraged LLG
representatives (noted in the MDHHS Home Visiting Unit Guidance
Manual).
b. Drive change by partnering with and integrating parents who are
experiencing home visiting as active members of the LLG and CQI team.
The attendance of parents at the three HVU Grantee Meetings held
annually is also required.
c. Learn how the local home visiting is connected through the annual
facilitation of a local Home Visiting Array of Models Project Plan and identify
one goal to implement that helps to improve the coordination of the local
home visiting system and achieve better outcomes for families.
d. Use Continuous Quality Improvement approaches to learn how to improve
collaboration among the early childhood and local home visiting system.
e. Leverage partnerships and resources to continue the LLG’s strategic goals,
objectives, and activities that result in improvements in the local community
or region home visiting system by implementing one goal annually from the
community’s Sustainability Plan.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to LLG
membership/participation, development of CQI efforts as well as the implementation of
Home Visiting Array and Sustainability Plans.
Funding Requirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting Unit activities as specified in this
agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Unit Guidance Manual.
PROJECT TITLE: Maternal Infant Early Child Home Visiting Initiative Rural
Local Home Visiting Group
and
Maternal Infant Early Child Home Visiting Initiative Rural Local Home
Visiting Group 3
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The purpose of the Local Leadership Group (LLG) is to support the development of a
local home visiting system that leads to increased opportunities for coordination and
collaboration of home visiting programs at the community or regional level.
Reporting Requirements (if different than agreement language):
The LLG shall submit all required reports in accordance with the Department’s reporting
requirements.
a. Staffing Changes: Within 10 days of a staffing change, notify the State LLG
Coordinator via e-mail and incorporate the change(s) into the budget and
facesheet during the next amendment cycle as appropriate. The facesheet
identifies the agency contacts and their assigned permissions related to the tasks
they can perform in E-GrAMS. The assigned Project Director in E-GrAMS can
make the facesheet changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually on June 30 for preapproval from the State LLG
Coordinator. Upon approval, upload the Work Plan to Groupsite. See the
Michigan Department of Health and Human Services’ (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. See the MDHHS Home Visiting Guidance Manual for specific Continuous Quality
Improvement (CQI) reporting requirements.
e. The Grantee shall permit the Department or its designee to visit, either in person
or virtually, and make an evaluation of the project as determined by the Contract
Manager.
All reports and/or information (a-f), unless stated otherwise, shall be submitted
electronically to the State LLG Coordinator or Groupsite.
Any additional requirements (if applicable):
Comply with MDHHS Home Visiting Program Requirements:
The Grantee shall operate the LLG with fidelity to the requirements of MDHHS as
outlined in the MDHHS Home Visiting Unit Guidance Manual.
1. The LLG will work with the State LLG Coordinator and the Michigan Public Health
Institute (MPHI) Quality Improvement Consultant. See the MDHHS Home Visiting
Unit Guidance Manual for details.
2. The LLG will achieve the following deliverables to create and sustain a local home
visiting system.
a. Convene and build a local home visiting collaborative body by ensuring the
recruitment and participation of both required and strongly encouraged LLG
representatives (noted in the MDHHS Home Visiting Unit Guidance
Manual).
b. Drive change by partnering with and integrating parents who are
experiencing home visiting as active members of the LLG and CQI team.
The attendance of parents at the three HVU Grantee Meetings held
annually is also required.
c. Learn how the local home visiting is connected through the annual
facilitation of a local Home Visiting Array of Models Project Plan and identify
one goal to implement that helps to improve the coordination of the local
home visiting system and achieve better outcomes for families.
d. Use Continuous Quality Improvement approaches to learn how to improve
collaboration among the early childhood and local home visiting system.
e. Leverage partnerships and resources to continue the LLG’s strategic goals,
objectives, and activities that result in improvements in the local community
or region home visiting system by implementing one goal annually from the
community’s Sustainability Plan.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to LLG
membership/participation, CQI efforts as well as the implementation of Home Visiting
Array and Sustainability Plans.
Funding Requirements:
The funding can be used to:
a. Enable the LLG to pay for staff support.
b. Financially support LLG parent leaders to attend the Michigan Home
Visiting Conference.
c. Financially support LLG members, including parent leaders, to be part of
the LLG and CQI efforts.
d. Carry out MDHHS Home Visiting Unit activities as specified in this
agreement.
Promotional Materials
If the LLG wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements as outlined in the MDHHS
Home Visiting Unit Guidance Manual.
PROJECT: Medicaid Outreach
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Medicaid Outreach activities are performed to inform Medicaid beneficiaries or potential
beneficiaries about Medicaid, enroll individuals in Medicaid and improve access and
utilization of Medicaid covered services. All outreach activities must be specific to
Medicaid. Reference bulletin: MSA 18-41
Additional instructions can be found in Attachment I.
Reporting Requirements (if different than contract language)
Submit quarterly reports no later than 1 month after the end of the quarter. The
exception is the 4th quarter report which is due at the time as the final FSR. If the report
due date falls on a weekend or holiday, the report the next business day.
Reporting Period Due Date
October 1 – December 31 January 31
January 1 – March 31 April 30
April 1 – June 30 July 31
July 1 – September 30 November 30
• Quarterly reports must be attached/uploaded on the Source of Funds/Federal
Medicaid Outreach line on the FSR in EGrAMS.
• Reimbursements occur based on actual expenditures reported on Financial Status
Reports (FSR) using the reporting format and deadlines as required by the
Department through EGrAMS.
Any additional requirements (if applicable)
• All claimable outreach activities must be in support of the Medicaid program.
Activities that are part of a direct service are not claimable as Medicaid Outreach.
• Must maintain documentation in support of administrative claims which are
sufficiently detailed to allow determination of whether the activities were necessary
for the proper and efficient administration of the Medicaid State Plan.
• Must maintain a system to appropriately identify the activities and costs in
accordance with federal requirements.
• Must provide quarterly summary reports of Medicaid outreach activities conducted
during the quarter. The following reporting elements must be included in the
quarterly report:
1. Name of Health Department
2. Name and contact information of the individual completing the report.
3. Time period the report covers (e.g., FY 20: 1st quarter, or October-
December)
4. Types of services provided during the quarter (Note: the types of services
provided do not have to include every single activity the LHD conducted
during the quarter. Rather, simply include examples of the types of services
provided. The Grantee can include as much or as little detail as they
chose.)
5. Number of clients served.
6. Amount of funds expended during the quarter and total expenditures.
7. Number of FTEs who provided these activities.
Successes/Challenges
This is not a reporting requirement but provides an opportunity for the LHD to
share successes during the quarter (e.g., For the first time, someone from the
school board attended the Infant Mortality Reduction Coalition meeting) or to
describe any challenges encountered during the quarter (e.g., the health advocate
quit, and the lactation consultant went on maternity leave, so we are down 2 staff)
PROJECT TITLE: Michigan Adolescent Pregnancy and Parenting
Program
Start Date: 10/1/2023
End Date: 9/31/2024
Project Synopsis:
The goal of MI-APPP is to create an integrated system of care, including linkages to
support services, for pregnant and parenting adolescents 15-19 years of age, the
fathers, and their families. MI-APPP grantees implement the Adolescent Family Life
Program-Positive Youth Development (AFLP-PYD; a California model), an evidence-
informed case management curriculum designed to elicit strengths, address various risk
behaviors, the impact of trauma, and provide a connection to health care and
community services. In addition, MI-APPP grantees engage communities through
locally driven steering committees, a comprehensive needs assessment, and creation of
support services to ensure the program is responsive to the needs of pregnant and
parenting teens.
MI-APPP aims to:
1. Reduce repeat, unintended pregnancies,
2. Strengthen access to and completion of secondary education,
3. Improve parental and child health outcomes, and
4. Strengthen familial connections between adolescents and their support networks.
Reporting Requirements (if different than agreement language):
Report Time Period Due Date Submit To
Program
Narrative
October 1- December 31 January 15
Program
Coordinator
January 1-March 31 April 15
April 1-June 30 July 15
July 1-September 30 October 15
Evaluation/Data
Submission Monthly Submit the 10th of
every month REDcap
Any additional requirements (if applicable):
• Information provided must be medically accurate, age-appropriate, culturally
relevant, and up-to-date.
• Pregnancy prevention education must be delivered separate and apart from any
religious education or promotion. MI-APPP funding cannot not be used to
support inherently religious activities including, but not limited to, religious
instruction, worship, prayer, or proselytizing (45 CFR Part 87).
• Family planning drugs and/or devices cannot be prescribed, dispensed, or
otherwise distributed on school property as part of the pregnancy prevention
education funded by MI-APPP as mandated in the Michigan School Code.
• Abortion services, counseling and/or referrals for abortion services cannot be
provided as part of the pregnancy prevention education funded under MI-APPP.
• Must adhere to the Minimum Program Requirements for MI-APPP.
• MI-APPP funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT TITLE: MI Home Visiting Initiative Rural Expansion
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma-informed care. The program is designed to
promote positive parent-child relationships and healthy attachment. It is a strengths-
based and family-centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department’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. Work Plan: Due annually on June 30 to the HVU Model Consultant for
preapproval. Upload approval, upload 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. HVU data collection requirements due in REDCap and/or HVOL by the 5th
business day of each month.
e. Quality Improvement Reporting:
• Documentation of a QI team will be submitted with the quarterly Work Plan
Report.
• Documentation of QI activities will be submitted with the quarterly Work
Plan Report.
• Annual summary of QI activities will be submitted to the HVU Model
Consultant by April 30.
f. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the CoIIN’s schedule. Participating LIAs are required to use the
HV CoIIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (a-f) shall be submitted as described above. Additional guidance concerning data
collection and Quality Improvement is provided in the MDHHS Home Visiting Unit
Guidance Manual.
Grantee Specific Requirements:
The LIA shall serve families as a result of outreach efforts based on the findings of their
MDHHS- HVU Outreach Toolkit.
a. The Healthy Families Northern Michigan HFA Program (operated from the Health
Department of Northwest Michigan in collaboration with District Health Department #2
and Central Michigan District Health Department) will serve the applicable number of
families in communities experiencing disadvantage per section d. below.
b. The District Health Department #10 HFA Program will serve the applicable number of
families in communities experiencing disadvantage per section d. below.
c. The Healthy Families Upper Peninsula (operated from the Luce-Mackinac-Alger-
Schoolcraft Health Department in collaboration with the Western Upper Peninsula
Health Department, Marquette County Health Department, Dickinson-Iron District
Health, and Public Health Delta Menominee counties) HFA Program will serve the
applicable number of families in communities experiencing disadvantage per section
d. below.
d. In general, across all regions, the home visitor-to-family ratio should agree with the
following:
• 16 families or a caseweight of 30 per 1.0 FTE for traditional HFA. It is expected
`that caseloads will be lower for staff members in their first and second year
and must align with model expectations. Caseload expectations for other fund
sources are documented in language specific to that source.
Maintain Fidelity to the Model
The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy
Families America affiliates shall comply with the requirements of the Central
Administration for the Multi-Site State System (also known as “The State Office”) housed
within the Michigan Public Health Institute. All HFA model-required training will be
accessed through the Central Administration as available. Contact the HFA State Office
for details.
Comply with MDHHS Program Requirements
The LIA shall operate the program with fidelity to the requirements of MDHHS based on
the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home
Visiting Unit Guidance Manual. The LIA will fulfill these requirements while strengthening
efforts towards health and racial equity through staff education, programmatic data
evaluation and client supportive services.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Unit Guidance Manual for requirements related to PA 291.
Staffing
The LIA’s HFA home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Unit Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures as described in the MDHHS Home Visiting Unit Guidance
Manual.
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPHI) with regards to program development and monitoring (including annual
site visits either in-person or virtual), training, support and technical assistance services.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
program monitoring, quality assessment, support and TA.
Professional Development and Training
:
All of the LIA’s HFA program staff associated with this funding will participate in
professional development and training activities as required by both HFA and the
Department. All LIA HFA
program staff must receive HFA-specific training from a Michigan-based approved HFA
training entity. See the MDHHS Home Visiting Unit Guidance Manual for requirements
related to professional development and training activities.
Supervision:
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro-rated as allowed by the Best Practice Standards. Written policies and procedures shall specify how reflective supervision is included in, or added to, that time to ensure provision for each home visitor at a minimum of one hour per month.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have the lived experience and
expertise.
The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start
Collaborative.
The LIA shall participate in the Regional Perinatal Quality Collaboratives.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to data collection.
Quality Improvement (QI):
The LIA shall participate in all HFA quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all state and local Home Visiting QI activities as required by
MDHHS. Required activities include, but are not limited to:
a. Developing and maintaining a QI team
b. Participating in QI activities during the fiscal year
c. Consulting with QI coaches
d. See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
QI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Unit Guidance Manual.
PROJECT TITLE: Maternal Infant Childhood Home Visiting Program
(MIECHVP) Healthy Families America Expansion
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The Healthy Families America (HFA) program was designed by Prevent Child Abuse
America and is built on the tenants of trauma-informed care. The program is designed to
promote positive parent-child relationships and healthy attachment. It is a strengths-
based and family-centered approach.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department’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. 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. HVU data collection requirements due in REDCap and/or HVOL by the 5th
business day of each month.
e. Quality Improvement Reporting:
• Documentation of a QI team will be submitted with the quarterly Work Plan
Report.
• Documentation of QI activities will be submitted with the quarterly Work
Plan Report.
• Annual summary of QI activities will be submitted to the HVU Model
Consultant by April 30.
f. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the CoIIN’s schedule. Participating LIAs are required to use the
HV CoIIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (a-f) shall be submitted as described above. Additional guidance concerning data
collection and Quality Improvement is provided in the MDHHS Home Visiting Unit
Guidance Manual.
Grantee Specific Requirements:
The LIA shall serve families as a result of outreach efforts based on the findings of their
MDHHS-HVU Outreach Toolkit.
a. The Kalamazoo County Health and Community Services Department HFA program
will serve families in Kalamazoo County as a result of outreach efforts based on the
findings of their MDHHS-HVU Outreach Toolkit.
b. Kalamazoo home visiting programs should prioritize outreach to families who have
low-income and pregnant persons and families who are African-American, Hispanic,
Asian, Native-American, or multi-racial who have historically experienced racism and
are living in the City of Kalamazoo and adjacent townships. Outreach priorities should
also include families with a history of child abuse or maltreatment, including parents
who were abused as children. In addition, Kalamazoo County should conduct
outreach to young (under 21) pregnant persons and families with low educational
attainment.
c. The Wayne County Babies HFA program families in Wayne County as a result of
outreach efforts based on the findings of their MDHHS-HVU Outreach Toolkit.
d. Wayne County should prioritize low-income families, families with pregnant persons
who have not attained age 21, families with a history of child abuse or neglect
(including parents who experienced abuse as children), families that have low
educational attainment, and families with children with developmental delays or
disabilities. Additionally, Wayne County should prioritize families who have historically
experienced racism, engaging families who identify as African-American, Hispanic,
Asian, Native-American, or multi-racial.
MDHHS HVU expects the LIAs to serve 16 families per fully trained and
experienced 1.0 FTE under traditional HFA funding. Caseload expectations for
other funding sources are documented in additional contract language specific to
that source.
Maintain Fidelity to the Model
The LIA shall adhere to the HFA Best Practice Standards. In addition, all Healthy
Families America affiliates shall comply with the requirements of the Central
Administration for the Multi-Site State System (also known as “The State Office”) housed
within the Michigan Public Health Institute. All HFA model-required training will be
accessed through the Central Administration as available. Contact the HFA State Office
for details.
Comply with MDHHS Program Requirements
The LIA shall operate the program with fidelity to the requirements of MDHHS based on
the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home
Visiting Unit Guidance Manual. The LIA will fulfill these requirements while strengthening
efforts towards health and racial equity through staff education, programmatic data
evaluation and client supportive services.
P.A. 291
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Unit Guidance Manual for requirements related to PA 291.
Staffing
The LIA’s HFA home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Unit Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures as described in the MDHHS Home Visiting Unit Guidance
Manual.
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and the Michigan Public Health
Institute (MPHI) with regards to program development and monitoring (including annual
site visits either in-person or virtual), training, support and technical assistance services.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
program monitoring, quality assessment, support and TA.
Professional Development and Training:
All of the LIA’s HFA program staff associated with this funding will participate in
professional development and training activities as required by both HFA and the
Department. All LIA HFA program staff must receive HFA-specific training from a
Michigan-based approved HFA training entity. See the MDHHS Home Visiting Unit
Guidance Manual for requirements related to professional development and training
activities.
Supervision:
The LIA shall adhere to the HFA supervision requirements of weekly 1.5 - 2 hours of individual supervision per 1.0 FTE and pro-rated as allowed by the Best Practice Standards. Written policies and procedures shall specify how reflective supervision is included in, or added to, that time to ensure provision for each home visitor at a minimum of one hour per month.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have the lived experience and
expertise.
The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start
Collaborative.
The LIA shall participate in the Regional Perinatal Quality Collaborative.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all HFA and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to data collection.
Quality Improvement (QI):
The LIA shall participate in all HFA quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all state and local Home Visiting QI activities as required by
MDHHS. Required activities include, but are not limited to:
a. Developing and maintaining a QI team
b. Participating in QI activities during the fiscal year
c. Consulting with QI coaches
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to QI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Unit Guidance Manual.
PROJECT: MRC STTRONG 10/1 – 5/31
Start Date: 10/01/2023
End Date: 05/31/2024
Project Synopsis
As a Grantee of funding, provided through the Administration for Strategic Preparedness
and Response (ASPR), each Grantee will be utilized to ensure that the Michigan Medical
Reserve Corp are ready for future response activities by providing training, education and
exercise opportunities, direct funding MRCs to improve their preparedness and
strengthen the volunteer base for the Medical Reserve Corps across Michigan. These
activities will result in a stronger, more agile MRC, with increased capability to respond to
future public health disasters.
Reporting Requirements
Local Health Departments will need to file quarterly FSRs in EGrAMS, following the same
reporting pattern as contracts that are already established with BEPESoC.
Additional Requirements (if applicable)
Code of Federal Regulations
The Federal Office of Management and Budget (OMB) issued guidance for the
administration of federal awards (2 CFR Part 200) in a document commonly called the
Code of Federal Regulations or “Uniform Guidance”. The guidance combines multiple
circulars with a goal to streamline administrative requirements, cost principles and audit
requirements. This has been codified by the U.S. Department of Health and Human
Services in 45 CFR Part 75, and can be found here: eCFR :: 2 CFR Part 200 -- Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards.
Financial Accountability
Sub-recipients must maintain records which adequately identify the source and
application of funds provided for financially assisted activities. These records must
contain information pertaining to grant or subgrant awards and authorizations, obligation,
unobligated balances, assets, liabilities, outlays or expenditures and income. The
awardee, and all its sub-recipients, should expect that Administration for Strategic
Preparedness and Response (ASPR), or its designee, may conduct a financial compliant
audit and on-site program review of grants with significant amounts of Federal funding.
Allowable Costs
Administration costs that can be specifically allocated to this project must be justified and
reasonable. Since this program exists primarily to support healthcare organizations
directly in preparing for public health and medical emergencies, costs associated with
program administration are not considered direct support of healthcare entities, but
administrative. Cost items under program administration include:
• Personnel (including contractual staff)
• Contracts to provide support to MRC-STTRONG program
• Travel expenses (the fiduciary should have a written policy on
limits/allowable expenses)
• Meeting expenses
• Administrative/programmatic equipment and supplies
• Fringe benefits
• Phone, postage, and electronic mail
• Audit and accounting costs
• Rent
For further clarification, operating costs for personal service contracts related to
administration and personnel for coalition planning is considered administrative support,
not as direct support of health care entities or coalition planning costs. Any contracts for
services provided to support the activities of the coalition generally are placed in the
administrative costs of each coalition budget. Requests to cover personal service
contracts with MRC-STTRONG funds must be reviewed annually by Division of
Emergency Preparedness and Response on a case-by-case basis.
Uniforms
Purchase of uniforms must meet the guidelines established for use as Personal
Protective Equipment or Volunteer Security/Safety. Uniform components must be
returned to the respective unit/program office at the end of the event/project/volunteer
tenure. All purchases of uniforms must be pre-approved by DEPR.
Equipment Procurement
When procuring equipment, the recipient must comply with the procurement standards at
45 CFR 75.329, Procurement Procedures, which required the performance and
documentation of some form of cost or price analysis with every procurement action.
Funding Restrictions
Restrictions must be taken into account while writing the budget.
Restrictions are as follows:
• Awardees may not use funds for research.
• Reimbursement of pre-award costs generally is not allowed, unless ASPR
provides written approval to the awardee.
• Other than for normal and recognized executive-legislative relationships, no funds
may be used for:
o publicity or propaganda purposes, for the preparation, distribution, or use of
any material designed to support or defeat the enactment of legislation
before any legislative body
o the salary or expenses of any grant or contract recipient, or agent acting for
such recipient, related to any activity designed to influence the enactment of
legislation, appropriations, regulation, administrative action, or executive
order proposed or pending before any legislative body
• The direct and primary recipient in a cooperative agreement program must
perform a substantial role in carrying out project outcomes and not merely serve
as a conduit for an award to another party or provider who is ineligible.
• Awardees may supplement but not supplant existing state or federal funds for
activities described in the budget.
• None of the funds made available through this award may be used, in whole or in
part, to advocate or promote gun control.
• None of the funds made available through this award may be used to maintain or
establish a computer network unless such network blocks the viewing,
downloading, and exchanging of pornography.
• No federal funds associated with this cooperative agreement shall be used to
purchase sterile needs or syringes for the hypodermic injection of any illegal drug.
Provided that such limitations does not apply to the use of funds for elements of
the program other than making such purchases if the relevant State or local health
department, in consultation with the Center for Disease Control and Prevention
(CDC), determines that the State for local jurisdiction, as applicable, is
experiencing or is at risk for, a significant increase in hepatitis, infections or an HIV
outbreak due to infection drug use, and such program is operating in accordance
with State and local law.
• Trafficking in persons, such as engaging in severe forms of trafficking in persons
during the period of time that the ward is in effect, procure a commercial sex act
during the period of the time that the award is in effect or use forced labor in the
performance of the award or subaward may result in the unilateral termination of
this award.
Requiring Prior Approval
• Awardees may use funds only for reasonable program purposes, including
personnel, travel, supplies, and services.
• Awardees may purchase basic (non-motorized) trailers with prior approval from
ASPR Office of Grant Services.
• HPP awardees can (with prior approval) use funds to purchase material-handling
equipment (MHE) such as industrial or warehouse-use trucks to be used to move
materials, such as forklifts, lift trucks, turret trucks, etc. Vehicles must be of a type
not licensed to travel on public roads.
• HPP awardees can use funds to purchase caches of antibiotics for use by first
responders and their families to ensure the health and safety of the public health
workforce.
Publications
All grantee publications, including research publications, press releases, other publication
or documents about research that is funded by ASPR must include the following two
statements:
• Research reporting in the [publication/press release] was supported by [name of
the program office(s), or other ASPR offices] the Department of Health and Human
Services Administration for Strategic Preparedness and Response under award
number U3REP230698.
• The content is solely the responsibility of the authors and does not necessarily
represent the official view of the Department of Health and Human Services
Administration for Strategic Preparedness and Response.
PROJECT TITLE: Nurse Family Partnership (NFP) Services
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The Nurse-Family Partnership (NFP) program offers families one-on-one home visits with
a registered nurse. The model is grounded in human attachment, human ecology, and
self-efficacy theories. Home visitors use model-specific resources to build on a parent’s
own interests to attain the model goals.
Reporting Requirements (if different than agreement language):
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department’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. Medicaid Outreach Report (Berrien, Calhoun, Kalamazoo and Kent counties only):
Due within 30 days of the end of each quarter.
c. 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.
d. 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).
e. HVU data collection requirements due in REDCap and Flo on the 5th business day
of each month.
f. Quality Improvement Reporting:
• Documentation of a QI team will be submitted with the quarterly Work Plan
Report.
• Documentation of QI activities will be submitted with the quarterly Work
Plan Report.
• Annual summary of QI activities will be submitted to the HVU Model
Consultant by April 30.
g. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the CoIIN’s schedule. Participating LIAs are required to use the
HV CoIIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (a-g) shall be submitted as described above. Additional guidance concerning
data collection and Quality Improvement is provided in the MDHHS Home Visiting Unit
Guidance Manual.
Additional requirements:
Maintain Fidelity to the Model:
The LIA shall adhere to the Nurse-Family Partnership National Service Office (NSO)
program standards and operate the program with fidelity monitored by the NSO review
and discussion of Quarterly Outcomes Reports, Network Partner Self-assessment,
Fidelity Index, Collaborative Success Plan, Site Visits and ongoing consultation.
Comply with MDHHS Program Requirements:
The LIA shall operate the program with fidelity to the requirements of the Michigan
Department of Health and Human Services based on the agreement executed in E-
GrAMS and the conditions as outlined in the MDHHS Home Visiting Unit Guidance
Manual. The LIA will fulfill these requirements while strengthening efforts towards health
and racial equity through staff education, programmatic data evaluation and client
supportive services.
Data-Informed Outreach:
Michigan is using NFP as a specialized home visiting service strategy for first-time
mothers who are low-income. This specialized service strategy is a focused way of using
limited resources, directing them to populations who live in communities placing them at
higher risk. The LIA will conduct outreach activities to the population groups identified in
their MDHHS-HVU Outreach Toolkit in order to enroll families from those outreach
efforts.
• The MDHHS HVU expects the LIA to maintain a caseload capacity of 25
families per 1.0 FTE.
P.A. 291:
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Unit Guidance Manual for requirements related to PA 291.
Staffing:
The LIA’s NFP home visiting staff will reflect the community served. The LIA will provide
documentation to demonstrate due diligence if unable to fully meet this requirement
within 90 days of a MDHHS site visit in which this was a finding. See the MDHHS Home
Visiting Unit Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures described in the MDHHS Home Visiting Unit Guidance Manual.
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the NFP NSO, the Department, and the Michigan
Public Health Institute (MPHI) with regards to program development and monitoring
(including annual site visits either in-person or virtual), training, support and technical
assistance services. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to program monitoring, quality assessment, support and TA.
Professional Development and Training:
All of the LIA NFP staff associated with this funding will participate in professional
development and training activities as required by the NFP NSO and the Department.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
professional development and training activities.
Supervision:
The LIA shall adhere to the NFP supervision requirements.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have the lived experience and
expertise.
The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start
Collaborative.
The LIA shall participate in the Regional Perinatal Quality Collaborative.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all NFP and MDHHS data training, collection, entry and
submission requirements. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to data collection.
Quality Improvement (QI):
The LIA shall participate in all NFP quality initiatives including research, evaluation and
continuous quality improvement.
The LIA shall participate in all state and local Home Visiting QI activities as required by
MDHHS. Required activities include, but are not limited to:
a. Developing and maintaining a QI team
b. Participating in QI activities during the fiscal year
c. Consulting with QI coaches
d. Submit a QI Summary each year by April 30
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to QI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Unit Guidance Manual.
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PROJECT: Public Health Emergency Preparedness (PHEP) and Cities
Readiness Initiative (CRI)
9 Month Project – BIONINE/CRININE
Beginning Date: 10/1/2023
End Date: 6/30/2024
3 Month Project – BIOTHREE/CRITHREE
Beginning Date: 7/1/2024
End Date: 9/30/2024
Project Synopsis
As a Grantee of funding provided through the Centers for Disease Control and
Prevention (CDC) Public Health Emergency Preparedness (PHEP) Cooperative
Agreement, each Grantee shall conduct activities to build preparedness and response
capacity and capability. These activities shall be conducted in accordance with the PHEP
Cooperative Agreement guidance for BP5(2023-2024) plus any and all related guidance
from the CDC and the Department that is issued for the purpose of clarifying or
interpreting overall program requirements.
Reporting Requirements (if different than contract language)
1. Grantee are required to submit a 3-month (July 1 to September 30) budget and a
9-month (October 1 to June 30) for both Base PHEP and CRI funding, including
the 10% MATCH for those periods (see below for detail regarding Match).
Submitted to the Financial Analyst, Janis Tipton at tiptonj2@michigan.gov with a
cc to MDHHS-BETP-DEPR-PHEP@michigan.gov by April 7, 2023.
2. ALL activities funded through the PHEP cooperative agreement must be
completed between July 1, and June 30, and all BP5 funding must be obligated
by June 30, 2024, and activity completed by the August 15, 2024 Final FSR
submission deadline.
3. Grantee must submit required PHEP program data and reports by the stated
deadlines. This includes, but is not limited to, progress reports, performance
measure data reports, National Incident Management System (NIMS) compliance
reports, updated emergency plans, budget narratives, Financial Status Reports
(FSR), etc. Failure to do so will constitute a benchmark failure. All deliverables
must be submitted by the designated due date in the LHD BP5 work plan.
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4. Grantee must maintain National Incident Management System (NIMS) compliance
as detailed in the LHD work plan and submit annually to the Department – DEPR
per the LHD BP5 work plan.
5. Each subrecipient Grantee must retain program-related documentation for
activities and expenditures consistent with Title 2 CFR Part 200; Uniform
Administrative Requirements, Cost Principles and Audit Requirements for Federal
Awards, to the standards that will pass the scrutiny of audit.
Any additional requirements (if applicable)
All Grantee activities shall be consistent with all approved BP5 work plan(s) and
budget(s) on file with the Department through the EGrAMS. In addition to these broad
requirements, the Grantee will comply with the following:
• Grantee provides the required 10% MATCH of the MDHHS Comprehensive
amount for July 1 to September 30 and October 1 to June 30. Grantee are
required to submit a letter (on agency letterhead) stating the source, calculation,
and narrative description of how the match was achieved, unless said match is
met using local dollars. This is due with the narrative budget submission to the
Division of Emergency Preparedness and Response-DEPR.
• Grantee will maintain a 1.0 full-time equivalent (FTE) emergency preparedness
coordinator (EPC) position, to support emergency preparedness and response
activities and as a program point of contact. This position will be supported at a
minimum of 75% with PHEP funding. Other grants may be used up to 25% to
support flexibility in grant utilization. In addition to the Grantee health officer, the
EPC shall participate in collaborative capacity building activities of the PHEP
Cooperative Agreement, all required reporting and exercise requirements and in
regional Healthcare Coalition (HCC) initiatives. Any changes to this staffing model
must be approved by the Public Health Emergency Preparedness Program
Manager at the Division of Emergency Preparedness and Response (517-335-
8150).
• Under the PHEP cooperative agreements, Grantees must continue to partner with
the Regional Healthcare Coalitions (HCC) and support HCC initiatives to ensure
that healthcare organizations receive resources to meet medical surge demands.
Working well together during a crisis is facilitated by meeting on a regular basis.
To this end, EPCs, supported by CDC PHEP are required to participate in and
support regional HCC initiatives. In addition, the EPC or designee is required to
attend regional HCC planning or advisory board meetings. The intent is for LHDs
that cross regional boundaries to align with one regional coalition.
• There are a number of special initiatives, projects, and/or supplemental funding
opportunities that are facilitated under this cooperative agreement. For example,
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the Cities Readiness Initiative (CRI) performance and evaluation initiatives. Each
Grantee that is designated to participate in any of these types of supplemental
opportunities is required to comply with all CDC and the Department – Division of
Emergency Preparedness and Response (DEPR) guidance, and all
accompanying work plan and budgeting requirements implemented for the
purpose of subrecipient monitoring and accountability. Some or all supplemental
opportunities may require separate recordkeeping of expenditures. If so, this
separate accounting will be identified in separate project budgets in the EGrAMS.
These supplemental opportunities may also require additional reporting and
exercise activities.
• Budget amendments that contain line items deviating more than 15% or $10,000
(whichever is greater) from the original budgeted line item must be approved by
DEPR prior to implementation via email to the Financial Analyst, Janis Tipton at
tiptonj2@michigan.gov with a cc to MDHHS-BETP-DEPR-PHEP@michigan.gov
• In response to repeated communications from CDC strongly urging states to
ensure all funds are spent each year a threshold has been established to limit the
amount of unspent funds. A maximum of 2% of the Grantee allocation or $3,000
(whichever is greater) of unspent funds is allowable each budget period. Failure to
meet this requirement, or misuse of funds, will affect the amount that is allocated
in subsequent budget periods.
Unallowable and Allowable Costs
• Grantee may not use funds for research.
• Grantee may not use funds for clinic care except as allowed by law.
• Generally, Grantee may not use funds to purchase furniture or equipment. Any
such proposed spending must be clearly identified in the budget.
• Reimbursement of pre-award costs generally is not allowed unless the CDC
provides written approval to the recipient.
• Other than for normal and recognized executive-legislative relationships, no funds
may be used for:
a. Publicity or propaganda purposes, for the preparation, distribution, or use of
any material designed to support or defeat the enactment of legislation
before any legislative body.
b. The salary or expenses of any grant or contract recipient, or agent acting
for such recipient related to any activity designed to influence the
enactment of legislation, appropriations regulation, administrative action, or
Executive order proposed or pending before any legislative body.
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• Lobbying is prohibited.
• The direct and primary recipient in a cooperative agreement must perform a
substantial role in carrying out project outcomes and not merely serve as a conduit
for an award to another party or provider who is ineligible.
• Grantee may not use funds to purchase vehicles to be used as means of
transportation for carrying people or goods, e.g., passenger cars or trucks,
electrical or gas-driven motorized carts.
• Grantee can (with prior approval) use funds to lease vehicles to be used as means
of transportation for carrying people or goods, e.g., passenger cars or trucks and
electrical or gas-driven motorized carts.
• Payment or reimbursement of backfilling costs for staff is not allowed.
• No clothing may be purchased with these funds.
• Items considered as give away such as first aid kits, flashlights, shirts etc., are not
allowable.
• None of the funds awarded to these programs may be used to pay the salary
of an individual at a rate in excess of Executive Level II or $189,600 per year.
• Grantee may not use funds for construction or major renovations.
• Grantee may not use funds to purchase a house or other living quarter for those
under quarantine.
• PHEP funds may not be used to purchase or support (feed) animals for labs,
including mice. Any requests for such must receive prior approval of protocols
from the Animal Control Office within CDC and subsequent approval from the CDC
OGS as to the allowable of costs.
• Grantee may supplement but not supplant existing state or federal funds for
activities described in the budget. Supplantation is the replacement of non-federal
funds with federal funds to support the same activities. Under Public Health
Service Act, Title I, Section 319(c), it strictly and expressly prohibits using
cooperative agreement funds to supplant any current state or local expenditures.
• Grantee may use funds only for reasonable program purposes including
personnel, travel, supplies and services.
• Grantee may (with prior approval) use funds for overtime for individuals directly
associated (listed in personnel costs) with the award.
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• Grantee can (with prior approval) use funds to purchase material-handling
equipment (MHE) such as industrial or warehouse-use trucks to be used to move
materials, such as forklifts, lift trucks, turret trucks, etc. Vehicles must be of a type
not licensed to travel on public roads.
• Grantee can use funds to purchase caches of medical or non-medical
Counter measures for use by public health first responders and their families to
ensure the health and safety of the public health workforce.
• Grantee can use funds to support appropriate accreditation activities that meet the
Public Health Accreditation Board’s preparedness-related standards.
Audit Requirement
A grantee may use its Single Audit to comply with 42 USC 247d – 3a(j)(2) if at least once
every two years the awardee obtains an audit in accordance with the Single Audit Act (31
USC 7501 – 7507) and Title 2 CFR, Part 200 Subpart F; submits that audit to and has the
audit accepted by the Federal Audit Clearinghouse; and ensures that applicable PHEP
CFDA number 93.069 are listed on the Schedule of Expenditures of Federal Awards
(SEFA) contained in that audit.
Pandemic and All Hazards Preparedness and Advancing Innovation Act of 2018
Requires the withholding of amounts from entities that fail to achieve PHEP benchmarks.
The following PHEP benchmarks have been identified by CDC and MDHHS-DEPR for
the Fiscal Year:
• Demonstrated adherence to all PHEP application and reporting deadlines.
Grantees must submit required PHEP program data and reports by the stated
deadlines. This includes, but is not limited to, progress reports, performance
measure data reports, National Incident Management System (NIMS) compliance
reports, updated emergency plans, budget narratives, Financial Status Reports
(FSR), etc. Failure to do so will constitute a benchmark failure. All deliverables
must be submitted by the designated due date in the LHD BP5 work plan.
• Demonstrated capability to receive, stage, store, distribute, and dispense medical
countermeasures (MCM) l during a public health emergency, per the LHD BP5
Work Plan.
• Further guidance related to specific preparedness deliverables will be included in
the LHD workplan.
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Benchmark Failure
Awardees are expected to “substantially meet” the PAHPIA benchmarks. Per the
Cooperative Agreement, failure to do so constitutes a benchmark failure, which carries an
allowable penalty withholding of funds. Failure to meet any one of the two benchmarks
and/or the spending threshold is considered a single benchmark failure. Any awardee (or
sub-awardee) that does not meet a benchmark, and/or the spending threshold will have
an opportunity to correct the deficiency during a probationary period. If the deficiency is
not corrected during this period, the awardee is subject to a 10% withholding of funds the
following budget period. Failure to meet the pandemic influenza plan requirement
constitutes a separate benchmark failure and is also subject to a 10% withholding. The
total potential withholding allowable is 20% the first year. If the deficiency is not
corrected, the allowable penalty withholding increases to 30% in year two and 40% in
year three.
Regional Epidemiology Support
For those Grantees receiving additional funds to provide workspace for Regional
Epidemiologists, the grantee must provide adequate office space, telephone connections,
and high-speed Internet access. The position must also have access to fax and
photocopiers.
PROJECT: Public Health Infrastructure
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis
The Strengthening Public Health Workforce and Infrastructure in Michigan grant is
intended to support critical public health infrastructure needs in local jurisdictions related
to the public health workforce, foundational capabilities and data modernization.
Funding is intended to be highly flexible to meet the unique needs of each jurisdiction.
Reporting Requirements (if different than contract language)
Grantees will be required to report progress biannually in winter and summer of each
grant year. The MDHHS Division of Local Health Services will communicate the format
for grant reporting during the grant year.
Any additional requirements (if applicable)
Examples of allowable expenses include:
• Expenses related to recruitment/hiring of new staff or retention of existing staff
• Supplies and equipment necessary for staff to complete job functions
• Training and conference expense
• Software or IT equipment purchases, leases, upgrades or repair
• Investments in workforce engagement, well-being and other related programs
and services
• Expenses related to purchasing or leasing office space in an existing building
• Physical infrastructure repairs, improvements etc. (buildings, vehicles,
equipment, etc.)
o Improvements to existing structures must be approved by the MDHHS
Division of Local Health Services (LHS) through the budget review
process. Accompanying justification will be required.
Examples of allowable activities:
• Hiring staff to fill new or existing position
• Holding training events for new or existing staff
• Purchasing/leasing new vehicles, equipment, IT equipment, etc.
• Remodeling existing office space
Non-allowable expenses include:
• New building construction (e.g. breaking ground on a brand-new facility
• Funding restrictions and limitations listed under CDC’s general terms and
conditions for non-research grants (see:
https://www.cdc.gov/grants/documents/General-Terms-and-Conditions-Non-
Research-Awards.pdf)
o Includes lobbying activities, advocacy/promotion of gun control, needle
exchange programs, certain telecommunications/surveillance services or
equipment and other limitations.
PROJECT TITLE: Regional Perinatal Care System
Start Date: 10/01/2023
End Date: 09/30/2024
Project Synopsis:
The aim of the Regional Perinatal Quality Collaboratives (RQPCs) is to develop data-
informed innovative strategies and efforts that are tailored to the strengths and
challenges of each region to improve maternal, infant, and family outcomes; especially
looking at preterm birth, very low birth weight infants, low birth weight infants, and
maternal health. Furthermore, RPQCs ensure statewide alignment with the strategies
and goals outlined in Michigan’s plan to advance birth equity and improve birth outcomes
(formerly the Mother Infant Health and Equity Improvement Plan) and are tasked with
addressing disparities in birth outcomes and health inequities. Each RPQC engages
cross-sector, diverse stakeholders and implements evidence-based, or promising
practice, interventions utilizing quality improvement methodology.
Reporting Requirements (if different than agreement language):
The Grantee shall submit the following reports on a quarterly basis:
• Report on Aim statement, measures, and corresponding outcomes, as identified
by the grantee and MDHHS, through submission of quarterly progress reports.
• RPQCs will submit quarterly narrative reports summarizing member agency
efforts, new partnerships, community achievements, member participation in and
status of other MDHHS initiatives, as well as the composition and number of
attendees at each Collaborative meeting. This report will be submitted with the
quarterly progress report to the Contract Manager Perinatal Quality Collaborative
Nurse Coordinator, Emily Goerge, via email at: GoergeE@michigan.gov. A
template for the narrative report will be provided.
• RPQCs are expected to comply with any other reporting requirements that may
arise during the fiscal year, as identified, and communicated by the Contract
Manager to RPQC leadership.
• When an RPQC has multiple funding sources in the contract budget, the fiduciary
must submit a breakdown of expenditures by funding source to the contract
manager with each FSR.
• RPQCs will be required to report on the number of participants with ‘active
membership’ in their quarterly progress reports. See definitions below for what
qualifies as ‘active membership’.
Any such other information as specified above shall be developed and submitted by the
Grantee as required by the Contract Manager.
Any additional requirements (if applicable):
• In alignment with the Regional Perinatal Quality Collaborative’s (RPQC) role of
authentically engaging families and convening diverse stakeholders, the
Collaborative must be comprised of a multi-stakeholder and diverse membership;
ensuring to recruit families, faith-based organizations, clinicians, Medicaid Health
Plans, community-based organizations, business partners, and etcetera.
• MDHHS stresses the importance of garnering the input and feedback of families
most impacted by adverse birth outcomes. Therefore, continuing in fiscal year
2024, there must be family representation in the RPQC’s membership
• Family engagement is essential to the success of the RPQCs and can be fostered
via various avenues, for example: family groups through Great Start Collaborative
and Children Special Health Care Services, community centers, local churches,
focus groups, parent panel and etcetera
• RPQCs are expected to convene periodic (with frequency of at least quarterly)
collaborative meetings, inclusive of diverse regional partners, to garner feedback
and discussion, including but not limited to, regional maternal and infant vitality
concerns, review of data, analysis of gaps in care and birth outcomes, quality
improvement efforts, alignment with the Mother Infant Health and Equity
Improvement Plan and etcetera Advancing Healthy Births: An Equity Plan for
Michigan Families and Communities.
*The collaborative meetings are to be in addition to any leadership or steering
team meetings that the RPQC may choose to convene as oversight for the RPQC.
Definitions
Active membership is defined as attending a minimum of two (2) Collaborative
meetings, participating in RPQC quality improvement efforts, reporting out on their
respective agency’s efforts related to maternal and infant mortality, and etcetera.
Family active membership is defined as a family presence at a minimum of two
(2) Collaborative meetings, garnering family input at least twice per fiscal year,
and/or participation in the planning or implementation of quality improvement
efforts.
• Family and community presence should comprise 10% of the RPQC’s active
membership.
Membership includes, but is not limited to:
• Families
• Clinicians
• Community-based organizations
• Local public health
• Medicaid health plans
• Faith-based organizations
• Business partners
• Others
To promote regional and state alignment, RPQCs will need to infuse maternal and infant
Statewide initiatives into their Collaborative (example: Michigan Maternal Mortality
Surveillance (MMMS), Fetal Infant Mortality Review (FIMR), Michigan Alliance for
Innovation on Maternal Health (MI AIM), Michigan Fatality Review and Prevention
(MFRP), etc.and etcetera.)
• Each Collaborative will dedicate time during meetings for members to share
updates, as well as time for reporting out on participation in other Statewide
initiatives.
• In Fiscal Year 2024, RPQCs will specifically be required to:
1. Include updates on region-specific MI AIM efforts and best practices at a
minimum of two (2) fiscal year 2024 collaborative meetings. Updates should
be given by MI-AIM birthing hospital leads and MI AIM regional
representatives
2. Encourage birthing hospital and other clinical provider engagement and
participation in the RPQC, such as at Collaborative meetings, with quality
improvement efforts, on leadership team, etcetera to build stronger
community-clinical linkages and networks
3. Know the current MI-AIM designation status of the birthing hospitals in their
respective region.
• The names and titles of the RPQC leadership, and the Quality Improvement
project team leads, for fiscal year Fiscal Year 2024, must be identified on the
work plans submitted to the Contract Manager Perinatal Quality Collaborative
Nurse Coordinator via email, GoergeE@michigan.gov
• Selected quality improvement objective(s), corresponding evidence-based or
promising practices intervention(s), and all efforts put forth, must align with
Michigan’s plan to advance birth equity and improve birth outcomes. the
Advancing Healthy Births: An Equity Plan for Michigan Families and
Communities.
All quality improvement efforts must:
• Be data informed.
• Utilize quality improvement methodology.
• Address disparate outcomes.
• Utilize evidence-based and/or promising practices interventions that address
improving outcomes for mothers, infants, and families.
• RPQCs must also actively address health inequities, social determinants of
health, and disparate outcomes throughout all efforts and as inclusive of their
dedication to improving birth outcomes.
• It is expected that RPQCs align with regional efforts to address perinatal
substance use disorder (PSUD) including, but not limited to screening, treatment,
and patient and family centered support and care.
• As the RPQCs are a conduit to the community, the region must provide
representation at MDHHS Division of Maternal and Infant Health hosted
meetings, as requested, such as the Mother Infant Health and Equity
Collaborative (MIHEC) meeting and the State Perinatal Quality Collaborative
meetings (i.e., RPQC Leadership meetings)
1. Attendance is required unless prior approval received from State consultant.
2. For MIHEC meetings, each RPQC should have two attendees present, with at
least one representing the leadership team.
3. For the quarterly State Perinatal Quality Collaborative meetings, at least two
members of the RPQC leadership team are required to attend.
4. Each region will be required to report on their efforts, challenges, successes
and etcetera at one of the quarterly MIHEC meetings.
5. RPQCs will host regional Town Hall meetings in collaboration with MDHHS, as
requested; not to exceed once per year.
6. Regional collaborative leadership is expected to work collectively with assigned
State consultant and other members of the MIHEIP team.
Budget Allowances
To ensure most of the awarded funding is funneled into the community for quality
improvement efforts:
• Budgets line items for external consultants must be capped at 25% for
contractors/consultants who have been hired as subject matter experts.
• Budgets must be capped at 75% for contractors hired to carry out the quality
improvement tasks of the collaborative.
• Total budgets for external consultants hired as subject matter experts must be
capped at 20%.
• Total staffing budgets, including fringe/benefits, must be capped at 20% or
$150,000, whichever is more, for those hired to carry out the leadership, project
coordination, and/or quality improvement tasks of the collaborative.
• Indirect rates which cover a fiduciary agency’s overhead costs must be capped at
10%.
Funds have been appropriated in FY24 to RPQCs with the specific intent of supporting
local efforts and strategies to improve birth outcomes and address the root cause of birth
inequities within their respective Region. It is expected that each RPQC allocates funds
to local entities and/or efforts for this purpose.
PROJECT: SDOH Hubs Pilot
Start Date: 1/1/2024
End Date: 9/30/2024
Project Synopsis
SDOH Hubs will strengthen how health care and social care organizations collaborate to
meet the needs of community members by developing and promoting the technological,
human, and organizational capacities necessary for coordinated social care.
Reporting Requirements (if different than contract language)
Any additional requirements (if applicable)
PROJECT: SDOH Planning
Start Date: 10/1/2023
End Date: 09/30/2024
Project Synopsis
The local health departments will utilize funding to implement Community Health
Needs Assessment (CHNA), plan for Community Information Exchange (CIE), and
implement community-driven initiatives that support social determinants of health
(SDOH) priorities. For those who have conducted CHNAs, funding will be used to
advance CHNA efforts by addressing SDOH priorities that were identified during the
CHNA.
Local health departments will utilize the funding to implement the Good Housing =
Good Health Program (awarded though the Michigan Housing Community Develop
(HCDF) and Michigan State Housing Development Authority (MSHDA)) to provide
Social Determinants of Health (SDOH) and housing services and will be administered
by Michigan Department of Health and Human Services (MDHHS) in partnership with
local health departments participating in the MDHHS Community Needs Health
Assessment (CNHA) and Community Information Exchange (CIE) planning grants.
Reporting Requirements (if different than contract language)
When engaging with community members, Grantees are asked to provide reports on
community feedback for review by the MDHHS Social Determinants of Health Team.
Submit reports to Darien Pipkin and Tiwanna Hatcher, MDHHS Office of Policy and
Planning, via email at MDHHS-SDOH-PolicyandPlanning@michigan.gov.
Following the conclusion of the grant period (September 30), Grantees are required to
submit a final report of work accomplished in scope of their initial proposal. and
complete a survey to support strategic planning of Phase III of the MDHHS Social
Determinants of Health Strategy.
The survey will collect information on the following:
During the grant period, grantees are required to submit a quarterly performance report
via Qualtrics Survey. A progress report template and link will be provided. The following
information will be collected.
• Opportunities to leverage technology to facilitate referrals for social care.
• Infrastructure and/or resources needed to support Community Information
Exchange (CIE) and community driven solutions through more effective
policy, funding, and technological support.
• Priority populations identified through Community Health Needs Assessment
(CHNA) implementation.
• Social determinants of health (SDOH) domains prioritized through CHNA
implementation.
• Scope of local/regional efforts to integrate community health workers (CHWs),
reduce the burden of chronic disease, and/or advance racial and/or rural
health equity.
• Barriers encountered during implementation of CHNA or CIE planning efforts
• Scope of local/regional efforts to integrate community health workers (CHWs),
reduce the burden housing instability, racial and/or rural health equity.
• Barriers encountered during implementation of Good Housing = Good Health
Program Funds
• Output/Outcome measures around SDOH and Housing services to increase
access to health and housing services/resources
Output Measures:
• Number of eligible households each Local Health Department
served.
• Number of eligible households that received MI Bridges Navigation
• Number of eligible households that received housing stabilization
services.
• Number of eligible households that received referrals.
• Number of total individuals served.
• Number of quarterly outreach hours worked in the community to
support participating households.
• Plus, demographic information about the households: family
composition, age, race, ethnicity, disability, gender, sexual
orientation, veteran status, income, and any other SDOH
demographics
Quarterly SLFRF Narrative Report are due in Qualtrics on the following dates:
• October 1, 2023 – Dec 31, 2023: January 10
• January 1, 2024– March 31, 2024: April 10
• April 1, 2024 – June 30, 2024: July 10
• July 1, 2024– September 30, 2024: October 10
The provided progress report information will be included in the Quarterly SLFRF
Narrative Report.
Additional opportunities identified to improve health outcomes and advance equity
within their respective geographic area.
Surveys will be sent out by February 29 and must be completed by March 31. Final
reports are due by March 31.
• Grantees are required to attach a signed attestation statement form with each
financial status report in EGrAMS. Failure to submit the signed form will result in
a hold on reimbursements as this is a requirement of the HCDF funds.
• Grantees are required to collect a signed Self-certification form for each
individual or family who applies for and/or receives assistance under the HCDF.
• Grantees must collect a signed client authorization form for each individual or
family who applies for and/or receives assistance under the HCDF.
• Grant Opening Certification, due immediately upon signing this Agreement. A
template will be provided.
• Grant Closing Certification: The Grantee must complete and submit the Grant
Closing Certification within 46 days of the end of this agreement. A template will
be provided.
• Annual SLFRF Narrative Report: The Grantee must complete and submit the
Annual Narrative Report form by June 30th annually.
• Outcomes, output measures, and results to-date (including the communication of
intended outcomes and output measures) will be reported on an annual basis, by
June 30th annually, to capture program success.
Any additional requirements (if applicable)
Grantee participation in bimonthly meetings to share updates, best practices, and
barriers will be required.
• Grantees are required to adhere to all requirements in the provided Good
Housing = Good Health Program Manual.
• Grantees participation in quarterly meetings to share updates, best practices,
and barriers will be required.
• Grantees are required to provide a detailed outline of their scope of work, budget,
and deliverables with each contractor as it relates to the Good Housing = Good
Health Program Funds.
• Grantees are required to keep all records including books, financial status
reports, personnel, accounts, receipts, contractual contracts, contractual
spending reports, workplans, supporting documentation, and any other
information related to the Good Housing = Good Health Program funds.
Federal Grant Requirements:
1. Subject to the State of Michigan Records Retention and Disposal
Schedule for the Authority’s Office of Equity and Engagement, as amended,
grantees must retain all financial records, supporting documents, statistical
records, and all other pertinent records for a period of five (5) years after all of
the Total Funding Amount has been disbursed, as required by Treasury and
the State of Michigan, or for a longer period of time if required by state or
federal law, and in any event shall continue through at least December 31,
2031. The retention period must commence from the date that MDHHS is
notified in writing that the Authority has completed its final review of the
activities described and stated herein. MDHHS and its subgrantees agree to
provide or make these records available for audit proposes to the Authority,
Treasury, and to any authorized oversight body, including but not limited to
the Auditor General of the State of Michigan, the Government Accountability
Office, Treasury’s Office of Inspector General, and the Pandemic Relief
Accountability Committee.
Grantees:
a. agrees that the Authority may, at the Authority’s discretion and
consistent with generally accepted auditing principles, annually monitor
and audit participating Local Health Departments, compliance with the
terms and conditions of the Agreement
b. agrees to provide books, records, or other documentation as the
Authority or Treasury may request that are reasonably necessary to
ensure conformity with the terms of the Agreement, and state and
federal requirements, as applicable.
c. acknowledges that it must provide a copy of any single or program
specific audit to the Authority for the Authority’s required review within
thirty (30) days of the completion of the audit or the effective date of
the Agreement.
d. acknowledges that it may be subject to the Single Audit Act and the
implementing regulations at 2 CFR Part 200, Subpart F.
Diversity, Equity, and Inclusion (DEI) Program Requirements
1. Fair Housing Training: Local Health Departments will participate
in one (1) Fair Housing training approved by the MSHDA Office of
Equity and Engagement within the first sixty (60) days of the earlier of
(a) implementing the Program, (b) the date of hire, or (c) the date of
the contract and annually thereafter for the duration of the Program.
The MSHDA-approved trainings for this program MSHDA Tenants
Training. For additional Fair Housing Training and Resources, please
visit https://www.michigan.gov/mshda/fairhousing.
2. Program Accessibility: Local Health Departments must provide
(1) Program documents, trainings, webinars, and services that are
ADA accessible; (2) key Program documents that are (to the extent
possible) published in English, Spanish, and Arabic and any other
language/dialect based on local community needs; and (3) translation
services. For technical assistance tools from the US General
Services Administration Section 508.gov ADA Accessible Guides and
Video Trainings, see their website at Accessibility Training |
Section508.gov or https://www.section508.gov/training-home/.
3. Affirmative Marketing: Local Health Departments Program
materials related to the Good Housing = Good Health Program must
include the Fair Housing logo, the ADA Accessible logo, and the
provided affirmative statement.
PROJECT TITLE: SEAL! Michigan Dental Sealant
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
SEAL! MI is the School Based Dental Sealant Program, providing oral health
prevention to students in Michigan schools.
Reporting Requirements (if different than agreement language):
• Quarterly Report Dental Sealant Tracking Form’s at the end of each quarter to the
Michigan Department of Health and Human Services Oral Health Program.
• Submit completed copies of the SEAL! MI MDHHS Student Data and Event Data
forms within two weeks of the end of the fiscal year and upon request.
Any additional requirements (if applicable):
• All program staff (paid and unpaid) must attend the annual SEAL! MI Training via
webinar.
• At least one person from program must attend the SEAL! MI Annual Workshop, in
person, all day.
• All monies collected from insurance billing from dental sealants must be allocated
back into the SEAL! MI program (equipment, staff, supplies, travel, incentives
etc.).
• There must be one EXTRA complete treatment set up available for program use in
the event of equipment failure (including: portable dental unit, curing light, Isolite
other isolation system, patient chair, operator light and operator chair).
• Patient privacy screens must be available for use
• Any MDHHS infection control policies specific to Covid-19 must be followed in all
SEAL! Michigan events.
PROJECT TITLE: Sexually Transmitted Infection (STI) Control
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health
care cost. Women, especially those of child-bearing age, and adolescents are particularly
at risk for negative health outcomes. Local health STI programs ensure prompt reporting
of cases, provide screening and treatment services for Michigan's citizens, and respond to
critical morbidity increases in their jurisdiction.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit Report
STI 340B
Utilization/
Inventory
Report
Quarterly
Within 10 days
after the end of
the quarter
Log into SGRX340BFlex.com website,
generate a quarterly report on the
reporting tab, and it will be transferred
automatically to ScriptGuide/BHSP
Any additional requirements (if applicable):
Grant Program Operation
1. Maintain core STI clinical service, including prioritizing the testing, treatment of
individuals referred by MDHHS DIS; this includes people reported with a positive
lab result and those identified as contacts to incident cases of syphilis, gonorrhea,
and HIV.
2. Participate in technical assistance/capacity development, quality assurance, and
program evaluation activities as directed by Bureau of HIV and STI
Programs/Sexually Transmitted Infections (BHSP/STI).
3. Implement program standards and practices to ensure the delivery of culturally,
linguistically, and developmentally appropriate services. Standards and practices
must address sexual minorities.
4. For gonorrhea and chlamydia cases in the Michigan Disease Surveillance System,
50% shall be completed within 30 days and 60% within 60 days from the date of
specimen collection.
5. For gonorrhea and chlamydia cases, develop plans to respond to issues in quality,
completeness, and timeliness.
Mandatory Disclosures
1. Inform STI program at least two weeks prior to changes in clinic operation (hours,
scope of service, etc.).
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in the
BHSP SHOARS system. These roles must match what the agency has listed for
these roles in the EGrAMS system. If you have access related questions, contact
MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov
PROJECT: Statewide Lead Case Management
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
All local health departments in Michigan are eligible to participate in this program to
receive reimbursement for nursing case management services to children not enrolled
in Medicaid, as well as reimbursement for community health workers (CHWs) to
complete case management activities. This will allow LHD nurses to offer case
management to all children regardless of insurance status. NCM visits will be
reimbursed at a rate of $201.58 and community health worker visits at a rate of $100.
This funding is to support local health departments in providing case management
services to all children with elevated blood lead levels in Michigan. All services should
be provided according to CLPPP guidance documents for case management for nurses
and community health workers.
Reporting Requirements (if different than agreement language)
1. Quarterly FSR and FSR Supplemental Attachment
• Submit request for reimbursement through the EGrAMS system based on the
“fixed unit rate” method. The fixed rate for case management services is
$201.58 per home visit, for up to 6 home visits. Additionally, a FSR
supplemental attachment form is required to be uploaded in EGrAMS that
specifies the number of children and home visits for which reimbursement is
being requested on. The FSR and the FSR supplemental attachment form
must be submitted no later than thirty (30) days after the close of the quarter.
2. Quarterly Case Management Logs
• A complete spreadsheet of CM activities is due quarterly, submitted
electronically through the CLPPP’s secure DCH-File Transfer Site available
through MiLogin, using a template provided by CLPPP. The quarterly
spreadsheet must be submitted no later than thirty (30) days after the close of
the quarter.
3. Annual Report
• An Annual Report covering the reporting period for FY22 is May 1 –
September 30. The format for the submission will be determined by CLPPP,
communicated to the local health departments. The Annual report must be
submitted no later than thirty (30) days after the close of Quarter 4.
Any additional requirements (if applicable)
Continuation of this project is contingent upon funding availability.
The local health department shall:
• Have home case management conducted by a registered nurse trained by
MDHHS CLPPP. ** To be reimbursed for a home visit, the visit must be
completed by a registered nurse.
• Sign up for the DCH-File Transfer Site available through MiLogin maintained
by MDHHS CLPPP, to be used for data sharing of confidential information.
• Complete case management activities according to the MDHHS CLPPP Case
Management Guide.
• Document all required case management activities in the child’s electronic file
in the HHLPPS database. Required documentation includes an initial home
visit form, follow-up visit forms, dates of chelation therapy, and plan of care.
PROJECT TITLE: Sexually Transmitted Infection (STI) Specialty Services
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
Sexually Transmitted Infections (STIs) result in excessive morbidity, mortality, and health
care cost. The purpose of this project is to provide a community access point for specialty
STI clinical service with a focus on the LGBTQ+ community.
Reporting Requirements (if different than agreement language):
Report Period Due Date(s) How to Submit
Report
Quarterly Progress Report
& Data Report Quarterly 30 days after the
end of the quarter
Email to MDHHS
contract liaison
Any additional requirements (if applicable):
GRANTEE REQUIREMENTS
Mandatory Disclosures
1. Inform STI program at least two weeks prior to changes in clinic operation (key
staff, hours of operation, scope of service, etc.).
Technical Assistance
1. Technical assistance (TA) requests must be submitted via the MDHHS SHOARS
system. In addition, if your contract is to be amended, the request will have to be
logged into SHOARS. Registration instructions and further information can be
found at: https://bit.ly/3HS7xdG
2. Recipient agency must register an Authorized Official and Program Manager in the
BHSP SHOARS system. These roles must match what the agency has listed for
these roles in the EGrAMS system. If you have access related questions, contact
MDHHS-SHOARS-SUPPORT MDHHS-SHOARS-SUPPORT@michigan.gov
PROJECT TITLE: Substance Use Home Visiting Program
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
The focus of the Substance Use Home Visiting programs is to increase support for
families who have been impacted by substance misuse either through the expansion of
home visiting services or Peer Navigator services that connect families to resources.
The MDHHS-HVU substance use programs encompass implementation of an evidence-
based home visiting model or the implementation of the MDHHS Peer Navigator Pilot.
Reporting Requirements (if different than agreement language):
Home Visiting Expansion (Only applies to grantees implementing a Home Visiting
Model)
The Local Implementing Agency (LIA) shall submit all required reports in accordance with
the Department reporting requirements. See the Michigan Department of Health and
Human Services’ (MDHHS) Home Visiting 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. In addition to other data required by MDHHS, LIAs are required to record and submit
monthly HMHB billable reporting through REDCap by the 5th business day of each
month.
This data includes:
• Family Model ID#
• Funding Source
• Referral Source
• How Substance Use was identified
• Enrollment/Exit Status
• Family Type (e.g., pregnant, etc.)
c. 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.
d. 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).
e. HVU data/caseload collection and HMHB requirements due in REDCap by the 5th
business day of each month. In addition, grantees must use the appropriate model
database. HFA programs must use Home Visiting On-Line (HVOL) and NFP
programs must use FLO for all model and other MDHHS required data.
f. Quality Improvement Reporting:
• Documentation of a QI team will be submitted with the quarterly Work Plan
Report.
• Documentation of QI activities will be submitted with the quarterly Work
Plan Report.
• Annual summary of QI activities will be submitted to the HVU Model
Consultant by April 30.
g. HV CoIIN Reporting (for those LIAs participating) for QI efforts shall occur in
accordance with the CoIIN’s schedule. Participating LIAs are required to use the
HV CoIIN site to complete monthly submissions of PDSA cycles and required data
(the frequency of data collection may vary).
Reports (a-g) shall be submitted as described above. Additional guidance concerning
data collection and Quality Improvement is provided in the MDHHS Home Visiting Unit
Guidance Manual.
Any additional requirements (if applicable):
Grantee Specific Requirements for Home Visiting Model Implementation:
Home visitors funded through Family First Prevention Services Act will serve families
referred from local Child Welfare agencies, in proportion to their FFPSA FTE.
HFA
a. 13 HMHB families per 1.0 FTE for fully trained and experienced home visitors.
NFP
b. 25 HMHB families per 1.0 FTE
MOU
LIAs are required to work with MDHHS to complete a Memorandum of Understanding
with MDHHS to establish expectations for the relationship that is being built between
child welfare and the home visiting program.
Maintain Fidelity to the Model:
The LIA shall adhere to the Home Visiting model Best Practice Standards or Model
Elements. In addition, all Healthy Families America and Parents as Teachers affiliates
shall comply with the requirements of the Central Administration for HFA/PAT State
Office housed within the Michigan Public Health Institute.
Comply with MDHHS Program Requirements:
The LIA shall operate the program with fidelity to the requirements of MDHHS based on
the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS Home
Visiting Unit Guidance Manual. The LIA will fulfill these requirements while strengthening
efforts towards health and racial equity through staff education, programmatic data
evaluation and client supportive services.
P.A. 291:
The LIA shall comply with the provisions of Public Act 291 of 2012. See the MDHHS
Home Visiting Unit Guidance Manual for requirements related to PA 291.
Staffing:
LIAs will reflect the community served. The LIA will provide documentation to
demonstrate due diligence if unable to fully meet this requirement within 90 days of a
MDHHS site visit in which this was a finding. See the MDHHS Home Visiting Unit
Guidance Manual for requirements related to program staffing.
Performance Measures:
The LIA shall comply with MDHHS expectations of demonstrating improvement in the
performance measures described in the MDHHS Home Visiting Unit Guidance Manual.
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the NFP NSO, the Department and the Michigan Public
Health Institute (MPHI) with regards to program development and monitoring (including
annual site visits either in-person or virtual), training, support and technical assistance
services. See the MDHHS Home Visiting Unit Guidance Manual for requirements related
to program monitoring, quality assessment, support and TA.
Professional Development and Training:
All of the LIA’s NFP staff associated with this funding will participate in professional
development and training activities as required by the NFP NSO and the Department.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
professional development and training activities.
Supervision:
The LIA shall adhere to the NFP supervision requirements.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall build upon and maintain diverse community collaboration and support with
authentic engagement of parent representatives who have the lived experience and
expertise.
The LIA shall build a relationship with their local DHHS office. LIAs are expected to
inform the DHHS worker for their assigned Title IV-E eligible families of the enrollment
date, referral status within two weeks of referral, if a home visitor has not been able to
connect with a family in two weeks, and closure date. LIA will coordinate with DHHS
when approaching annual review for any enrolled Title IV-E eligible families.
The LIA shall participate in the Local Leadership Group (LLG) or, if none, the Great Start
Collaborative.
The LIA shall participate in the Regional Perinatal Quality Collaborative.
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all model and MDHHS HVU data training, collection, entry, and
submission requirements. See the MDHHS Home Visiting Unit Guidance Manual for
requirements related to data collection.
Quality Improvement (QI):
The LIA shall participate in all HV Model quality initiatives including research, evaluation,
and continuous quality improvement.
The LIA shall participate in all state and local Home Visiting QI activities as required by
MDHHS. Required activities include, but are not limited to:
a. Developing and maintaining a QI team
b. Participating in QI activities during the fiscal year
c. Consulting with QI coaches
See the MDHHS Home Visiting Unit Guidance Manual for requirements related to QI.
Promotional Materials:
If the LIA wishes to produce any marketing, advertising or educational materials using
grant agreement funds, they must follow the requirements outlined in the MDHHS Home
Visiting Unit Guidance Manual.
Peer Navigator Pilot (Only applies to grantees implementing the Peer Navigator
Pilot)
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 MDHHS Home
Visiting Unit Substance Use Coordinator via e-mail and incorporate the change(s)
into the budget and facesheet during the next amendment cycle as appropriate.
The facesheet identifies the agency contacts and their assigned permissions
related to the tasks they can perform in E-GrAMS. The assigned Project Director
in E-GrAMS can make the facesheet changes once the agreement is available to
be amended.
b. Grantees are required to record and submit monthly reporting through REDCap by
the 5th business day of each month. This data includes:
• Referrals
• Enrollments
• Exits
• Every Family Contact
• Plan of Safe Care Completion
• Community Service Referrals
• Referral Follow-up
• Engagement in Home Visiting
• Child Welfare Involvement
c. Work Plan: Due annually on June 30 to the to the MDHHS Home Visiting Unit
Substance Use Coordinator 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.
d. 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).
Comply with MDHHS Peer Navigator Pilot Program Requirements:
The LIA shall operate the program with fidelity to the requirements of the Michigan
Department of Health and Human Services (MDHHS) based on the agreement executed
in E-GrAMS and the conditions as outlined in the MDHHS Peer Navigator Pilot
Implementation Guide. The LIA will fulfill these requirements while strengthening efforts
towards health and racial equity through staff education, programmatic data evaluation
and client supportive services.
Data-Informed Outreach:
Michigan is using the Peer Navigator Pilot as a specialized service strategy for pregnant
and postpartum people impacted by substance misuse. The LIA will conduct outreach
activities to the families impacted by substance misuse identified in order to enroll
families from those outreach efforts.
• The MDHHS expects the LIA to maintain a caseload maximum of 30 families per
1.0 FTE Peer Navigator
Program Monitoring, Quality Assessment, Support and Technical Assistance (TA):
The LIA shall fully participate with the Department and with regards to program
development and monitoring, training, support, and technical assistance services.
Professional Development and Training:
Peer Navigator Pilot staff associated with this funding will participate in professional
development and training activities as required by MDHHS and those necessary to
continue their Peer Recovery Coach and Community Health Worker certifications. See
the Peer Navigator Pilot Implementation Guide for requirements related to professional
development and training activities.
Peer Mentoring Consultation:
The LIA shall adhere to engaging in Group Peer Mentoring Consultation at least
monthly. Individual mentoring sessions are available as needed to the LIA.
Engage and Coordinate with Community Members, Partners and Parents:
The LIA shall engage community members to build relationships, coordinate care, and
increase awareness of the Peer Navigator Pilot Program services in their community.
Data Collection:
The LIA shall comply with all MDHHS data training, collection, entry and submission
requirements including REDCaP data entry completed by the 5th business day of each
month and the completion of a Plan of Safe Care on every family enrolled in the Peer
Navigator Pilot.
PROJECT: TAKING PRIDE IN PREVENTION (TPIP)
Start Date: 10/1/2022
End Date: 9/30/2023
Project Synopsis
The purpose of this project is to implement a comprehensive, evidence-based teen pregnancy
prevention program for youth 12-19 years of age.
Reporting Requirements
The Grantee shall submit the following reports and data via the appropriate reporting
mechanism on the dates specified below:
Report Time Period Due Date Submit To
Work Plan
October 1 - December 31 January 31
EGrAMS
https://egrams-mi.com/mdhhs
January 1 - March 31 April 15
April 1 - June 30 July 31
July 1 - September 30 October 15
Program
Narrative
October 1 - December 31 January 31
EGrAMS
https://egrams-mi.com/mdhhs
January 1 - March 31 April 15
April 1 - June 30 July 31
July 1 - September 30 October 15
Participant
Level Data
(Youth)
October 1 - December 31 January 15
REDCap
https://chc.mphi.org
January 1 - March 31 April 5
April 1 - June 30 July 15
July 1 - September 30 October 5
Program
Level Data
(Parents)
October 1 - December 31 January 15
REDCap
https://chc.mphi.org
January 1 - March 31 April 5
April 1 – June 30 July 15
July 1 - September 30 October 5
Program
Level Data
(Performance
Measures)
October 1, 2022 –
September 30, 2023
(MPHI will open this data section in
REDCap in June)
July 15 REDCap
https://chc.mphi.org
Fidelity Logs February 2023 March 31 Email to MDHHS
andersonk10@michigan.gov May 2023 June 30
A. Any other information, as specified in the Statement of Work and TPIP Report Fact Sheet,
shall be developed and submitted by the Grantee as required by the Contract Manager.
Additional Program Requirements
• TPIP programs must serve 80, 175 or 250 unduplicated youth each fiscal year (FY) who
complete at least 75% of the program, which is determined by the intensity level of the
selected curriculum:
• TPIP programming must be delivered separate and apart from any religious education or
promotion and funding cannot be used to support inherently religious activities including,
but not limited to, religious instruction, worship, prayer, or proselytizing.
• Family planning drugs and/or devices cannot be prescribed, dispensed, or otherwise
distributed on school property at any time, including as part of the pregnancy prevention
education funded under TPIP.
• Abortion services, counseling and/or referrals for abortion services cannot be provided as
part of the pregnancy prevention education funded under TPIP.
• TPIP funding may not be used to pay for costs associated with health care services, for
which referrals are made.
• TPIP funding may not be used for fundraising activities, political education, or lobbying.
• TPIP grantees must adhere to all of the TPIP Minimum Program Requirements (MPRs)
• The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the projects as determined by the Contract Manager.
Approved Curriculum Intensity
Level Target Number Minimum Target
Number
Number of unduplicated
youth who complete at
least 75% of program
each FY
90% of the target
number
Teen Outreach Program
(TOP) High 80 72
Michigan Model-Healthy &
Responsible Relationships Medium 175 156
Making Proud Choices Low 250 225
PROJECT TITLE: Telehealth Family Planning
Start Date: 10/01/2023
End Date: 05/31/2024
Project Synopsis:
The Michigan Family Planning Program assists individuals and couples in planning and
spacing births, preventing pregnancy, and seeking preventive health screenings. The
program prioritizes serving low-income individuals, adolescents, and un/underinsured
individuals. During the COVID-19 public health emergency, telehealth was a service
delivery tool used by Family Planning clinics to maintain access to contraception, STI
screening and treatment, and related preventive health services. This project aims to
expand and enhance telehealth for partnering Family Planning clinics through improved
telehealth technical capabilities and systems, telehealth-specific training and/or technical
assistance to clinics and staff, hiring of qualified staff to support telehealth efforts, as well
as outreach and promotion for telehealth and reproductive health services.
Reporting Requirements (if different than agreement language):
Each grantee shall submit the required reporting on the following dates:
Report Time Period Due Date to
Department Submit To
Work Plan October 1 – May 31 October 13
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit
@michigan.gov
Work Plan
Progress Report October 1 – May 31 June 28
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit
@michigan.gov
Telehealth Project
Reporting October 1 – May 31 June 28
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit
@michigan.gov
American Rescue
Plan Specific
Reporting
October 1 – May 31 As requested
MDHHS Family
Planning Inbox
mdhhs-
reproductivehealthunit
@michigan.gov
Any additional requirements (if applicable):
1. Each grantee will implement its telehealth project in accordance with their approved
work plan and budget.
2. Each grantee will improve telehealth technical capabilities and systems for their
Family Planning clinic to increase access to telehealth services and improve client
experiences.
3. Each grantee will ensure clinic staff are adequately trained to perform high-quality,
client-centered service delivery competently and effectively for family planning via
telehealth.
4. Each grantee will develop project strategies to increase Michiganders’ awareness of
telehealth availability in their Family Planning clinic through outreach and program
promotion so populations in their service areas that experience significant barriers to
care, and health disparities have meaningful access to telehealth services.
5. Each grantee will implement telehealth clinical services for Family Planning in
accordance with their approved protocols/policies, including consent for services,
and adhere to clinical documentation and billing/reimbursement requirements for
telehealth.
6. Each grantee will comply with reporting requirements for this telehealth project and
any other reporting requirements, as indicated and/or requested by MDHHS and/or
the Office of Population Affairs (OPA) for the purposes of monitoring and reporting
performance.
7. Each grantee may be required to provide American Rescue Plan specific reporting,
as requested by MDHHS and/or OPA.
8. Each grantee will ensure their one-time telehealth project budget is fully expended
by May 31, 2024 in accordance with the federal award.
9. Each grantee will be required to adhere to Federal Statue and Regulations for Title
X Family Planning Programs, including legislative mandates, executive orders, and
grant administration regulations.
10. Each grantee will be required to adhere to the current Michigan Title X Family
Planning Program Standards and Guidelines Manual.
11. Each grantee will provide MDHHS a minimum of 30 days advance notice of any
clinic site changes, including additions, closures, or changes to street address.
Service site changes can be sent to each grantee’s agency consultant.
12. Each grantee will ensure that low-income individuals (i.e., ≤100% of federal poverty
level) are given priority to receive family planning services.
13. Each grantee will provide family planning clients with a broad range of acceptable
and effective medically approved family planning methods, including natural family
planning, and services, including pregnancy testing and counseling, assistance to
achieve pregnancy, basic infertility services, sexually transmitted infection (STI)
services, preconception health services, and adolescent-friendly health services.
14. Each grantee will provide family planning services on a voluntary basis, without
coercion to accept services or any particular method of family planning, and without
making acceptance of services a prerequisite to eligibility for any other service or
assistance in another program offered by grantee.
15. Each grantee will offer client-centered counseling services on-site or by referral and
ensure the information is medically accurate, balanced, provided in a non-
judgmental manner, and is non-coercive.
16. Each grantee will provide confidential family planning and related preventive health
services to minors and will not require written consent of parents or guardians for
the provision of services to minors. Nor can grantee notify parents or guardians
before or after a minor has requested and/or received family planning services.
17. Each grantee will encourage family involvement in the decision of minors to seek
family planning services and must provide counseling to minors on how to resist
efforts that coerce minors into engaging in sexual activities.
18. Each grantee will comply with all state mandated reporting laws related to child
abuse and neglect; abuse, neglect, and exploitation of vulnerable adults; and human
trafficking. Confidentiality cannot be invoked to circumvent requirements for
mandated reporting.
19. Each grantee will provide family planning services in a manner that is client-
centered, culturally and linguistically appropriate, inclusive and trauma-informed;
protects the dignity of the individual and ensures equitable and quality service
delivery.
20. Each grantee will provide family planning services without regard to race, sex,
religion, age, national origin, color, height, weight, marital status, number of
pregnancies, gender identification or expression, sexual orientation, partisan
considerations, sex characteristics, disability or genetic information that is unrelated
to the person’s circumstances.
21. Each grantee will not provide abortion as a method of family planning and will have
written policy that no Title X funds are used to provide abortion as a method of
family planning.
22. Each grantee will offer services on a sliding fee scale, based on the current Federal
Poverty Guidelines, for individuals with a family income between 100% and 250% of
the federal poverty level to assure services are billed based on ability to pay. No one
can be denied services due to inability to pay.
23. Each grantee will ensure no charges will be made for services provided to low-
income clients (i.e., ≤100% of federal poverty level) except when that payment will
be made by a third-party, which is authorized to or is under legal obligation to pay
this charge. Donations are permissible from eligible clients, as long as clients are
not pressured to make one and donations are not a prerequisite to family planning
services or supplies.
24. Each grantee where there is legal obligation or authorization for third-party
reimbursement, including public or private sources, all reasonable efforts must be
made to obtain third-party payment without application of any discounts. Where the
cost of services is to be reimbursed under Title XIX, XX, or XXI of the Social
Security Act, a written agreement with the title agency is required.
25. Each grantee will have a schedule of fees designed to recover the reasonable cost
of providing services for clients whose income exceeds 250% of federal poverty
level based on an analysis of the costs of providing services and identification of
other factors used to determine the fee schedule is reasonable.
26. Each grantee will provide family planning services without the imposition of any
residency requirement or requirement that the client be referred by a physician.
27. Each grantee will provide that family planning medical services will be performed
under the direction of a clinical services provider with special training or experience
in family planning.
28. Each grantee will have written clinical protocols that are in accordance with
nationally recognized standards of care and Providing Quality Family Planning
Services recommendations that are reviewed and signed annually by the directing
clinical services provider overseeing the Family Planning project.
29. Each grantee will have a current list of social services agencies and medical referral
resources that is reviewed and updated annually.
30. Each grantee will address clients’ social determinants of health to the extent feasible
through the coordination and use of referral arrangements for other health care,
related social services, counseling.
31. Each grantee will offer education on HIV and AIDS and risk reduction information to
clients, as appropriate via telehealth.
32. Each grantee will operate in accordance with federal and state laws regarding the
provision of pharmaceuticals, including but not limited to, security and record
keeping for drugs and devices.
33. Each grantee will operate its project in accordance with federal and state laws and
guidelines regarding the provision of laboratory services related to family planning
and preventive health.
34. Each grantee will establish a medical record for all clients who receive clinical
services, including but not limited to, pregnancy testing, counseling, and emergency
contraception. Medical records must comply with HIPAA privacy and security
standards and document quality care standards.
35. Each grantee will provide that all services purchased for project participants will be
authorized by the project director or his/her designee on the project staff.
36. Each grantee will have a separate budget for its telehealth expansion and
enhancement project and maintain a financial management system that meets the
standards specified in 45 CFR Part 75.
37. Each grantee assures all project expenditures comply with 45 CFR Part 75 and are
expended solely for the purpose of expanding and enhancing telehealth services for
Family Planning.
38. Each grantee assures that if family planning services are provided by contract or
other similar arrangements with actual providers of services, services will be
provided in accordance with a plan, which establishes rates and method of payment
for medical care. These payments must be made under agreements with a schedule
of rates and payment procedures maintained by each grantee. Grantees must be
prepared to substantiate these rates are reasonable and necessary.
39. Each grantee will have a data collection system in place to assure accurate
telehealth project reporting and American Rescue Plan reporting.
40. Funding awards were made in compliance with 2002 Public Act (PA) 360 MCL §
333.1091. Grantees qualify as a priority family planning provider who do not engage
in any activities outlined in 2002 PA 360 MCL § 333.1091.
41. Grantee funding cannot be used for fundraising activities and/or political education
or lobbying, including membership costs for advocacy or lobbying organizations.
42. Grantee funding cannot be used to supplant funding for an existing program
supported with another source of funds.
PROJECT: Tobacco Control Grant Program
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
The focus of the program is for health departments to educate communities about
evidence-based tobacco policies to decrease youth initiation and increase tobacco
dependence treatment, tobacco-free spaces, and health equity by working with
populations who are the most negatively affected by tobacco use disparities.
Reporting Requirements (if different than contract language)
The Grantee shall submit the following reports on the following dates:
1. Evaluation data tracking tool bi-annually on April 15 and October 15 (format to be
provided by MDHHS TCP).
2. Quarterly progress reports are due January 15, April 15, July 15, and October 15
Any additional requirements (if applicable)
• Grantee will create action plans for any recommendation of the MDHHS TCP
Contract Manager. Grantee will meet every other month or more frequently, as
needed, with the MDHHS TCP Contract Manager.
• Grantee will communicate every other month or more frequently, as needed, with
their consultant about budget projections.
PROJECT: Tobacco Use Reduction for People Living with HIV
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Tobacco use remains the leading cause of preventable disease and death in the United
States with almost 500,000 people dying annually from tobacco-related diseases (heart
disease, cancer, stroke, COPD, and diabetes). People living with HIV (PLWH) who smoke
cigarettes die an average of 12 years sooner from smoking-related disease compared to
those who have not smoked (Helleberg, online Journal of Clinical Infectious Disease). In
Michigan, 42% of People Living with HIV (PLWH) are tobacco users according to the 2017
HIV Tobacco Reduction Client Survey, Tobacco Section MDHHS which is twice than the
state average. To reduce the smoking rate in PLWH, the MDHHS Tobacco Section and
HIV Care and Prevention Section have collaborated to fund AIDS Service Organizations,
Local Health Departments, and Infectious Disease clinics to provide Tobacco
Dependence Treatment services.
Reporting Requirements (if different or in addition to contract language)
Site visits:
Monitoring may include a review of fiscal, program, administrative, quality
management, and client health records to ensure compliance with Federal,
Department, and contract requirements.
a. Additional documentation will be requested to support FSRs, client chart
reviews, incentive tracking forms, etc.
b. This documentation can be provided electronically through secured
email, confidential fax, secure file transfer through MILOGIN
The Department will provide written notice of site visits, including an agenda and
the assessment tool to be used.
1. The Grantee must complete the Performance Improvement Plan (PIP)
template and submit to the Department within 30 calendar days of receipt of
the site visit report.
Quarterly Progress Reports:
Required CAREWare reports and supplemental documentation should be sent via
email to program monitor.
Data Entry:
The Grantee and its subcontractors are required to use the HRSA-supported
software CAREWare to enter client and service data into the centrally managed
database on a secure server.
The Grantee must:
• Enter all Ryan White services delivered to HIV-infected and affected clients.
• Enter all data by the 10th of the following month.
• Complete collection of all required data variables and the clean-up of any missing
data or service activities by the 10th of the following month.
Any additional requirements (if applicable)
1. Implement standardized work plan that describes the objectives, activities, and
measures for work to be performed under this contract. The work plan will
include measurable outcomes for services provided for each funded service.
• Workplan must include specific activities related to program priority
populations, best practices, and promising practices such as (but not limited
to): Health Equity, Trauma informed Care, Behavioral Health services, Peer
support specialists, telehealth, and outreach to communities with tobacco use
disparities (LGBTQ, Black/African American, Population between 25-34 years
of age, Population with education less than high school, Native American,
and Hispanic/Latinx).
2. Ryan White is payer of last resort; as such, the Grantee must adhere to the Ryan
White HIV/AIDS Treatment Extension Act.
3. The Grantee must adhere to applicable federal and state laws, as well as policies
and program standards issued by the Department including but not limited to the
TURP Tobacco Treatment Specialist Manual and Tobacco Control Program
Manual. The Department may update and/or add guidance within the contract year
with written notice. The Department will supply any new additions to the
organization/agency.
The Grantee must adhere to:
• All Federal and Michigan laws pertaining to HIV/AIDS treatment, disability
accommodations, non-discrimination, and confidentiality.
• Procedures for the confidentiality and security of client information.
• All Federal and state issued guidance(s) and policy(ies) for services provided.
• MDHHS Ryan White Guidance #20-03 regarding store cards, vouchers etc.
4. The Grantee will ensure that records are available for review by the Department
auditors, staff, and Federal government agencies, if applicable, to monitor
performance. The Grantee will maintain and provide access to primary source
documentation.
5. The Grantee may enter into subcontracts or vendor agreements to fulfill the service
delivery expectations of this agreement.
6. The Grantee must monitor subcontractors to assess compliance with the
subcontract; take primary responsibility to monitor follow-up and remediate in
cases where the subcontracted entity is not in compliance with the contract;
report the results of all contract monitoring activities to the Department.
• The Grantee must provide, upon request, a copy of all fully signed subcontracts,
memoranda of understanding (MOUs) or letters of agreement related to the
services.
7. The Grantee must provide immediate notification to the Department, in writing, in the
event of any of the following:
a. Any formal grievance initiated by a client and subsequent resolution of
that grievance.
b. Any event occurring, or notice received by the Grantee or subcontractor, that
reasonably suggests that the Grantee or subcontractor may be the subject of,
or a defendant in, legal action. This includes, but is not limited to, events or
notices related to grievances by service recipients or Grantee or subcontractor
employees.
c. Any staff vacancies funded for this project that exceed 30 days.
8. When issuing statements, press releases, requests for proposals, bid solicitations
and other documents describing projects or programs funded in whole or in part with
Federal money, the Grantee receiving Federal funds, including but not limited to
State and local governments and recipients of Federal research grants, must clearly
state:
a. The percentage of the total costs of the program or project that will be
financed with Federal money.
b. The dollar amount of Federal funds for the project or program.
c. Percentage and dollar amount of the total costs of the project or program that
will be financed by non-governmental sources.
9. The Grantee must participate in the Department needs assessment and planning
activities, as requested.
10. The Grantee must maintain, for a minimum of four years after the end of the budget
period, program and fiscal records and files including documentation to support
program activities and expenditures, under the terms of this agreement.
11. Each employee funded in whole or in part with Federal funds must record time and
effort spent on the project funded.
The Grantee must:
• Adhere to administrative cap on FTE for staff that are not providing direct tobacco
dependence treatment. This includes the following: managers, supervisors,
support staff, finance staff, etc. The FTE for these positions may not exceed .10
FTE.
• Have policies and procedures to ensure time and effort reporting.
• Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
• Denote accurately the percent of effort to the project. The percent of effort may
vary from month to month, and the effort recorded for Ryan White funds must
match the percentage claimed on the Ryan White FSR for the same period.
12. The Grantee will participate in regular Grantee meetings which may be face-to-face,
teleconferences, webinars, etc. The Grantee must participate in trainings provided
by MDHHS and the Tobacco Section.
13. If it has been identified through fiscal monitoring, that funds will not be spent by the
end of the fiscal year as intended, then the Department reserves the right to reduce
award amount through an amendment.
• FTE and Budgets must be adjusted to reflect the reduced award amount and
must be reviewed and approved by the Department.
14. The Grantee must collaborate with the Tobacco Section staff to accomplish goals
through, bi-monthly calls, one annual site visit, and other grant monitoring tools and
technical assistance activities.
15. Performance will be measured on progress toward meeting the overall Tobacco
Use Reduction in PLWH workplan objectives.
16. Failure to comply with these requirements may result in punitive consequences
such as denial of future funding or other consequences as appropriate.
PROJECT: Tuberculosis Control
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Each Grantee as a sub-recipient of the CDC Tuberculosis Elimination
Cooperative Agreement shall conduct activities for the purposes of tuberculosis
control and elimination.
• Funds may be used to support personnel, purchase equipment and supplies,
and provide services directly related to core TB control front-line activities, with
a priority emphasis on DOT (Directly Observed Therapy) and electronic DOT,
case management, completion of treatment and contact investigations.
• Funds may also be used to support incentive or enabler offerings to
mitigate barriers for patients to complete treatment.
• Disallowed Costs: Federal (CDC) guidelines prohibit the use of these funds
to purchase anti-tuberculosis medications or to pay for inpatient services.
• Examples of appropriate incentive/enabler offerings include retail coupons,
public transit tickets, food, non-alcoholic beverages, or other goods/services that
may be desirable or critical to a particular patient.
For more information and suggested uses of incentive/enabler options, refer to
CDC's Self-Study Module #6: Self-Study Modules on Tuberculosis Module 6
Managing Tuberculosis Patients and Improving Adherence (cdc.gov).
Reporting Requirements (if different than contract language)
DOT Logs are maintained on site and available if needed. All other data must be entered
into MDSS as stipulated in contract specific requirements.
Ensure that confidential public health data is maintained and transmitted to the
Department in compliance with applicable standards defined in the "CDC Data
Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted
Diseases, and Tuberculosis Programs"
http://www.cdc.gov/nchhstp/programintegration/docs/PCSIDataSecurityGuidelines.pdf
Any additional requirements (if applicable)
• Utilize DOT as the standard of care to achieve at minimum 80% of TB cases
enrolled in DOT or electronic DOT (Jan 1- Dec 31).
• Document in Michigan Disease Surveillance System (MDSS) all changes to
treatment regimen using the Report of Verified Case of Tuberculosis (RVCT)
comments field (pg. 12), and completion of therapy using RVCT Follow-Up 2 (pg.
7).
• Maintain evidence of monthly DOT logs on site (to be made available if needed).
Monthly submission of DOT logs is no longer required.
• Achieve at least 94% completion of treatment within 12 months for eligible TB
cases. The determination of treatment completion is based on the total number of
doses taken, not solely on the duration of therapy. Consult the most current ATS
document Treatment of Tuberculosis for guidance in the number of doses needed
and the length of treatment required following any interruptions in therapy.
• Maintain appropriate documentation on site (to be made available if needed).
Document the appropriate use of expenditures for incentive and enablers for
clients to best meet their needs to complete appropriate therapy.
• Ensure >90% completion of RVCT pages 1 - 6 in MDSS within one month of
diagnosis.
Unallowable Costs per federal guidelines
• Funds cannot be used for procurement of anti-tuberculosis medications.
• Funds cannot be used for research.
• Funds cannot be used for inpatient services.
PROJECT: Vector-Borne Disease Surveillance
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
This agreement is intended to support the development of vector-borne disease
surveillance and control capacity at the local health department level. Funds may be used
to support a low-cost, community-level surveillance system for 1) the early detection of
arbovirus threats by identifying potential invasive mosquito vectors or local virus
transmission in mosquitoes and 2) populations of ticks including Ixodes scapularis,
Amblyomma americanum, and Haemaphysalis longicornis. This information can be
utilized by participating local health departments to notify its citizens of any local
transmission risk using education campaigns and to potentially work with local
municipalities to conduct vector control activities such as drain management, scrap-tire
campaigns, breeding site removal, landscape modifications, or pesticide application.
Requirements for participation in this program include providing for the placement of a
minimum number of mosquito traps, operating for at least five “trap-nights” per week,
conducting a minimum number of targeted tick “drags,” and identifying ticks and
mosquitoes. Bi-weekly (occurring every two weeks) reporting to MDHHS of grant
activities is also required. MDHHS EZID should be notified immediately if an invasive
mosquito or tick species is identified.
Reporting Requirements (if different than contract language)
The subrecipient shall submit bi-weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe@michigan.gov) and
Rachel Wilkins (rwilkins3@michigan.gov) at the MDHHS EZID Section.
• A final report on all activities completed is due at the end of the fiscal year, by
October 15
Any additional requirements (if applicable)
• Mosquito and/or Tick Surveillance
• Minimum recommended mosquito and tick surveillance effort according to the
point formula in Table 1 (below) over a period of 14 weeks.
• Provide bi-weekly reporting of surveillance results to MDHHS EZID Section (see
contact information below).
• Use surveillance data to notify the public of risks related to vector borne disease in
mosquitoes or ticks in the jurisdiction.
• The total funds allocated for this project to participating local health departments
must be utilized prior to September 30.
• Each local health department as a sub-recipient of the State of Michigan Emerging
Public Health Funds shall conduct activities for the purposes of mosquito and tick
surveillance in their jurisdiction. For mosquito surveillance, funds may be used to
support personnel, to purchase equipment and supplies related to conducting
mosquito surveillance in areas of historically high incidence of arboviral disease,
and to produce and distribute educational and other materials related to mosquito-
borne disease prevention and control. For tick surveillance, funds may be used to
support personnel, to purchase equipment and supplies, and to produce and/or
distribute educational and other materials related to tick-borne disease prevention
and control.
• Activities can be conducted according to the needs of the local jurisdiction but
must conform to the point allocation formula in the table below. For instance, if
mosquitoes are more of a concern in the jurisdiction, the funded LHD can focus its
efforts on mosquito surveillance, educational activities, etc. If ticks are more of a
concern in the jurisdiction, the funded LHD can focus its efforts on tick
surveillance, educational activities, etc.
Local Health Department VBDSP Activity Formula
*Devices can include BG-2 traps, CDC light traps, resting boxes, etc.
Activity Required
Activity / Weeks
Metric
5 mosquito collection devices*
placed for 24-hour period
20/10 Report to MDHHS bi-weekly
2 mosquito collection devices*
placed for 24-hour period in
August
2/4 Report to MDHHS bi-weekly
1,000 meter tick drag 4 / 2 Report to MDHHS bi-weekly
Educational outreach activity /
event
Report to MDHHS bi-weekly
Press release Report to MDHHS bi-weekly
Coordination of control efforts
with local municipalities / other
prevention efforts
Report to MDHHS bi-weekly
PROJECT: West Nile Virus Community Surveillance
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
This agreement is intended to support the development of a low-cost surveillance
system for the early detection of West Nile virus in mosquitoes at the community level,
for the purpose of educating the public and healthcare providers and preventing
outbreaks. This information can be utilized by participating local health departments to
notify its citizens and healthcare providers of any local transmission risk using education
campaigns, press-releases and other means, and to potentially work with local
municipalities to conduct mosquito population mitigation activities such as drain
management, scrap-tire campaigns, breeding site removal, larviciding, and adulticiding.
Requirements for participation in this program include providing for the placement of a
minimum number of mosquito traps, operating for at least two “trap nights” per week,
identifying mosquitoes, and weekly reporting to the Department of surveillance results.
Reporting Requirements (if different than contract language)
The Grantee shall submit weekly tables of surveillance data (template provided)
documenting trap rates and disease detections to Emily Dinh (dinhe@michigan.gov),
and Rachel Wilkins (wilkinsr3@michigan.gov) at the MDHHS EZID Section.
• A final report on all activities completed is due at the end of the fiscal year, by
October 15.
Any additional requirements (if applicable)
Each Grantee as a sub-recipient of the Centers for Disease Control and Prevention
(CDC) Epidemiology and Laboratory Capacity Cooperative Agreement shall conduct
activities for the purposes of West Nile virus (WNV) surveillance among mosquito
populations in their jurisdiction. Funds may be used to support personnel and travel, to
purchase equipment and supplies related to conducting mosquito surveillance in areas
of historically high incidence of WNV, and to produce and/or distribute educational and
other materials related to West Nile virus prevention and control.
Mosquito Surveillance:
• Minimum recommended mosquito traps for this project is 5 traps utilized per
county, operating 2 nights per week for a total of 10 “trap nights” per week for
approximately 16 weeks.
• Provide weekly reporting of surveillance results to the Department EZID Section
(see contact information below).
• Use surveillance data to notify the public and healthcare providers of any risk
related to West Nile Virus in mosquitoes in the jurisdiction.
• The total funds allocated for this project to participating local health departments
must be utilized prior to September 30.
PROJECT TITLE: Wisewoman
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis:
WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation)
is a program designed to screen women for chronic disease risk factors, counsel them
about lifestyle changes to reduce risk factors, and refer them for medical treatment of
hypertension, hyperlipidemia, and/or diabetes mellitus.
Reporting Requirements (if different than agreement language):
All Grantees implementing WISEW OMAN shall submit Quarterly Progress Reports Period Covered Report Due
October 1 - December 31 January 31
January 1 - March 31 April 30
April 1 - June 30 July 31
July 1 - September 30 October 31
Quarterly Reports shall be submitted to the Program Director:
Courtney Cole
E-mail: ColeC13@michigan.gov
Each agency must provide matching funds in the amount of $1 for each $3 of Coordination dollars. A WISEWOMAN Matching Funds Report form along with instructions is issued by MDHHS for LCAs to use for documentation of amounts and types of community match. It is available at www.michigan.gov/wisewoman The Matching Funds Report should be submitted in EGrAMS as an attachment to Courtney Cole at ColeC13@michigan.gov.
Any additional requirements (if applicable):
Instructions for contractor use of MBCIS, the statewide database, are provided in
manuals for programs that contribute data to this database. The CPCS will exchange
relevant program reports with appropriate contractors through a secure file transfer
system, as noted in the same program manuals.
For specific WISEWOMAN Program requirements, refer to the most current
WISEWOMAN Program Manual available at www.michigan.gov/wisewoman.
PROJECT: Women Infant Children (WIC)
WIC Breastfeeding
WIC Migrant
WIC Resident
Start Date: 10/1/2023
End Date: 9/30/2024
Project Synopsis
Women, Infants, and Children (WIC) is a federally funded Special Supplemental
Nutrition Program of the Food and Nutrition Service of the United States Department of
Agriculture and is administered by the Michigan Department of Health and Human
Services to serve low and moderate income pregnant, breastfeeding, and postpartum
women, infants, and children up to age five who are found to be at nutritional risk
through its statewide local WIC agencies.
WIC is a health and nutrition program that has demonstrated a positive effect on
pregnancy outcomes, child growth and development. The program provides a
combination of nutrition education, supplemental foods, breastfeeding promotion and
support, and referrals to health care. Participants redeem WIC food benefits at
approved retail grocery stores and pharmacies. WIC foods are selected to meet nutrient
needs such as calcium, iron, folic acid, vitamins A & C.
Reporting Requirements (if different than contract language)
• A Financial Status Report (FSR) must be submitted to the Department on a
quarterly basis by deadlines as defined by MDHHS Expenditure Operations.
Grantees shall (when requested) annually report expenditures on a supplemental
form, if needed and required, to be provided by the Department and attached to the
final Financial Status Report (FSR) which is due on November 30 after the end of the
fiscal year in EGrAMS.
• As part of the Breastfeeding Peer Counseling Grant, the Grantee must submit
quarterly progress reports to the State Breastfeeding Peer Counselor
Coordinator (or designee) by the 15th of the month following end of quarter.
• Funds allocated for the Breastfeeding Peer Counseling Program are exempt
from the WIC Nutrition Education and Breastfeeding Time Study.
Additional Requirements
• The Grantee is required to comply with all applicable WIC federal regulations,
policy and guidance.
• The Grantee is required to comply with all State WIC Policies.
• The Grantee is required to complete the NE and BF Time Study as instructed by the
MDHHS WIC Program. Breastfeeding Peer Counseling grant, if supported with
funds allocated through the WIC funding formula, must report as time study data.
• The Grantee must follow the allowable expense guidelines provided by USDA
FNS for the Peer Counselor Grant.
The primary purpose of these funds is to provide breastfeeding support services
through peer counseling to WIC participants. The Grantee must follow the
staffing requirements as set forth in the WIC Breastfeeding Model Components
for Peer Counseling and through a signed allocation letter for the Breastfeeding
Peer Counseling Grant. This signed letter needs to be returned annually to the
State Breastfeeding Peer Counselor Coordinator.
Due to the limited nature of the Breastfeeding Peer Counselor Funding total
indirect cost shall not exceed 30% of the total grant award (budgeted and/or
reported, whichever is less). To maintain consistency across budgets, County-
City Central Services reported under a direct expense line item will be included
as indirect cost even if captured outside of indirect line item on the budget.
Additional local funds can be supplemented to cover indirect costs exceeding
30%.
• Comply with the requirements of the WIC program as prescribed in the
Code of Federal Regulations (7 CFR, Part 246) including the following special
provisions from Part 246.6 (f)(1)(2):
(f) Outreach/Certification In Hospitals. The State agency shall ensure that
each local agency operating the program within a hospital and/or that has
a cooperative arrangement with a hospital:
(1) Advises potentially eligible individuals that receive inpatient or
outpatient prenatal, maternity, or postpartum services, or that accompany
a child under the age of 5 who receives well-child services, of the
availability of program services; and
(2) To the extent feasible, provides an opportunity for individuals who may
be eligible to be certified within the hospital for participation in the WIC
Program. [246.6(F)(1)].
• The Grantee in accordance with the general purposes and objectives of this
agreement, will comply with the federal regulations requiring that any individual
that embezzles, willfully misapplies, steals or obtains by fraud, any funds,
assets or property provided, whether received directly or indirectly from the
USDA, that are of a value of $100 or more, shall be subject to a fine of not more
than $25,000.
• The Grantee is required to operate the Project FRESH Program within the
guidelines as laid out in the “WIC Project FRESH Local Agency Guidebook”.
• The Grantee is required to abide by the Dissemination License Agreement
between Michigan State University (MSU) and Michigan Department of Health
and Human Services for “Mothers in Motion” and the Dissemination License
Agreement between MSU, Ohio State Innovative Foundation and MDHHS for
“Communicate to Motivate”. Any use of these licensed materials in the provision
of program related services is subject to the terms and conditions outlined in the
licensure agreement, which is included in Addendum 1, as reference.
WIC Resident Services/Migrant/Breastfeeding Peer Counseling Grant Training and
Education Requirements:
The Grantee is required to comply with MI-WIC Policy 1.07L Staff Training Plan as
detailed for applicable staff as it pertains to all State WIC training opportunities.
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.
DRAFT01/09/2024
Contract #: 20240239-01
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 $12,189,775 to $14,312,350,
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:
Local Health Department - 2024, Date: 01/09/2024
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DRAFT01/09/2024
1. Body Art Fixed Fee
2. Child and Adolescent Health Center Construction - New
3. Public Health Infrastructure - New
4. Regional Perinatal Care System
5. SDOH Hub Pilot - New
6. SDOH Planning
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
Children's Special Hlth Care Services (CSHCS)
Outreach & Advocacy
294,402 64,772 359,174
Food ELPHS 1,176,612 1,004,035 2,180,647
Gonococcal Isolate Surveillance Project 24,713 (2,713)22,000
Harm Reduction Support Services 250,000 120,000 370,000
MDHHS-Essential Local Public Health Services
(ELPHS)
2,557,216 708,481 3,265,697
Nurse Family Partnership Services 675,540 62,000 737,540
Oral Health- Kindergarten Assessment 110,597 30,000 140,597
Public Health Emergency Preparedness (PHEP) CRI
10/1 - 6/30
196,551 36,000 232,551
Sexually Transmitted Infection (STI) Control 70,265 100,000 170,265
Total Comprehensive Funding 5,355,896 2,122,575 7,478,471
Performance Level Adjustments
N/A
Budget category Adjustments
Contract #Project Title
E20243268-00 Adolescent STI Screening
E20241543-00 Body Art Fixed Fee
E20241390-00 Children's Special Hlth Care Services (CSHCS) Care Coordination
E20241318-00 CSHCS Medicaid Outreach
E20243879-00 HIV PrEP Clinic
E20243322-00 HIV Prevention
It is understood and agreed that all other conditions of the original agreement remains
the same.
Local Health Department - 2024, Date: 01/09/2024
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DRAFT01/09/2024
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 12/27/2023
___________________________________________________________________
Christine H. Sanches, Director Date
Bureau of Purchasing
Local Health Department - 2024, Date: 01/09/2024
__________________________________________________________________________
Page: 3 of 69
DRAFT01/09/2024
Attachments
Attachment I - Instructions for the Annual Budget
Attachment III - Program Specific Assurances and Requirements
Local Health Department - 2024, Date: 01/09/2024
__________________________________________________________________________
Page: 4 of 69
DRAFTContract # Date: 01/09/2024MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESATTACHMENT IV - 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)Adolescent STI ScreeningReg. Alloc.F73,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientBody Art Fixed FeeCalc. Amt.S50,000Fixed Unit Rate (2)N/AN/AN/AN/AN/ARecepientChildren's Special Hlth CareServices (CSHCS) CareCoordinationCalc. Amt.S234,794Fixed Unit Rate (1),(7)N/AN/AN/AN/AN/ASubrecepientChildren's Special Hlth CareServices (CSHCS) Outreach &AdvocacyReg. Alloc.F147,201Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.S147,201CSHCS Medicaid Elevated BloodLead Case MgmtCalc. Amt.201.58/VariousFixed Unit Rate (2)N/AN/AN/AN/AN/ASubrecepientCSHCS Vaccine InitiativeReg. Alloc.F18,968Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientEastern Equine Encephalitis VirusSurveillance ProjectReg. Alloc.F15,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientEGLE Drinking Water and OnsiteWastewater ManagementReg. Alloc.S985,042ELPHS (3), (6)N/AN/AN/AN/AN/ARecepientEmerging Threats - Hepatitis CReg. Alloc.S166,000Actual CostReimbursementN/AN/AN/AN/AN/ARecepientFetal Infant Mortality Review(FIMR) Case AbstractionCalc. Amt.S0Fixed Unit Rate (2)N/AN/AN/AN/AN/ASubrecepientFIMR InterviewsCalc. Amt.S0Fixed Unit Rate (2),(11)N/AN/AN/AN/AN/ASubrecepientFood ELPHSReg. Alloc.S1,176,612ELPHS (3), (4)N/AN/AN/AN/AN/ARecepientGonococcal Isolate SurveillanceProjectReg. Alloc.F6,178Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.S18,535Grief and BereavementReg. Alloc.S23,529Actual CostReimbursementN/AN/AN/AN/AN/ARecepientHarm Reduction Support ServicesReg. Alloc.F250,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientLocal Health Department - 2024, Date: 01/09/2024________________________________________________________________________________________________________________Page: 5 of 69
DRAFTContract # Date: 01/09/2024MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESATTACHMENT IV - 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)Hearing ELPHSReg. Alloc.L253,969ELPHS (3), (6)N/AN/AN/AN/AN/ARecepientHIV PrEP ClinicReg. Alloc.F343,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.P3,500Reg. Alloc.S3,500HIV PreventionReg. Alloc.F22,612Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.P22,612Reg. Alloc.S407,021Immunization Action Plan (IAP)Reg. Alloc.F526,990Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientImmunization Fixed FeesCalc. Amt.S0Fixed Unit Rate (2),(7)N/AN/AN/AN/AN/ASubrecepientImmunization Vaccine QualityAssuranceReg. Alloc.S105,347Actual CostReimbursementN/AN/AN/AN/AN/ARecepientInfant Safe SleepReg. Alloc.F7,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.S63,000Integrating MPOX into STI ClinicsReg. Alloc.F6,500Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientLaboratory Services BioReg. Alloc.F1,500Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientLocal Health Department (LHD)Sharing SupportReg. Alloc.F70,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientMCH - All OtherLocal MCHS249,377Local MCH (3), (6)N/AN/AN/AN/AN/ASubrecepientMCH - ChildrenLocal MCHS72,080Local MCH (3), (6)N/AN/AN/AN/AN/ASubrecepientMDHHS-Essential Local PublicHealth Services (ELPHS)Reg. Alloc.S2,557,216ELPHS (3),(6)N/AN/AN/AN/AN/ARecepientNurse Family PartnershipServicesReg. Alloc.F405,324Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.S270,216Local Health Department - 2024, Date: 01/09/2024________________________________________________________________________________________________________________Page: 6 of 69
DRAFTContract # Date: 01/09/2024MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESATTACHMENT IV - 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)Oral Health- KindergartenAssessmentReg. Alloc.S110,597Actual CostReimbursementN/AN/AN/AN/AN/ARecepientPublic Health EmergencyPreparedness (PHEP) 10/1 - 6/30Reg. Alloc.F222,449Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientPublic Health EmergencyPreparedness (PHEP) CRI 10/1 -6/30Reg. Alloc.F196,551Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientSexually Transmitted Infection(STI) ControlReg. Alloc.F33,418Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientReg. Alloc.S703Reg. Alloc.S36,144Statewide Lead CaseManagement - Fixed FeeCalc. Amt.S0Fixed Unit Rate (7),(11)N/AN/AN/AN/AN/ARecepientTuberculosis (TB) ControlReg. Alloc.F15,426Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientVector-Borne Surveillance &PreventionReg. Alloc.S9,000Actual CostReimbursementN/AN/AN/AN/AN/ARecepientVision ELPHSReg. Alloc.L253,968ELPHS (3), (6)N/AN/AN/AN/AN/ARecepientWest Nile Virus CommunitySurveillanceReg. Alloc.F10,000Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientWIC BreastfeedingReg. Alloc.F267,619Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientWIC Resident ServicesReg. Alloc.F2,615,870Actual CostReimbursementN/AN/AN/AN/AN/ASubrecepientTOTAL MDHHS FUNDING12,474,569*SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENTAttachment IV NotesLocal Health Department - 2024, Date: 01/09/2024________________________________________________________________________________________________________________Page: 7 of 69
DRAFTContract # Date: 01/09/2024
Project Budgets
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Adolescent STI Screening
DATE PREPARED
1/9/2024
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 41,858.00 41,858.00
2 Fringe Benefits 21,076.00 21,076.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 3,616.00 3,616.00
6 Travel 66.00 66.00
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.)603.00 603.00
Total Program Expenses 67,219.00 67,219.00
TOTAL DIRECT EXPENSES 67,219.00 67,219.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 20,095.00 20,095.00
Total Indirect Costs 20,095.00 20,095.00
TOTAL INDIRECT EXPENSES 20,095.00 20,095.00
TOTAL EXPENDITURES 87,314.00 87,314.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 8 of 69
DRAFTContract # Date: 01/09/2024
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 73,000.00 73,000.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 14,314.00 0.00 14,314.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 87,314.00 73,000.00 14,314.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse
Notes : PH Nurse 3 R. Ross
Position P00000755
Notes: This position is
responsible for testing clients in
OCJ, treatment of clients as
needed, and educational
support.
0.1202 82457.000 0.000 FTE 9,911.00
Public Health Nurse
Notes : PH Nurse 3 D. Vines
Position P00002616
Notes: This position is
responsible for testing clients in
OCJ, treatment of clients as
needed, and educational
support.
0.1202 82457.000 0.000 FTE 9,911.00
Medical Technologist
Notes : Z. Zelmanov Position
P00012305
Notes: This position is
responsible for running lab work
in OC labs from client testing.
0.0961 75800.000 0.000 FTE 7,284.00
Clerk
Notes : Office Support Clerk
Senior S. Cloutier Position
P00006538
Notes: This position is
responsible for intake paperwork,
scheduling of clients, follow-up
with nurses and clients.
0.2885 51135.000 0.000 FTE 14,752.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Total for Salary & Wages 41,858.00
2 Fringe Benefits
Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 50.350 41858.000 21,076.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies
Notes : Notes: Supplies and
materials needed for general
office use such as paper, pes,
envelopes, folders, etc.
0.0000 0.000 0.000 1,000.00
Medical Supplies
Notes : Notes: lancets, blood
tubes, specimen cups, gauze,
band aids, etc for speciman
collecting and handling $167/mo
*12 months
0.0000 0.000 0.000 1,043.00
Printing
Notes : Notes: Printing costs of
service for client charts,
treatment sheets, etc
0.0000 0.000 0.000 573.00
Educational Supplies
Notes : Notes: Pamphlets for
client education
0.0000 0.000 0.000 1,000.00
Total for Supplies and Materials 3,616.00
6 Travel
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Mileage
Notes : 100 miles @ 0.655
0.0000 0.000 0.000 66.00
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 603.00
Total Program Expenses 67,219.00
TOTAL DIRECT EXPENSES 67,219.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 5,781.00
Health Adm Distribution 0.0000 0.000 0.000 9,405.00
Nursing Adm Distribution 0.0000 0.000 0.000 4,909.00
Total for Cost Allocation Plan / Other 20,095.00
Total Indirect Costs 20,095.00
TOTAL INDIRECT EXPENSES 20,095.00
TOTAL EXPENDITURES 87,314.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Body Art Fixed Fee
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
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.)0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 50,000.00 50,000.00
Total Indirect Costs 50,000.00 50,000.00
TOTAL INDIRECT EXPENSES 50,000.00 50,000.00
TOTAL EXPENDITURES 50,000.00 50,000.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 0.00 0.00 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
Body Art Fee 50,000.00 50,000.00 0.00 0.00
Totals 50,000.00 50,000.00 0.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Distributions for Fees-from
Environmental Administration
0.0000 0.000 0.000 50,000.00
Total Indirect Costs 50,000.00
TOTAL INDIRECT EXPENSES 50,000.00
TOTAL EXPENDITURES 50,000.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Children's Special Hlth
Care Services (CSHCS) Care Coordination
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
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.)0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 234,794.00 234,794.00
Total Indirect Costs 234,794.00 234,794.00
TOTAL INDIRECT EXPENSES 234,794.00 234,794.00
TOTAL EXPENDITURES 234,794.00 234,794.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 16 of 69
DRAFTContract # Date: 01/09/2024
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 0.00 0.00 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
CSHCS Care Coordination 234,794.00 234,794.00 0.00 0.00
Totals 234,794.00 234,794.00 0.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Distributions for Fees-from
CSHCS Outreach & Advoc
0.0000 0.000 0.000 234,794.00
Total Indirect Costs 234,794.00
TOTAL INDIRECT EXPENSES 234,794.00
TOTAL EXPENDITURES 234,794.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / CSHCS Medicaid
Outreach
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
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.)0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 295,861.00 295,861.00
Total Indirect Costs 295,861.00 295,861.00
TOTAL INDIRECT EXPENSES 295,861.00 295,861.00
TOTAL EXPENDITURES 295,861.00 295,861.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 113,344.00 113,344.00 0.00 0.00
Required Match - Local 113,344.00 0.00 113,344.00 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 0.00 0.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 69,173.00 0.00 69,173.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 295,861.00 113,344.00 182,517.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Distributions for Medicaid 0.0000 0.000 0.000 295,861.00
Total Indirect Costs 295,861.00
TOTAL INDIRECT EXPENSES 295,861.00
TOTAL EXPENDITURES 295,861.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Public Health Emergency
Preparedness (PHEP) CRI 10/1 - 6/30
DATE PREPARED
1/9/2024
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2023 To : 6/30/2024
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 88,192.00 88,192.00
2 Fringe Benefits 49,634.00 49,634.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 24,458.00 24,458.00
6 Travel 8,214.00 8,214.00
7 Communication 1,674.00 1,674.00
8 County-City Central Services 0.00 0.00
9 Space Costs 5,053.00 5,053.00
10 All Others (ADP, Con. Employees, Misc.)28,072.00 28,072.00
Total Program Expenses 205,297.00 205,297.00
TOTAL DIRECT EXPENSES 205,297.00 205,297.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 38,764.00 38,764.00
Total Indirect Costs 38,764.00 38,764.00
TOTAL INDIRECT EXPENSES 38,764.00 38,764.00
TOTAL EXPENDITURES 244,061.00 244,061.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 22 of 69
DRAFTContract # Date: 01/09/2024
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 19,655.00 0.00 19,655.00 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 196,551.00 196,551.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 27,855.00 0.00 27,855.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 244,061.00 196,551.00 47,510.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Specialist
Notes : Emergency
Preparedness Specialist
T. Bravender Position
P00009999
0.7500 90688.000 0.000 FTE 68,016.00
Chief
Notes : PO00015362 M. Wiegers
Chief
Match
0.0938 98050.000 0.000 FTE 9,197.00
Specialist
Notes : PH Emerg Preparedness
Specialist
Pos#P00007416
L Chiasson
0.1538 71382.000 0.000 FTE 10,979.00
Total for Salary & Wages 88,192.00
2 Fringe Benefits
Composite Rate
Notes : MATCH $2,916
FICA
Unemp Ins
Retirement
Hospital Insurance
Life Insurance
Vision Ins.
Short/Long Term Disability
Dental Insurance
Work Comp
0.0000 56.280 88192.000 49,634.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 1,000.00
Disaster Supplies 0.0000 0.000 0.000 23,458.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Total for Supplies and Materials 24,458.00
6 Travel
Mileage
Notes : 785 x 0..655 per mile
0.0000 0.000 0.000 514.00
Conferences 0.0000 0.000 0.000 7,700.00
Total for Travel 8,214.00
7 Communication
Telephone 0.0000 0.000 0.000 1,674.00
8 County-City Central Services
9 Space Costs
Space/Rental Costs
Notes : MATCH $15,039
0.0000 0.000 0.000 5,053.00
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 558.00
IT Operations 0.0000 0.000 0.000 2,514.00
Professional Services 0.0000 0.000 0.000 25,000.00
Total for All Others (ADP, Con. Employees, Misc.)28,072.00
Total Program Expenses 205,297.00
TOTAL DIRECT EXPENSES 205,297.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 10,909.00
Health Adm Distribution 0.0000 0.000 0.000 27,855.00
Total for Cost Allocation Plan / Other 38,764.00
Total Indirect Costs 38,764.00
TOTAL INDIRECT EXPENSES 38,764.00
TOTAL EXPENDITURES 244,061.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Children's Special Hlth
Care Services (CSHCS) Outreach & Advocacy
DATE PREPARED
1/9/2024
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 258,990.00 258,990.00
2 Fringe Benefits 121,261.00 121,261.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 12,200.00 12,200.00
6 Travel 1,155.00 1,155.00
7 Communication 9,720.00 9,720.00
8 County-City Central Services 0.00 0.00
9 Space Costs 30,966.00 30,966.00
10 All Others (ADP, Con. Employees, Misc.)59,137.00 59,137.00
Total Program Expenses 493,429.00 493,429.00
TOTAL DIRECT EXPENSES 493,429.00 493,429.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other -199,027.00 -199,027.00
Total Indirect Costs -199,027.00 -199,027.00
TOTAL INDIRECT EXPENSES -199,027.00 -199,027.00
TOTAL EXPENDITURES 294,402.00 294,402.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 26 of 69
DRAFTContract # Date: 01/09/2024
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 294,402.00 294,402.00 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 294,402.00 294,402.00 0.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Clerk
Notes : PH Clerk 2
1.0000 51140.000 0.000 FTE 51,140.00
Supervisor
Notes : PH Nursing Supervisor
1.0000 101871.000 0.000 FTE 101,871.00
Nurse
Notes : PH Nurse 2
0.4808 67173.460 0.000 FTE 32,297.00
Clerk
Notes : PH Clerk 2
1.0000 49928.000 0.000 FTE 49,928.00
Clerk
Notes : Auxiliary Health Clerk
0.4808 27106.000 0.000 FTE 13,032.00
Clerk
Notes : Office Support Clerk
0.4808 22301.000 0.000 FTE 10,722.00
Total for Salary & Wages 258,990.00
2 Fringe Benefits
Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 46.820 258990.000 121,259.00
Rounding 0.0000 100.000 2.000 2.00
Total for Fringe Benefits 121,261.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 3,000.00
Postage 0.0000 0.000 0.000 3,600.00
Printing 0.0000 0.000 0.000 5,600.00
Total for Supplies and Materials 12,200.00
6 Travel
Mileage
Notes : 1,000 miles @.0.655
0.0000 0.000 0.000 655.00
Conferences 0.0000 0.000 0.000 500.00
Total for Travel 1,155.00
7 Communication
Telephone 0.0000 0.000 0.000 9,720.00
8 County-City Central Services
9 Space Costs
Building Space Rental 0.0000 0.000 0.000 30,966.00
10 All Others (ADP, Con. Employees, Misc.)
IT Print Services 0.0000 0.000 0.000 5,928.00
Insurance 0.0000 0.000 0.000 2,429.00
IT Operations 0.0000 0.000 0.000 49,280.00
Incentives 0.0000 0.000 0.000 1,500.00
Total for All Others (ADP, Con. Employees, Misc.)59,137.00
Total Program Expenses 493,429.00
TOTAL DIRECT EXPENSES 493,429.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Other Cost Distributions-CSHCS
Care Coor Fees
0.0000 0.000 0.000 -234,794.00
Health Adm Distribution 0.0000 0.000 0.000 68,270.00
Other Cost Distributions-Nursing
Staff
0.0000 0.000 0.000 191,996.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Nursing Adm Distribution 0.0000 0.000 0.000 35,595.00
Other Cost Distributions-CSHCS
- Medicaid Outreach
0.0000 0.000 0.000 -295,861.00
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 35,767.00
Total for Cost Allocation Plan / Other -199,027.00
Total Indirect Costs -199,027.00
TOTAL INDIRECT EXPENSES -199,027.00
TOTAL EXPENDITURES 294,402.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 30 of 69
DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Food ELPHS
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
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.)0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 5,080,338.00 5,080,338.00
Total Indirect Costs 5,080,338.00 5,080,338.00
TOTAL INDIRECT EXPENSES 5,080,338.00 5,080,338.00
TOTAL EXPENDITURES 5,080,338.00 5,080,338.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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
1,595,710.00 0.00 1,595,710.00 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 1,176,612.00 1,176,612.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 2,308,016.00 0.00 2,308,016.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 5,080,338.00 1,176,612.00 3,903,726.00 0.00
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Environmental Hlth Adm
Distribution
0.0000 0.000 0.000 3,702,469.00
Health Adm Distribution 0.0000 0.000 0.000 1,377,869.00
Total for Cost Allocation Plan / Other 5,080,338.00
Total Indirect Costs 5,080,338.00
TOTAL INDIRECT EXPENSES 5,080,338.00
TOTAL EXPENDITURES 5,080,338.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Gonococcal Isolate
Surveillance Project
DATE PREPARED
1/9/2024
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 13,478.00 13,478.00
2 Fringe Benefits 8,310.00 8,310.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 860.00 860.00
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.)204.00 204.00
Total Program Expenses 22,852.00 22,852.00
TOTAL DIRECT EXPENSES 22,852.00 22,852.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 6,707.00 6,707.00
Total Indirect Costs 6,707.00 6,707.00
TOTAL INDIRECT EXPENSES 6,707.00 6,707.00
TOTAL EXPENDITURES 29,559.00 29,559.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 24,713.00 24,713.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 4,846.00 0.00 4,846.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 29,559.00 24,713.00 4,846.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse
Notes : PH Nurse 3 F. McClish
Position P00002147
This position is responsible for
the preparation & collection of
GISP, N. gonorrhoeae
specimens and result reporting of
specimens collected in Oakland
County Health Division's STI
clinics.
0.0817 82480.000 0.000 FTE 6,739.00
Public Health Nurse
Notes : PH Nurse 3 M. McCarthy
Position P00001122
This position is responsible for
the preparation & collection of
GISP, N. gonorrhoeae
specimens and result reporting of
specimens collected in Oakland
County Health Division's STI
clinics.
0.0817 82480.000 0.000 FTE 6,739.00
Total for Salary & Wages 13,478.00
2 Fringe Benefits
Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
0.0000 61.656 13478.000 8,310.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Insurance
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies
Notes : Purchase of supplies
necessary for all services related
directly to the GISP: MTM
plates, chocolate plates,
disposable transfer pipets, KWIK
sticks for QC organisms, culture
loops, 2 ml tubes for freezing
broth, Tsoy broth, cryo pens,
NAAT urine and swab collection
kits
0.0000 0.000 0.000 860.00
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 204.00
Total Program Expenses 22,852.00
TOTAL DIRECT EXPENSES 22,852.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 1,861.00
Health Adm Distribution 0.0000 0.000 0.000 3,184.00
Nursing Adm Distribution 0.0000 0.000 0.000 1,662.00
Total for Cost Allocation Plan / Other 6,707.00
Total Indirect Costs 6,707.00
TOTAL INDIRECT EXPENSES 6,707.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
TOTAL EXPENDITURES 29,559.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / HIV PrEP Clinic
DATE PREPARED
1/9/2024
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 151,366.00 151,366.00
2 Fringe Benefits 86,814.00 86,814.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 8,636.00 8,636.00
6 Travel 828.00 828.00
7 Communication 2,160.00 2,160.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.)79,292.00 79,292.00
Total Program Expenses 329,096.00 329,096.00
TOTAL DIRECT EXPENSES 329,096.00 329,096.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 65,996.00 65,996.00
Total Indirect Costs 65,996.00 65,996.00
TOTAL INDIRECT EXPENSES 65,996.00 65,996.00
TOTAL EXPENDITURES 395,092.00 395,092.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 350,000.00 350,000.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 45,092.00 0.00 45,092.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 395,092.00 350,000.00 45,092.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Specialist
Notes : Clinical Health Specialist
E. Mazur Kozio
Po#P00015913
1.0000 91732.000 0.000 FTE 91,732.00
Clerk
Notes : Auxilary Health Clerk
Po#0006100
VACANT
1.0577 56381.000 0.000 FTE 59,634.00
Total for Salary & Wages 151,366.00
2 Fringe Benefits
Composite Rate
Notes : Fica, Unemp Ins,
Retirement, Hospital Ins, Life Ins,
Vision Ins, Dental Ins,
Workcomp, Short/Long Term
Disability
0.0000 57.354 151366.000 86,814.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 2,136.00
Drugs 0.0000 0.000 0.000 500.00
Medical Supplies 0.0000 0.000 0.000 6,000.00
Total for Supplies and Materials 8,636.00
6 Travel
Mileage
Notes : 0.655 per mile x 500
miles
0.0000 0.000 0.000 328.00
Conferences 0.0000 0.000 0.000 500.00
Total for Travel 828.00
7 Communication
Telephone Communications 0.0000 0.000 0.000 2,160.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 2,888.00
IT Operations 0.0000 0.000 0.000 16,404.00
Professional Services 0.0000 0.000 0.000 48,000.00
Lab Fees - PrEP Creatine
Clearance
0.0000 0.000 0.000 12,000.00
Total for All Others (ADP, Con. Employees, Misc.)79,292.00
Total Program Expenses 329,096.00
TOTAL DIRECT EXPENSES 329,096.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 20,904.00
Health Adm Distribution 0.0000 0.000 0.000 45,092.00
Total for Cost Allocation Plan / Other 65,996.00
Total Indirect Costs 65,996.00
TOTAL INDIRECT EXPENSES 65,996.00
TOTAL EXPENDITURES 395,092.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / HIV Prevention
DATE PREPARED
1/9/2024
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 250,197.00 250,197.00
2 Fringe Benefits 120,002.00 120,002.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 10,498.00 10,498.00
6 Travel 1,328.00 1,328.00
7 Communication 3,300.00 3,300.00
8 County-City Central Services 0.00 0.00
9 Space Costs 10,276.00 10,276.00
10 All Others (ADP, Con. Employees, Misc.)22,092.00 22,092.00
Total Program Expenses 417,693.00 417,693.00
TOTAL DIRECT EXPENSES 417,693.00 417,693.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 92,908.00 92,908.00
Total Indirect Costs 92,908.00 92,908.00
TOTAL INDIRECT EXPENSES 92,908.00 92,908.00
TOTAL EXPENDITURES 510,601.00 510,601.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 452,245.00 452,245.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 58,356.00 0.00 58,356.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 510,601.00 452,245.00 58,356.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Coordinator
Notes : Health Program
Coordinator
E. Trepkowski Position
P00006426
1.0000 94953.000 0.000 FTE 94,953.00
Clerk
Notes : Office Support Clerk
Senior
S. Cloutier Position P00006538
0.7115 51142.000 0.000 FTE 36,388.00
Public Health Nurse
Notes : Public Health Nurse III
J. Lombardi-Perwerton Position
P00007557
0.4327 84122.000 0.000 FTE 36,399.00
Public Health Nurse
Notes : Public Heath Nurse III
L. Drouillard Position P00009668
1.0000 82457.000 0.000 FTE 82,457.00
Total for Salary & Wages 250,197.00
2 Fringe Benefits
Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 47.963 250197.000 120,002.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 3,000.00
Medical Supplies 0.0000 0.000 0.000 1,000.00
Postage 0.0000 0.000 0.000 2,000.00
Printing 0.0000 0.000 0.000 2,000.00
Supplies & Materials 0.0000 0.000 0.000 890.00
Training-Ed Supplies 0.0000 0.000 0.000 1,608.00
Total for Supplies and Materials 10,498.00
6 Travel
Mileage
Notes : 500 miles @ 0.655
0.0000 0.000 0.000 328.00
Conferences 0.0000 0.000 0.000 1,000.00
Total for Travel 1,328.00
7 Communication
Telephone 0.0000 0.000 0.000 3,300.00
8 County-City Central Services
9 Space Costs
Space/Rental Costs 0.0000 0.000 0.000 10,276.00
10 All Others (ADP, Con. Employees, Misc.)
IT Operations
Notes : HP LJ 4250 NOHC ($416
x1) Laptop computers:
Trepkowski, Drouillard, Cloutier,
Lombardi-Pewerton ($838 x4)
Mobile Printer ($369x1) Scanner
($369x1) Office Jet Pro at 148 N
Saginaw ($369x1) x4
0.0000 0.000 0.000 16,360.00
Insurance 0.0000 0.000 0.000 3,732.00
Interpretation 0.0000 0.000 0.000 200.00
Miscellaneous
Notes : subscriptions
0.0000 0.000 0.000 1,800.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Total for All Others (ADP, Con. Employees, Misc.)22,092.00
Total Program Expenses 417,693.00
TOTAL DIRECT EXPENSES 417,693.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 34,552.00
Health Adm Distribution 0.0000 0.000 0.000 58,356.00
Total for Cost Allocation Plan / Other 92,908.00
Total Indirect Costs 92,908.00
TOTAL INDIRECT EXPENSES 92,908.00
TOTAL EXPENDITURES 510,601.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Harm Reduction Support
Services
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 60,988.00 60,988.00
6 Travel 9,828.00 9,828.00
7 Communication 4,721.00 4,721.00
8 County-City Central Services 0.00 0.00
9 Space Costs 32,400.00 32,400.00
10 All Others (ADP, Con. Employees, Misc.)142,063.00 142,063.00
Total Program Expenses 250,000.00 250,000.00
TOTAL DIRECT EXPENSES 250,000.00 250,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 32,209.00 32,209.00
Total Indirect Costs 32,209.00 32,209.00
TOTAL INDIRECT EXPENSES 32,209.00 32,209.00
TOTAL EXPENDITURES 282,209.00 282,209.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 250,000.00 250,000.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 32,209.00 0.00 32,209.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 282,209.00 250,000.00 32,209.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 3,000.00
Materials and Supplies 0.0000 0.000 0.000 9,000.00
Printing 0.0000 0.000 0.000 1,500.00
Medical Supplies 0.0000 0.000 0.000 40,988.00
Educational Supplies 0.0000 0.000 0.000 2,000.00
Drugs 0.0000 0.000 0.000 2,500.00
Computer Supplies 0.0000 0.000 0.000 1,500.00
Postage 0.0000 0.000 0.000 500.00
Total for Supplies and Materials 60,988.00
6 Travel
Transportation of Clients 0.0000 0.000 0.000 6,500.00
Conferences 0.0000 0.000 0.000 3,000.00
Mileage
Notes : 500 miles @ .655
0.0000 0.000 0.000 328.00
Total for Travel 9,828.00
7 Communication
Telephone Communications 0.0000 0.000 0.000 1,980.00
WiFi 0.0000 0.000 0.000 2,741.00
Total for Communication 4,721.00
8 County-City Central Services
9 Space Costs
Rent 0.0000 0.000 0.000 30,000.00
Building Space Rental
(Electrical)
0.0000 0.000 0.000 2,400.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Total for Space Costs 32,400.00
10 All Others (ADP, Con. Employees, Misc.)
Professional Services 0.0000 0.000 0.000 125,000.00
IT Operations 0.0000 0.000 0.000 6,703.00
Interpretation Fees 0.0000 0.000 0.000 500.00
Incentives 0.0000 0.000 0.000 2,000.00
Laundry and Cleaning 0.0000 0.000 0.000 3,360.00
Advertising 0.0000 0.000 0.000 4,500.00
Total for All Others (ADP, Con. Employees, Misc.)142,063.00
Total Program Expenses 250,000.00
TOTAL DIRECT EXPENSES 250,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Health Adm Distribution 0.0000 0.000 0.000 32,209.00
Total Indirect Costs 32,209.00
TOTAL INDIRECT EXPENSES 32,209.00
TOTAL EXPENDITURES 282,209.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Nurse Family Partnership
Services
DATE PREPARED
1/9/2024
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 394,267.00 394,267.00
2 Fringe Benefits 210,116.00 210,116.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 6,536.00 6,536.00
6 Travel 21,710.00 21,710.00
7 Communication 5,100.00 5,100.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.)37,811.00 37,811.00
Total Program Expenses 675,540.00 675,540.00
TOTAL DIRECT EXPENSES 675,540.00 675,540.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 132,464.00 132,464.00
Total Indirect Costs 132,464.00 132,464.00
TOTAL INDIRECT EXPENSES 132,464.00 132,464.00
TOTAL EXPENDITURES 808,004.00 808,004.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 675,540.00 675,540.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 132,464.00 0.00 132,464.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 808,004.00 675,540.00 132,464.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Nurse
Notes : Angela Varela Position
P00003427 PH Nurse 3
0.2500 82457.000 0.000 FTE 20,614.00
Public Health Nurse
Notes : Susan Martinez Position
P00000906 PH Nurse 3
1.0000 82457.000 0.000 FTE 82,457.00
Public Health Nurse
Notes : Tamera Gordon Position
P00003107 PH Nurse 3
1.0000 82457.000 0.000 FTE 82,457.00
Public Health Nurse
Notes : Marybeth Reader
Position P00003183 PH Nurse 3
0.5000 82457.000 0.000 FTE 41,229.00
Public Health Nurse
Notes : Katie Smedley Positon
P00000752 PH Nurse 3
1.0000 82457.000 0.000 FTE 82,457.00
Supervisor
Notes : Michele Maloff Position
P00004736 NFP Program
Supervisor
0.8000 106316.000 0.000 FTE 85,053.00
Total for Salary & Wages 394,267.00
2 Fringe Benefits
Composite Rate
Notes : Fica
Unemp Ins
Retirement
Hosp Ins
Life Ins
Vision Ins
Dental Ins
Work Comp
Short/Long Term Disability
0.0000 53.293 394267.000 210,116.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 1,500.00
Educational Supplies 0.0000 0.000 0.000 2,500.00
Printing 0.0000 0.000 0.000 1,200.00
Socialization 0.0000 0.000 0.000 1,336.00
Total for Supplies and Materials 6,536.00
6 Travel
Mileage
Notes : 12,000 miles @ .655
0.0000 0.000 0.000 7,860.00
Conferences 0.0000 0.000 0.000 13,850.00
Total for Travel 21,710.00
7 Communication
Telephone Communications 0.0000 0.000 0.000 2,700.00
Wi-Fi 0.0000 0.000 0.000 2,400.00
Total for Communication 5,100.00
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 5,575.00
IT Operations-laptops 0.0000 0.000 0.000 18,236.00
Staff Training 0.0000 0.000 0.000 1,500.00
Translation and Interpretation 0.0000 0.000 0.000 10,000.00
Incentives 0.0000 0.000 0.000 2,500.00
Total for All Others (ADP, Con. Employees, Misc.)37,811.00
Total Program Expenses 675,540.00
TOTAL DIRECT EXPENSES 675,540.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Health Adm Distribution 0.0000 0.000 0.000 87,033.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Nursing Adm Distribution 0.0000 0.000 0.000 45,431.00
Total for Cost Allocation Plan / Other 132,464.00
Total Indirect Costs 132,464.00
TOTAL INDIRECT EXPENSES 132,464.00
TOTAL EXPENDITURES 808,004.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Oral Health- Kindergarten
Assessment
DATE PREPARED
1/9/2024
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 43,404.00 43,404.00
2 Fringe Benefits 20,075.00 20,075.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 12,800.00 12,800.00
5 Supplies and Materials 20,751.00 20,751.00
6 Travel 3,120.00 3,120.00
7 Communication 540.00 540.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.)3,913.00 3,913.00
Total Program Expenses 104,603.00 104,603.00
TOTAL DIRECT EXPENSES 104,603.00 104,603.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 20,243.00 20,243.00
Total Indirect Costs 20,243.00 20,243.00
TOTAL INDIRECT EXPENSES 20,243.00 20,243.00
TOTAL EXPENDITURES 124,846.00 124,846.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 110,597.00 110,597.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 14,249.00 0.00 14,249.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 124,846.00 110,597.00 14,249.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Public Health Clerk
Notes : PH Clerk
Pos#P00002029 Andrea
Addison
0.2404 51140.000 0.000 FTE 12,293.00
Coordinator 0.2404 70292.000 0.000 FTE 16,897.00
Dental Hygenist
Notes : PH Dental Hygenist
Pos#P00015844 VACANT
0.2404 59131.000 0.000 FTE 14,214.00
Total for Salary & Wages 43,404.00
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 46.251 43404.000 20,075.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
Professional Services
Notes : Dr Joe
0.0000 0.000 0.000 12,800.00
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 500.00
Postage 0.0000 0.000 0.000 250.00
Printing 0.0000 0.000 0.000 5,254.00
Medical Supplies 0.0000 0.000 0.000 8,500.00
Educational Supplies 0.0000 0.000 0.000 3,747.00
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
Materials and Supplies 0.0000 0.000 0.000 2,500.00
Total for Supplies and Materials 20,751.00
6 Travel
Mileage
Notes : 4000miles * 0.655 per
mile
0.0000 0.000 0.000 2,620.00
Conferences 0.0000 0.000 0.000 500.00
Total for Travel 3,120.00
7 Communication
Telephone Communications 0.0000 0.000 0.000 540.00
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Insurance 0.0000 0.000 0.000 913.00
Interpretation Fees 0.0000 0.000 0.000 2,000.00
Advertising 0.0000 0.000 0.000 1,000.00
Total for All Others (ADP, Con. Employees, Misc.)3,913.00
Total Program Expenses 104,603.00
TOTAL DIRECT EXPENSES 104,603.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 5,994.00
Health Adm Distribution 0.0000 0.000 0.000 14,249.00
Total for Cost Allocation Plan / Other 20,243.00
Total Indirect Costs 20,243.00
TOTAL INDIRECT EXPENSES 20,243.00
TOTAL EXPENDITURES 124,846.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / MDHHS-Essential Local
Public Health Services (ELPHS)
DATE PREPARED
1/9/2024
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 0.00 0.00
2 Fringe Benefits 0.00 0.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 0.00 0.00
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.)0.00 0.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 8,766,438.00 8,766,438.00
Total Indirect Costs 8,766,438.00 8,766,438.00
TOTAL INDIRECT EXPENSES 8,766,438.00 8,766,438.00
TOTAL EXPENDITURES 8,766,438.00 8,766,438.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 720,413.00 0.00 720,413.00 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 2,557,216.00 2,557,216.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 5,488,809.00 0.00 5,488,809.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 8,766,438.00 2,557,216.00 6,209,222.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
2 Fringe Benefits
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Health Adm Distribution 0.0000 0.000 0.000 239,431.00
Nursing Adm Distribution 0.0000 0.000 0.000 189,159.00
Other Cost Distributions-MISC
Distributions
0.0000 0.000 0.000 5,852,033.00
Federally Provided Vaccines 0.0000 0.000 0.000 720,413.00
Other Cost Distributions-Non
Community Water & Std
0.0000 0.000 0.000 1,765,402.00
Total for Cost Allocation Plan / Other 8,766,438.00
Total Indirect Costs 8,766,438.00
TOTAL INDIRECT EXPENSES 8,766,438.00
TOTAL EXPENDITURES 8,766,438.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2024 / Sexually Transmitted
Infection (STI) Control
DATE PREPARED
1/9/2024
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 40,049.00 40,049.00
2 Fringe Benefits 24,474.00 24,474.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 211.00 211.00
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.)0.00 0.00
Total Program Expenses 64,734.00 64,734.00
TOTAL DIRECT EXPENSES 64,734.00 64,734.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 18,747.00 18,747.00
Total Indirect Costs 18,747.00 18,747.00
TOTAL INDIRECT EXPENSES 18,747.00 18,747.00
TOTAL EXPENDITURES 83,481.00 83,481.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
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 70,265.00 70,265.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 13,216.00 0.00 13,216.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 83,481.00 70,265.00 13,216.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Medical Technologist
Notes : P. Lafroy-Wolff Position
P00002106
Medical Technologist: This
position is responsible for the
preparation, analysis and result
reporting of specimens collected
in Oakland County Health
Division's STI clinics.
0.4808 83297.000 0.000 FTE 40,049.00
2 Fringe Benefits
Composite Rate
Notes : FICA
Unemployment Insurance
Retirement Insurance
Hospital Insurance
Life Insurance
Vision Insurance
Dental Insurance
Workers Comp
Short and Long Term Disability
Insurance
0.0000 61.110 40049.000 24,474.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 211.00
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Total Program Expenses 64,734.00
Local Health Department - 2024, Date: 01/09/2024
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DRAFTContract # Date: 01/09/2024
Line Item Qty Rate Units UOM Total
TOTAL DIRECT EXPENSES 64,734.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Health Adm Distribution 0.0000 0.000 0.000 13,216.00
Cost Allocation Plan
Notes : 13.81%
0.0000 0.000 0.000 5,531.00
Total for Cost Allocation Plan / Other 18,747.00
Total Indirect Costs 18,747.00
TOTAL INDIRECT EXPENSES 18,747.00
TOTAL EXPENDITURES 83,481.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 67 of 69
DRAFTContract # Date: 01/09/2024
Summary of Budget
PROGRAM / PROJECT
Local Health Department - 2024 / Local Health Department -
2024
DATE PREPARED
1/9/2024
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 20,612,857.00 20,612,857.00
2 Fringe Benefits 11,001,246.00 11,001,246.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 823,990.00 823,990.00
5 Supplies and Materials 2,137,288.00 2,137,288.00
6 Travel 403,396.00 403,396.00
7 Communication 282,021.00 282,021.00
8 County-City Central Services 0.00 0.00
9 Space Costs 1,875,836.00 1,875,836.00
10 All Others (ADP, Con. Employees, Misc.)3,245,369.00 3,245,369.00
Total Program Expenses 40,382,003.00 40,382,003.00
TOTAL DIRECT EXPENSES 40,382,003.00 40,382,003.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 1,892,521.00 1,892,521.00
2 Cost Allocation Plan / Other 7,186,869.00 7,186,869.00
Total Indirect Costs 9,079,390.00 9,079,390.00
TOTAL INDIRECT EXPENSES 9,079,390.00 9,079,390.00
TOTAL EXPENDITURES 49,461,393.00 49,461,393.00
SOURCE OF FUNDS
Category Total Amount Cash Inkind
1 Fees and Collections - 1st and 2nd 3,927,923.00 0.00 3,927,923.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 68 of 69
DRAFTContract # Date: 01/09/2024
Party
2 Fees and Collections - 3rd Party 241,000.00 0.00 241,000.00 0.00
3 Federal or State (Non MDHHS)2,463,226.00 0.00 2,463,226.00 0.00
4 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00
5 Federally Provided Vaccines 720,413.00 0.00 720,413.00 0.00
6 Federal Medicaid Outreach 547,764.00 547,764.00 0.00 0.00
7 Required Match - Local 589,664.00 0.00 589,664.00 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 11,868,318.00 11,868,318.00 0.00 0.00
14 MCH Funding 321,457.00 321,457.00 0.00 0.00
15 Local Funds - Other 28,334,099.00 0.00 28,334,099.00 0.00
16 Inkind Match 0.00 0.00 0.00 0.00
17 MDHHS Fixed Unit Rate 447,529.00 447,529.00 0.00 0.00
TOTAL 49,461,393.00 13,185,068.00 36,276,325.00 0.00
Local Health Department - 2024, Date: 01/09/2024
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Page: 69 of 69
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 1 of 20
FY 2024 MDHHS LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND
AND REMEMBERING CHERUBS
This Agreement is made between Oakland County, a Constitutional Corporation, 1200 North Telegraph,
Pontiac, Michigan 48341 ("County") and Remembering Cherubs, 1420 Washington Blvd Suite 301
Detroit, MI 48226, a Non-Profit Entity ("Recipient"). The County and Recipient shall be collectively
referred to as the “Parties.”
Part I
1.Purpose:
The Parties enter into this Agreement for the purpose of delineating their relationship and responsibilities
regarding the County’s use of Grant funds to reimburse the Recipient to provide support, guidance, and
educational materials in the immediate aftermath of pregnancy loss or infant death.
The County has entered into a Grant Agreement with the State of Michigan (State) where the County is
eligible to receive reimbursement for facilitating the delivery of public health services to the citizens of
Michigan within its jurisdiction (Attachment D).
The County intends to use a portion of the Grant funds to reimburse the Recipient, as described below,
subject to the terms and conditions of this Agreement.
In consideration of the mutual promises, obligations, representations, and assurances in this
Agreement, the Parties agree to the following:
2.Period of Agreement:
This Agreement will commence on October 1, 2023, and continue through September 30, 2024.
No service will be provided and no costs to the County will be incurred by the Recipient outside
tthe Period of the Agreement. This Agreement is in full force and effect for the period specified.
3.Program Budget and Agreement Amount:
A.Agreement Amount
The total amount of the award committed to the Recipient under this Agreement is not to exceed
$23,529 and will be allocated in accordance with Attachment A.
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 2 of 20
Any adjustment to the total amount of this Agreement, must be made in writing and
executed by all parties to this Agreement before the modifications can be implemented.
The grant Agreement is designated as a Recipient relationship (non-federal funding).
The grant Agreement is not a research and development project.
B.Equipment Purchases and Title
Recipient will not purchase capital assets or equipment using funds from this Agreement without
the approval of the County.
4.Statement of Work:
The Recipient agrees to undertake, perform and complete the services described in Attachment A, which
is part of this Agreement through reference.
5.Financial Requirements:
The financial requirements shall be followed as described in Part II of this Agreement.
6.Performance/Progress Report Requirements:
The progress reporting methods shall be followed as described in Part II and Attachment B, which are
part of this Agreement.
7.General Provisions:
The Recipient agrees to comply with the General Provisions outlined in Part II, which are part of this
Agreement. The Recipient also agrees that it will comply with all of the terms and conditions of the
County’s Grant Agreement with the State (Grant Agreement) and any amendments thereto, which are
included and incorporated into this Agreement as Attachment D. In the event of a conflict between the
Grant Agreement and this Agreement or any subcontract, the provisions of the Grant Agreement will
prevail.
8.Administration of the Agreement:
The person acting for the County in administering this Agreement (hereinafter referred to as the Project
Manager) is: Jennifer Floyd, Public Health Administrator, (248) 217-7296, floydj@oakgov.com.
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 3 of 20
9.Recipient's Financial Contact for the Agreement:
The person acting for the Recipient on the financial reporting for this Agreement is:
Name: Monica Anderson, Executive Director, Remembering Cherubs
E-Mail Address: info@rememberingcherubs.org Telephone No.: 313-617-9254
10.Special Conditions:
A.This Agreement is valid upon approval and execution by the County and
signature by the Recipient.
B.This Agreement is conditionally approved subject to and contingent upon the availability of
funds.
C.The County will not assume any responsibility or liability for costs incurred by the Recipient prior
to the signing of this Agreement. Upon signature by all parties, the Agreement shall be effective
for the period specified in Section 2., Period of Agreement above.
Part II General Provisions
1.Responsibilities - Recipient
The Recipient in accordance with the general purposes and objectives of this Agreement shall:
A.Royalty Free Rights to Use Software or Documentation Developed
Agree that the federal government reserves a royalty-free, non-exclusive, and irrevocable
license to reproduce, publish, or otherwise use, and to authorize others to use, for federal
government purposes, the copyright in any work developed under a grant, subgrant, or
contract under grant or subgrant or any rights of copyright to which a contractor purchases
ownership.
B.Fees
Guarantee that any claims made to the County under this Agreement shall not be
financed by any sources other than the County under the terms of this Agreement. If funding
is received through any other source, the Recipient agrees to budget the additional source
of funds and reflect the source of funding in the Financial Status Report.
C.Grant Program Operation
Provide the necessary administrative, professional, and technical staff for the operation of the
grant program. The Recipient must obtain and maintain all necessary licenses, permits, and
insurances under Part II and any other authorizations necessary for the performance of this
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 4 of 20
Agreement.
D.Reporting
Utilize all report forms and reporting formats required by the County at the effective date of
this Agreement and provide the County with timely review and commentary on any new report
forms and reporting formats proposed for issuance thereafter.
E.Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source documentation, to
support program activities and all expenditures made under the terms of this Agreement, as
required. The Recipient must assure that all terms of the Agreement will be appropriately
adhered to and that records and detailed documentation for the grant project or grant program
identified in this Agreement will be maintained for a period of not less than four years from the
date of termination, the date of submission of the final expenditure report or until litigation and
audit findings have been resolved. This Section applies to Recipient, any parent, affiliate, or
subsidiary organization of Recipient, and any subcontractor that performs Agreement activities
in connection with this Agreement.
F.Audit and Access to Records
Recipient certifies by signing this Agreement that it complies with regulations set forth in Title
2 Code of Federal Regulations (CFR) Part 200 and will provide notice of the completion of
required audits and any adverse findings which impact this subaward as required by parts
200.501-200.521 and will provide access to records as required by parts 200.336, 200.337
and 200.201, as applicable. The County, MDHHS or federal agencies may also conduct or
arrange for “agreed upon procedures” or additional audits to meet their needs.
G.Notification of Modifications
Provide timely notification to the County, in writing, of any action by its governing board or
any other funding source that would require or result in significant modification in the provision
of services, funding or compliance with operational procedures.
H.Mandatory Disclosures
i.Disclose to the County in writing within 14 days of receiving notice of any litigation,
investigation, arbitration, or other proceeding (collectively, “Proceeding”) involving
Recipient, a subcontractor, or an officer or director of Recipient or subcontractor, or that
arises during the term of this Agreement including:
1.All violations of federal and state criminal law involving fraud, bribery, or
gratuity violations potentially affecting the Agreement.
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2.A criminal Proceeding.
3.A parole or probation Proceeding.
4.A Proceeding under the Sarbanes-Oxley Act.
5.A civil Proceeding involving:
a.A claim that might reasonably be expected to adversely affect Recipient’s
viability or financial stability; or
b.A governmental or public entity’s claim or written allegation of fraud; or
c.Any complaint filed in a legal or administrative proceeding alleging the
Recipient or its subcontractors discriminated against its employees,
subcontractors, vendors, or suppliers during the term of this Agreement.
6.A Proceeding involving any license that Recipient is required to possess in
order to perform under this Agreement.
ii.Notify the County, at least 90 calendar days before the effective date, of a change in
Recipient’s ownership or executive management
I.Statement of Work Progress Reports
Reserved.
J.Conflict of Interest and Code of Conduct Standards
i.The Recipient is subject to the provisions of 1968 PA 317, as amended, 1973 PA 196,
as amended, and Title 2 Code of Federal Regulations, Section
200.318 (c) (1) and (2).
ii.The Recipient will uphold high ethical standards and is prohibited from:
1.Holding or acquiring an interest that would conflict with this Agreement.
2.Doing anything that creates an appearance of impropriety with respect to the
award or performance of this Agreement.
3.Attempting to influence or appearing to influence any County employee by the
direct or indirect offer of anything of value; or
4.Paying or agreeing to pay any person, other than employees and consultants
working for Recipient, any consideration contingent upon the award of this
Agreement.
iii.Immediately notify the County of any violation or potential violation of these standards.
This Section applies to Recipient, any parent, affiliate, or subsidiary organization of
Recipient, and any subcontractor that performs activities in connection with this
Agreement.
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K.Travel Costs
i.Be reimbursed for travel cost (including mileage, meals, and lodging) budgeted and
incurred related to services provided under this Agreement.
1.If the Recipient has a documented policy related to travel reimbursement for
employees and if the Recipient follows that documented policy, the County will
reimburse the Recipient for travel costs at the Recipient’s documented
reimbursement rate for employees. Otherwise, the State of Michigan
reimbursement rate for applies.
2.State of Michigan travel rates may be found at the following
website: http://www.michigan.gov/dtmb/0.5552.7-150-
141_13132-00.html.
3.International travel must be preapproved by the County and
itemized in the budget.
L.Insurance Requirements
i.Maintain a minimum of the insurances or governmental self-insurances listed below and
be responsible for all deductibles. All required insurance or self- insurance must:
1.Protect the state of Michigan and the County from claims that may a rise out of, are
alleged to arise out of, or result from Recipient or a subcontractor’s
performance.
2.Be primary and non-contributing to any comparable liability insurance (including
self-insurance) carried by the state and County; and
3.Be provided by a company with an A.M. Best rating of “A” or better and a
financial size of VII or better.
ii.Insurance Types
1.Commercial General Liability Insurance or Governmental Self- Insurance:
Except for Governmental Self-Insurance, policies must be endorsed to add
“the County of Oakland, and its officers, directors, employees, appointees,
and commissioners” and “the state of Michigan, its departments, divisions,
agencies, office, commissions, officers, employees, and agents” as additional
insureds using endorsement CG 20 10 11 85, or both CG 2010 12 19 and CG
20 37 12 19.
2.If the Recipient will interact with children, schools, or the cognitively impaired,
the Recipient must maintain appropriate insurance coverage related to sexual
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abuse and molestation liability.
3.Workers’ Compensation Insurance or Governmental Self-Insurance: Coverage
according to applicable laws governing work activities. Policies must include
waiver of subrogation, except where waiver is prohibited by law.
4.Employers Liability Insurance or Governmental Self-Insurance.
5.Privacy and Security Liability (Cyber Liability) Insurance: cover information
security and privacy liability, privacy notification costs, regulatory defense and
penalties, and website media content liability.
iii.At all times during this Agreement, the Recipient shall obtain and maintain insurance
according to this Section and the specific County requirements listed in Attachment C,
which is incorporated into this Agreement.
iv.Recipient must require that subcontractors maintain the required insurances
contained in this Section.
v.This Section is not intended to and is not to be construed in any manner as waiving,
restricting or limiting the liability of the Recipient from any obligations under this
Agreement.
vi.Each Party must promptly notify the other Party of any knowledge regarding an
occurrence which the notifying Party reasonably believes may result in a claim against
either Party. The Parties must cooperate with each other regarding such claim.
M.Fiscal Questionnaire
i.Submit yearly fiscal questionnaire to the County by the 15th of December.
ii.The fiscal questionnaire template will be provided by Oakland County
Fiscal Services.
N.Criminal Background Check
i.Conduct or cause to be conducted a search that reveals information similar or
substantially similar to information found on an Internet Criminal History Access Tool
(ICHAT) check and a national and state sex offender registry check for each new
employee, employee, subcontractor, subcontractor employee, or volunteer who, under
this Agreement, works directly with clients or has access to client information.
1.ICHAT: http://apps.michigan.gov/ichat
2.Michigan Public Sex Offender Registry: http://www.mipsor.state.mi.us
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3.National Sex Offender Registry: http://www.nsopw.gov
ii.Conduct or cause to be conducted a Central Registry (CR) check for each employee,
subcontractor, subcontractor employee, or volunteer who, under this Agreement, works
directly with children.
1.Central Register: https://www.michigan.gov/mdhhs/0,5885,7-339-
73971_7119_50648_48330-180331--,00.html.
iii.Require each new employee, employee, subcontractor, subcontractor employee, or
volunteer who, under this Agreement, works directly with clients or who has access to
client information to notify the Recipient in writing of criminal convictions (felony or
misdemeanor), pending felony charges, or placement on the Central Registry as a
perpetrator, at hire or within 10 days of the event after hiring.
iv.Determine whether to prohibit any employee, subcontractor, subcontractor employee,
or volunteer from performing work directly with clients or accessing client information
under this Agreement, based on a positive ICHAT response or reported criminal felony
conviction or perpetrator identification.
v.Determine whether to prohibit any employee, subcontractor, subcontractor employee,
or volunteer from performing work directly with children under this Agreement, based
on the results of a positive CR response or reported perpetrator identification.
vi.Require any employee, subcontractor, subcontractor employee or volunteer who may
have access to any databases of information maintained by the federal government that
contain confidential or personal information, including, but not limited to, federal tax
information, to have a fingerprint background check performed by the Michigan State
Police.
2.Responsibilities - County
The County in accordance with the general purposes and objectives of this Agreement will:
A.Reimbursement
Provide reimbursement in accordance with the terms and conditions of this Agreement based
upon appropriate reports, records, and documentation maintained by the Recipient.
B.Report Forms
Provide any report forms and reporting formats required by the County at the effective date of
this Agreement and provide to the Recipient any new report forms and reporting formats
proposed for issuance thereafter at least 90 days prior to their required usage in order to afford
the Recipient an opportunity to review.
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3.Assurances
The following assurances are hereby given to the County:
A.Compliance with Applicable Laws
The Recipient will comply with applicable federal and state laws, guidelines, rules and
regulations in carrying out the terms of this Agreement. The Recipient will also comply with all
applicable general administrative requirements, such as Title 2 Code of Federal Regulations
(CFR) covering cost principles, grant/agreement principles, and audits, in carrying out the terms
of this Agreement. The Recipient will comply with all applicable requirements in the original
grant awarded to the County. The County may determine that the Recipient has not complied
with applicable federal or state laws, guidelines, rules, and regulations in carrying out the terms
of this Agreement and may then terminate this Agreement under Part II, Section 4, G.
Agreement Termination.
B.Anti-Lobbying Act
The Recipient will comply with the Anti-Lobbying Act, 31 USC 1352 as revised by the Lobbying
Disclosure Act of 1995, 2 USC 1601 et seq, Federal Acquisition Regulations 52.203.11 and
52.203.12, and Section 503 of the Departments of Labor, Health and Human Services and
Education, and Related Agencies section of the current FY Omnibus Consolidated
Appropriations Act. Further, the Recipient shall require that the language of this assurance be
included in the award documents of all subawards at all tiers (including subcontracts, subgrants,
and contracts under grants, loans and cooperative agreements) and that all Recipients shall
certify and disclose accordingly.
C.Non-Discrimination
i.The Recipient must comply with MDHHS’s non-discrimination statement: The Michigan
Department of Health and Human Services will not discriminate against any individual or
group because of race, sex, religion, age, national origin, color, height, weight, marital
status, gender identification or expression, sexual orientation, partisan considerations, or a
disability or genetic information that is unrelated to the person’s ability to perform the duties
of a particular job or position. The Recipient further agrees that every subcontract entered
into for the performance of any contract or purchase order resulting therefrom, will contain
a provision requiring non-discrimination in employment, activity delivery and access, as
herein specified, binding upon each subcontractor. This covenant is required pursuant to
the Elliot-Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2101 et seq., and the
Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et seq.,
and any breach thereof may be regarded as a material breach of this Agreement.
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ii.The Recipient will comply with all federal statutes relating to
nondiscrimination. These include, but are not limited to:
1.Title VI of the Civil Rights Act of 1964 (P.L. 88-352), which prohibits
discrimination based on race, color or national origin.
2.Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
§§1681-1683, and 1685-1686), which prohibits discrimination based on sex.
3.Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination based on disabilities.
4.The Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101- 6107),
which prohibits discrimination based on age.
5.The Drug Abuse Office and Treatment Act of 1972 (P.L. 92- 255), as amended,
relating to nondiscrimination based on drug abuse.
6.The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91-616) as amended, relating to
nondiscrimination based on alcohol abuse or alcoholism.
7.Sections 523 and 527 of the Public Health Service Act of 1944 (42 U.S.C.
290dd-2), as amended, relating to confidentiality of alcohol and drug abuse
patient records.
8.Any other nondiscrimination provisions in the specific statute(s) under which
application for federal assistance is being made; and
9.The requirements of any other nondiscrimination statute(s) which may apply to
the application.
iii.Additionally, assurance is given to the County that proactive efforts will be made to identify
and encourage the participation of minority-owned and women-owned businesses, and
businesses owned by persons with disabilities in contract solicitations. The Recipient shall
incorporate language in all contracts awarded under this Agreement which (1) prohibits
discrimination against minority-owned and women-owned businesses and businesses
owned by persons with disabilities in subcontracting; and (2) makes discrimination a material
breach of contract.
D.Debarment and Suspension
The Recipient will comply with Federal Regulation, 2 CFR part 180 and certifies to the best of
its knowledge and belief that it, its employees and its subcontractors:
i.Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
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voluntarily excluded from covered transactions by any federal department or contractor.
ii.Have not within a five-year period preceding this Agreement been convicted of or had
a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a public
(federal, state, or local) or private transaction or contract under a public or private
transaction; violation of federal or state antitrust statutes or commission of embezzlement,
theft, forgery, bribery, falsification or destruction of records, making false statements, tax
evasion, receiving stolen property, making false claims, or obstruction of justice.
iii.Are not presently indicted or otherwise criminally or civilly charged by a government entity
(federal, state or local) with commission of any of the offenses enumerated in section 2.
iv.Have not within a five-year period preceding this Agreement had one or more public
transactions (federal, state or local) terminated for cause or default; and
v.Have not committed an act of so serious or compelling a nature that it affects your present
responsibilities.
E.Federal Requirement: Pro-Children Act
i.The Recipient will comply with the Pro-Children Act of 1994 (P.L. 103-227; 20 USC 6081,
et seq.), which requires that smoking not be permitted in any portion of any indoor facility
owned or leased or contracted by and used routinely or regularly for the provision of health,
day care, early childhood development activities, education or library activities to children
under the age of 18, if the activities are funded by federal programs either directly or
through state or local governments, by federal grant, contract, loan or loan guarantee. The
law also applies to children’s activities that are provided in indoor facilities that are
constructed, operated, or maintained with such federal funds. The law does not apply to
children’s activities provided in private residences; portions of facilities used for inpatient
drug or alcohol treatment; activity providers whose sole source of applicable federal
funds is Medicare or Medicaid; or facilities where Women, Infants, and Children (WIC)
coupons are redeemed. Failure to comply with the provisions of the law may result in the
imposition of a civil monetary penalty of up to $1,000 for each violation and/or the
imposition of an administrative compliance order on the responsible entity. The Recipient
also assures that this language will be included in any subawards which contain provisions
for children’s activities.
ii.The Recipient also assures, in addition to compliance with Public Law 103-227, any activity
funded in whole or in part through this Agreement will be delivered in a smoke-free facility
or environment. Smoking shall not be permitted anywhere in the facility, or those parts of
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the facility under the control of the Recipient. If activities are delivered in facilities or areas
that are not under the control of the Recipient (e.g., a mall, restaurant or private work site),
the activities shall be smoke-free.
F.Hatch Political Activity Act and Intergovernmental Personnel Act
The Recipient will comply with the Hatch Political Activity Act, 5 USC 1501-1508 and 7321-
7326, and the Intergovernmental Personnel Act of 1970 (PL 91-648), as amended by Title VI of
the Civil Service Reform Act of 1978 (PL 95-454). Federal funds cannot be used
for partisan political purposes of any kind by any person or organization involved in the
administration of federally assisted programs.
G.National Defense Authorization Act Employee Whistleblower Protections
The Recipient will comply with 41 USC 4712 and shall insert this clause in all subcontracts.
H.Clean Air Act and Federal Water Pollution Control Act
The Recipient will comply with the Clean Air Act (42 U.S.C. 7401-7671(q)) and the Federal
Water Pollution Control Act (33 U.S.C. 1251-1387), as amended.
i.This Agreement and anyone working on this Agreement will be subject to the Clean Air
Act and Federal Water Pollution Control Act and must comply with all applicable
standards, orders or regulations issued pursuant to these Acts. Violations must be
reported to the County.
I.Trafficking Victims Protection Act
The Recipient will comply with the Victims of Trafficking and Violence Protection Act of 2000 (P.L.
106-386), as amended.
i.This Agreement and anyone working on this Agreement will be subject to P.L. 106-386
and must comply with all applicable standards, orders or regulations issued pursuant to
this Act. Violations must be reported to the County.
J.Procurement of Recovered Materials
The Recipient will comply with section 6002 of the Solid Waste Disposal Act of 1965 (P.L. 89-
272), as amended.
i.This Agreement and anyone working on this Agreement will be subject to section 6002
of P.L. 89-272, as amended, and must comply with all applicable standards, orders or
regulations issued pursuant to this Act. Violations must be reported to the County.
K.Procurement
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i.Recipient will ensure that all purchase transactions, whether negotiated or advertised,
shall be conducted openly and competitively in accordance with the principles and
requirements of Title 2 Code of Federal Regulations, Part 200.
ii.Funding from this Agreement shall not be used for the purchase of foreign goods or
services or both.
iii.Preference must be given to goods and services manufactured or provided by Michigan
businesses, if they are competitively priced and of comparable quality.
iv.Preference must be given to goods and services that are manufactured or provided by
Michigan businesses owned and operated by veterans, if they are competitively bid and of
comparable quality.
v.Records must be sufficient to document the significant history of all purchases and shall
be maintained for a minimum of four years after the end of the Agreement period.
L.Health Insurance Portability and Accountability Act
To the extent that the Health Insurance Portability and Accountability Act (HIPAA) is applicable
to the Recipient under this Agreement, the Recipient assures that it is in compliance with
requirements of HIPAA including the following:
i.The Recipient must not share any protected health data and information provided by
the County that is covered by HIPAA except as permitted or required by applicable law,
or to a subcontractor as appropriate under this Agreement.
ii.The Recipient will ensure that any subcontractor will have the same obligations as the
Recipient not to share any protected health data and information from the County that
falls under HIPAA requirements in the terms and conditions of the subcontract.
iii.The Recipient must only use the protected health data and information for the purposes
of this Agreement.
iv.The Recipient must have written policies and procedures addressing the use of
protected health data and information that falls under the HIPAA requirements. The
policies and procedures must meet all applicable federal and state requirements
including the HIPAA regulations. These policies and procedures must include restricting
access to the protected health data and information by the Recipient’s employees.
v.The Recipient must have a policy and procedure to immediately report to the County
any suspected or confirmed unauthorized use or disclosure of
protected health information that falls under the HIPAA requirements of which the
Recipient becomes aware. The Recipient will work with the County to mitigate the
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breach and will provide assurances to the County of corrective actions to prevent further
unauthorized uses or disclosures. The County may demand specific corrective actions
and assurances and the Recipient must provide the same to the County.
vi.Failure to comply with any of these contractual requirements may result in the
termination of this Agreement in accordance with Part II, Section 4, G. Agreement
Termination.
vi. In accordance with HIPAA requirements, the Recipient is liable for any claim, loss or
damage relating to unauthorized use or disclosure of protected health data and
information, including without limitation, the County’s and/or state’s costs in responding
to a breach, received by the Recipient from the State, County, or any other source.
vii.The Recipient will enter into a business associate agreement should the County
determine such an agreement is required under HIPAA.
M.Website Incorporation
The County is not bound by any content on Recipient’s website or other internet communication
platforms or technologies, unless expressly incorporated directly into this Agreement. The
County is not bound by any end user license agreement or terms of use unless specifically
incorporated in this Agreement or any other agreement signed by the County. The Recipient
may not refer to the County on the Recipient's website or other internet communication
platforms or technologies without the prior written approval of the County.
N.Survival
The provisions of this Agreement that impose continuing obligations will survive
the expiration or termination of this Agreement.
O.Non-Disclosure of Confidential Information
i.The Recipient agrees that it will use Confidential Information solely for the purpose of
this Agreement. The Recipient agrees to hold all Confidential Information in strict
confidence and not to copy, reproduce, sell, transfer or otherwise dispose of, give or
disclose such Confidential Information to third parties other than employees, agents,
or subcontracts of a party who have a need to know in connection with this Agreement
or to use such Confidential Information for any purpose whatsoever other than the
performance of this Agreement. The Recipient must take all reasonable precautions
to safeguard the Confidential Information. These precautions must be at least as
great as the precautions the Recipient takes to protect its own confidential or proprietary
information.
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ii.Meaning of Confidential Information
For the purpose of this Agreement the term “Confidential Information” means all
information and documentation that:
1.Has been marked “confidential” or with words of similar meaning, at the time
of disclosure by such party.
2.If disclosed orally or not marked “confidential” or with words of similar meaning,
was subsequently summarized in writing by the disclosing party and marked
“confidential” or with words of similar meaning.
3.Should reasonably be recognized as confidential information of the disclosing
party.
4.Is unpublished or not available to the general public; or
5.Is designated by law as confidential.
iii.The term “Confidential Information” does not include any information or documentation
that was:
1.Subject to disclosure under the Michigan Freedom of Information Act
(FOIA).
2.Already in the possession of the receiving party without an obligation of
confidentiality.
3.Developed independently by the receiving party, as demonstrated by
the receiving party, without violating the disclosing party’s proprietary rights.
4.Obtained from a source other than the disclosing party without an obligation of
confidentiality; or
5.Publicly available when received or thereafter became publicly available (other
than through an unauthorized disclosure by, through or on behalf of, the
receiving party).
iv.The Recipient must notify the County within one (1) business day after discovering any
unauthorized use or disclosure of Confidential Information. The Recipient will
cooperate with the County in every way possible to regain possession of the
Confidential Information and prevent further unauthorized use or disclosure.
4.Financial Requirements
A.Requests for Reimbursement
i.Invoices shall be prepared and submitted to the Project Manager using forms provided
by the County. Invoices must be submitted on a monthly basis, no later than fifteen (15)
days after the close of each calendar month. The monthly invoice must reflect total
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actual program expenditures, regardless of the source of funds. Failure to meet financial
reporting responsibilities as identified in this Agreement may result in withholding future
payments.
ii.By submitting the invoice, the individual is certifying to the best of their knowledge and
belief that the information included therein is true, complete and accurate and the
expenditures, disbursements, and cash receipts are for the purposes and objectives set
forth in the terms and conditions of this Agreement. The individual submitting the invoice
should be aware that any false, fictitious, or fraudulent information, or the omission of
any material facts, may subject them to criminal, civil or administrative penalties for
fraud, false statements, false claims or otherwise.
B.Requests for an Amendment to Budget
i.A request for an amendment can be submitted at any time up until June 1, 2024.
ii.A written request for a budget amendment with revised budget pages is required when
there is a change in a budget category over $5,000 or 15% of the category, whichever
constitutes the greater amount. The deviation allowance does not authorize new
categories or line items within the category.
iii.A determination of approval, disapproval or pending status will be sent within 10
business days or comments/questions if further clarification is required.
iv.Submit amendment requests to Jennifer Floyd at floydj@oakgov.com For questions,
call 248-217-7296.
C.Reimbursement Method
The Grantee will be reimbursed in accordance with the staffing grant reimbursement method
as follows:
i.Reimbursement from the County is based on the understanding that County funds will
be paid up to the total County allocation as agreed to in the approved budget. County
funds are the first source after the application of fees and earmarked sources unless a
specific local match condition exists.
ii.To request reimbursement for eligible expenditures, the Recipient shall submit to the
County the documentation described in the following subparagraphs with the monthly
invoice. If the County, in its sole discretion, determines the documentation submitted
by the Recipient does not reconcile, then the Recipient shall provide any additional
documentation requested by the County in order to process payment.
1.A fully completed and signed invoice.
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2.A payroll report that supports reimbursement requests for salaries and/or fringe
benefits.
3.Employee timesheets with a signature from the project manager or supervisor
for those individuals whose time is requested for reimbursement.
4.General ledger listing qualified expenditures requested for reimbursement.
5.Receipts or invoices that include date of service, cost, and/rate for qualified
expenditures.
6.Date and detail of miles traveled for allowable travel expenditures.
D.Final Obligations and Financial Status Reporting Requirements
i.Obligation Report
The Obligation Report, based on annual guidelines, must be submitted by the third
Friday in September using the format provided by the County. The Recipient must
provide an estimate of total expenditures for the entire Agreement period. The
information on the report will be used to record the County’s year-end accounts
payables and receivables for this Agreement.
ii.Final Invoices
Final invoices are due nine (9) days following the end of the Agreement period. The
final invoice must be clearly marked “Final." Final invoices not received by the due date
may result in the loss of funding requested on the Obligation Report and may result in
the potential reduction in the subsequent year’s agreement amount.
E.Unobligated Funds
Any unobligated balance of funds held by the Recipient at the end of the Agreement period
will be returned to the County within 30 days of the end of the Agreement or treated in
accordance with instructions provided by the County.
F.Indirect Costs
G.There are no Indirect Costs as part of this Agreement.
H.Agreement Termination
The County may terminate this Agreement without further liability or penalty to the County for
any of the following reasons:
i.This Agreement may be terminated by either party by giving 30 days written notice to
the other party stating the reasons for termination and the effective date.
ii.This Agreement may be terminated by either party with 30 days prior written notice upon
the failure of either party to carry out the terms and conditions of this
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Agreement provided the alleged defaulting party is given notice of the alleged breach
and fails to cure the default within the 30-day period.
iii.This Agreement may be terminated immediately if the Recipient or an official of the
Recipient or an owner is convicted of any activity referenced in Part II, Section 3, D.
Debarment and Suspension, of this Agreement during the term of this Agreement or any
extension thereof.
The County or the Michigan Department of Health and Human Services may seek
administrative, contractual, or legal remedies if the Recipient violates or breaches any contract
terms.
I.Stop Work Order
The County may suspend any or all activities under this Agreement at any time. The County will
provide the Recipient with a written stop order detailing the suspension. Recipient must comply
with the stop work order upon receipt. The County will not pay for activities, Recipient’s incurred
expenses or financial losses, or any additional compensation during a stop work order.
J.Final Reporting Upon Termination
Should this Agreement be terminated by either party, within 30 days after the termination, the
Recipient shall provide the County with all financial, performance and other reports required as
a condition of this Agreement. The County will make payments to the Recipient for allowable
reimbursable costs not covered by previous payments or other state or federal programs. The
Recipient shall immediately refund to the County any funds not authorized for use and any
payments or funds advanced to the Recipient in excess of allowable reimbursable expenditures.
K.Severability
If any part of this Agreement is held invalid or unenforceable, by any court of competent
jurisdiction, that part will be deemed deleted from this Agreement and the severed part will be
replaced by agreed upon language that achieves the same or similar objectives. The remaining
parts of the Agreement will continue in full force and effect.
L.Waiver
Failure to enforce any provision of this Agreement will not constitute a waiver to enforce any
other provision of this Agreement. Any clause or condition of this Agreement found to be an
impediment to the intended and effective operation of this Agreement may be waived in writing
by the County or the Recipient, upon presentation of written justification by the requesting party.
Such waiver may be temporary or for the life of the Agreement and may affect any or all program
elements covered by this Agreement.
M.Amendments
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 19 of 20
Any changes to this Agreement will be valid only if made in writing and accepted by all Parties
to this Agreement. Any change proposed by the Recipient which would affect the County’s
funding of any project, in whole or in part of the Agreement, must be submitted in writing to the
County for approval immediately upon determining the need for such change.
N.Liability
The Recipient assumes all liability to third parties, loss, or damage as a result of claims,
demands, costs, or judgments arising out of activities, such as direct service delivery, to be
carried out by the Recipient in the performance of this Agreement, under the following
conditions:
i.The liability, loss, or damage is caused by, or arises out of, the actions of or failure to
act on the part of the Recipient, any of its subcontractors, or anyone directly or indirectly
employed by the Recipient.
ii.Nothing herein shall be construed as a waiver of any governmental immunity that has
been provided to the Recipient or its employees by statute or court decisions.
The County is not liable for consequential, incidental, indirect, or special damages, regardless
of the nature of the action.
O.Governing Law
This Agreement shall be governed, interpreted, and enforced by the laws of the State of
Michigan, excluding Michigan’s conflict of law principles. Except as otherwise provided by law
or court rule any action or claim to enforce, interpret, or arising under or related to this
Agreement shall be brought in the Sixth Judicial Circuit Court of the State of Michigan, the 50th
District of the State of Michigan, or the United State District Court for the Eastern District of
Michigan, Southern Division, as dictated by the applicable jurisdiction of the court. Except as
otherwise required by law or court rule venue is proper in the courts set forth above.
Notwithstanding the above, any complaints against or involving the State must be resolved in
the Court of Claims and initiated in Ingham County. Recipient waives any objections, such as
lack of personal jurisdiction or forum non conveniens. Recipient must appoint an agent in
Michigan to receive service of process.
P.This Agreement represents the entire agreement and understanding between the Parties. This
Agreement supersedes all other oral or written agreements between the Parties. The language
of this Agreement shall be construed as a whole according to its fair meaning, and not construed
strictly for or against any Party.
_________________________________________________________________________________________________________________
FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT:
RECIPIENT AGREEMENT BETWEEN
THE COUNTY OF OAKLAND AND
REMEMBERING CHERUBS
Page 20 of 20
IN WITNESS WHEREOF, David T. Woodward, Chairperson, Oakland County Board of Commissioners,
acknowledges that he has been authorized by a resolution of the Oakland County Board of Commissioners, and
hereby accepts and binds the County to the terms and conditions of this Agreement.
EXECUTED:
David T. Woodward, Chairperson
Oakland County Board of Commissioners
DATE:
IN WITNESS WHEREOF, _________________ , acknowledges that he/she has been authorized to sign
this Agreement on behalf of the Recipient, and hereby accepts and binds the Recipient to the terms and
conditions of this Agreement
EXECUTED:
Printed Name: Monica Anderson
Title: Executive Director, Remembering Cherubs
DATE:_______________
Monica Anderson
Monica Anderson
01/16/2014
Attachment A
Minimum Contractor Scope of Service Requirements
Recipient, in accordance with the general purposes and objectives of this Agreement, will
provide support, guidance, and educational materials in the immediate aftermath of pregnancy
loss or infant death as follows:
•Comply with all of the program requirements outlined in the Grant Agreement.
•Follow the allowable expense guidelines provided by MDHHS for this grant.
•Coordinate with the Contract Administrator and comply with all program, financial, and
reporting procedures.
•Maintain an inventory of all supplies purchased with these grant funds.
• Adhere to all grant activities as outlined in the most up-to-date State approved workplan.
•Maintain confidentiality of records on clients served and allow for the sharing of client
information between the County and Recipient staff. Obtain signed Release of Information
forms for sharing client information with other community service agencies/providers.
•All materials and advertising used to promote these contracted services shall also include
Oakland County as partner and be pre-approved by Oakland County.
Attachment B Reporting Requirements
Reporting: As part of the Grant Agreement, Recipient shall maintain monthly records
detailing its expenditure of grant funds. Supplemental reporting forms will be provided by
Oakland County to complete this requirement. The Recipient must complete any reporting
forms provided by Oakland County. Reports are due to the Oakland County Health
Division by the 5th day of every month for review.
Invoicing process: Recipient shall submit the actual costs incurred for the reimbursable grant activities
using the electronic invoice provided by OCHD monthly. The Recipient can only submit reimbursement
requests consistent with this Agreement and the approved budget.
ATTACHMENT C
RECIPIENT INSURANCE REQUIREMENTS WITH COUNTY
During this Agreement, the Recipient shall provide and maintain, at their own expense, all insurance as set
forth and marked below, protecting the County against any Claims. Claims means any loss; complaint;
demand for relief or damages; lawsuit; cause of action; proceeding; judgment; penalty; costs or other liability of
any kind which is imposed on, incurred by, or asserted against the County or for which the County may become
legally or contractually obligated to pay or defend against, whether commenced or threatened, including, but not
limited to, reimbursement for reasonable attorney fees, mediation, facilitation, arbitration fees, witness fees, court
costs, investigation expenses, litigation expenses, or amounts paid in settlement. The insurance shall be written
for not less than any minimum coverage herein specified. Limits of insurance required in no way limit the
liability of the Recipient.
Primary Coverages
Commercial General Liability Occurrence Form including: (a) Premises and Operations; (b) Products and
Completed Operations (including On and Off Premises Coverage); (c) Personal and Advertising Injury; (d)
Broad Form Property Damage; (e) Broad Form Contractual including coverage for obligations assumed in this
Agreement;
$1,000,000 – Each Occurrence Limit
$1,000,000 – Personal & Advertising Injury
$2,000,000 – Products & Completed Operations Aggregate Limit
$2,000,000 – General Aggregate Limit
$ 100,000 – Damage to Premises Rented to You (formally known as Fire Legal Liability)
Workers’ Compensation Insurance with limits statutorily required by any applicable Federal or State Law
and Employers Liability insurance with limits of no less than $500,000 each accident, $500,000 disease each
employee, and $500,000 disease policy limit.
1.☒ Fully Insured or State approved self-insurer.
2.☐ Sole Proprietors must submit a signed Sole Proprietor form.
3.☐ Exempt entities, Partnerships, LLC, etc., must submit a State of Michigan form WC-337 Certificate of
Exemption.
Commercial Automobile Liability Insurance covering bodily injury or property damage arising out of the
use of any owned, hired, or non-owned automobile with a combined single limit of $1,000,000 each accident.
This requirement is waived if there are no company owned, hired or non-owned automobiles utilized in the
performance of this Agreement.
Commercial Umbrella/Excess Liability Insurance with minimum limits of $2,000,000 each occurrence.
Umbrella or Excess Liability coverage shall be no less than following form of primary coverages or broader.
This Umbrella/Excess requirement may be met by increasing the primary Commercial General Liability limits
to meet the combined limit requirement.
Third Party Theft Insurance in an amount not less than the grant award with Oakland County named as an
additional insured.
Supplemental Coverages – As Needed
1.Professional Liability/Errors & Omissions Insurance (i.e., Consultants, Technology Vendors,
Architects, Engineers, Real Estate Agents, Insurance Agents, Attorneys, etc.) with minimum limits
of $1,000,000 per claim and $1,000,000 aggregate shall be required when the Recipient provides
professional services that the County relies upon.
2.Cyber Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate
shall be required when the Recipient has access to County IT systems and/or stores County data
electronically.
3.Commercial Property Insurance. The Recipient shall be responsible for obtaining and maintaining
insurance covering their equipment and personal property against all physical damage.
4.Liquor Legal Liability Insurance with a limit of $1,000,000 each occurrence shall be required when
liquor is served and/or provided by Recipient.
5.Pollution Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000
aggregate shall be required when storage, transportation and/or cleanup & debris removal of
pollutants are part of the services utilized.
6.Medical Malpractice Insurance with minimum limits of $1,000,000 per claim and $1,000,000
aggregate shall be required when medically related services are provided.
7.Garage Keepers Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000
aggregate shall be required when County owned vehicles and/or equipment are stored and/or
serviced at the Recipient’s facilities.
8.Other Insurance Coverages as may be dictated by the provided product/service and deemed
appropriate by the County Risk Management Department.
General Insurance Conditions
The aforementioned insurance shall be endorsed, as applicable, and shall contain the following terms,
conditions, and/or endorsements. All certificates of insurance shall provide evidence of compliance with
all required terms, conditions and/or endorsements.
1.All policies of insurance shall be on a primary, non-contributory basis with any other insurance or
self-insurance carried by the County;
2.The insurance company(s) issuing the policy(s) shall have no recourse against the County for
subrogation (policy endorsed written waiver), premiums, deductibles, or assessments under any
form. All policies shall be endorsed to provide a written waiver of subrogation in favor of the County;
3.Any and all deductibles or self-insured retentions shall be assumed by and be at the sole risk of the
Recipient;
4.Recipient shall be responsible for their own property insurance for all equipment and personal
property used and/or stored on County property;
5.The Commercial General Liability and Commercial Automobile Liability policies along with any
required supplemental coverages shall be endorsed to name the County of Oakland and its officers,
directors, employees, appointees and commissioners as additional insureds where permitted by law
and policy form;
6.If the Recipient’s insurance policies have higher limits than the minimum coverage requirements
stated in this document the higher limits shall apply and in no way shall limit the overall liability
assumed by the Recipient under contract.
7.The Recipient shall require its contractors or sub-contractors, not protected under the Recipient’s
insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or
clauses equal to those required in this Agreement;
8.Certificates of insurance must be provided no less than ten (10) Business Days prior to the County’s
execution of the Agreement and must bear evidence of all required terms, conditions, and
endorsements; and provide 30 days’ notice of cancellation/material change endorsement.
9.All insurance carriers must be licensed and approved to do business in the State of Michigan along
with the Recipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A-
unless otherwise approved by the County Risk Management Department.
Oakland County, Michigan
HEALTH AND HUMAN SERVICES DEPARTMENT/HEALTH DIVISION - FY 2024 HEALTH LOCAL HEALTH DEPARTMENT (LHD) 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 Greenal Fund - Grants Health FND10101 CCN1060212 RC610313 PRG133930 GRN-1004228 610000 Federal Operating Grants $16,582 $-$-
R Greenal Fund - Grants Health FND10101 CCN1060220 RC615571 PRG134000 GRN-1004200 615000 State Operating Grants 1,004,035 --
R Greenal Fund - Grants Health FND10101 CCN1060283 RC615571 PRG133930 GRN-1004228 615000 State Operating Grants 13,153 --
R Greenal Fund - Grants Health FND10101 CCN1060201 RC615675 PRG133150 GRN-1004205 615000 Health State Subsidy 708,481 --
Total Revenues $1,742,251 $-$-
E General Fund Non-Departmental FND10100 CCN9090101 SC730359 PRG196030 730000 Contingency $1,742,251 $-$-
Total Expenditures $1,742,251 $-$-
R Human Services Grants Health FND11007 CCN1060290 RC610313 PRG115035 GRN-1004181 610000 Federal Operating Grants $36,000 $-$-
R Human Services Grants Health FND11007 CCN1060290 RC615463 PRG115035 GRN-1004181 615000 Grant Fees and Collections 3,600 --
Total Revenues $39,600 $-$-
E Human Services Grants Health FND11007 CCN1060290 SC722740 PRG115035 GRN-1004181 722000 Fringe Benefits $(531)--
E Human Services Grants Health FND11007 CCN1060290 SC730926 PRG115035 GRN-1004181 730000 Indirect Costs (4,550)--
E Human Services Grants Health FND11007 CCN1060290 SC731213 PRG115035 GRN-1004181 730000 Membership Dues 2,500 --
E Human Services Grants Health FND11007 CCN1060290 SC750077 PRG115035 GRN-1004181 750000 Disaster Supplies (16,419)--
E Human Services Grants Health FND11007 CCN1060290 SC770631 PRG115035 GRN-1004181 770000 Bldg Space Cost Allocation 3,600 --
E Human Services Grants Health FND11007 CCN1060290 SC774636 PRG115035 GRN-1004181 770000 Info Tech Operations 55,000 --
Total Expenditures $39,600 $-$-
R Human Services Grants Health FND11007 CCN1060291 RC610313 PRG134420 GRN-1004185 610000 Federal Operating Grants $32,386 $-$-
R Human Services Grants Health FND11007 CCN1060291 RC615571 PRG134420 GRN-1004185 615000 State Operating Grants 32,386 --
Total Revenues $64,772 $-$-
E Human Services Grants Health FND11007 CCN1060291 SC730926 PRG134420 GRN-1004185 730000 Indirect Costs $(14,918)--
E Human Services Grants Health FND11007 CCN1060291 SC730982 PRG134420 GRN-1004185 730000 Interpreter Fees 2,000 --
E Human Services Grants Health FND11007 CCN1060291 SC750301 PRG134420 GRN-1004185 750000 Medical Supplies 2,000 --
E Human Services Grants Health FND11007 CCN1060291 SC750567 PRG134420 GRN-1004185 750000 Training - Educational Supplies 11,190 --
E Human Services Grants Health FND11007 CCN1060291 SC750245 PRG134420 GRN-1004185 750000 Incentives 12,000 --
E Human Services Grants Health FND11007 CCN1060291 SC731773 PRG134420 GRN-1004185 730000 Software Rental Lease 4,000 --
E Human Services Grants Health FND11007 CCN1060291 SC730072 PRG134420 GRN-1004185 730000 Advertising 35,000 --
E Human Services Grants Health FND11007 CCN1060291 SC731941 PRG134420 GRN-1004185 730000 Training 10,000 --
E Human Services Grants Health FND11007 CCN1060291 SC750399 PRG134420 GRN-1004185 750000 Office Supplies 2,000 --
E Human Services Grants Health FND11007 CCN1060291 SC750154 PRG134420 GRN-1004185 750000 Expendable Equipment 1,500 --
Total Expenditures $64,772 $-$-
R Human Services Grants Health FND11007 CCN1060234 RC610313 PRG133120 GRN-1004207 610000 Federal Operating Grants $(2,713)$-$-
Total Revenues $(2,713)$-$-
E Human Services Grants Health FND11007 CCN1060234 SC702010 PRG133120 GRN-1004207 702000 Salaries Regular $(674)$-$-
E Human Services Grants Health FND11007 CCN1060234 SC722740 PRG133120 GRN-1004207 722000 Fringe Benefits (417)--
E Human Services Grants Health FND11007 CCN1060234 SC730926 PRG133120 GRN-1004207 730000 Indirect Costs (830)--
E Human Services Grants Health FND11007 CCN1060234 SC750399 PRG133120 GRN-1004207 750000 Office Supplies (792)--
Total Expenditures $(2,713)$-$-
R Human Services Grants Health FND11007 CCN1060294 RC610313 PRG133390 GRN-1004208 610000 Federal Operating Grants $120,000 $-$-
Total Revenues $120,000 $-$-
E Human Services Grants Health FND11007 CCN1060294 SC702010 PRG133390 GRN-1004208 702000 Salaries Regular $67,962 $-$-
E Human Services Grants Health FND11007 CCN1060294 SC722740 PRG133390 GRN-1004208 722000 Fringe Benefits 41,985 --
E Human Services Grants Health FND11007 CCN1060294 SC731458 PRG133390 GRN-1004208 730000 Professional Services (82,000)--
E Human Services Grants Health FND11007 CCN1060294 SC730926 PRG133390 GRN-1004208 730000 Indirect Costs 5,470 --
E Human Services Grants Health FND11007 CCN1060294 SC731997 PRG133390 GRN-1004208 730000 Client Transportation (4,000)--
E Human Services Grants Health FND11007 CCN1060294 SC750112 PRG133390 GRN-1004208 750000 Drugs (1,000)--
E Human Services Grants Health FND11007 CCN1060294 SC750294 PRG133390 GRN-1004208 750000 Material and Supplies 3,915 --
E Human Services Grants Health FND11007 CCN1060294 SC750301 PRG133390 GRN-1004208 750000 Medical Supplies (30,988)--
E Human Services Grants Health FND11007 CCN1060294 SC750399 PRG133390 GRN-1004208 750000 Office Supplies (1,500)--
E Human Services Grants Health FND11007 CCN1060294 SC750567 PRG133390 GRN-1004208 750000 Training-Educational Supplies (1,000)--
E Human Services Grants Health FND11007 CCN1060294 SC760188 PRG133390 GRN-1004208 760000 Vehicles 121,155 --
Total Expenditures $120,000 $-$-
R Human Services Grants Health FND11007 CCN1060230 RC610313 PRG133215 GRN-1004222 610000 Federal Operating Grants $62,000 $-$-
Total Revenues $62,000 $-$-
E Human Services Grants Health FND11007 CCN1060230 SC702010 PRG133215 GRN-1004222 702000 Salaries Regular $(3,467)$-$-
E Human Services Grants Health FND11007 CCN1060230 SC722740 PRG133215 GRN-1004222 722000 Fringe Benefits (4,570)--
E Human Services Grants Health FND11007 CCN1060230 SC730982 PRG133215 GRN-1004222 730000 Interpreter Fees 2,000 --
E Human Services Grants Health FND11007 CCN1060230 SC731346 PRG133215 GRN-1004222 730000 Personal Mileage 3,930 --
E Human Services Grants Health FND11007 CCN1060230 SC731388 PRG133215 GRN-1004222 730000 Printing 800 --
E Human Services Grants Health FND11007 CCN1060230 SC732018 PRG133215 GRN-1004222 730000 Travel and Conference (2,850)--
E Human Services Grants Health FND11007 CCN1060230 SC732165 PRG133215 GRN-1004222 730000 Workshop and Meetings 5,000 --
E Human Services Grants Health FND11007 CCN1060230 SC770631 PRG133215 GRN-1004222 770000 Building Space Cost Allocation 18,941 --
E Human Services Grants Health FND11007 CCN1060230 SC730373 PRG133215 GRN-1004222 730000 Contractual Services 24,000 --
E Human Services Grants Health FND11007 CCN1060230 SC750168 PRG133215 GRN-1004222 750000 Medical Equipment 1,203 --
E Human Services Grants Health FND11007 CCN1060230 SC750392 PRG133215 GRN-1004222 750000 Metered Postage 1,050 --
E Human Services Grants Health FND11007 CCN1060230 SC730072 PRG133215 GRN-1004222 730000 Advertising 6,000 --
E Human Services Grants Health FND11007 CCN1060230 SC774637 PRG133215 GRN-1004222 770000 Info Tech Managed Print Svcs 7,860 --
E Human Services Grants Health FND11007 CCN1060230 SC750245 PRG133215 GRN-1004222 750000 Incentives 2,664 --
E Human Services Grants Health FND11007 CCN1060230 SC750399 PRG133215 GRN-1004222 750000 Office Supplies 1,250 --
E Human Services Grants Health FND11007 CCN1060230 SC750567 PRG133215 GRN-1004222 750000 Training-Educational Supplies 4,100 --
E Human Services Grants Health FND11007 CCN1060230 SC774636 PRG133215 GRN-1004222 770000 Info Tech Operations 164 --
E Human Services Grants Health FND11007 CCN1060230 SC774677 PRG133215 GRN-1004222 770000 Insurance Fund (3,975)--
E Human Services Grants Health FND11007 CCN1060230 SC778675 PRG133215 GRN-1004222 770000 Telephone Communications (2,100)--
Total Expenditures $62,000 $-$-
R Human Services Grants Health FND11007 CCN1060230 RC610313 PRG133215 GRN-1004223 610000 Federal Operating Grants $30,000 $-$-
Total Revenues $30,000 $-$-
E Human Services Grants Health FND11007 CCN1060230 SC702010 PRG133215 GRN-1004223 702000 Salaries Regular $14,839 $-$-
E Human Services Grants Health FND11007 CCN1060230 SC722740 PRG133215 GRN-1004223 722000 Fringe Benefits 8,153 --
E Human Services Grants Health FND11007 CCN1060230 SC730072 PRG133215 GRN-1004223 730000 Advertising 3,750 --
E Human Services Grants Health FND11007 CCN1060230 SC730926 PRG133215 GRN-1004223 730000 Indirect Costs (1,305)--
E Human Services Grants Health FND11007 CCN1060230 SC731346 PRG133215 GRN-1004223 730000 Personal Mileage 395 --
E Human Services Grants Health FND11007 CCN1060230 SC730373 PRG133215 GRN-1004223 730000 Contratual Services 16,000 --
E Human Services Grants Health FND11007 CCN1060230 SC731388 PRG133215 GRN-1004223 730000 Printing (2,068)--
E Human Services Grants Health FND11007 CCN1060230 SC731458 PRG133215 GRN-1004223 730000 Professional Services (12,800)--
E Human Services Grants Health FND11007 CCN1060230 SC731115 PRG133215 GRN-1004223 730000 Licenses and Permits 400 --
E Human Services Grants Health FND11007 CCN1060230 SC750294 PRG133215 GRN-1004223 750000 Material and Supplies (2,500)--
E Human Services Grants Health FND11007 CCN1060230 SC750301 PRG133215 GRN-1004223 750000 Medical Supplies (505)--
E Human Services Grants Health FND11007 CCN1060230 SC750567 PRG133215 GRN-1004223 750000 Training-Educational Supplies 813 --
E Human Services Grants Health FND11007 CCN1060230 SC774636 PRG133215 GRN-1004223 770000 Info Tech Operations 4,828 --
Total Expenditures $30,000 $-$-