Loading...
HomeMy WebLinkAboutResolutions - 2024.08.01 - 41402 AGENDA ITEM: Amendment #3 to the FY 2024 Local Health Department Comprehensive Agreement with the Michigan Department of Health and Human Services DEPARTMENT: Health & Human Services MEETING: Board of Commissioners DATE: Sunday, August 11, 2024 8:08 PM - Click to View Agenda ITEM SUMMARY SHEET COMMITTEE REPORT TO BOARD Resolution #2024-4227 Motion to approve Amendment #3 to the FY 2024 Local Health Department Agreement for funding in the amount of $680,883 for the period of October 1, 2023, through September 30, 2024; further, approve the attached Amendment #1 to the Subrecipient Agreement with Oakland Livingston Human Service Agency (OLSHA); further, authorize the Chair to execute attached amended agreement; further create a new union classification within the UAW, titled Community Health Worker, to be placed at salary grade 087/112, FLSA Status Non-Exempt and two (2) SR FTE Community Health Worker positions in the Health Division (#1060201); 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 #3 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 M.R. #2023-3305. Amendment #1 increased the funding to $12,189,775 and Amendment #2, approved via M.R. #24- 3808, increased the award amount to $14,312,350. Amendment #3 includes additional funding in the amount of $680,883, for a total award amount of $14,993,233. The Amendment provides funding in the amount of $382,000 to support critical public health infrastructure needs related to public health workforce, foundational capabilities, and data modernization. The FY 2024 Subrecipient Agreement between Oakland County and Oakland Livingston Human Service Agency (OLHSA), adopted on December 07, 2024, via MR #23-3575 for reimbursement of WIC Residential Services and WIC Breastfeeding and Peer Counseling services is amended to increase the reimbursement amount from $308,484 to $610,984, an increase of $2,500. BUDGET AMENDMENT REQUIRED: Yes Committee members can contact Michael Andrews, Chief of Staff 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 - 8/1/2024 AGENDA DEADLINE: 08/11/2024 6:00 PM ATTACHMENTS 1. Grant Review Sign-Off 2. Amend #3 Att IV 3. Draft contract amend #3 4. FY2024 LHD Agreement Grant Amedment 3 HR Write Up 5. Amend #3 Att I 6. Amend #3 Att III 7. OLHSA_FY24_Sub-Recipient_Contract - Signed 8. OLHSA budget WIC BF FY24 amendment 1 9. OLHSA contract amend FY24 10. OLHSA_FY24_Sub-Recipient_Contract - Signed 11. Amendment 1_OLHSA Subrecipient Agreement_7.12.24 12. PH&S_Health FY2024 LHD Amendment #3 COMMITTEE TRACKING 2024-07-23 Public Health & Safety - Forward to Finance 2024-07-24 Finance - Recommend to Board 2024-08-01 Full Board - Adopt Motioned by: Commissioner Yolanda Smith Charles Seconded by: Commissioner Linnie Taylor Yes: David Woodward, Penny Luebs, Karen Joliat, Christine Long, Robert Hoffman, Philip Weipert, Gwen Markham, Angela Powell, Marcia Gershenson, William Miller III, Yolanda Smith Charles, Charles Cavell, Brendan Johnson, Ajay Raman, Ann Erickson Gault, Linnie Taylor (16) No: None (0) Abstain: None (0) Absent: Michael Gingell, Michael Spisz, Kristen Nelson (3) Passed GRANT REVIEW SIGN-OFF – Health & Human Services / Health Division GRANT NAME: FY 2024 Local Health Department (Comprehensive) Agreement AWD00387 FUNDING AGENCY: Michigan Department of Health & Human Services DEPARTMENT CONTACT: Stacey Sledge 248-452-2151 STATUS: Grant Amendment #3 (Greater than 15% of award amount) DATE: 07/18/2024 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 (07/12/2024) Human Resources: Approved by Human Resources. Creates 1 new classification, and 2 FTE positions. HR action is needed; write up has been included. - Heather Mason (07/10/2024) Risk Management: Approved. Contract allows for governmental self-insurance and removes additional insured requirement. --Robert Erlenbeck (07/10/2024) Corporation Counsel: Approved. No legal issues with Amendment 3. – Sharon Kessler (07/12/2024) ATTACHMENT III MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES LOCAL HEALTH DEPARTMENT AGREEMENT October 1, 2023 – September 30, 2024 Fiscal Year 2024 PROGRAM SPECIFIC ASSURANCES AND REQUIREMENTS Local health service program elements funded under this agreement will be administered by the Grantee and the Department in accordance with the Public Health Code (P.A. 368 of 1978, as amended), rules promulgated under the Code, minimum program requirements and all other applicable Federal, State and Local laws, rules and regulations. These requirements are fulfilled through the following approach: A. Development and issuance of minimum program requirements, further describing the objective criteria for meeting requirements of law, rule, regulation, or professionally accepted methods or practices for the purpose of ensuring the quality, availability and effectiveness of services and activities. B. Utilization of a Minimum Reporting Requirements Notebook listing specific reporting formats, source documentation, timeframes and utilization needs for required local data compilation and transmission on program elements funded under this agreement. C. Utilization of annual program and budget instructions describing special program performance and funding policies and requirements unique to each State fiscal year. D. Execution of an agreement setting forth the basic terms and conditions for administration and local service delivery of the program elements. E. Emphasis and reliance upon service definitions, minimum program requirements, local budgets and projected output measures reports, State/local agreements, and periodic department on-site program management evaluation and audits, while minimizing local program plan detail beyond that needed for input on the State budget process. 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 Thomas Dunn dunnt2@michigan.gov Body Art Fixed Fee Seth Eckel eckels1@michigan.gov Breast & Cervical Cancer Control (BCCCP) Coordination Polly Hager hagerp@michigan.gov Bridge Access Program - Fixed Fee Kristina Paliwoda paliwodak@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 Child and Adolescent Health Center Renovation (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 Sara Pearson pearsons@michigan.govg g p @ gg Emerging Threats - Hepatitis C Macey Ladisky ladiskym@Michigan.gov Empowering Youth Today Robyn Corey coreyr1@michigan.gov Ending the HIV Epidemic Implementation Thomas Dunn dunnt2@michigan.gov Family Planning Services Steve Utter utters@michigan.gov Fetal Alcohol Spectrum Disorders Community Projects Michele Fanning Niles nilesm2@michigan.gov Fetal Infant Mortality Review (FIMR) Case Abstraction Nicholas Drzal / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov FFPSA HV Expansion Charisse Sanders sandersc2@michigan.gov FIMR Interviews Nicholas Drzal / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov Food ELPHS Carrie Fidler fidlerc@michigan.gov Gonococcal Isolate Surveillance Project Thomas Dunn dunnt2@michigan.gov Grief and Bereavement Michele Fanning Niles nilesm2@michigan.gov Harm Reduction Capacity Expansion Macey Ladisky ladiskym@Michigan.gov Harm Reduction Support Services Macey Ladisky ladiskym@Michigan.gov Hearing ELPHS Jennifer Dakers dakersj@michigan.gov HIV & STI Testing and Prevention Thomas Dunn dunnt2@michigan.gov HIV / STI Partner Services Thomas Dunn dunnt2@michigan.gov HIV Care Coordination Thomas Dunn dunnt2@michigan.gov HIV Data to Care Thomas Dunn dunnt2@michigan.gov HIV Housing Assistance Thomas Dunn dunnt2@michigan.gov HIV Linkage to Care Thomas Dunn dunnt2@michigan.gov HIV PrEP Clinic Thomas Dunn dunnt2@michigan.gov HIV PrEP Mobile Clinic Thomas Dunn dunnt2@michigan.gov HIV Prevention Thomas Dunn dunnt2@michigan.gov HIV Prevention - Forest Community Health Thomas Dunn dunnt2@michigan.gov HIV Ryan White Part B Thomas Dunn dunnt2@michigan.gov HIV Ryan White Part B MAI Thomas Dunn dunnt2@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 / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov Informed Consent Laura de la Rambelje delarambeljel@michigan.gov Integrating MPOX into STI Clinics Thomas Dunn dunnt2@michigan.gov Laboratory Services Bio Marty Soehnlen soehnlenm@michigan.gov Lactation Consultant Nicholas Drzal drzaln@michigan.gov Lead Hazard Control Chad Rhodes rhodesc2@michigan.gov Lead Health and Safety Courtney Wisinski MurtyC@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 Christine Farrell farrellc@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 tiptonj2@michigan.gov MRC STTRONG 6/1 - 9/30 Janis Tipton tiptonj2@michigan.gov Neighborhood Wellness Center Joseph Coyle greenj13@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 Thomas Dunn dunnt2@michigan.gov Statewide Lead Case Managment - Fixed Fee Carin Speidel speidelc@michigan.gov STI Specialty Services Thomas Dunn dunnt2@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: 9/30/2024 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: Bridge Access Program Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis The purpose of the project is to reimburse Local Health Departments (LHD) for COVID vaccine administration fees for vaccines administered under the Bridge Access Program. State of Michigan will allocate funds to LHDs for COVID vaccine administration fees. LHDs will be reimbursed $39.98 for each COVID vaccine administered to individuals eligible for the Bridge Access Program. The Bridge Access Program provides free COVID vaccine to under and uninsured adults aged 18 and older. Reporting Requirements (if different than contract language) All requests for reimbursement of the administration fee should be submitted monthly on the Comprehensive Financial Status Report (FSR). • NOTE: Reimbursement will be provided on a first come first served basis until funding has been depleted or the program comes to an end, whichever comes first. Any additional requirements (if applicable) LHDs participating in the Bridge Access Program must be visible on Vaccines.gov to participate in the program and must therefore indicate their vaccine availability. Instructions on how to manually indicate vaccine availability on Vaccines.gov can be found here. The Bridge Access Program does not require inventory reporting on Vaccines.gov. 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: 10/1/2023 End Date: 9/30/2024 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. Community Health Assessment & Improvement may be budgeted as part of the MDHHS- Other ELPHS budget. • 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 23/24 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 23/24, 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: • 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 January 1 – June 30 July 12 MDHHS Family Planning Inbox mdhhs- reproductivehealthunit@ michigan.gov 14) (Calendar 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. 49. Each grantee awarded an additional geographic service area (GSA) allocation in Fiscal Year 2024 (FY24) via the approved Family Planning funding formula must serve at least 25% of their additional GSA contracted caseload performance expectation. Each grantee’s FPAR data will be used to monitor contracted caseload performance. Year-end FPAR will be used to assess whether grantee has met the 25% contracted caseload performance expectation. 50. Grantees awarded contraceptive access funding in FY24 will use these funds to support access to a broad range of FDA-approved contraceptive methods on-site, including long-acting reversible contraceptives. These funds will be monitored via routine financial (e.g., financial status reports) and program oversight (e.g., FPAR, comprehensive site reviews) mechanisms. 51. Grantees awarded Chlamydia Quality Improvement/Quality Assurance (QI/QA) funding in FY24 will use these funds to support staff participation, implementation, and monitoring of an identified chlamydia screening QI/QA project. These funds will be monitored via routine financial (e.g., financial status reports) and program oversight (e.g. FPAR, comprehensive site reviews) mechanisms. 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 - Pilot Start Date: 11/1/2023 End Date: 6/30/2024 Project Synopsis The purpose of this project (also referred to as AA1) is to improve vaccination coverage among under-vaccinated populations and further prevent vaccine-preventable diseases in area jurisdictions throughout Michigan. The target population for this project is children aged 19 through 35 months of age living in Oscoda, Gladwin, and Houghton counties. The goal of this project is to improve vaccination coverage among this target population, as well as increase parents and the public’s understanding of the benefits of vaccines, raise awareness of the need for timely immunization, and to enhance confidence in the safety of vaccines. Reporting Requirements (if different than contract language Completion of the Quarterly Report Form. Reports and information should be emailed to: mdhhs-immsreports@michigan.gov. Any additional requirements (if applicable) 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. • Not allowable expenses include vehicles, food, alcoholic beverages, private stock vaccine purchases, building purchases, construction, capital improvement, entertainment costs, goods and services for personal use, and promotional and/or incentive material. 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. 10. Adhere to federal and state requirements regarding the use of programmatic funds. • Not allowable expenses include vehicles, food, alcoholic beverages, private stock vaccine purchases, building purchases, construction, capital improvement, entertainment costs, goods and services for personal use, and promotional and/or incentive material. 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 8 Month Project (MRCE) Start Date: 10/01/2023 End Date: 05/31/2024 4 Month Project (MRCF) Start Date: 6/1/2024 End Date: 9/30/2024 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: Neighborhood Wellness Centers Start Date: 5/1/2024 End Date: 9/30/2024 Project Synopsis To address health disparities in the community by providing healthcare services related to immunization, mobile health screenings, and preventive care for substance use and substance use disorder services, in collaboration with MDHHS/Neighborhood Wellness Centers. Reporting Requirements (if different than contract language) MDHHS TCC COVID-19 TESTING EVENTS DEMOGRAPHIC DATA SUBMISSIONS Vendors must provide to MDHHS TCC (Testing Collection and Coordination) team the individual demographic information on template provided from all Testing Events in the required format within 48 hours of event completion. This applies to any updated testing results as well. Questions asked and options for responses must remain identical to ensure user experience and data consistency at all events, regardless of vendor. An Excel template (<VendorName>COVIDTestingEventData.xlsx) has been provided that has the appropriate column headings, formats, and drop-down selections. Vendors may choose to export data from their own reporting tool and submit IF the datafile still follows the required naming conventions, fields, header names, formats and selection options. Datafile to be uploaded to the appropriate <VendorName>Data subfolder in the appropriate <VendorName> folder on SharePoint DTMB-Teams-COVID-Testing-Collection - MultiVendor - All Documents (sharepoint.com) Datafile can only be uploaded after access to the Vendor SharePoint Folder has been granted by the TCC Team. The list of who has the ability to upload should be given at vendor onboarding meetings. Subsequent staff updates or changes should be sent to MDHHS- COVIDTestingSupport@michigan.gov copying the TCC Team Implementation Managers (see staff directory). Any additional requirements (if applicable) 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. Project Title: Oral Health Kindergarten Assessment Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis: Local health departments (LHD) will perform no-cost oral health assessments on children enrolling into kindergarten or first grade and refer for dental treatment as assessment findings warrant. Additional Reporting Requirements: • The LHD shall submit quarterly progress reports on a form provided by the Contract Manager. These reports shall include a narrative description of program activities during the respective quarter. • The above reports shall be submitted via email directly to the Contract Manager no later than 30 days following the end of each quarter: Michele Kawabe, MPH, RD, CDCES Kindergarten Oral Health Assessment Program Consultant kawabem@michigan.gov Additional Requirements: • The LHD must be designated as a grantee health agency under P.A. 161 (MCL 333.1625) and permitted to operate as a Mobile Dental Facility within the state of Michigan unless the LHD subcontracts all assessments to an outside dental agency. Any agency that is subcontracted by an LHD to conduct assessments must be both designated as a grantee health agency under P.A. 161 and permitted to operate as a Mobile Dental Facility within the State of Michigan. • The LHD and any agency it subcontracts to perform oral health assessments must follow all applicable federal, state, and local laws, and all administrative rules, regulations, and ordinances, including those required for their PA 161 designation and mobile dental facility permit approval. • The LHD and any agency it subcontracts to perform oral health assessments must follow all guidance included in the Kindergarten Oral Health Assessment Program Guidelines. • The LHD shall develop an outreach plan to inform families, schools, daycare facilities, and other relevant stakeholders of KOHA. This plan shall include working collaboratively with school and other relevant community partners to publicize and host screening events. • The LHD shall conduct oral health assessments at a minimum rate of 50% of the total number of kindergarteners eligible for free or reduced lunch within the LHD’s jurisdiction; the assessments may be conducted by a subcontracted agency or agencies on behalf of the LHD. • The LHD and any subcontracted agencies shall adhere to all applicable safety and infection control standards while providing dental assessments. • The LHD shall attend scheduled meetings, calls, site visits, etc as requested by MDHHS and comply to all KOHA requirements as they are developed. 1 PROJECT: Public Health Emergency Preparedness (PHEP) and Cities Readiness Initiative (CRI) 9 Month Project – BIONINE/CRININE Start Date: 10/1/2023 End Date: 6/30/2024 3 Month Project – BIOTHREE/CRITHREE Start 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. 2 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, 3 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. 4 • 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. 5 • 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. 6 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 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 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), 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 2024, must be identified on the work plans submitted to the 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. 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: • 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 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, 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. 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. • 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: January 10 • January 1– March 31: April 10 • April 1 – June 30: July 10 • July 1– September 30: October 10 The provided progress report information will be included in the Quarterly SLFRF Narrative Report. • 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) • 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: 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: 10/1/2023 End Date: 9/30/2024 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: 10/1/2024 End Date: 9/30/2025 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. DR A F T 07/02/2024 Contract #: 20240239-02 Amendment Number: 3 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 $14,312,350 to $14,993,233, 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: 07/02/2024 __________________________________________________________________________ Page: 1 of 109 DR A F T 07/02/2024 1. CAHC Renovation (all locations) - New 2. Family 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 Bridge Access Program - Fixed Fee 0 0 0 Emerging Threats - Hepatitis C 166,000 122,107 288,107 Hearing ELPHS 253,969 6,000 259,969 Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 222,449 5,451 227,900 Public Health Emergency Preparedness (PHEP) 7/1- 9/30 0 74,150 74,150 Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 232,551 22,966 255,517 Public Health Emergency Preparedness (PHEP) CRI 7/1 - 9/30 0 62,209 62,209 Public Health Infrastructure 0 382,000 382,000 Vision ELPHS 253,968 6,000 259,968 Total Comprehensive Funding 1,128,937 680,883 1,809,820 Performance Level Adjustments N/A Budget category Adjustments Contract #Project Title E20241543-00 Body Art Fixed Fee E20241390-00 Children's Special Hlth Care Services (CSHCS) Care Coordination E20241322-00 Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy E20241318-00 CSHCS Medicaid Outreach E20241438-00 EGLE Drinking Water and Onsite Wastewater Management E20241539-00 Harm Reduction Support Services E20241791-00 Immunization Action Plan (IAP) E20241538-00 Immunization Vaccine Quality Assurance E20243105-00 Infant Safe Sleep E20242991-00 MCH - All Other E20242961-00 MCH - Children E20242168-00 MDHHS-Essential Local Public Health Services (ELPHS) E20243266-00 Medicaid Outreach E20241786-00 Nurse Family Partnership Services E20241439-00 Oral Health- Kindergarten Assessment E20241351-00 Tuberculosis (TB) Control E20241679-00 WIC Breastfeeding E20243218-00 WIC Resident Services Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 2 of 109 DR A F T 07/02/2024 It is understood and agreed that all other conditions of the original agreement remains the same. Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 3 of 109 DR A F T 07/02/2024 3.Signing this amendment The individual or officer signing this amendment certifies by their signature that they are authorized to sign this amendment on behalf of the responsible 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 06/04/2024 ___________________________________________________________________ Christine H. Sanches, Director Date Bureau of Purchasing Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 4 of 109 DR A F T 07/02/2024 Attachments Attachment I - Instructions for the Annual Budget Attachment III - Program Specific Assurances and Requirements Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 5 of 109 DR A F T Contract # Date: 07/02/2024 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Adolescent STI Screening Reg. Alloc.F 73,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Body Art Fixed Fee Calc. Amt.S 54,000 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Recepient Bridge Access Program - Fixed Fee Calc. Amt.39.98/Numbe rs Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient Children's Special Hlth Care Services (CSHCS) Care Coordination Calc. Amt.S 234,794 Fixed Unit Rate (1), (7) N/A N/A N/A N/A N/A Subrecepient Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy Reg. Alloc.F 179,587 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 179,587 CSHCS Medicaid Elevated Blood Lead Case Mgmt Calc. Amt.201.58/Vario us Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient CSHCS Vaccine Initiative Reg. Alloc.F 18,968 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Eastern Equine Encephalitis Virus Surveillance Project Reg. Alloc.F 15,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient EGLE Drinking Water and Onsite Wastewater Management Reg. Alloc.S 985,042 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient Emerging Threats - Hepatitis C Reg. Alloc.S 166,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Fetal Infant Mortality Review (FIMR) Case Abstraction Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient FIMR Interviews Calc. Amt.S 0 Fixed Unit Rate (2), (11) N/A N/A N/A N/A N/A Subrecepient Food ELPHS Reg. Alloc.S 2,180,647 ELPHS (3), (4)N/A N/A N/A N/A N/A Recepient Gonococcal Isolate Surveillance Project Reg. Alloc.F 5,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 16,500 Grief and Bereavement Reg. Alloc.S 23,529 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Local Health Department - 2024, Date: 07/02/2024 ________________________________________________________________________________________________________________ Page: 6 of 109 DR A F T Contract # Date: 07/02/2024 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Harm Reduction Support Services Reg. Alloc.F 370,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Hearing ELPHS Reg. Alloc.L 253,969 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient HIV PrEP Clinic Reg. Alloc.F 343,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 3,500 Reg. Alloc.S 3,500 HIV Prevention Reg. Alloc.F 22,612 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 22,612 Reg. Alloc.S 407,021 Immunization Action Plan (IAP)Reg. Alloc.F 526,990 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Immunization Fixed Fees Calc. Amt.S 0 Fixed Unit Rate (2), (7) N/A N/A N/A N/A N/A Subrecepient Immunization Vaccine Quality Assurance Reg. Alloc.S 105,347 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Infant Safe Sleep Reg. Alloc.F 7,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 63,000 Integrating MPOX into STI Clinics Reg. Alloc.F 6,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Laboratory Services Bio Reg. Alloc.F 1,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Local Health Department (LHD) Sharing Support Reg. Alloc.F 70,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient MCH - All Other Reg. Alloc.249,377 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MCH - All Other Local MCH S 249,377 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MCH - Children Reg. Alloc.72,080 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MCH - Children Local MCH S 72,080 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient Local Health Department - 2024, Date: 07/02/2024 ________________________________________________________________________________________________________________ Page: 7 of 109 DR A F T Contract # Date: 07/02/2024 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) MDHHS-Essential Local Public Health Services (ELPHS) Reg. Alloc.S 3,265,697 ELPHS (3),(6)N/A N/A N/A N/A N/A Recepient Nurse Family Partnership Services Reg. Alloc.F 442,524 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 295,016 Oral Health- Kindergarten Assessment Reg. Alloc.S 140,597 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 Reg. Alloc.F 222,449 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Emergency Preparedness (PHEP) 7/1- 9/30 Reg. Alloc.F 74,150 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 Reg. Alloc.F 232,551 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Emergency Preparedness (PHEP) CRI 7/1 - 9/30 Reg. Alloc.F 62,209 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Infrastructure Reg. Alloc.F 382,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Sexually Transmitted Infection (STI) Control Reg. Alloc.F 80,978 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 1,703 Reg. Alloc.S 87,584 Statewide Lead Case Management - Fixed Fee Calc. Amt.201.58/Vario us Fixed Unit Rate (7), (11) N/A N/A N/A N/A N/A Recepient Tuberculosis (TB) Control Reg. Alloc.F 15,426 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Vector-Borne Surveillance & Prevention Reg. Alloc.S 9,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Vision ELPHS Reg. Alloc.L 253,968 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient West Nile Virus Community Surveillance Reg. Alloc.F 10,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Local Health Department - 2024, Date: 07/02/2024 ________________________________________________________________________________________________________________ Page: 8 of 109 DR A F T Contract # Date: 07/02/2024 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) WIC Breastfeeding Reg. Alloc.F 267,619 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient WIC Resident Services Reg. Alloc.F 2,615,870 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient TOTAL MDHHS FUNDING 15,440,960 *SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Attachment IV Notes Local Health Department - 2024, Date: 07/02/2024 ________________________________________________________________________________________________________________ Page: 9 of 109 DR A F T Contract # Date: 07/02/2024 Project Budgets 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 123,254.00 123,254.00 2 Fringe Benefits 67,081.00 67,081.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 14,162.00 14,162.00 6 Travel 0.00 0.00 7 Communication 1,980.00 1,980.00 8 County-City Central Services 0.00 0.00 9 Space Costs 7,643.00 7,643.00 10 All Others (ADP, Con. Employees, Misc.)14,823.00 14,823.00 Total Program Expenses 228,943.00 228,943.00 TOTAL DIRECT EXPENSES 228,943.00 228,943.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 47,276.00 47,276.00 Total Indirect Costs 47,276.00 47,276.00 TOTAL INDIRECT EXPENSES 47,276.00 47,276.00 TOTAL EXPENDITURES 276,219.00 276,219.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 10 of 109 DR A F T Contract # Date: 07/02/2024 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 22,245.00 0.00 22,245.00 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 222,449.00 222,449.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 31,525.00 0.00 31,525.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 276,219.00 222,449.00 53,770.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 11 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Chief Public Health Notes : PO00015362 Marci Wiegers, Chief Public Health Match $9,197 0.0938 98049.000 0.000 FTE 9,197.00 Coordinator Notes : PO00003094 Samantha Montney Health Program Coodinator 0.7500 95352.000 0.000 71,514.00 Specialist Notes : PO00007416 Lyndsey Chiasson Public Health Emergency Preparedness Specialist 0.5962 71357.000 0.000 42,543.00 Total for Salary & Wages 123,254.00 2 Fringe Benefits Composite Rate Notes : MATCH $5,405 FICA Unemp Ins Retirement Hospital Ins Life Ins Vision Ins Short/Long Term Disability Dental Ins Work Comp 0.0000 54.425 123254.000 67,081.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 1,024.00 Disaster Supplies 0.0000 0.000 0.000 13,138.00 Total for Supplies and Materials 14,162.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 12 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total 6 Travel 7 Communication Telephone Communications 0.0000 0.000 0.000 1,980.00 8 County-City Central Services 9 Space Costs Building Space Rental Notes : MATCH $7,643 0.0000 0.000 0.000 7,643.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.0000 0.000 0.000 873.00 IT Operations 0.0000 0.000 0.000 11,100.00 Interpretation Fees 0.0000 0.000 0.000 600.00 Print services 0.0000 0.000 0.000 2,250.00 Total for All Others (ADP, Con. Employees, Misc.)14,823.00 Total Program Expenses 228,943.00 TOTAL DIRECT EXPENSES 228,943.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 15,751.00 Health Adm Distribution 0.0000 0.000 0.000 31,525.00 Total for Cost Allocation Plan / Other 47,276.00 Total Indirect Costs 47,276.00 TOTAL INDIRECT EXPENSES 47,276.00 TOTAL EXPENDITURES 276,219.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 13 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Body Art Fixed Fee DATE PREPARED 7/2/2024 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 # 3 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 54,000.00 54,000.00 Total Indirect Costs 54,000.00 54,000.00 TOTAL INDIRECT EXPENSES 54,000.00 54,000.00 TOTAL EXPENDITURES 54,000.00 54,000.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 14 of 109 DR A F T Contract # Date: 07/02/2024 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 54,000.00 54,000.00 0.00 0.00 Totals 54,000.00 54,000.00 0.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 15 of 109 DR A F T Contract # Date: 07/02/2024 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 54,000.00 Total Indirect Costs 54,000.00 TOTAL INDIRECT EXPENSES 54,000.00 TOTAL EXPENDITURES 54,000.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 16 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Children's Special Hlth Care Services (CSHCS) Care Coordination DATE PREPARED 7/2/2024 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 # 3 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: 07/02/2024 __________________________________________________________________________ Page: 17 of 109 DR A F T Contract # Date: 07/02/2024 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: 07/02/2024 __________________________________________________________________________ Page: 18 of 109 DR A F T Contract # Date: 07/02/2024 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: 07/02/2024 __________________________________________________________________________ Page: 19 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / CSHCS Medicaid Outreach DATE PREPARED 7/2/2024 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 # 3 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 299,577.00 299,577.00 Total Indirect Costs 299,577.00 299,577.00 TOTAL INDIRECT EXPENSES 299,577.00 299,577.00 TOTAL EXPENDITURES 299,577.00 299,577.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 20 of 109 DR A F T Contract # Date: 07/02/2024 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 114,768.00 114,768.00 0.00 0.00 Required Match - Local 114,768.00 0.00 114,768.00 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 70,041.00 0.00 70,041.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 299,577.00 114,768.00 184,809.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 21 of 109 DR A F T Contract # Date: 07/02/2024 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 0.000 299,577.00 Total Indirect Costs 299,577.00 TOTAL INDIRECT EXPENSES 299,577.00 TOTAL EXPENDITURES 299,577.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 22 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 DATE PREPARED 7/2/2024 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 # 3 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 49,103.00 49,103.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 7,692.00 7,692.00 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 9,000.00 9,000.00 10 All Others (ADP, Con. Employees, Misc.)85,572.00 85,572.00 Total Program Expenses 249,447.00 249,447.00 TOTAL DIRECT EXPENSES 249,447.00 249,447.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 38,744.00 38,744.00 Total Indirect Costs 38,744.00 38,744.00 TOTAL INDIRECT EXPENSES 38,744.00 38,744.00 TOTAL EXPENDITURES 288,191.00 288,191.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 23 of 109 DR A F T Contract # Date: 07/02/2024 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 23,255.00 0.00 23,255.00 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 232,551.00 232,551.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 32,385.00 0.00 32,385.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 288,191.00 232,551.00 55,640.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 24 of 109 DR A F T Contract # Date: 07/02/2024 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 55.677 88192.000 49,103.00 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 6,692.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 25 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Total for Supplies and Materials 7,692.00 6 Travel Mileage Notes : 0.67 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 9,000.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.0000 0.000 0.000 558.00 IT Operations 0.0000 0.000 0.000 57,514.00 Professional Services 0.0000 0.000 0.000 25,000.00 Membership Dues 0.0000 0.000 0.000 2,500.00 Total for All Others (ADP, Con. Employees, Misc.)85,572.00 Total Program Expenses 249,447.00 TOTAL DIRECT EXPENSES 249,447.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 6,359.00 Health Adm Distribution 0.0000 0.000 0.000 32,385.00 Total for Cost Allocation Plan / Other 38,744.00 Total Indirect Costs 38,744.00 TOTAL INDIRECT EXPENSES 38,744.00 TOTAL EXPENDITURES 288,191.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 26 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy DATE PREPARED 7/2/2024 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 # 3 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 27,390.00 27,390.00 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.)123,637.00 123,637.00 Total Program Expenses 573,119.00 573,119.00 TOTAL DIRECT EXPENSES 573,119.00 573,119.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other -213,945.00 -213,945.00 Total Indirect Costs -213,945.00 -213,945.00 TOTAL INDIRECT EXPENSES -213,945.00 -213,945.00 TOTAL EXPENDITURES 359,174.00 359,174.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 27 of 109 DR A F T Contract # Date: 07/02/2024 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 359,174.00 359,174.00 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 359,174.00 359,174.00 0.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 28 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Clerk Notes : PH Clerk 2 - B. Smith PO# 5129 1.0000 51140.000 0.000 FTE 51,140.00 Supervisor Notes : PH Nursing Supervisor - L. Bauer PO# 5130 1.0000 101871.000 0.000 FTE 101,871.00 Nurse Notes : PH Nurse 3 - M. Cresmen PO# 5163 0.4808 67173.460 0.000 FTE 32,297.00 Clerk Notes : PH Clerk 2 - V. Arrowsmith PO# 6824 1.0000 49928.000 0.000 FTE 49,928.00 Clerk Notes : Auxiliary Health Clerk - P. Lewis-Jones PO# 7839 0.4808 27106.000 0.000 FTE 13,032.00 Clerk Notes : Office Support Clerk - S. Doll PO# 12442 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 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 29 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Rounding 0.0000 100.000 2.000 2.00 Total for Fringe Benefits 121,261.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 5,000.00 Postage 0.0000 0.000 0.000 3,600.00 Printing 0.0000 0.000 0.000 5,600.00 Medical Supplies 0.0000 0.000 0.000 2,000.00 Training - Educational Supplies 0.0000 0.000 0.000 11,190.00 Total for Supplies and Materials 27,390.00 6 Travel Mileage Notes : 0.67 per mile 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 13,500.00 Interpretation Fees 0.0000 0.000 0.000 2,000.00 Software Rental Lease Purchase 0.0000 0.000 0.000 4,000.00 Advertising 0.0000 0.000 0.000 35,000.00 Training 0.0000 0.000 0.000 10,000.00 Expendable Equipment 0.0000 0.000 0.000 1,500.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 30 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Total for All Others (ADP, Con. Employees, Misc.)123,637.00 Total Program Expenses 573,119.00 TOTAL DIRECT EXPENSES 573,119.00 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 75,285.00 Other Cost Distributions-Nursing Staff 0.0000 0.000 0.000 185,276.00 Nursing Adm Distribution 0.0000 0.000 0.000 39,016.00 Other Cost Distributions-CSHCS - Medicaid Outreach 0.0000 0.000 0.000 -299,577.00 Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 20,849.00 Total for Cost Allocation Plan / Other -213,945.00 Total Indirect Costs -213,945.00 TOTAL INDIRECT EXPENSES -213,945.00 TOTAL EXPENDITURES 359,174.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 31 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / MCH - Children DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 45,890.00 45,890.00 2 Fringe Benefits 25,547.00 25,547.00 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 643.00 643.00 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 72,080.00 72,080.00 TOTAL DIRECT EXPENSES 72,080.00 72,080.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 9,288.00 9,288.00 Total Indirect Costs 9,288.00 9,288.00 TOTAL INDIRECT EXPENSES 9,288.00 9,288.00 TOTAL EXPENDITURES 81,368.00 81,368.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 32 of 109 DR A F T Contract # Date: 07/02/2024 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 72,080.00 72,080.00 0.00 0.00 Local Funds - Other 9,288.00 0.00 9,288.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 81,368.00 72,080.00 9,288.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 33 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Nutritionist/Dietician Notes : Melinda Blesch P0005401 PH Nutritionist 3 83134.0000 0.552 0.000 FTE 45,890.00 2 Fringe Benefits Composite Rate Notes : FICA Unemployment Retirement Hosp Life Insurance Vision Dental Workers Comp Short and Long Term Disability 0.0000 55.670 45890.000 25,547.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel Mileage Notes : $0.655 per mile 0.0000 0.000 0.000 643.00 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Total Program Expenses 72,080.00 TOTAL DIRECT EXPENSES 72,080.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 34 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Health Adm Distribution 0.0000 0.000 0.000 9,288.00 Total Indirect Costs 9,288.00 TOTAL INDIRECT EXPENSES 9,288.00 TOTAL EXPENDITURES 81,368.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 35 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Emerging Threats - Hepatitis C DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 82,457.00 82,457.00 2 Fringe Benefits 52,459.00 52,459.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 3,740.00 3,740.00 6 Travel 2,155.00 2,155.00 7 Communication 1,080.00 1,080.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)12,722.00 12,722.00 Total Program Expenses 154,613.00 154,613.00 TOTAL DIRECT EXPENSES 154,613.00 154,613.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 32,773.00 32,773.00 Total Indirect Costs 32,773.00 32,773.00 TOTAL INDIRECT EXPENSES 32,773.00 32,773.00 TOTAL EXPENDITURES 187,386.00 187,386.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 36 of 109 DR A F T Contract # Date: 07/02/2024 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 166,000.00 166,000.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 21,386.00 0.00 21,386.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 187,386.00 166,000.00 21,386.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 37 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Public Health Nurse Notes : PHN III Sasha Mievski Position P00007565 1.0000 82457.000 0.000 FTE 82,457.00 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 63.620 82457.000 52,459.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Postage 0.0000 0.000 0.000 56.00 Office Supplies 0.0000 0.000 0.000 500.00 Medical Supplies 0.0000 0.000 0.000 1,184.00 Drugs 0.0000 0.000 0.000 1,500.00 Educational Supplies 0.0000 0.000 0.000 500.00 Total for Supplies and Materials 3,740.00 6 Travel Mileage Notes : 1000 miles @ 0.655 per mile 0.0000 0.000 0.000 655.00 Conferences 0.0000 0.000 0.000 1,500.00 Total for Travel 2,155.00 7 Communication Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 38 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Telephone Communications 0.0000 0.000 0.000 1,080.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) IT Operations 0.0000 0.000 0.000 3,352.00 Insurance 0.0000 0.000 0.000 1,370.00 Incentives 0.0000 0.000 0.000 1,000.00 Lab Fees 0.0000 0.000 0.000 1,500.00 Advertising 0.0000 0.000 0.000 5,000.00 Staff Training 0.0000 0.000 0.000 500.00 Total for All Others (ADP, Con. Employees, Misc.)12,722.00 Total Program Expenses 154,613.00 TOTAL DIRECT EXPENSES 154,613.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 11,387.00 Health Adm Distribution 0.0000 0.000 0.000 21,386.00 Total for Cost Allocation Plan / Other 32,773.00 Total Indirect Costs 32,773.00 TOTAL INDIRECT EXPENSES 32,773.00 TOTAL EXPENDITURES 187,386.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 39 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Hearing ELPHS DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 366,263.00 366,263.00 2 Fringe Benefits 114,248.00 114,248.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 9,778.00 9,778.00 6 Travel 9,189.00 9,189.00 7 Communication 1,071.00 1,071.00 8 County-City Central Services 0.00 0.00 9 Space Costs 7,773.00 7,773.00 10 All Others (ADP, Con. Employees, Misc.)9,512.00 9,512.00 Total Program Expenses 517,834.00 517,834.00 TOTAL DIRECT EXPENSES 517,834.00 517,834.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 473,090.00 473,090.00 Total Indirect Costs 473,090.00 473,090.00 TOTAL INDIRECT EXPENSES 473,090.00 473,090.00 TOTAL EXPENDITURES 990,924.00 990,924.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 40 of 109 DR A F T Contract # Date: 07/02/2024 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 253,969.00 253,969.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 736,955.00 0.00 736,955.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 990,924.00 253,969.00 736,955.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 41 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Supervisor Notes : Lynn Covarubbias Position P00001402 Hearing and Vision Tech Supervisor 1.0000 72818.000 0.000 FTE 72,818.00 Technician Notes : Casey Sinacola Position P00000631 PH Tech 0.4567 45581.000 0.000 FTE 20,818.00 Technician Notes : Charlene Whitt Position P00012314 PH Tech 0.2404 41872.000 0.000 FTE 10,066.00 Technician Notes : Therese Spedding Position P00012320 PH Tech 0.3365 43732.000 0.000 FTE 14,716.00 Technician Notes : Vacant Position P00012321 PH Tech 0.3966 38169.000 0.000 FTE 15,139.00 Technician Notes : Cindy Vieregge Position P00012323 PH Tech 0.4567 43728.000 0.000 FTE 19,972.00 Technician Notes : Adrienne Lynch Position P000000642 PH Tech 0.4567 45581.000 0.000 FTE 20,818.00 Technician Notes : Diane Roeder Position P00010837 PH Tech 0.4567 49286.000 0.000 FTE 22,510.00 Technician Notes : Karen McPherson Position P00010838 PH Tech 0.4567 40022.000 0.000 FTE 18,279.00 Technician Notes : Denise Gaarder Position P00010841 PH Tech 0.4567 40022.000 0.000 FTE 18,279.00 Technician Notes : Vacant Position 0.4567 38169.000 0.000 FTE 17,433.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 42 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total P00010842 PH Tech Supervisor Notes : Diane Ferber Position P00001917 Hearing and Vision Program Supervisor 0.5000 106316.000 0.000 FTE 53,158.00 Auxillary Health Clerk Notes : Billie-Jean Wright Position P00006736 Aux Health Clerk 0.7000 56381.000 0.000 FTE 39,467.00 Clerk Notes : Soon to be vacant Position P00002891 PH Clerk 2 0.5000 45580.000 0.000 FTE 22,790.00 Total for Salary & Wages 366,263.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT/LONG TERM DISABILITY 0.0000 31.193 366263.000 114,248.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 942.00 Printing 0.0000 0.000 0.000 1,927.00 Postage 0.0000 0.000 0.000 6,110.00 Medical Supplies 0.0000 0.000 0.000 799.00 Total for Supplies and Materials 9,778.00 6 Travel Personal Mileage Notes : 0.655 PER MILE 0.0000 0.000 0.000 9,189.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 43 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total 7 Communication Telephone 0.0000 0.000 0.000 1,071.00 8 County-City Central Services 9 Space Costs Space/Rental Costs 0.0000 0.000 0.000 7,773.00 10 All Others (ADP, Con. Employees, Misc.) IT Print Services 0.0000 0.000 0.000 300.00 Insurance 0.0000 0.000 0.000 3,336.00 Equipment Repair 0.0000 0.000 0.000 1,434.00 Staff Training 0.0000 0.000 0.000 2,021.00 Interpreter Fees 0.0000 0.000 0.000 71.00 Expendable Equipment 0.0000 0.000 0.000 2,350.00 Total for All Others (ADP, Con. Employees, Misc.)9,512.00 Total Program Expenses 517,834.00 TOTAL DIRECT EXPENSES 517,834.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Health Adm Distribution 0.0000 0.000 0.000 73,231.00 Other Cost Distributions-Misc Distributions 0.0000 0.000 0.000 349,278.00 Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 50,581.00 Total for Cost Allocation Plan / Other 473,090.00 Total Indirect Costs 473,090.00 TOTAL INDIRECT EXPENSES 473,090.00 TOTAL EXPENDITURES 990,924.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 44 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Harm Reduction Support Services DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 67,962.00 67,962.00 2 Fringe Benefits 41,985.00 41,985.00 3 Cap. Exp. for Equip & Fac.121,154.00 121,154.00 4 Contractual 0.00 0.00 5 Supplies and Materials 30,415.00 30,415.00 6 Travel 5,828.00 5,828.00 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.)60,064.00 60,064.00 Total Program Expenses 364,529.00 364,529.00 TOTAL DIRECT EXPENSES 364,529.00 364,529.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 52,313.00 52,313.00 Total Indirect Costs 52,313.00 52,313.00 TOTAL INDIRECT EXPENSES 52,313.00 52,313.00 TOTAL EXPENDITURES 416,842.00 416,842.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 45 of 109 DR A F T Contract # Date: 07/02/2024 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 370,000.00 370,000.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 46,842.00 0.00 46,842.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 416,842.00 370,000.00 46,842.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 46 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Social Worker 67962.0000 1.000 0.000 FTE 67,962.00 2 Fringe Benefits Composite Rate 0.0000 61.777 67962.000 41,985.00 3 Cap. Exp. for Equip & Fac. Vehicle 0.0000 0.000 0.000 120,000.00 Vehicle Storage/Maintenance 0.0000 0.000 0.000 1,154.00 Total for Cap. Exp. for Equip & Fac.121,154.00 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 1,500.00 Materials and Supplies 0.0000 0.000 0.000 12,915.00 Printing 0.0000 0.000 0.000 1,500.00 Medical Supplies 0.0000 0.000 0.000 10,000.00 Educational Supplies 0.0000 0.000 0.000 1,000.00 Drugs 0.0000 0.000 0.000 1,500.00 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 30,415.00 6 Travel Transportation of Clients 0.0000 0.000 0.000 2,500.00 Conferences 0.0000 0.000 0.000 3,000.00 Mileage Notes : 0.67 per mile 0.0000 0.000 0.000 328.00 Total for Travel 5,828.00 7 Communication Telephone Communications 0.0000 0.000 0.000 1,980.00 WiFi 0.0000 0.000 0.000 2,741.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 47 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total 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 Total for Space Costs 32,400.00 10 All Others (ADP, Con. Employees, Misc.) Professional Services 0.0000 0.000 0.000 43,000.00 IT Operations 0.0000 0.000 0.000 6,704.00 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.)60,064.00 Total Program Expenses 364,529.00 TOTAL DIRECT EXPENSES 364,529.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Health Adm Distribution 0.0000 0.000 0.000 46,842.00 Cost Allocation Plan 0.0000 0.000 0.000 5,471.00 Total for Cost Allocation Plan / Other 52,313.00 Total Indirect Costs 52,313.00 TOTAL INDIRECT EXPENSES 52,313.00 TOTAL EXPENDITURES 416,842.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 48 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Immunization Action Plan (IAP) DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 300,752.00 300,752.00 2 Fringe Benefits 179,426.00 179,426.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 570.00 570.00 6 Travel 0.00 0.00 7 Communication 3,180.00 3,180.00 8 County-City Central Services 0.00 0.00 9 Space Costs 9,047.00 9,047.00 10 All Others (ADP, Con. Employees, Misc.)17,481.00 17,481.00 Total Program Expenses 510,456.00 510,456.00 TOTAL DIRECT EXPENSES 510,456.00 510,456.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 124,771.00 124,771.00 Total Indirect Costs 124,771.00 124,771.00 TOTAL INDIRECT EXPENSES 124,771.00 124,771.00 TOTAL EXPENDITURES 635,227.00 635,227.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 49 of 109 DR A F T Contract # Date: 07/02/2024 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)25,000.00 0.00 25,000.00 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 526,990.00 526,990.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 83,237.00 0.00 83,237.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 635,227.00 526,990.00 108,237.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 50 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Supervisor Notes : Immunization Program Supervisor Letha Martin Position P00002070 1.0000 104093.000 0.000 FTE 104,093.00 Coordinator Notes : Vaccine Supply Coordinator Sean Crottie Position P00007559 1.0000 62161.000 0.000 FTE 62,161.00 Public Health Nurse Notes : Heather Webber Position P00007413 PH Nurse 2 0.3726 67177.000 0.000 FTE 25,030.00 Office Leader Notes : Jacqueline Vermilya Position P00007414 Office Leader 1.0000 53696.000 0.000 FTE 53,696.00 Clerk Notes : Meghan Rompa Position P00007415 PH Clerk 2 1.0000 51140.000 0.000 FTE 51,140.00 Coordinator Notes : Irene Highfield Position P00002436 Vaccine Supply Coordinator 0.0745 62161.000 0.000 FTE 4,632.00 Total for Salary & Wages 300,752.00 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 59.659 300752.000 179,426.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 51 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Insurance 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Postage 0.0000 0.000 0.000 570.00 6 Travel 7 Communication Telephone 0.0000 0.000 0.000 3,180.00 8 County-City Central Services 9 Space Costs Building Space Rental 0.0000 0.000 0.000 9,047.00 10 All Others (ADP, Con. Employees, Misc.) IT Operations 0.0000 0.000 0.000 13,132.00 Insurance 0.0000 0.000 0.000 4,349.00 Total for All Others (ADP, Con. Employees, Misc.)17,481.00 Total Program Expenses 510,456.00 TOTAL DIRECT EXPENSES 510,456.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Other Cost Distributions-Nurse Train/VFC/AFIX 0.0000 0.000 0.000 -25,000.00 Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 41,534.00 Health Adm Distribution 0.0000 0.000 0.000 71,115.00 Nursing Adm Distribution 0.0000 0.000 0.000 37,122.00 Total for Cost Allocation Plan / Other 124,771.00 Total Indirect Costs 124,771.00 TOTAL INDIRECT EXPENSES 124,771.00 TOTAL EXPENDITURES 635,227.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 52 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Infant Safe Sleep DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 11,860.00 11,860.00 2 Fringe Benefits 5,974.00 5,974.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 27,853.00 27,853.00 6 Travel 5,700.00 5,700.00 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.)16,435.00 16,435.00 Total Program Expenses 68,362.00 68,362.00 TOTAL DIRECT EXPENSES 68,362.00 68,362.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 15,386.00 15,386.00 Total Indirect Costs 15,386.00 15,386.00 TOTAL INDIRECT EXPENSES 15,386.00 15,386.00 TOTAL EXPENDITURES 83,748.00 83,748.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 53 of 109 DR A F T Contract # Date: 07/02/2024 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 70,000.00 70,000.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 13,748.00 0.00 13,748.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 83,748.00 70,000.00 13,748.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 54 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Health Educator Notes : PH Educator III Pos#P00006735 Carla Roseman 0.0769 70440.000 0.000 FTE 5,417.00 Chief Public Health Notes : Chief PH Pos#P00000733 Lisa Hahn 0.0101 111632.000 0.000 FTE 1,127.00 Supervisor Notes : PH Nursing Supervisor Pos#P00000865 David Roth 0.0500 106316.000 0.000 FTE 5,316.00 Total for Salary & Wages 11,860.00 2 Fringe Benefits Composite Rate Notes : FICA, UNEMP INS, RETIREMENT, HOSPITAL INS, LIFE INS, VISION INS, SHORT/LONG TERM DISABILITY, DENTAL INS, WORK COMP 0.0000 50.370 11860.000 5,974.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 225.00 Incentives 0.0000 0.000 0.000 4,900.00 Supplies & Materials Notes : BF Gift Bag Supplies 0.0000 0.000 0.000 646.00 Postage Notes : Safety Fair 0.0000 0.000 0.000 1,000.00 Training - Educational Supplies Notes : Safety Fair Ed supplies items 0.0000 0.000 0.000 12,200.00 Printing Notes : Safety Fair Ed supplies 0.0000 0.000 0.000 8,882.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 55 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total items Total for Supplies and Materials 27,853.00 6 Travel Conferences Notes : Staff Training, MALC Conference, Charlies Safe Sleep Conference (PA), MIHS 0.0000 0.000 0.000 5,700.00 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.) IT Operations 0.0000 0.000 0.000 3,352.00 Interpretation Fees Notes : Translate ISS Books and Baby Shower Gift Cards 0.0000 0.000 0.000 583.00 Advertising Notes : Social Media posts, bus ads, Metro Parent 0.0000 0.000 0.000 3,500.00 Staff Training Notes : IBCLC and CLC Certifications 0.0000 0.000 0.000 9,000.00 Total for All Others (ADP, Con. Employees, Misc.)16,435.00 Total Program Expenses 68,362.00 TOTAL DIRECT EXPENSES 68,362.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 1,638.00 Health Adm Distribution 0.0000 0.000 0.000 9,020.00 Nursing Adm Distribution 0.0000 0.000 0.000 4,728.00 Total for Cost Allocation Plan / Other 15,386.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 56 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Total Indirect Costs 15,386.00 TOTAL INDIRECT EXPENSES 15,386.00 TOTAL EXPENDITURES 83,748.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 57 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Nurse Family Partnership Services DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 390,800.00 390,800.00 2 Fringe Benefits 205,545.00 205,545.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 24,000.00 24,000.00 5 Supplies and Materials 25,103.00 25,103.00 6 Travel 22,790.00 22,790.00 7 Communication 3,000.00 3,000.00 8 County-City Central Services 0.00 0.00 9 Space Costs 18,941.00 18,941.00 10 All Others (ADP, Con. Employees, Misc.)47,360.00 47,360.00 Total Program Expenses 737,539.00 737,539.00 TOTAL DIRECT EXPENSES 737,539.00 737,539.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 141,813.00 141,813.00 Total Indirect Costs 141,813.00 141,813.00 TOTAL INDIRECT EXPENSES 141,813.00 141,813.00 TOTAL EXPENDITURES 879,352.00 879,352.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 58 of 109 DR A F T Contract # Date: 07/02/2024 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 737,540.00 737,540.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 141,812.00 0.00 141,812.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 879,352.00 737,540.00 141,812.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 59 of 109 DR A F T Contract # Date: 07/02/2024 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 0.3918 80848.000 0.000 FTE 31,676.00 Public Health Nurse Notes : Susan Martinez Position P00000906 PH Nurse 3 1.0000 80841.000 0.000 FTE 80,841.00 Public Health Nurse Notes : Tamera Gordon Position P00003107 PH Nurse 3 1.0000 80841.000 0.000 FTE 80,841.00 Public Health Nurse Notes : Marybeth Reader Position P00003183 PH Nurse 3 0.5000 80841.000 0.000 FTE 40,421.00 Public Health Nurse Notes : Katie Smedley Positon P00000752 PH Nurse 3 1.0000 80841.000 0.000 FTE 80,841.00 Coordinator Notes : Michele Maloff Position P00004736 Health Program Coordinator 0.8029 93621.000 0.000 FTE 75,168.00 Overtime (PHN)0.0100 101200.000 0.000 1,012.00 Total for Salary & Wages 390,800.00 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 52.596 390800.000 205,545.00 3 Cap. Exp. for Equip & Fac. Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 60 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total 4 Contractual NFP Nurse Consultation 0.0000 0.000 0.000 24,000.00 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 2,750.00 Educational Supplies 0.0000 0.000 0.000 6,600.00 Printing 0.0000 0.000 0.000 2,000.00 Workshops and Meetings 0.0000 0.000 0.000 5,000.00 Metered Postage 0.0000 0.000 0.000 1,050.00 Incentives 0.0000 0.000 0.000 6,500.00 Medical Supplies 0.0000 0.000 0.000 1,203.00 Total for Supplies and Materials 25,103.00 6 Travel Mileage Notes : 0.67 per mile 0.0000 0.000 0.000 11,790.00 Conferences 0.0000 0.000 0.000 11,000.00 Total for Travel 22,790.00 7 Communication Telephone Communications 0.0000 0.000 0.000 3,000.00 8 County-City Central Services 9 Space Costs Space/Rental Costs 0.0000 0.000 0.000 18,941.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.0000 0.000 0.000 1,600.00 IT Operations-laptops 0.0000 0.000 0.000 18,400.00 Staff Training 0.0000 0.000 0.000 1,500.00 Translation and Interpretation 0.0000 0.000 0.000 12,000.00 IT Managed Print Services 0.0000 0.000 0.000 7,860.00 Advertising 0.0000 0.000 0.000 6,000.00 Total for All Others (ADP, Con. Employees, Misc.)47,360.00 Total Program Expenses 737,539.00 TOTAL DIRECT EXPENSES 737,539.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 61 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Health Adm Distribution 0.0000 0.000 0.000 93,373.00 Nursing Adm Distribution 0.0000 0.000 0.000 48,440.00 Total for Cost Allocation Plan / Other 141,813.00 Total Indirect Costs 141,813.00 TOTAL INDIRECT EXPENSES 141,813.00 TOTAL EXPENDITURES 879,352.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 62 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Oral Health- Kindergarten Assessment DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 58,243.00 58,243.00 2 Fringe Benefits 28,228.00 28,228.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 16,000.00 16,000.00 5 Supplies and Materials 16,491.00 16,491.00 6 Travel 3,515.00 3,515.00 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.)12,891.00 12,891.00 Total Program Expenses 135,908.00 135,908.00 TOTAL DIRECT EXPENSES 135,908.00 135,908.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 22,489.00 22,489.00 Total Indirect Costs 22,489.00 22,489.00 TOTAL INDIRECT EXPENSES 22,489.00 22,489.00 TOTAL EXPENDITURES 158,397.00 158,397.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 63 of 109 DR A F T Contract # Date: 07/02/2024 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 140,597.00 140,597.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 17,800.00 0.00 17,800.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 158,397.00 140,597.00 17,800.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 64 of 109 DR A F T Contract # Date: 07/02/2024 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 0.4808 51138.000 0.000 FTE 24,587.00 Coordinator Notes : Health Program Coordinator Pos#P00002466 Lisa Dobias 0.2053 75467.000 0.000 FTE 15,493.00 Dental Hygenist Notes : PH Dental Hygenist Pos#P00015844 VACANT 0.2404 75555.000 0.000 FTE 18,163.00 Total for Salary & Wages 58,243.00 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 48.466 58243.000 28,228.00 3 Cap. Exp. for Equip & Fac. 4 Contractual Professional Services Notes : Dr. Joe Przeslawski - $3,000 Entech - $13,000 0.0000 0.000 0.000 16,000.00 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 500.00 Postage 0.0000 0.000 0.000 250.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 65 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Printing 0.0000 0.000 0.000 3,186.00 Medical Supplies 0.0000 0.000 0.000 7,995.00 Educational Supplies 0.0000 0.000 0.000 4,560.00 Total for Supplies and Materials 16,491.00 6 Travel Mileage Notes : 4500miles * 0.67 per mile 0.0000 0.000 0.000 3,015.00 Conferences 0.0000 0.000 0.000 500.00 Total for Travel 3,515.00 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 4,750.00 IT Operations 0.0000 0.000 0.000 4,828.00 License and Permits 0.0000 0.000 0.000 400.00 Total for All Others (ADP, Con. Employees, Misc.)12,891.00 Total Program Expenses 135,908.00 TOTAL DIRECT EXPENSES 135,908.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 4,689.00 Health Adm Distribution 0.0000 0.000 0.000 17,800.00 Total for Cost Allocation Plan / Other 22,489.00 Total Indirect Costs 22,489.00 TOTAL INDIRECT EXPENSES 22,489.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 66 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total TOTAL EXPENDITURES 158,397.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 67 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Medicaid Outreach DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 494,910.00 494,910.00 2 Fringe Benefits 277,150.00 277,150.00 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 28,432.00 28,432.00 10 All Others (ADP, Con. Employees, Misc.)0.00 0.00 Total Program Expenses 800,492.00 800,492.00 TOTAL DIRECT EXPENSES 800,492.00 800,492.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 180,284.00 180,284.00 Total Indirect Costs 180,284.00 180,284.00 TOTAL INDIRECT EXPENSES 180,284.00 180,284.00 TOTAL EXPENDITURES 980,776.00 980,776.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 68 of 109 DR A F T Contract # Date: 07/02/2024 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 434,420.00 434,420.00 0.00 0.00 Required Match - Local 434,420.00 0.00 434,420.00 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 111,936.00 0.00 111,936.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 980,776.00 434,420.00 546,356.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 69 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Multiple positons Notes : Amount determined based on time studies. 1.0000 494910.000 0.000 FTE 494,910.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOY RETIREMENT HOSPITAL LIFE INSURANCE VISION DENTAL WORKERS COMP SHORT/LONG TERM DISABILITY 0.0000 56.000 494910.000 277,150.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication 8 County-City Central Services 9 Space Costs Office Space Rental 0.0000 0.000 0.000 28,432.00 10 All Others (ADP, Con. Employees, Misc.) Total Program Expenses 800,492.00 TOTAL DIRECT EXPENSES 800,492.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 70 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 68,348.00 Health Adm Distribution 0.0000 0.000 0.000 111,936.00 Total for Cost Allocation Plan / Other 180,284.00 Total Indirect Costs 180,284.00 TOTAL INDIRECT EXPENSES 180,284.00 TOTAL EXPENDITURES 980,776.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 71 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / MCH - All Other DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 135,306.00 135,306.00 2 Fringe Benefits 83,120.00 83,120.00 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 566.00 566.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)11,699.00 11,699.00 Total Program Expenses 230,691.00 230,691.00 TOTAL DIRECT EXPENSES 230,691.00 230,691.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 4,741,586.00 4,741,586.00 Total Indirect Costs 4,741,586.00 4,741,586.00 TOTAL INDIRECT EXPENSES 4,741,586.00 4,741,586.00 TOTAL EXPENDITURES 4,972,277.00 4,972,277.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 72 of 109 DR A F T Contract # Date: 07/02/2024 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 249,377.00 249,377.00 0.00 0.00 Local Funds - Other 4,722,900.00 0.00 4,722,900.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 4,972,277.00 249,377.00 4,722,900.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 73 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Nutritionist/Dietician Notes : Melinda Blesch Position P00005401 PH Nutritionist 2 0.4471 83003.802 0.000 FTE 37,111.00 Public Health Nurse Notes : Angela Varela Position P00003427 PH Nurse 2 0.7486 82452.000 0.000 FTE 61,724.00 Public Health Nurse Notes : Marybeth Reader Position P00003183 PH Nurse 2 0.4423 82457.000 0.000 FTE 36,471.00 Total for Salary & Wages 135,306.00 2 Fringe Benefits Composite Rate Notes : FICA, LIFE INS, DENTAL, UNEMPLOYMENT, VISION, WORK COMP, RETIREMENT, HOSPITALIZATION, SHORT/LONG TERM DISABILITY 0.0000 61.431 135306.000 83,120.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials 6 Travel 7 Communication Telephone 0.0000 0.000 0.000 566.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Info Tech Operations 0.0000 0.000 0.000 3,352.00 Insurance 0.0000 0.000 0.000 2,653.00 Incentives 0.0000 0.000 0.000 5,694.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 74 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Total for All Others (ADP, Con. Employees, Misc.)11,699.00 Total Program Expenses 230,691.00 TOTAL DIRECT EXPENSES 230,691.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 18,686.00 Health Adm Distribution 0.0000 0.000 0.000 34,102.00 Other Cost Distributions-Nursing Notes : This distribution takes total costs of Field Nursing and allocates them back to various cost centers by a time study. The % back to MCH is 55.12% 0.0000 0.000 0.000 4,622,503.00 Nursing Adm Distribution 0.0000 0.000 0.000 16,960.00 Other Cost Distributions- Education Notes : this distribution takes total costs of Education and allocates them back to various cost centers by a time study. The % back to MCH is 1.727% 0.0000 0.000 0.000 49,335.00 Total for Cost Allocation Plan / Other 4,741,586.00 Total Indirect Costs 4,741,586.00 TOTAL INDIRECT EXPENSES 4,741,586.00 TOTAL EXPENDITURES 4,972,277.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 75 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / MDHHS-Essential Local Public Health Services (ELPHS) DATE PREPARED 7/2/2024 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 # 3 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 8,586,911.00 8,586,911.00 Total Indirect Costs 8,586,911.00 8,586,911.00 TOTAL INDIRECT EXPENSES 8,586,911.00 8,586,911.00 TOTAL EXPENDITURES 8,586,911.00 8,586,911.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 76 of 109 DR A F T Contract # Date: 07/02/2024 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 3,265,697.00 3,265,697.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 4,600,801.00 0.00 4,600,801.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 8,586,911.00 3,265,697.00 5,321,214.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 77 of 109 DR A F T Contract # Date: 07/02/2024 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 0.000 235,100.00 Nursing Adm Distribution 0.0000 0.000 0.000 190,298.00 Other Cost Distributions-MISC Distributions 0.0000 0.000 0.000 5,675,698.00 Federally Provided Vaccines 0.0000 0.000 0.000 720,413.00 Other Cost Distributions-STD 0.0000 0.000 0.000 1,765,402.00 Total for Cost Allocation Plan / Other 8,586,911.00 Total Indirect Costs 8,586,911.00 TOTAL INDIRECT EXPENSES 8,586,911.00 TOTAL EXPENDITURES 8,586,911.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 78 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Tuberculosis (TB) Control DATE PREPARED 7/2/2024 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 # 3 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 81,475.00 81,475.00 6 Travel 3,200.00 3,200.00 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.)39,832.00 39,832.00 Total Program Expenses 124,507.00 124,507.00 TOTAL DIRECT EXPENSES 124,507.00 124,507.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 1,252,048.00 1,252,048.00 Total Indirect Costs 1,252,048.00 1,252,048.00 TOTAL INDIRECT EXPENSES 1,252,048.00 1,252,048.00 TOTAL EXPENDITURES 1,376,555.00 1,376,555.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 79 of 109 DR A F T Contract # Date: 07/02/2024 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 15,426.00 15,426.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 1,361,129.00 0.00 1,361,129.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 1,376,555.00 15,426.00 1,361,129.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 80 of 109 DR A F T Contract # Date: 07/02/2024 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 Client Supp Material/Incentives Enablers Notes : TB GRANT 0.0000 0.000 0.000 1,000.00 Postage Notes : TB GRANT 0.0000 0.000 0.000 75.00 Medical Supplies Notes : TB GRANT 0.0000 0.000 0.000 100.00 Office Supplies Notes : TB GRANT 0.0000 0.000 0.000 300.00 Drugs Notes : COUNTY BUDGET 0.0000 0.000 0.000 80,000.00 Total for Supplies and Materials 81,475.00 6 Travel Client Transportation Notes : TB GRANT 0.0000 0.000 0.000 200.00 Conferences Notes : TB GRANT 0.0000 0.000 0.000 3,000.00 Total for Travel 3,200.00 7 Communication 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Lab Fees Notes : TB GRANT $3,011.00 COUNTY BUDGET $8,000.00 0.0000 0.000 0.000 11,011.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 81 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total IT Print Services Notes : COUNTY BUDGET 0.0000 0.000 0.000 71.00 Professional Services Notes : COUNTY BUDGET 0.0000 0.000 0.000 11,910.00 TB Cases/Outside Notes : COUNTY BUDGET 0.0000 0.000 0.000 9,000.00 Translation & Interpretation Notes : TB GRANT $300.00 COUNTY BUDGET $100.00 0.0000 0.000 0.000 400.00 Software Support Maintenance Notes : TB GRANT 0.0000 0.000 0.000 7,440.00 Total for All Others (ADP, Con. Employees, Misc.)39,832.00 Total Program Expenses 124,507.00 TOTAL DIRECT EXPENSES 124,507.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Health Adm Distribution 0.0000 0.000 0.000 19,426.00 Nursing Adm Distribution 0.0000 0.000 0.000 17,436.00 Other Cost Distributions-Misc Distribution 0.0000 0.000 0.000 1,215,186.00 Total for Cost Allocation Plan / Other 1,252,048.00 Total Indirect Costs 1,252,048.00 TOTAL INDIRECT EXPENSES 1,252,048.00 TOTAL EXPENDITURES 1,376,555.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 82 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Vision ELPHS DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 419,038.00 419,038.00 2 Fringe Benefits 116,438.00 116,438.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 11,024.00 11,024.00 6 Travel 10,362.00 10,362.00 7 Communication 1,208.00 1,208.00 8 County-City Central Services 0.00 0.00 9 Space Costs 8,766.00 8,766.00 10 All Others (ADP, Con. Employees, Misc.)10,725.00 10,725.00 Total Program Expenses 577,561.00 577,561.00 TOTAL DIRECT EXPENSES 577,561.00 577,561.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 359,179.00 359,179.00 Total Indirect Costs 359,179.00 359,179.00 TOTAL INDIRECT EXPENSES 359,179.00 359,179.00 TOTAL EXPENDITURES 936,740.00 936,740.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 83 of 109 DR A F T Contract # Date: 07/02/2024 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 253,968.00 253,968.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 682,772.00 0.00 682,772.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 936,740.00 253,968.00 682,772.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 84 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Supervisor Notes : S. Jodway Position P00011503 Hearing and Vision Tech Supervisor 1.0000 70082.000 0.000 FTE 70,082.00 Technician Notes : Evelyn James Position P00000632 PH Tech 0.4567 45581.000 0.000 FTE 20,818.00 Technician Notes : Terri Alcocer Position P00000633 PH Tech 0.3846 51140.000 0.000 FTE 19,669.00 Technician Notes : Kelly Feld Position P00000634 PH Tech 0.4567 43728.000 0.000 FTE 19,972.00 Technician Notes : Kim Ferrell Position P00000636 PH Tech 0.4567 40022.000 0.000 FTE 18,279.00 Technician Notes : Theresa Pechy Position P0012316 PH Tech 0.4087 51135.000 0.000 FTE 20,899.00 Technician Notes : Natalie Hall Position P00012317 PH Tech 0.4087 45628.000 0.000 FTE 18,648.00 Technician Notes : Lisa Arden Position P00012318 PH Tech 0.4087 47428.000 0.000 FTE 19,384.00 Technician Notes : Meghan O'Connell Position P00012319 PH Tech 0.3606 41872.000 0.000 FTE 15,099.00 Technician Notes : Karen Peterson Position P00000639 PH Tech 0.4567 41879.000 0.000 FTE 19,126.00 Technician Notes : Vacant Position 0.4567 40022.000 0.000 FTE 18,279.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 85 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total P00000644 PH Tech Technician Notes : Vacant Position P00012315 PH Tech 0.2404 40022.000 0.000 FTE 9,621.00 Technician Notes : Kimberly Shepard Position P00003672 PH Tech 0.4567 45581.000 0.000 FTE 20,818.00 Technician Notes : Vacant Position P00010836 PH Tech 0.1923 40022.000 0.000 FTE 7,697.00 Technician Notes : Vacant Position P00010839 PH Tech 0.2164 40014.000 0.000 FTE 8,659.00 Technician Notes : Kathryn Buchler Position P00010840 PH Tech 0.4567 41879.000 0.000 FTE 19,126.00 Supervisor Notes : Diane Ferber Position P00001917 Hearing and Vision Program Supervisor 0.5000 106316.000 0.000 FTE 53,158.00 Auxillary Health Clerk Notes : Billie-Jean Wright Position P00006736 Aux Health Clerk 0.3000 56381.000 0.000 FTE 16,914.00 Clerk Notes : Soon to be vacant Position P00002891 PH Clerk 2 0.5000 45580.000 0.000 FTE 22,790.00 Total for Salary & Wages 419,038.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS HEARING INS DENTAL INS 0.0000 27.787 419038.000 116,438.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 86 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total WORK COMP SHORT/LONG TERM DISABILITY 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 1,060.00 Printing 0.0000 0.000 0.000 2,173.00 Postage 0.0000 0.000 0.000 6,890.00 Medical Supplies 0.0000 0.000 0.000 901.00 Total for Supplies and Materials 11,024.00 6 Travel Personal Mileage Notes : $0.655 per mile 0.0000 0.000 0.000 10,362.00 7 Communication Telephone 0.0000 0.000 0.000 1,208.00 8 County-City Central Services 9 Space Costs Space/Rental Costs 0.0000 0.000 0.000 8,766.00 10 All Others (ADP, Con. Employees, Misc.) Staff Training 0.0000 0.000 0.000 2,279.00 Equipment Repair 0.0000 0.000 0.000 1,617.00 IT Print Services 0.0000 0.000 0.000 338.00 Insurance 0.0000 0.000 0.000 3,761.00 Interpreter Fees 0.0000 0.000 0.000 80.00 Expendable Equipment 0.0000 0.000 0.000 2,650.00 Total for All Others (ADP, Con. Employees, Misc.)10,725.00 Total Program Expenses 577,561.00 TOTAL DIRECT EXPENSES 577,561.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 87 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 57,869.00 Health Adm Distribution 0.0000 0.000 0.000 81,865.00 Other Cost Distributions-Misc Distribution 0.0000 0.000 0.000 219,445.00 Total for Cost Allocation Plan / Other 359,179.00 Total Indirect Costs 359,179.00 TOTAL INDIRECT EXPENSES 359,179.00 TOTAL EXPENDITURES 936,740.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 88 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / Immunization Vaccine Quality Assurance DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 2,441,870.00 2,441,870.00 2 Fringe Benefits 1,302,855.00 1,302,855.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 0.00 0.00 5 Supplies and Materials 1,323,604.00 1,323,604.00 6 Travel 8,000.00 8,000.00 7 Communication 29,364.00 29,364.00 8 County-City Central Services 0.00 0.00 9 Space Costs 114,244.00 114,244.00 10 All Others (ADP, Con. Employees, Misc.)395,617.00 395,617.00 Total Program Expenses 5,615,554.00 5,615,554.00 TOTAL DIRECT EXPENSES 5,615,554.00 5,615,554.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other -4,719,700.00 -4,719,700.00 Total Indirect Costs -4,719,700.00 -4,719,700.00 TOTAL INDIRECT EXPENSES -4,719,700.00 -4,719,700.00 TOTAL EXPENDITURES 895,854.00 895,854.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 89 of 109 DR A F T Contract # Date: 07/02/2024 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 705,507.00 0.00 705,507.00 0.00 Fees and Collections - 3rd Party 85,000.00 0.00 85,000.00 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 105,347.00 105,347.00 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 895,854.00 105,347.00 790,507.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 90 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Coordinator Notes : VQA GRANT Vaccine Supply Coordinator L. HIghfield Position P00002436 0.9399 62161.000 0.000 FTE 58,425.00 PH Clinic Nurses-COUNTY BUDGET 1.0000 2383445.000 0.000 FTE 2,383,445.00 Total for Salary & Wages 2,441,870.00 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 VQA GRANT 0.0000 64.809 58425.000 37,865.00 Composite Rate - COUNTY BUDGET Notes : FICA Unemployment Insurance Retirement Insurance Hospital Insurance Life Insurance Vision Insurance Dental Insurance Workers Comp Short and Long Term Disability Insurance 0.0000 53.074 2383445.00 0 1,264,990.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 91 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Total for Fringe Benefits 1,302,855.00 3 Cap. Exp. for Equip & Fac. 4 Contractual 5 Supplies and Materials Drugs/Vaccines-COUNTY BUDGET 0.0000 0.000 0.000 1,244,685.00 Medical Supply-COUNTY BUDGET 0.0000 0.000 0.000 64,900.00 Office Supplies-COUNTY BUDGET 0.0000 0.000 0.000 10,000.00 Printing-COUNTY BUDGET 0.0000 0.000 0.000 3,900.00 Materials & Supplies - VQA GRANT Notes : VQA GRANT 0.0000 0.000 0.000 119.00 Total for Supplies and Materials 1,323,604.00 6 Travel Mileage Notes : COUNTY BUDGET 0.655 per mile 0.0000 0.000 0.000 4,000.00 Conferences Notes : COUNTY BUDGET 0.0000 0.000 0.000 3,800.00 Transportation of Clients- COUNTY BUDGET 0.0000 0.000 0.000 200.00 Total for Travel 8,000.00 7 Communication Telephone-COUNTY BUDGET 0.0000 0.000 0.000 29,364.00 8 County-City Central Services 9 Space Costs Space/Rental Costs Notes : COUNTY BUDGET 0.0000 0.000 0.000 114,244.00 10 All Others (ADP, Con. Employees, Misc.) Insurance Notes : VQA GRANT 0.0000 0.000 0.000 869.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 92 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Insurance Notes : COUNTY BUDGET 0.0000 0.000 0.000 15,368.00 Professional Services-COUNTY BUDGET 0.0000 0.000 0.000 1,500.00 IT Oper-COUNTY BUDGET 0.0000 0.000 0.000 209,496.00 Staff Training Notes : COUNTY BUDGET 0.0000 0.000 0.000 200.00 Laundry-COUNTY BUDGET 0.0000 0.000 0.000 74,430.00 Uniforms-COUNTY BUDGET Notes : COUNTY BUDGET 0.0000 0.000 0.000 81,351.00 Interpreter Fees - COUNTY BUDGET Notes : COUNTY BUDGET 0.0000 0.000 0.000 1,000.00 Equipment Rental - COUNTY BUDGET 0.0000 0.000 0.000 840.00 IT Managed Print Svs - COUNTY BUDGET 0.0000 0.000 0.000 2,322.00 Employee License-Cert COUNTY BUDGET 0.0000 0.000 0.000 4,241.00 Equipment Repair Notes : COUNTY BUDGET 0.0000 0.000 0.000 4,000.00 Total for All Others (ADP, Con. Employees, Misc.)395,617.00 Total Program Expenses 5,615,554.00 TOTAL DIRECT EXPENSES 5,615,554.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : VQA GRANT 13.81% 0.0000 0.000 0.000 8,068.00 Cost Allocation Plan Notes : 13.81% COUNTY BUDGET 0.0000 0.000 0.000 329,154.00 Health Adm Distribution 0.0000 0.000 0.000 766,920.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 93 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Nursing Adm Distribution 0.0000 0.000 0.000 400,332.00 Other Cost Distributions-Misc Distributions 0.0000 0.000 0.000 -6,224,174.00 Total for Cost Allocation Plan / Other -4,719,700.00 Total Indirect Costs -4,719,700.00 TOTAL INDIRECT EXPENSES -4,719,700.00 TOTAL EXPENDITURES 895,854.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 94 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / WIC Breastfeeding DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 91,455.00 91,455.00 2 Fringe Benefits 74,462.00 74,462.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 84,867.00 84,867.00 5 Supplies and Materials 175.00 175.00 6 Travel 59.00 59.00 7 Communication 1,500.00 1,500.00 8 County-City Central Services 0.00 0.00 9 Space Costs 0.00 0.00 10 All Others (ADP, Con. Employees, Misc.)2,471.00 2,471.00 Total Program Expenses 254,989.00 254,989.00 TOTAL DIRECT EXPENSES 254,989.00 254,989.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 47,108.00 47,108.00 Total Indirect Costs 47,108.00 47,108.00 TOTAL INDIRECT EXPENSES 47,108.00 47,108.00 TOTAL EXPENDITURES 302,097.00 302,097.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 95 of 109 DR A F T Contract # Date: 07/02/2024 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 267,619.00 267,619.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 34,478.00 0.00 34,478.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 302,097.00 267,619.00 34,478.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 96 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Lactation Specialist Notes : T. Brickey Position P00011579 1.0000 42924.000 0.000 FTE 42,924.00 Lactation Specialist Notes : S. Palanjian Position P00015436 1.0000 42924.000 0.000 FTE 42,924.00 Nutritionist/Dietician 0.0673 83301.000 0.000 FTE 5,607.00 Total for Salary & Wages 91,455.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMP INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP SHORT/LONG TERM DISABILITY 0.0000 81.419 91455.000 74,462.00 3 Cap. Exp. for Equip & Fac. 4 Contractual Subcontracting Agency-OLSHA Notes : OLSHA 0.0000 0.000 0.000 84,867.00 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 75.00 Printing 0.0000 0.000 0.000 50.00 Postage 0.0000 0.000 0.000 50.00 Total for Supplies and Materials 175.00 6 Travel Mileage 0.0000 0.000 0.000 59.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 97 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Notes : 90 miles * 0.655 per mile 7 Communication Telephone Communications 0.0000 0.000 0.000 1,500.00 8 County-City Central Services 9 Space Costs 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.0000 0.000 0.000 2,267.00 Interpretation 0.0000 0.000 0.000 204.00 Total for All Others (ADP, Con. Employees, Misc.)2,471.00 Total Program Expenses 254,989.00 TOTAL DIRECT EXPENSES 254,989.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 12,630.00 Health Adm Distribution 0.0000 0.000 0.000 34,478.00 Total for Cost Allocation Plan / Other 47,108.00 Total Indirect Costs 47,108.00 TOTAL INDIRECT EXPENSES 47,108.00 TOTAL EXPENDITURES 302,097.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 98 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / WIC Resident Services DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 1,098,078.00 1,098,078.00 2 Fringe Benefits 683,718.00 683,718.00 3 Cap. Exp. for Equip & Fac.0.00 0.00 4 Contractual 522,000.00 522,000.00 5 Supplies and Materials 19,780.00 19,780.00 6 Travel 1,024.00 1,024.00 7 Communication 7,920.00 7,920.00 8 County-City Central Services 0.00 0.00 9 Space Costs 57,177.00 57,177.00 10 All Others (ADP, Con. Employees, Misc.)74,528.00 74,528.00 Total Program Expenses 2,464,225.00 2,464,225.00 TOTAL DIRECT EXPENSES 2,464,225.00 2,464,225.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 0.00 0.00 2 Cost Allocation Plan / Other 610,721.00 610,721.00 Total Indirect Costs 610,721.00 610,721.00 TOTAL INDIRECT EXPENSES 610,721.00 610,721.00 TOTAL EXPENDITURES 3,074,946.00 3,074,946.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 99 of 109 DR A F T Contract # Date: 07/02/2024 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 2,615,870.00 2,615,870.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 459,076.00 0.00 459,076.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 3,074,946.00 2,615,870.00 459,076.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 100 of 109 DR A F T Contract # Date: 07/02/2024 3 Program Budget - Cost Detail Line Item Qty Rate Units UOM Total DIRECT EXPENSES Program Expenses 1 Salary & Wages Supervisor Notes : Lisa Banks Position P00001865 PH Nutrition Supervisor 1.0000 106316.000 0.000 FTE 106,316.00 Supervisor Notes : Kai Scott Position P00000958 Office Supervisor 2 1.0000 61869.000 0.000 FTE 61,869.00 Supervisor Notes : Katharine Beszka Position P00003073 Office Supervisor 2 1.0000 75556.000 0.000 FTE 75,556.00 Clerk Notes : Latoya Anderson Position P00001328 Aux Health Clerk 1.0000 56381.000 0.000 FTE 56,381.00 Clerk Notes : Nicole Case Position P00000674 Aux Health Clerk 1.0000 56381.000 0.000 FTE 56,381.00 Clerk Notes : Linda Crowder Position P00004771 Aux Health Clerk 1.0000 46167.000 0.000 FTE 46,167.00 Clerk Notes : Joyce Heenan Position P00007563 Aux Health Clerk 1.0000 56381.000 0.000 FTE 56,381.00 Clerk Notes : Josh Hutson Position P00007384 Aux Health Clerk 1.0000 56381.000 0.000 FTE 56,381.00 Technician Notes : Cathrice Bacon Position P00002509 Nutrition Tech - WIC 1.0000 59200.000 0.000 FTE 59,200.00 Technician Notes : Vacant Position P00007382 Nutrition Tech - WIC 0.1202 46330.000 0.000 FTE 5,569.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 101 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total Technician Notes : Olivia Schuelke Position P00007562 Nutrition Tech - WIC 1.0000 59200.000 0.000 FTE 59,200.00 Technician Notes : Tammy Shaffer Position P00005234 Nutrition Technician 1.0000 59200.000 0.000 FTE 59,200.00 Technician Notes : Debra Calhoun Position P00005233 Nutrition Technician 1.0000 57055.000 0.000 FTE 57,055.00 Nutritionist/Dietician Notes : Amanda Vagts Position P00000912 PH Nutritionist 0.9327 83301.000 0.000 FTE 77,694.00 Nutritionist/Dietician Notes : Jennifer Cook Position P00002074 PH Nutritionist 2 1.0000 59131.000 0.000 FTE 59,131.00 Nutritionist/Dietician Notes : M. Seefelt Position P00005693 PH Nutritionist 2 1.0000 75557.000 0.000 FTE 75,557.00 Nutritionist/Dietician Notes : Jez Vedua-Cardenas Position P00007381 PH Nutritionist 3 1.0000 80283.000 0.000 FTE 80,283.00 Technician Notes : Teresa Saputo Position P00005235 Nutrition Technician 1.0000 48476.000 0.000 FTE 48,476.00 OCHD Staff Overtime - Various positions 1.0000 1281.000 0.000 FTE 1,281.00 Total for Salary & Wages 1,098,078.00 2 Fringe Benefits Composite Rate Notes : FICA UNEMPLOYMENT INS RETIREMENT HOSPITAL INS LIFE INS VISION INS DENTAL INS WORK COMP 0.0000 62.265 1098078.00 0 683,718.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 102 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total SHORT AND LONG TERM DISABILITY 3 Cap. Exp. for Equip & Fac. 4 Contractual Subcontracting Agency-OLSHA- WIC svcs in Oakland Co. 0.0000 0.000 0.000 522,000.00 5 Supplies and Materials Office Supplies 0.0000 0.000 0.000 2,000.00 Medical Supplies 0.0000 0.000 0.000 6,000.00 Educational Supplies 0.0000 0.000 0.000 2,100.00 Postage 0.0000 0.000 0.000 5,180.00 Printing 0.0000 0.000 0.000 3,500.00 Materials & Supplies 0.0000 0.000 0.000 500.00 Computer Supplies 0.0000 0.000 0.000 500.00 Total for Supplies and Materials 19,780.00 6 Travel Mileage Notes : 800 Miles * 0.655 per mile 0.0000 0.000 0.000 524.00 Conferences 0.0000 0.000 0.000 500.00 Total for Travel 1,024.00 7 Communication Telephone 0.0000 0.000 0.000 7,920.00 8 County-City Central Services 9 Space Costs Space/Rental Costs 0.0000 0.000 0.000 37,892.00 Rent 0.0000 0.000 0.000 19,285.00 Total for Space Costs 57,177.00 10 All Others (ADP, Con. Employees, Misc.) Insurance 0.0000 0.000 0.000 22,180.00 Equipment Maintenance 0.0000 0.000 0.000 850.00 Info Tech Print Managed Svcs 0.0000 0.000 0.000 3,500.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 103 of 109 DR A F T Contract # Date: 07/02/2024 Line Item Qty Rate Units UOM Total IT Operations 0.0000 0.000 0.000 42,440.00 Staff Training 0.0000 0.000 0.000 500.00 Interpretation 0.0000 0.000 0.000 4,458.00 Laundry & Cleaning 0.0000 0.000 0.000 600.00 Total for All Others (ADP, Con. Employees, Misc.)74,528.00 Total Program Expenses 2,464,225.00 TOTAL DIRECT EXPENSES 2,464,225.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 2 Cost Allocation Plan / Other Cost Allocation Plan Notes : 13.81% 0.0000 0.000 0.000 151,645.00 Health Adm Distribution 0.0000 0.000 0.000 337,013.00 Other Cost Distributions-Misc Distributions 0.0000 0.000 0.000 122,063.00 Total for Cost Allocation Plan / Other 610,721.00 Total Indirect Costs 610,721.00 TOTAL INDIRECT EXPENSES 610,721.00 TOTAL EXPENDITURES 3,074,946.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 104 of 109 DR A F T Contract # Date: 07/02/2024 1 Program Budget Summary PROGRAM / PROJECT Local Health Department - 2024 / EGLE Drinking Water and Onsite Wastewater Management DATE PREPARED 7/2/2024 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 # 3 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 3,180,868.00 3,180,868.00 Total Indirect Costs 3,180,868.00 3,180,868.00 TOTAL INDIRECT EXPENSES 3,180,868.00 3,180,868.00 TOTAL EXPENDITURES 3,180,868.00 3,180,868.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 105 of 109 DR A F T Contract # Date: 07/02/2024 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 985,042.00 985,042.00 0.00 0.00 MCH Funding 0.00 0.00 0.00 0.00 Local Funds - Other 2,195,826.00 0.00 2,195,826.00 0.00 Inkind Match 0.00 0.00 0.00 0.00 MDHHS Fixed Unit Rate Totals 3,180,868.00 985,042.00 2,195,826.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 106 of 109 DR A F T Contract # Date: 07/02/2024 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 2,138,307.00 Health Adm Distribution 0.0000 0.000 0.000 795,765.00 Other Cost Distributions-Misc Distribution 0.0000 0.000 0.000 246,796.00 Total for Cost Allocation Plan / Other 3,180,868.00 Total Indirect Costs 3,180,868.00 TOTAL INDIRECT EXPENSES 3,180,868.00 TOTAL EXPENDITURES 3,180,868.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 107 of 109 DR A F T Contract # Date: 07/02/2024 Summary of Budget PROGRAM / PROJECT Local Health Department - 2024 / Local Health Department - 2024 DATE PREPARED 7/2/2024 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 # 3 CITY Pontiac STATE MI ZIP CODE 48341-1032 FEDERAL ID NUMBER 38-6004876 Category Total Amount DIRECT EXPENSES Program Expenses 1 Salary & Wages 20,693,499.00 20,693,499.00 2 Fringe Benefits 11,045,784.00 11,045,784.00 3 Cap. Exp. for Equip & Fac.121,154.00 121,154.00 4 Contractual 851,190.00 851,190.00 5 Supplies and Materials 2,210,730.00 2,210,730.00 6 Travel 420,337.00 420,337.00 7 Communication 283,881.00 283,881.00 8 County-City Central Services 0.00 0.00 9 Space Costs 1,898,724.00 1,898,724.00 10 All Others (ADP, Con. Employees, Misc.)3,314,184.00 3,314,184.00 Total Program Expenses 40,839,483.00 40,839,483.00 TOTAL DIRECT EXPENSES 40,839,483.00 40,839,483.00 INDIRECT EXPENSES Indirect Costs 1 Indirect Costs 1,892,521.00 1,892,521.00 2 Cost Allocation Plan / Other 6,831,027.00 6,831,027.00 Total Indirect Costs 8,723,548.00 8,723,548.00 TOTAL INDIRECT EXPENSES 8,723,548.00 8,723,548.00 TOTAL EXPENDITURES 49,563,031.00 49,563,031.00 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: 07/02/2024 __________________________________________________________________________ Page: 108 of 109 DR A F T Contract # Date: 07/02/2024 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 549,188.00 549,188.00 0.00 0.00 7 Required Match - Local 594,688.00 0.00 594,688.00 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 13,990,893.00 13,990,893.00 0.00 0.00 14 MCH Funding 321,457.00 321,457.00 0.00 0.00 15 Local Funds - Other 26,302,714.00 0.00 26,302,714.00 0.00 16 Inkind Match 0.00 0.00 0.00 0.00 17 MDHHS Fixed Unit Rate 451,529.00 451,529.00 0.00 0.00 TOTAL 49,563,031.00 15,313,067.00 34,249,964.00 0.00 Local Health Department - 2024, Date: 07/02/2024 __________________________________________________________________________ Page: 109 of 109 REQUEST: 1. That the Oakland County Board of Commissioners hereby approves Amendment #3 to the FY 2024 Local Health Department (Comprehensive) Agreement for funding in the amount of $680,883 for the period of October 1, 2023, through September 30, 2024. 2. To create a new union classification within the UAW, titled Community Health Worker, to be placed at salary grade 087/112, FLSA Status Non-Exempt. 3. To create two (2) SR FTE Community Health Worker positions in the Health Division (#1060201). PROPOSED FUNDING: FY 2024 Local Health Department (Comprehensive) Agreement. OVERVIEW: The Oakland County Health Division has received Amendment #3 to the Fiscal Year (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 (M.R.) #23-3305. Amendment #1 increased the funding to $12,189,775 and Amendment #2, approved via M.R. #24-3808, increased the award amount to $14,312,350. Amendment #3 includes additional funding in the amount of $680,883, for a total award amount of $14,993,233. The Amendment provides funding in the amount of $382,000 to support critical public health infrastructure needs related to public health workforce, foundational capabilities, and data modernization. It has been determined that the Health Division has a need for a new classification of Community Health Worker to promote health initiatives to champion health equity and reduce disparities within the community for all vulnerable populations. These positions will assist residents to gain access to needed services and build individual capacity by increasing health knowledge and self-sufficiency. The Health Division is requesting to create two (2) Special Revenue (SR) Full-Time Eligible (FTE) Community Health Worker positions in the Health Division (#1060201) to fill this gap within the Health Division and the community. PERTINENT SALARIES FY 2024 *Note: Annual rates are shown for illustrative purposes only. Class Gr Period Step 01 Step 12 Step 24 Step 36 Step 48 Step 60 Step 72 Step 84 Community Health Worker 112 Bi-wkly Annual 1,699.44 44,185 1,781.94 46,330 1,864.44 48,475 1,946.94 50,620 2,029.44 52,765 2,111.93 54,910 2,194.44 57,055 2,276.93 59,200 SALARY AND FRINGE BENEFIT SAVINGS **Note: Fringe benefit rates displayed are County averages. Annual costs are shown for illustrative purposes only. Actual costs are reflected in the budget amendment. Create two (2) SR FTE Community Health Worker positions Salary at Step 12 $46,330 Fringes @34.59% $16,026 Total Health Care Based Fringes $15,973 Cost of one position $78,329 Cost of two positions $156,658 ATTACHMENT I MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Local Health Department Agreement October 1, 2023- September 30, 2024 Fiscal Year 2024 INSTRUCTIONS FOR THE ANNUAL BUDGET INSTRUCTIONS FOR THE ANNUAL BUDGET FOR LOCAL HEALTH DEPARTMENT SERVICES TABLE OF CONTENTS Page INTRODUCTION ............................................................................................................................ 1 MINIMUM BUDGETING REQUIREMENTS ................................................................................... 1 REIMBURSEMENT CHART ........................................................................................................... 2 LOCAL ACCOUNTING SYSTEM STRUCTURE OF ACCOUNTS/COST ALLOCATION PROCEDURES .............................................................................................................................. 3 BUDGET PREPARATION DETAIL……………………………………………………………………....3 General Information…………………………………………………………………………………3 Expense Line-Item Detail…………………………………………………………………………..4 Source of Funds……………………………………………………………………………..…….15 SPECIAL BUDGET and REPORTING INSTRUCTIONS…………………………………………….18 1. Public Health Emergency Preparedness (PHEP) .................................................... 19 2. WIC ......................................................................................................................... 19 3. Family Planning ..................................................................................................... 21 4. Breast and Cervical Cancer ................................................................................... 22 5. WISEWOMAN……………………………………………………………………………...24 5. Medicaid Outreach Activities Reimbursement Procedures ..................................... 24 Medicaid…………………………………………………………………………………..25 Nurse Family Partnership Services Medicaid Outreach…………………………….25 CSHCS Medicaid Outreach…………………………………………………………….26 6. Immunization 317 and VFC Allowable Expenditures .............................................. 29 1 INTRODUCTION The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used to establish budgets for many Department programs. In the Annual Budget, the Department consolidates many of its categorical programs’ funding and Essential Local Public Health Services (ELPHS) into a single, Comprehensive Agreement for local health departments. The Department's Plan and Budget Framework serves as a principal reference point for budget development. The Annual Budget for Local Health Services must be completed in accordance with and adhere to the established requirements as specified in these instructions and submitted to the Department as required by the agreement. The MI E-Grants System is an on-line application, including the budget entry forms, are utilized to develop a budget summary for each program element administered by the local Grantee. The system is designed to accommodate any number of local program elements including those unique to a particular local Grantee. Applications, including budget forms, are completed for all program elements, regardless of the reimbursement mechanism, including Agency administration(s) fee for service program elements, categorical program elements, performance- based program elements and Medicaid Outreach associated program elements. Budget entry is required for each major expenditure and source of fund categories for which costs/funds are identified. MINIMUM BUDGETING REQUIREMENTS Cost Principles Types or items of cost which will be considered for reimbursement are generally consistent with definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Federal Block Grant Funds Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide inpatient services; make cash payments to intended recipients of health services; purchase or improve land; purchase, contract or permanently improve (other than minor remodeling defined as work required to change the interior arrangements or other physical characteristics of any existing facility or installed equipment when the cost of the remodeling incident does not exceed $2,000) any building or other facility; or purchase major medical equipment (any item of medical equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients, excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of non-federal 2 funds as a condition for the receipt of Federal funds; or provide financial assistance to any entity other than a public or nonprofit private entity. Expenditure and Funding Source Breakdown For purposes of development, analysis and negotiation activities must be budgeted at the individual expenditure and funding source category level on the Annual Budget for Local Health Services. Special Budget Requirements for Certain Categorical Program Elements The Annual Budget for Local Health Services is completed in the MI E-Grants System through the application budget to include details for all program elements (excluding Administration and Grantee Support). See special budget and reporting section below section. Local MCH Local MCH funds can be used to support the health of women, children, and families in communities across Michigan. Funding addresses one or more Title V Maternal and Child Health Block Grant national and state priority areas and/or a local MCH priority need identified through a needs assessment process. Priority areas are developed into Local MCH Work Plans which are described in the Annual Local MCH Plan. These funds are to be budgeted as a funding source in two project categories. The Local MCH projects need to be budgeted separately. Please note only two LMCH project titles can be used: • MCH – Children • MCH – All Other These funding sources cannot be used under the WIC element except in extreme circumstances where a waiver is requested in advance of expenditures, and evidence is provided that the expenditures satisfy all funding requirements. Local health departments are encouraged to select only one to two performance measures and delve deeper into the strategies in an effort to “move the needle.” REIMBURSEMENT CHART The Reimbursement Chart notes elements/funding sources, applicable payment methods, target levels, output measures for each program/element having a performance reimbursement option. In addition, the chart also provides the subrecipient, contractor, or recipient designations, as in prior years. The type of project designation is indicated by footnote and is used if the project meets the Research and Development Project criteria. Research and Development Projects are defined by 3 Title 2 CFR, Section 200.87, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Research and development (R&D) means all research activities, both basic and applied, and all development activities that are performed by non-Federal entities. Research is defined as a systematic study directed toward fuller scientific knowledge or understanding of the subject studied. The term research also includes activities involving the training of individuals in research techniques where such activities utilize the same facilities as other research and development activities and where such activities are not included in the instruction function. Development is the systematic use of knowledge and understanding gained from research directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes. LOCAL ACCOUNTING SYSTEM STRUCTION OF ACCOUNTS / COST ALLOCATION PROCEDURES As in past years, no additional accounting system detail is being required beyond local uniform accounting procedures prescribed by the Michigan Department of Treasury, Local Financial Management System requirements, documentation requirements of categorical program funding sources and any local requirements. Some agencies may already have separate cost centers in their accounting system to directly identify costs and related funding of required services, but such breakdowns are not essential to being able to meet minimum reporting requirements if proper allocation procedures are used and adequate documentation is maintained. All allocations must have clearly measurable bases that directly apply to the amounts being allocated, must be documented with work papers that will provide an adequate audit trail and must result in a representative reporting of costs and funding for affected programs. More specific guidance can be found in Title 2 CFR, Part 200 Appendix V State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans and the brochure published by the Department of Health and Human Services entitled “A Guide for State, Local and Indian Tribal Governments: Cost Principles and Procedures for Developing Cost Allocation Plans and Indirect Cost Rates for Agreements with the Federal Government. BUDGET PREPERATION DETAIL 1. Budgeted expenditures are to be entered for each program element, project, or group of services by applicable major category. 4 2. The Budget should reflect all planned expenditures and revenues associated with the program. Funding source revenues include Federal funding sources, fees and collections, local, state, and other sources. 3. When developing the budget, it is important to note that total program expenditures must equal total program revenues. 4. Although a Grantee’s budget is approved, it does not mean expenses are approved. Reported expenses are subject to audit and must comply with Federal regulations, the terms of the agreement, and other policy impacting the allowability of expenses. Certain expenses may require prior approval, which should be in writing from MDHHS. 5. It is the Grantee’s responsibility to ensure budgeted expenses comply with Federal regulations, the terms of the agreement, and other policy impacting the allowability of expenses, and have documented prior approval, as needed, when the budget is submitted for review. EXPENSE LINE- ITEM CATEGORIES 1. Salaries and Wages a. This category includes compensation paid to permanent and part-time employees on the payroll of the Grantee who work in the program. Is reasonable for the services rendered and conforms to the established written policy of the Grantee consistently applied to both Federal and non-Federal activities. b. This category may include the cost of leave/paid time off (e.g., vacation, sick, holiday, bereavement, military) or the cost of leave/paid time off may be included as a fringe benefit, based on the Grantee’s written policy. See Section 2, Fringe Benefits. Leave/paid time off cannot be included in both categories and must be consistently budgeted and expensed for all Federally and non-Federally funded programs and activities of the Grantee. c. This category does not include personnel hired on a private contract basis or through a personnel service, contractual services, or professional fees. Consulting services, professional fees or personnel hired on a private contracting basis should be included in Contractual – Professional Services. d. Charges to salaries and wages must be based on records that accurately reflect the work performed. The records must: 5 1) Reflect the total activity for which the employee is compensated by the non-federal entity, not to exceed 100 percent. 2) Encompass federally assisted and all other activities compensated by the non- federal entity on an integrated basis but may include the use of subsidiary records as defined in the non-federal entity’s written policy. 3) Support the distribution of the salaries or wages among specific activities or cost objectives if the employee works on more than one federal or non-federal program; an indirect cost activity and a direct cost activity; more than one indirect activity which are allocated using different distribution bases; or an allowable and unallowable activity. e. See Title 2 CFR 200.430 for salaries and wages regulations. 2. Fringe Benefits a. Fringe benefits include, but are not limited to, the costs of leave/paid time off (e.g., vacation, sick, holiday, bereavement, military), employee insurance (e.g., employer paid portion of health, dental, vision, life), pensions, employer contribution to a retirement account, bonuses, health stipends in lieu of health insurance, unemployment, workers compensation, social security. b. The cost of leave/paid time off, and other taxable income (e.g., bonuses, health stipends in lieu of health insurance) may be included in salaries/wages, . See Item 1 above. It cannot be included in both categories and must be consistently budgeted and expensed for all Federally and non-Federally funded programs and activities of the Grantee. c. The cost of fringe benefits is allowable provided they are reasonable and are required by law, or a Grantee-employee agreement or established in the Grantee’s written policy. d. Fringe benefit costs must be equitably allocated to all activities (Federal award activity and non-Federal award activity). e. See Title 2 CFR 200.431 for fringe benefit regulations. 3. Employee Travel and Training a. This category includes the cost of travel and training for full and part-time employees working in the program. 6 b. This category does not include travel and training costs for personnel hired on a private contract basis or through a personnel service, for contractual services, or for volunteers. c. This category includes the cost of mileage, lodging, per diem, meals, tips, modes of transportation, approved registration fees for conferences, seminars, and other types of training related to the program. d. The costs must be consistent with the Grantee’s written policy and procedures to be allowable. e. See Title 2 CFR 200.474 for travel expense requirements. 4. Supplies and Materials a. This category includes consumable and short-term items costing less than five thousand dollars ($5,000). b. Examples include office supplies, office furniture, computers, computer software, printers, printing, postage, janitorial supplies, educational supplies, medical supplies, etc. according to the requirements of the program. c. This category does not include the cost of supplies and materials related to operating a shelter or other emergency housing. d. Purchases of materials and supplies must be charged at the actual price, net of applicable credits. e. For budgeting purposes, when the Supplies and Materials line item budget will not exceed 10 percent of the total budgeted grant expenses, specific detail will not be required. Detail is required only when the Supplies and Materials line item budget will exceed 10 percent. 5. Subawards – Subrecipient Services a. This category includes the cost of an agreement (subaward) between the Grantee and another organization for the purpose of carrying out a portion of the Grant program. A subaward is a subrecipient relationship. b. See below to differentiate between a subrecipient and a contractor. SUBRECIPIENT AND CONTRACTOR DETERMINATION FACTORS Title 2 CFR 200.331states that a pass-through entity (in this case the Grantee) must make case by case determinations whether an agreement it makes for the disbursement of Federal funds casts the party receiving the funds in the role of a subrecipient or contractor. 7 In determining whether an agreement casts the role of party receiving the Federal funds from the Grantee as a subrecipient or contractor, the substance of the relationship is more important than the form of the agreement. All characteristics listed below may not be present in all cases and the Grantee must use judgement when determining if the agreement is a subaward or a procurement contract. Subrecipient Characteristics A subaward is for the purpose of carrying out a portion of a Federal award and creates a Federal assistance relationship with the subrecipient. Characteristics of a subrecipient include: 1. In accordance with its agreement, uses the Federal awards to carry out a public purpose specified in authorizing statute, as opposed to providing goods and services for the benefit of the pass-through entity. 2. Is responsible for adherence to applicable Federal program requirements specified in the Federal award. 3. Has responsibility for programmatic decision making. 4. Determines who is eligible to receive what Federal assistance. 5. Has its performance measured in relation to whether objectives of the Federal program are met. Contractor Characteristics A contract is for the purpose of obtaining goods or services for the non-Federal entity’s own use and creates a procurement relationship with the contractor. Characteristics of a contractor include: 1. Provides goods and services within normal business operations. 2. Provides similar goods and services to many different purchasers. 3. Normally operates in a competitive environment. 4. Provides goods or services that are necessary to support the operation of the Federal program. 5. Is not subject to compliance requirements of the Federal program as a result of the agreement although similar requirements may apply of other reasons. 6. Contractual – Professional and Personnel Services 8 a. This category includes the costs of professional and personnel services rendered by members of a particular profession or possess a certain skill set and are not employees of the Grantee. b. This category includes the costs of services such as accounting, auditing, payroll, consulting, services, contract employees, etc. c. Grantees generally hire contract employees in place of part-time or full-time staff because of the need for specialized skills or budgetary reasons. d. The Grantee is not responsible for taxes, social security, workers compensation, unemployment, health benefits, sick or vacation time for contract employees. e. Travel expenses may be included when it is part of the contract terms between the Grantee and the contractor. f. Training expenses may be included when it is part of the contract terms between the Grantee and the contractor. 7. Communications a. This category includes the cost of telephone services (cell and/or land lines), hotline, data lines, internet services, cloud services, copy machine, and website necessary for the operation of the program. b. The cost of certain telecommunication and video surveillance services or equipment are prohibited in accordance with Title 2 CFR 200.216. c. For budgeting purposes, when the Communications line item budget will not exceed 10 percent of the total budgeted grant expenses, specific detail will not be required. Detail is required only when the Communications line item budget will exceed 10 percent. 8. Grantee Rent Expense a. This category includes the cost of rent/leases by the Grantee for space related to the operation of the program. b. This category does not include the cost of client rent assistance or equipment rentals/leases. 9. Space Expenses a. This category includes costs to maintain a facility related to the operation of the program. Costs include electricity, heating and air conditioning, maintenance and repairs, lawncare 9 and snowplowing, janitorial services, insurance, security system, depreciation (when the space is owned by the Grantee), etc. b. These costs must be allocated equitably to all Federal and non-Federal activities related to the space. c. Shelter Expenses – The costs associated with operating a shelter. Includes such things as rent or depreciation, insurance, utilities, maintenance and repairs, snow removal, lawn care, trash removal, security system etc. 10. Capital Expenditures – Equipment and Other a. Capital Expenditures – Equipment 1) Equipment is defined as an article of non-expendable property having a useful live of more than one year and acquisition cost of $5,000 or more per unit. Items with an acquisition cost of less than $5,000 classified as supplies and materials. 2) The cost of single a single unit or piece of equipment includes the necessary accessories and installation costs. 3) When the Grantee’s definition and threshold differs from the definition above, the Grantee will budget and report only those equipment purchases of $5,000 or more, on the Capital Expenditures – Equipment and Other line item. 4) Equipment purchases must have prior written approval from MDHHS if the item will be expensed in the year of purchase. The approved Budget does not qualify as prior written approval. When equipment purchases are not expensed in the year of purchase, the Grantee may only expense the deprecation calculated in accordance with its written policy. b. Capital Expenditures – Other 1) This category includes capital outlay for capital assets other than equipment. 10 CAPITAL ASSETS AND DEPRECIATION Title 2 CFR 200.1 defines capital assets as tangible or intangible assets used in operations having a useful life of more than one year which are capitalized in accordance with Generally Accepted Accounting Principles and includes: • Land, buildings (facilities), equipment, and intellectual property (including software) whether acquired by purchase, construction, manufacture, exchange, or through a lease accounted for as financial purchase under GASB or a finance lease under FASB. Additions, improvements, modifications, replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially increase their value or useful life. Title 2 CFR 200.439(b) includes the following rules of allowability for equipment and other capital expenditures. 1. Capital expenditures for general purpose equipment, building, and land are unallowable as direct charges, except with the prior written approval of the Federal awarding agency or the pass-through entity. 2. Capital expenditures for special purpose equipment are allowable as direct costs, provided that items with a cost of $5,000 or more have prior written approval of the Federal awarding agency or the pass-through entity. 3. Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life are unallowable as a direct cost except with prior written approval from the Federal awarding agency or the pass-through entity. 4. When approved as a direct charge, capital expenditures will be charged in the period in which the expenditure is incurred. 5. The unamortized portion of any equipment written off as a result of a change in capitalization levels may be recovered by continuing to claim the otherwise allowable depreciation on the equipment or by amortizing the amount to be written off over a period of years negotiated with the Federal cognizant agency for indirect cost. 6. Cost of equipment disposal is allowable if the non-Federal entity is instructed by the Federal awarding agency to otherwise dispose or transfer the equipment. 7. Equipment and other capital assets are unallowable as indirect costs. Title 2 CFR 200.1 defines capital assets as tangible or intangible assets used in operations having a useful life of more than one year which are capitalized in accordance with Generally Accepted Accounting Principles and includes: 11 • Land, buildings (facilities), equipment, and intellectual property (including software) whether acquired by purchase, construction, manufacture, exchange, or through a lease accounted for as financial purchase under GASB or a finance lease under FASB. • Additions, improvements, modifications, replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially increase their value or useful life. 11. Client Assistance – Rent a. This category includes the cost of rental assistance provided for eligible clients in accordance with the program requirements. b. The Grantee must account for rental assistance separate from all other client assistance. 12. Client Assistance – All Other a. This category includes the costs of providing assistance for eligible clients in accordance with program requirements. The guidance below is not meant to be comprehensive, and some costs may not be allowable for a particular program. It is the Grantee’s responsibility to budget and report expenses in accordance with the program requirements. b. Examples include: 1. Gift Cards/Prepaid Cards/E-Cards/Store Cards/Vouchers – The cost various types of purchase cards (e.g., gas, phone, food), vouchers (e.g., laundry vouchers for a local laundromat), and public transportation cards/tokens, etc. in accordance with program requirements. 2. Transportation – The cost of taxis, Uber, Lyft, etc. for eligible clients when necessary for the health and safety for eligible clients in accordance with program requirements. 3. Utilities – The costs associated with heat, electricity, water, etc. for eligible clients in accordance with program requirements. 4. Personal Care – The costs associated with food, formula, clothing, diapers, toiletries, medication, medical equipment, etc. for eligible clients in accordance with program requirements. 5. Safety – The cost of changing windows and doors or locks, cost of short-term alternative housing (e.g., hotel due to shelter capacity), security cameras, assistance for 12 obtaining long-term housing for a victim (regardless of distance, based on safety needs) etc. for eligible clients in accordance with program requirements. 6. Other – The cost of assistance not specifically identified above for eligible clients in accordance with program requirements . 13. Other Expenses a. This cost category includes expenses not previously identified on other line items purchased for the operation of the program. b. If the Grantee will claim the DeMinimis Indirect rate, the Grantee’s accounting records must clearly identify the following excluded expenses which are included as Other Expenses for budget and FSR purposes and excluded when determining Total Modified Direct Costs. 1. Charges for Patient Care – Medical, social, and educational services to patients relating to prevention, diagnosis, and treatment. Includes medical fees, laboratory, pharmacy, and other health inpatient care, home care services, treatments, professional and consultation fees and related travel costs, transportation of patients including accompanying parents or guardians (or other escort), and for sundry related support such as meals and housing. 2. Participant Support Costs – Direct costs for such items for stipends or subsistence allowances, travel allowances, and registration fees paid to or on behalf of participants or trainees (not employees) in connection with conferences or training projects. 2 CFR 200.201 3. Tuition Remission – Refers to ways that a college or university pays tuition costs for students. Includes tuition waivers and tuition payments. Does not include tuition reimbursement for employees when the Grantee offers tuition reimbursement as an employee fringe benefit. 4. Scholarships and Fellowships – A scholarship is generally an amount paid or allowed to a student at an educational institution for the purpose of study. A fellowship grant is generally an amount paid or allowed to an individual for the purpose of study or research. www.irs.gov c. This cost category does not include indirect expenses which are included below. 13 14. County / City Central Services a. These are costs associated with central support activities of the local governing unit allocated to the local health department accordance with Title 2 CFR, part 200. 15. General and Administrative Indirect Expenses These cost categories are used to distribute costs of general administrative operations that have not been directly charged to individual subrecipient programs. The Indirect Cost expenditures distribute administrative overhead costs to each program element, project, or service grouping. Two separate local rates may apply to the agreement period (i.e., one for each local fiscal year). Use Calendar Rate 1 to reflect the rate applicable to the first part of the agreement period and Calendar Rate 2 for the rate applicable to the latter part. Indirect costs are not allowed on programs elements designated as vendor relationship. An indirect rate proposal and related supporting documentation must be retained for audit in accordance with records retention requirements. In addition, these documents are reviewed as part of the Single Audit, subrecipient monitoring visit, or other State of Michigan reviews. Following is further clarification regarding indirect rate and/or cost allocation approval requirements to distribute administrative overhead costs, in accordance with Title 2 CFR Part 200 (formerly Circular A-87 2 CFR Part 225, Appendix E), for Local Health Departments budgeting indirect costs: 1. Local Health Departments receiving more than $35 million in direct Federal awards are required to have an approved indirect cost rate from a Federal Cognizant Agency. If your Local Health Department has received an approved indirect rate from a Federal Cognizant agency, attach the Federal approval letter to your MI E-Grants Grantee Profile. 2. Local Health Departments receiving $35 million or less in direct Federal awards are required to prepare indirect cost rate proposals in accordance with Title 2 CFR and maintain the documentation on file subject to review. 3. Local Health Departments that received approved indirect cost rates from another State of Michigan Department should attach their State approval letter to their MI E-Grants Grantee Profile. 4. Local Health Departments with cost allocation plans should reflect these allocations in the Other Cost Distributions budget category. 5. As a Subrecipient of federal funds from MDHHS, a Local Health Department that has never received a negotiated indirect cost rate, your Local Health Department may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) based on Title 2 CFR part 200 requirements. MTDC includes all direct salaries and wages, fringe benefits, supplies and materials, travel, services, and contractual expenses up to the first $25,000 of each contract. MTDC excludes all equipment, capital expenditures, charges for patient care, rental costs, tuition remission, 14 scholarships and fellowships, participant support costs, and portions sub contractual and/or subaward expenses in excess of $25,000 per contract. Attach a current copy of the letter stating the applicable indirect costs rate or calculation information justifying the de minimis rate calculation to you MI E-Grants Grantee profile. Detail on how the indirect costs was calculated must be shown on the Budget Detail Schedule. The amount of Indirect Cost should be allocated to all appropriate program elements with the total equivalent amount reflected as a credit or minus in the Administration projects. County-City Central Services Cost Allocation Plan a. This category includes the allocation of central services costs allocated to the program. b. Central service departments are within the county or city government that exist to provide support services to other operating departments within that unit of government. c. Examples of central service departments include finance, accounting, facilities maintenance, information technology, human resources, purchasing, motor pools, etc. d. All costs and data used the distribute the costs included in the plan must be supported by formal accounting and other records that support the propriety of the costs assigned to Federal awards. e. Each central service cost allocation plan is required to be certified by the local government. f. See Title 2 CFR Part 200 Appendix V, State/Local Governmentwide Central Service Cost Allocation Plans for specific requirements. Other Indirect Cost Distributions a. This category includes various contributing activity costs to appropriate program areas based on a documented allocation methodology in accordance with Title 2 CFR 200. b. This category is generally associated with governmental entities that utilize a City-County Central. c. Use to distribute various contributing activity costs to appropriate program areas based upon activity counts, time study supporting data or other reasonable and equitable means. An example of Other Cost Distributions is nursing supervision. The distribution process permits costs reflected in a single program element to be subsequently distributed, perhaps only in part, to other programs or projects as appropriate. If an allocation is made, the charges must be reflected in the appropriate program element and the offsetting credit reflected in the 15 program element being distributed. There must be a documented, well-defined rationale and audit trail for any cost distribution or allocation based upon Title 2 CFR, Part 200 Cost Principles Local Health Departments using the cost distribution or cost allocation must develop the plan in accordance with the requirements described in Title 2 CFR, Part 200. Local Health Departments should maintain supporting documentation for audit in accordance with record retention requirements. The plan should include a Certification of Cost Allocation plan in accordance with Title 2 CFR, Part 200 Appendix V. The cost allocation plan documentation is not required to be submitted unless specifically requested. d. Cost associated with the Essential Local Public Health Services (ELPHS), Maternal and Child Health (MCH) Block Grant and Fixed Fee may be budgeted in the associated program element and distributed to the associated projects. e. Federal Provided Vaccine Value should be reported on a separate line and clearly identified. SOURCE OF FUNDS Source of funds are to be entered for each program element, project, or group of services by applicable major category as follows. 1. MDHHS Comprehensive Funding (Federal and/or State dollars) provided by MDHHS for this grant agreement. 2. Fees and Collections – 1st and 2nd Party a. 1st party funds received from private payers, including patients, source users, and any member of the general public receiving services. b. 2nd party funds received from organizations, private or public, who might reimburse services for a group or under a special plan. c. Revenues will be reported when earned (accrual basis of accounting) or when received (cash basis of accounting). 3. Fees and Collections – 3rd Party a. 3rd Party funds received from private insurances, Medicaid, Medicare, or other applicable titles of the Social Security Act directly related to the cost of providing patient care or other services. 16 b. Revenues will be reported when earned (accrual basis of accounting) or when received (cash basis of accounting). 4. Local Funds All local support in the appropriate element, project, or service group column. This may include local property tax, and other local revenue. Does not include fees. 5. Federal or State (Non MDHHS) Funds provided to directly to the Grantee from the State of Michigan or the Federal government (other than MDHHS) to support the program. 6. Other Funding provided by foundation grants, United Way grants, private donations, fund-raising, charitable contributions, etc. that provide support to the program. 7. In-Kind Match Represents the value of donated services (e.g., accounting, legal, medical, etc.), donated materials and supplies, donated space, etc. that support the program. 8. MDHHS Fixed Unit Rate Select the type of fee-for-services from the lookup button to correspond with the program element. 9. MCH Funding This section includes all the funding projected to be due under Comprehensive Agreement specific to the CMH eligible program elements. Please note: the MI E-Grants System validates the MCH budgeted funds across the appliable program elements to assure the agreement does not exceed the MCH allocation. 10. Required Match – Local Funds projected to be local contribution for programs that have a match contribution requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach, or Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach and Required Local match amounts should equal each other.) 17 12. Federal Medicaid Outreach (Please note: to be used only for Medicaid Outreach, CSHCS Medicaid Outreach or Nurse Family Partnership Medicaid Outreach program elements.) Funds projected to be received from the federal government for allowable Medicaid Outreach activities. This amount represents the anticipated 50% federal administrative match of local contributions. 13. Federally Provided Vaccines The projected value of federally provided vaccines. 14. Local Non-ELPHS (Local funds budgeted for the following expenditures) 1. Expenditures for services not designated as required and allowable for ELPHS funding (e.g., medical examiner and inpatient maternity services); expenditures determined not to be reasonable; and expenditures in excess of the maximum state share of funds available. 2. Any losses arising from uncollectible accounts and other related claims. Under-recovery of reimbursable expenditures from, or failure to bill, available funding sources that would otherwise result in exclusions from ELPHS funding, if recovered. 3. However, no exclusion is required where the local jurisdiction has made and documented a decision to have local funds underwrite: a. The cost of uncollectible accounts or bad debts incurred in support of providing required or allowable health services. An example of this condition would be for services provided to indigents who are billed as a matter of procedure with little chance for receipt of payment. b. Potential recoveries or under-recoveries from other sources for the principal purpose of providing required and allowable health services at free or reduced cost to the public served by the Grantee. An example would be keeping fees for services at a reduced level for the benefit of the people served by the Grantee while recognizing that to do so limits recovery from third parties for the same types of services. 4. Contributions to a contingency reserve or any similar provisions for unforeseen events. 5. Charitable contributions and donations. 6. Salaries and other incidental expenditures of the chief executive of a political subdivision (i.e., county executive and mayor). Legislative expenditures, such as, salaries and other incidental 18 expenditures of local governing bodies (i.e., county commissioners and city councils). Do not enter board of health expenses. 7. Expenditures for amusements, social activities and other incidental expenditures related to, such as, meals, beverages, lodging, rentals, transportation, and gratuities. 8. Fines, penalties, and interest on borrowings. 9. Capital Expenditures - Local capital outlay for purchase of facilities and equipment (assets) are excluded from ELPHS funding. 15. Other Non- ELPHS Funds budgeted from sources other than state, federal and local appropriations to the extent that they are not eligible for ELPHS (e.g., funding from local substance abuse coordinating grantee, local area on aging grantees). 16. Federal Cost Based Reimbursement Funds received from Federal Cost Based Reimbursement must be budgeted and reported in the program in which they were earned. See MCBR Budget and FSR MDHHS Guidance for reporting requirements. SPECIAL BUDGET AND REIMBURSEMENT PROCEDURE INSTRUCTIONS Certain elements are supported by federal or other categorical program funds for which special budgeting requirements are placed upon grantees and subgrantees. Element Federal or Other Funding Contractor Public Health Emergency Preparedness U.S. Department of Health & Human Services, Centers for Disease Control WIC U.S. Department of Agriculture, Food & Nutrition Service Family Planning U.S. Department of Health & Human Services, Public Health Service Breast and Cervical Cancer U.S. Department of Health & Human Services, Centers for Disease Control 19 CSHCS Outreach & Advocacy Michigan Department of Health & Human Services Medicaid Outreach Activities Centers for Medicare and Medicaid Services In general, subgrantee budgets must provide sufficient budget detail to support grantee budget requests and be in a format consistent with grantor Contractor requirements. Certain types of costs must receive approval of the federal grantor Contractor and/or the grantee prior to being incurred. 1. Public Health Emergency Preparedness Local Health Departments will receive the initial FY 23/24 allocation of the CDC Public Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period October 1, 2023 through June 30, 2024. LHDs must submit a nine-month budget and a quarterly Financial Status Report (FSR) for each of the following COMPREHENSIVE Local Health Department program elements: • Public Health Emergency Preparedness (PHEP) (October 1 – June 30) • Public Health Emergency Preparedness (PHEP)– Cities of Readiness (October 1 –June 30) • Laboratory Services - Bioterrorism (October 1 – September 30) 2. WIC Special Budget Requirements WIC licensing MOUs are in the show documents section in the EGrAMS system for review. The following local budget breakdowns are required to fulfill WIC grant application budget requirements each fiscal year: • Salaries & Fringe Benefits • Automated Management Systems • Space Utilization Costs • Equipment • Supplies • Communications & Travel • All Other Direct Costs • Indirect Costs • All Funding Sources by Type The WIC cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget form in the MI E-Grants System. 20 Agencies receiving WIC-USDA Infrastructure grants must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR. Agencies receiving WIC-USDA Breastfeeding Peer Counselor funds must budget these funds as a separate element. Agencies must track and report expenditures separately on the FSR and comply with special reporting requirements. • Costs Allowable Only With Prior Approval - The following costs are allowable only with prior review/approval of the Michigan Department of Health & Human Services as specified by the U.S. Department of Agriculture, Food and Nutrition Service (Ref.: 7 CFR Part 246, and USDA-WIC Administrative Cost Handbook 3/86). Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Automated Information Systems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B. Capital Expenditures of $2,500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C. Management Studies - performed by agencies or departments other than the local Grantee or those performed by outside consultants under contract with the local Grantee. D. Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E. Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1. Contractual private physician providing certification data. 2. Contractual organization providing laboratory data. 3. Contractual translators and interpreters at the local Grantee level. F. Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out-of-service training over extended periods of time. G. Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H. Non-Fringe Insurance and Indemnification Costs 21 All charges to WIC must be necessary, reasonable, allowable and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. 3. Family Planning Special Budget Requirements The following local budget breakdowns are required to fulfill Family Planning grant application budget requirements each fiscal year: • Salaries & Wages • Fringe Benefits • Travel • Equipment • Supplies • Contractual • Construction • All Other Direct Costs • Indirect Costs • All Funding Sources by Type The Family Planning cost/funding categories and supporting budget detail requirements are satisfied by completion of an application budget in the MI E-Grants System. • Costs Allowable Only With Prior Approval - The following costs are allowable only with prior review/approval of MDHHS. Prior approval is accomplished by providing appropriate detail in the budget request approved by MDHHS or subsequently in a written request approved in writing by MDHHS. A. Alterations and Renovations - to change the interior arrangements or other physical characteristics of existing facilities or installed equipment, to the extent that such changes cost more than $1,000 each. B. Audiovisual Materials and Activities - acquired, produced, presented, or disseminated to the general public. C. Consultant Contracts for General Support Services - including equipment and supplies, that will cost in excess of $25,000 or 10% of the total direct cost budget (whichever is greater). D. Equipment - including general purpose and special equipment (e.g., air conditioning) costing $5,000 or more per unit. E. Insurance - contributions to a reserve for a self-insurance program. 22 F. Public Information Service Costs – for the cost of providing public information services. G. Publication and Printing Costs - for the cost of publications. H. Capital Expenditures - for land or buildings. I. Indemnification Against Third Parties Costs - insurance against potential liabilities. J. Mass Severance Pay - involving grant-supported personnel. K. Organization/Reorganization Costs - allocable to the program. L. Overtime Premium - involving grant-supported personnel. M. Patient Care Costs – re-budgeting out of or reduction in patient care costs (considered a change in scope). N. Professional Services - in connection with Patent/Copyright Infringement Litigation. O. Trailers or Modular Units – for costs of trailers and modular units. P. Transfers Between Construction and Non-construction - for approved construction funds. Q. Transfers Between Indirect and Direct Costs - for amounts awarded for indirect costs to absorb increases in direct costs. R. Transfers for Substantive Programmatic Work - to a third party, by contracting, or any other means used for the actual performance of substantive programmatic work. All charges to Family Planning must be necessary, reasonable, allowable, and allocable, for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including 2 CFR, Part 225 (OMB Circular A-87), A-102 Common Rule and 2 CFR, Part 215 (OMB Circular A-110) 4. Breast and Cervical Cancer Control Coordination Program Special Budget Requirements The Breast and Cervical Cancer Control Navigation Program (BC3NP) budget is to be developed based on specific responsibilities of Local Health Departments (LHDs) participating in the Breast and Cervical Cancer Control Navigation Program. LHDs agreeing to participate in the program fall into two categories: LHDs agreeing to participate as Local Coordinating Agencies (LCAs) and LHDs agreeing to participate as Local Community Partners (LCPs). A. LHDs agreeing to participate as Local Coordinating Agencies (LCAs) – LCAs are responsible in assuring implementation of all program requirements and policies and 23 procedures. This includes client outreach and recruitment into BC3NP to achieve yearly targeted caseload allocations, financial monitoring of program expenses and claims for provision of client clinical services, obtaining results of client services and entry of client data into the program’s secure statewide database to monitor timeliness and completeness of care delivery and authorize payment for services, and assuring appropriate providers are contracted with the program to provide screening and diagnostic services to enrolled clients. Only coordination expenses will be reimbursed through the Comprehensive Agreement. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCA and/or direct service providers with contracts or letters of agreement with the LCA will be responsible for billing clinical services claims to the MDHHS Cancer Prevention and Control Section. The Coordination amount of $205-$210 per woman is based on achievement of a target caseload established for each LCA by MDHHS. Requirements. Each LCAs target caseload is evaluated yearly based on the BC3NP Tiered Program Performance requirements. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. B. LHDs agreeing to participate as Community Partners (LCPs) – LCPs are responsible for implementing strategies to identify and recruit clients eligible for the BC3NP, enroll clients into the program, and arrange for provision of screening and diagnostic clinical services through contracted providers. LCPs will obtain results of all clinical services provided to BC3NP clients and send this information to MDHHS for data entry into the secure program’s statewide database. Information entered into the database will be reviewed by MDHHS staff to evaluate timeliness and completeness of care delivery and authorize payment for services. MDHHS staff will oversee financial monitoring of program expenses and claims for provision of client clinical services. LCPs will be awarded a base award (to be determined yearly by MDHHS) that is to be used to implement strategies to recruit a minimum target caseload of BC3NP women established for these agencies by MDHHS. No clinical services will be reimbursed through the Comprehensive Agreement. All clinical service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The LCP and/or direct service providers with contracts or letters of agreement with the LCP will be responsible for billing clinical service claims to the MDHHS Cancer Prevention and Control Section. There is no longer a match requirement. Match is recorded by the program and reported to MDHHS in EGrAMS. For specific billing requirements refer to the most recent BC3NP Participation Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement Rates refer to the current fiscal year Unit Cost Reimbursement Rate Schedule for the BC3NP issued in August of each fiscal year. The above referenced documents are available at https://michigan.gov/BC3NP 24 5. The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) budget is to be developed in the following way: 1. WISEWOMAN Coordination and Screening should be used to budget costs associated with coordination of the program and delivery of the initial screening and risk reduction counseling to WISEWOMAN participants. This includes collecting answers to health intake questions, WISEWOMAN screening services (height, weight, body mass index, 2 blood pressure readings, total cholesterol, HDL cholesterol, and fasting glucose or A1C), and delivery of risk reduction counseling. 2. All Direct Service claims must be billed to the MDHHS Cancer Prevention and Control Section for claim processing. The Local Coordinating Agency (LCA) and/or direct service providers with contracts or letters of agreements with the LCA will be responsible for billing Direct Service claims to the MDHHS Cancer Prevention and Control Section. This includes follow- up fasting lipid panel, fasting glucose, A1c, and one diagnostic exam. No Direct Services expenses will be reimbursed through the Comprehensive Agreement. The Coordination and Screening amount is $150 per woman based on a target caseload established by MDHHS. 3. Performance reimbursement will be based upon the understanding that a certain level of performance (measured by outputs) must be met. There is a 95% caseload performance requirement for this project. For specific billing requirements refer to the most recent Billing Manual. For specific program requirements, including current fiscal year Direct Service Reimbursement rates and documentation related to the match requirement, refer to the current fiscal year Special Budgeting and other Program instructions for the WISEWOMAN Program issued in August of each fiscal year. The above referenced documents are available at www.michigan.gov/ wisewoman. 6. Medicaid Outreach Activities and Reimbursement Procedures Medicaid Outreach Activities that are funded by local dollars and meet federal requirements are eligible for reimbursement at a 50% federal administrative match rate. Local Health Departments must maintain proper documentation of the activities performed and those activities must conform with the activities outlined in MSA Bulletin 05-29. Medicaid Outreach Activities funding is a subrecipient relationship. 25 Budget Preparation A. Medicaid Outreach Activities Complete the MI E-Grants application and budget forms for the application Medicaid Outreach Activities that occur during the fiscal year: 10/1-09/30. Reimbursable activities included in the budget must conform to the requirements as specified in the MSA Bulletin 05-29. Complete the MI E-Grants application and budget forms for this program. 1. Expenditure Category Tab Enter the expenditures budgeted for the fiscal year 10/1-9/30 Expenses budgeted for each of the listed expenditure categories are allowable and must be specific to the Medicaid program as described in MSA Bulletin 05-29. Outreach activities must not be part of direct service. Expenditures must be reflected in the cost allocation plan. 2. Source of Funds Tab Budget the amount expected from the federal government for allowable Medicaid Outreach Activities. Federal Medicaid Outreach represents the anticipated 50% federal administrative match of local contributions. Budget the local contribution. Required Match - Local represents the 50% matching local contribution for Medicaid Outreach activities. These two amounts must match. 3. Sources of Local Funds Types Local Health Departments may utilize their county appropriation, any earned income, funds received from local or private foundations, local contributors or donators, and from other non-state/non-federal grant agreements that are specific to Medicaid outreach or are to be used at the discretion of the Health Department as a source for matching funds. Other state and/or federal grant awards for Medicaid Outreach must be recorded on the appropriate line as indicated in the Comprehensive Budget Instructions - Attachment I. B. Nurse-Family Partnership Outreach Expenditures related to Nurse-Family Partnership Medicaid Outreach should be reflected under one program element. The budget should reflect the entire fiscal year period: 10/1- 09/30. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD Nurse-Family Partnership program has been applied. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 26 2. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution in Required Match – Local. Federal Medicaid Outreach and Required Match – Local must equal each other. Additional local contribution related to service provision for non- Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds – Other. 3. Sources of Local Fund Types Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non- state/non-federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the Health Department as a source for matching funds. C. CSHCS Medicaid Outreach Complete the MI E-Grants application and budget forms for the application titled CSHCS Medicaid Outreach for the timeframe: 10/01-09/30. Expenditures related to CSHCS Medicaid Outreach should be reflected under one program element and adhere to Section IV, Special Instruction Section found in the Comprehensive Budget Instructions - Attachment I. The budget should reflect the entire fiscal year period: 10/1-09/30. 1. Federal Medicaid Outreach Fifty percent (50%) of local funds after the percentage of Medicaid clients enrolled in the LHD CSHCS program has been applied. A table containing each health jurisdiction Medicaid Participation Rate is located in the MI E-Grants site. The formula for calculating the federal funding is as follows: Federal funding = (Local funds x % of Medicaid Participation Rate) x 50% Federal Administrative Match rate) 2. Required Match - Local Represents the 50% match of local contributions. Budget the local match contribution. Federal Medicaid Outreach and Required Match – Local must equal each other. Additional local contribution that is not eligible for the 50% federal match should be reported on the Local Funds – Other line. 27 3. Sources of Local Fund Types Local Health Departments may utilize their county appropriation, funds received from local or private foundations, local contributors or donators, and from other non- state/non-federal grant agreements that are specific to Medicaid Outreach or are to be used at the discretion of the health department as a source for matching funds to be used at the discretion of the health department as a source for matching funds. 4. Comprehensive CSHCS Outreach and Advocacy and Case Management/Care Coordination Funds Should be reported in a separate program element. Indirect Costs There are three (3) options for indirect costs. They are: 1. an approved federal or state indirect rate; 2. a 10% de minimis rate; or 3. a cost allocation/distribution plan Most Health Departments will use the cost allocation plan for indirect costs. For further detail, go to VI. Form Preparation, L. Indirect Cost, on page 5 of this document. Cost Allocation Certification The Cost Allocation Certification remains on file with the Department until there is a change in the Cost Allocation Plan. When the cost allocation plan on file with the program (MDHHS- Medicaid-Outreach), the local health department must: 1) submit a copy of the revised cost allocation plan with the budget request; and 2) complete a revised cost allocation methodology certification. Both documents are to be attached to a Detailed Budget line in EGrAMS. Financial Status Report (FSR) – LHDs seeking 50% federal administrative match must request reimbursement by submitting their actual expenses for allowable Medicaid Outreach activities on their quarterly FSRs through MI E-Grants. A. Quarterly and Final FSR LHDs must reflect the actual Medicaid Outreach expenses incurred on the quarterly and final FSR. Actual expenses incurred must be specific to Medicaid Outreach as defined by the MSA Bulletin 05-29 and not part of a direct service. All expenses should be supported by an approved methodology and appropriate support documentation. 28 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match for Medicaid Outreach. 2. Required Match - Local Should be used to report the local match for Medicaid Outreach. Both the federal and local amounts must match. 3. Source of Funds Category Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds – Other). Total Source of Funds must equal Total Expenditures. B. Nurse-Family Partnership Medicaid Outreach – Quarterly and Final FSRs For Quarters 1-3, LHDs must reflect the actual Medicaid Outreach expenses incurred in a separate program element titled Medicaid Outreach. Actual expenses incurred for each of the listed expenditure categories are allowable but must be specific to Medicaid Outreach as defined by MSA Bulletin 05-29 and not part of a direct service. Expenses should be supported by a time study or other federally approved methodology. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Both lines should equal. Additional local contribution related to service provision for non-Medicaid eligible participants which are not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Category 29 Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I (e.g., Local non-ELPHS or Local Funds – Other). C. CSHCS Medicaid Outreach – Final FSR CSHCS Medicaid Outreach billing may occur before the final FSR through the MI E-Grants system after Comprehensive Agreement CSHCS Outreach and Advocacy funds have been fully expended. Local contributions eligible for the Medicaid Outreach match should be cost distributed to the CSHCS Medicaid Outreach program element from the CSHCS Outreach and Advocacy program element and reported as indicated below. 1. Federal Medicaid Outreach Should be used to request the 50% federal administrative match. Match is determined by multiplying local contribution for the program by the percentage of Medicaid enrollees. This product is then multiplied by 50% in order to determine the eligible federal administrative match. 2. Required Match - Local Should be used to report the remaining portion of the local contribution for the Medicaid Outreach Match. Additional local contribution that is not eligible for the 50% federal match should be reported in Local Funds - Other. 3. Source of Funds Category Other source of funds that are non-reimbursable for Medicaid Outreach (i.e., other federal grants, other MDHHS grants, etc.) should be reported on the appropriate line has indicated in the Comprehensive Budget Instructions - Attachment I. 4. Comprehensive CSHCS Outreach and Advocacy and Care Coordination Should be billed as separate program element. 7. Immunization 317 and VFC Allowable Expenditures Please reference the Immunization VFC and 317 Allowable expenditures chart located in the documents section in EGrAMS. The information is provided from the “Immunization Program Operations Manual” (known as the IPOM), published by CDC. 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 Thomas Dunn dunnt2@michigan.gov Body Art Fixed Fee Seth Eckel eckels1@michigan.gov Breast & Cervical Cancer Control (BCCCP) Coordination Polly Hager hagerp@michigan.gov Bridge Access Program - Fixed Fee Kristina Paliwoda paliwodak@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 Child and Adolescent Health Center Renovation (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 Sara Pearson pearsons@michigan.govg g p @ gg Emerging Threats - Hepatitis C Macey Ladisky ladiskym@Michigan.gov Empowering Youth Today Robyn Corey coreyr1@michigan.gov Ending the HIV Epidemic Implementation Thomas Dunn dunnt2@michigan.gov Family Planning Services Steve Utter utters@michigan.gov Fetal Alcohol Spectrum Disorders Community Projects Michele Fanning Niles nilesm2@michigan.gov Fetal Infant Mortality Review (FIMR) Case Abstraction Nicholas Drzal / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov FFPSA HV Expansion Charisse Sanders sandersc2@michigan.gov FIMR Interviews Nicholas Drzal / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov Food ELPHS Carrie Fidler fidlerc@michigan.gov Gonococcal Isolate Surveillance Project Thomas Dunn dunnt2@michigan.gov Grief and Bereavement Michele Fanning Niles nilesm2@michigan.gov Harm Reduction Capacity Expansion Macey Ladisky ladiskym@Michigan.gov Harm Reduction Support Services Macey Ladisky ladiskym@Michigan.gov Hearing ELPHS Jennifer Dakers dakersj@michigan.gov HIV & STI Testing and Prevention Thomas Dunn dunnt2@michigan.gov HIV / STI Partner Services Thomas Dunn dunnt2@michigan.gov HIV Care Coordination Thomas Dunn dunnt2@michigan.gov HIV Data to Care Thomas Dunn dunnt2@michigan.gov HIV Housing Assistance Thomas Dunn dunnt2@michigan.gov HIV Linkage to Care Thomas Dunn dunnt2@michigan.gov HIV PrEP Clinic Thomas Dunn dunnt2@michigan.gov HIV PrEP Mobile Clinic Thomas Dunn dunnt2@michigan.gov HIV Prevention Thomas Dunn dunnt2@michigan.gov HIV Prevention - Forest Community Health Thomas Dunn dunnt2@michigan.gov HIV Ryan White Part B Thomas Dunn dunnt2@michigan.gov HIV Ryan White Part B MAI Thomas Dunn dunnt2@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 / Dan Thompson drzaln@michigan.gov / thompsond29@michigan.gov Informed Consent Laura de la Rambelje delarambeljel@michigan.gov Integrating MPOX into STI Clinics Thomas Dunn dunnt2@michigan.gov Laboratory Services Bio Marty Soehnlen soehnlenm@michigan.gov Lactation Consultant Nicholas Drzal drzaln@michigan.gov Lead Hazard Control Chad Rhodes rhodesc2@michigan.gov Lead Health and Safety Courtney Wisinski MurtyC@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 Christine Farrell farrellc@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 tiptonj2@michigan.gov MRC STTRONG 6/1 - 9/30 Janis Tipton tiptonj2@michigan.gov Neighborhood Wellness Center Joseph Coyle greenj13@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 Thomas Dunn dunnt2@michigan.gov Statewide Lead Case Managment - Fixed Fee Carin Speidel speidelc@michigan.gov STI Specialty Services Thomas Dunn dunnt2@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: 9/30/2024 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: Bridge Access Program Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis The purpose of the project is to reimburse Local Health Departments (LHD) for COVID vaccine administration fees for vaccines administered under the Bridge Access Program. State of Michigan will allocate funds to LHDs for COVID vaccine administration fees. LHDs will be reimbursed $39.98 for each COVID vaccine administered to individuals eligible for the Bridge Access Program. The Bridge Access Program provides free COVID vaccine to under and uninsured adults aged 18 and older. Reporting Requirements (if different than contract language) All requests for reimbursement of the administration fee should be submitted monthly on the Comprehensive Financial Status Report (FSR). • NOTE: Reimbursement will be provided on a first come first served basis until funding has been depleted or the program comes to an end, whichever comes first. Any additional requirements (if applicable) LHDs participating in the Bridge Access Program must be visible on Vaccines.gov to participate in the program and must therefore indicate their vaccine availability. Instructions on how to manually indicate vaccine availability on Vaccines.gov can be found here. The Bridge Access Program does not require inventory reporting on Vaccines.gov. PROJECT: CAHC Renovation (all locations) Start Date: 10/1/2024 End Date: 9/30/2025 Project Synopsis: The purpose of the project is to upgrade facilities within the Child and Adolescent Health Center program, including Child and Adolescent Health Centers (CAHC) and School Wellness Programs (SWP). Additional Reporting Requirements (if applicable): N/A Any Additional Requirements: For any project dedicated solely to construction - the Grantee shall consider whether 2023 PA 0010 is applicable when entering into subcontracts under this Agreement. 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: 10/1/2023 End Date: 9/30/2024 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. Community Health Assessment & Improvement may be budgeted as part of the MDHHS- Other ELPHS budget. • 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 23/24 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 23/24, 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: • 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 January 1 – June 30 July 12 MDHHS Family Planning Inbox mdhhs- reproductivehealthunit@ michigan.gov 14) (Calendar 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. 49. Each grantee awarded an additional geographic service area (GSA) allocation in Fiscal Year 2024 (FY24) via the approved Family Planning funding formula must serve at least 25% of their additional GSA contracted caseload performance expectation. Each grantee’s FPAR data will be used to monitor contracted caseload performance. Year-end FPAR will be used to assess whether grantee has met the 25% contracted caseload performance expectation. 50. Grantees awarded contraceptive access funding in FY24 will use these funds to support access to a broad range of FDA-approved contraceptive methods on-site, including long-acting reversible contraceptives. These funds will be monitored via routine financial (e.g., financial status reports) and program oversight (e.g., FPAR, comprehensive site reviews) mechanisms. 51. Grantees awarded Chlamydia Quality Improvement/Quality Assurance (QI/QA) funding in FY24 will use these funds to support staff participation, implementation, and monitoring of an identified chlamydia screening QI/QA project. These funds will be monitored via routine financial (e.g., financial status reports) and program oversight (e.g. FPAR, comprehensive site reviews) mechanisms. 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 - Pilot Start Date: 11/1/2023 End Date: 6/30/2024 Project Synopsis The purpose of this project (also referred to as AA1) is to improve vaccination coverage among under-vaccinated populations and further prevent vaccine-preventable diseases in area jurisdictions throughout Michigan. The target population for this project is children aged 19 through 35 months of age living in Oscoda, Gladwin, and Houghton counties. The goal of this project is to improve vaccination coverage among this target population, as well as increase parents and the public’s understanding of the benefits of vaccines, raise awareness of the need for timely immunization, and to enhance confidence in the safety of vaccines. Reporting Requirements (if different than contract language Completion of the Quarterly Report Form. Reports and information should be emailed to: mdhhs-immsreports@michigan.gov. Any additional requirements (if applicable) 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. • Not allowable expenses include vehicles, food, alcoholic beverages, private stock vaccine purchases, building purchases, construction, capital improvement, entertainment costs, goods and services for personal use, and promotional and/or incentive material. 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. 10. Adhere to federal and state requirements regarding the use of programmatic funds. • Not allowable expenses include vehicles, food, alcoholic beverages, private stock vaccine purchases, building purchases, construction, capital improvement, entertainment costs, goods and services for personal use, and promotional and/or incentive material. 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 8 Month Project (MRCE) Start Date: 10/01/2023 End Date: 05/31/2024 4 Month Project (MRCF) Start Date: 6/1/2024 End Date: 9/30/2024 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: Neighborhood Wellness Centers Start Date: 5/1/2024 End Date: 9/30/2024 Project Synopsis To address health disparities in the community by providing healthcare services related to immunization, mobile health screenings, and preventive care for substance use and substance use disorder services, in collaboration with MDHHS/Neighborhood Wellness Centers. Reporting Requirements (if different than contract language) MDHHS TCC COVID-19 TESTING EVENTS DEMOGRAPHIC DATA SUBMISSIONS Vendors must provide to MDHHS TCC (Testing Collection and Coordination) team the individual demographic information on template provided from all Testing Events in the required format within 48 hours of event completion. This applies to any updated testing results as well. Questions asked and options for responses must remain identical to ensure user experience and data consistency at all events, regardless of vendor. An Excel template (<VendorName>COVIDTestingEventData.xlsx) has been provided that has the appropriate column headings, formats, and drop-down selections. Vendors may choose to export data from their own reporting tool and submit IF the datafile still follows the required naming conventions, fields, header names, formats and selection options. Datafile to be uploaded to the appropriate <VendorName>Data subfolder in the appropriate <VendorName> folder on SharePoint DTMB-Teams-COVID-Testing-Collection - MultiVendor - All Documents (sharepoint.com) Datafile can only be uploaded after access to the Vendor SharePoint Folder has been granted by the TCC Team. The list of who has the ability to upload should be given at vendor onboarding meetings. Subsequent staff updates or changes should be sent to MDHHS- COVIDTestingSupport@michigan.gov copying the TCC Team Implementation Managers (see staff directory). Any additional requirements (if applicable) 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. Project Title: Oral Health Kindergarten Assessment Start Date: 10/1/2023 End Date: 9/30/2024 Project Synopsis: Local health departments (LHD) will perform no-cost oral health assessments on children enrolling into kindergarten or first grade and refer for dental treatment as assessment findings warrant. Additional Reporting Requirements: • The LHD shall submit quarterly progress reports on a form provided by the Contract Manager. These reports shall include a narrative description of program activities during the respective quarter. • The above reports shall be submitted via email directly to the Contract Manager no later than 30 days following the end of each quarter: Michele Kawabe, MPH, RD, CDCES Kindergarten Oral Health Assessment Program Consultant kawabem@michigan.gov Additional Requirements: • The LHD must be designated as a grantee health agency under P.A. 161 (MCL 333.1625) and permitted to operate as a Mobile Dental Facility within the state of Michigan unless the LHD subcontracts all assessments to an outside dental agency. Any agency that is subcontracted by an LHD to conduct assessments must be both designated as a grantee health agency under P.A. 161 and permitted to operate as a Mobile Dental Facility within the State of Michigan. • The LHD and any agency it subcontracts to perform oral health assessments must follow all applicable federal, state, and local laws, and all administrative rules, regulations, and ordinances, including those required for their PA 161 designation and mobile dental facility permit approval. • The LHD and any agency it subcontracts to perform oral health assessments must follow all guidance included in the Kindergarten Oral Health Assessment Program Guidelines. • The LHD shall develop an outreach plan to inform families, schools, daycare facilities, and other relevant stakeholders of KOHA. This plan shall include working collaboratively with school and other relevant community partners to publicize and host screening events. • The LHD shall conduct oral health assessments at a minimum rate of 50% of the total number of kindergarteners eligible for free or reduced lunch within the LHD’s jurisdiction; the assessments may be conducted by a subcontracted agency or agencies on behalf of the LHD. • The LHD and any subcontracted agencies shall adhere to all applicable safety and infection control standards while providing dental assessments. • The LHD shall attend scheduled meetings, calls, site visits, etc as requested by MDHHS and comply to all KOHA requirements as they are developed. 1 PROJECT: Public Health Emergency Preparedness (PHEP) and Cities Readiness Initiative (CRI) 9 Month Project – BIONINE/CRININE Start Date: 10/1/2023 End Date: 6/30/2024 3 Month Project – BIOTHREE/CRITHREE Start 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. 2 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, 3 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. 4 • 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. 5 • 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. 6 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 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 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), 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 2024, must be identified on the work plans submitted to the 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. 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: • 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 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, 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. 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. • 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: January 10 • January 1– March 31: April 10 • April 1 – June 30: July 10 • July 1– September 30: October 10 The provided progress report information will be included in the Quarterly SLFRF Narrative Report. • 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) • 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: 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: 10/1/2023 End Date: 9/30/2024 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: 10/1/2024 End Date: 9/30/2025 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. _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 1 of 22 FY 2024 MDHHS LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Unique Entity Identifier #:J25FVSQGPKM1 This Agreement is made between Oakland County, a Constitutional Corporation, 1200 North Telegraph, Pontiac, Michigan 48341 ("County") and Oakland Livingston Human Service Agency (OLHSA), 196 Cesar E. Chavez Ave., Pontiac, Michigan 48343-0598, a Michigan Municipal Corporation ("Subrecipient"). The County and Subrecipient 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 Subrecipient to implement WIC Resident and WIC Breastfeeding Peer Counseling Services. 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. The County intends to use a portion of the Grant funds to reimburse the Subrecipient, 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 Subrecipient 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 federal award committed to the Subrecipient under this Agreement is not DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 2 of 22 to exceed $604,848 and is allocated as follows: •$84,867– WIC Breastfeeding Peer Counseling Funding to fund 1.5 FTE peer counseling time and does not include supervisor or mentor time. Oakland County Health Division WIC program will provide Oakland Livingston Human Service Agency’s IBCLC services. •$519,981 – WIC Resident Services and reflects a budget submitted by OLHSA and approved by OCHD and State WIC to achieve an average monthly caseload of 3,676. 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: X Subrecipient relationship (federal funding); or Recipient (non-federal funding). The grant Agreement is designated as: Research and development project; or X Not a research and development project. B. Identification of Federal Dollars Awarded CFDA Title: Special Supplemental Nutrition Program for Women, Infants and Children CFDA Number: 10.557 Award Name: Women Infants and Children Award Number (FAIN): 232MI003W1003 Award Date: 10/18/22 CFDA Number: 10.557 Award Name: Women Infants and Children Breastfeeding Peer Counseling Program Award Number (FAIN): 232MI013W5003 Federal Agency Name: USDA Food and Nutrition Services Awarding Official Contact Information: Cecilia Hutson, Manager, Financial Management & FMNP Section Period of Performance: October 1, 2022, through September 30, 2023 Pass Through Entity (PTE): Michigan Department of Health & Human Services (MDHHS) DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 3 of 22 MDHHS Indirect Cost Rate: 10% De Minimis C. Equipment Purchases and Title Subrecipient will not purchase capital assets or equipment using funds from this Agreement without the approval of the County. 4.Statement of Work: The Subrecipient 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 and Attachments B1 through B4, which are part of this Agreement. 6.Performance/Progress Report Requirements: The progress reporting methods shall be followed as described in Part II and Attachment C, which are part of this Agreement. 7.General Provisions: The Subrecipient agrees to comply with the General Provisions outlined in Part II, which are part of this Agreement. The Subrecipient also agrees that it will comply with all of the terms and conditions of the County’s Grant Agreement with the State (Grant Agreement), which is included and incorporated into this Agreement as Attachment E. 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: Lisa McKay-Chiasson, Public Health Administrator (248) 858-1395 mckay- chiassonl@oakgov.com 9.Subrecipient's Financial Contact for the Agreement: The person acting for the Subrecipient on the financial reporting for this Agreement is: Name: Charles Blake, Deputy Director for Financial Compliance DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 4 of 22 E-Mail Address: Charlesb@olhsa.org Telephone No.: (248) 209-2632/210-8025 10.Special Conditions: A. This Agreement is valid upon approval and execution by the County and Signature by the Subrecipient. 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 Subrecipient 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 - Subrecipient The Subrecipient 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 Subrecipient 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 Subrecipient must obtain and maintain all necessary licenses, permits, and insurances under Part II.1.L, and any other authorizations necessary for the performance of this Agreement. D.Reporting Utilize all report forms and reporting formats required by the County at the effective date of DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 5 of 22 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 Subrecipient 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 Subrecipient, any parent, affiliate, or subsidiary organization of Subrecipient, and any subcontractor that performs Agreement activities in connection with this Agreement. F.Audit and Access to Records Subrecipient certifies by signing this Agreement that it complies with regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200 and will provide notice of the completion of required audits and any adverse findings which impact this subaward as required by parts 200.501-200.521 and will 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 Subrecipient, a subcontractor, or an officer or director of Subrecipient 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. 2.A criminal Proceeding. 3.A parole or probation Proceeding. 4.A Proceeding under the Sarbanes-Oxley Act. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 6 of 22 5.A civil Proceeding involving: a.A claim that might reasonably be expected to adversely affect Subrecipient’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 Subrecipient or its subcontractors discriminated against its employees, subcontractors, vendors, or suppliers during the term of this Agreement. 6.A Proceeding involving any license that Subrecipient 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 Subrecipient’s ownership or executive management I.Statement of Work Progress Reports Reserved J.Conflict of Interest and Code of Conduct Standards i.The Subrecipient is subject to the provisions of 1968 PA 317, as amended, 1973 PA 196, as amended, and Title 2 Code of Federal Regulations, Section 200.318 (c) (1) and (2). ii.The Subrecipient 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 Subrecipient, 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 Subrecipient, any parent, affiliate, or subsidiary organization of Subrecipient, and any subcontractor that performs activities in connection with this Agreement. K.Travel Costs i.Be reimbursed for travel cost (including mileage, meals, and lodging) budgeted and incurred related to services provided under this Agreement. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 7 of 22 1.If the Subrecipient has a documented policy related to travel reimbursement for employees and if the Subrecipient follows that documented policy, the County will reimburse the Subrecipient for travel costs at the Subrecipient’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 Subrecipient 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 Subrecipient will interact with children, schools, or the cognitively impaired, the Subrecipient must maintain appropriate insurance coverage related to sexual abuse and molestation liability. 3.Workers’ Compensation Insurance or Governmental Self-Insurance: Coverage according to applicable laws governing work activities. Policies must include DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 8 of 22 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 Subrecipient shall obtain and maintain insurance according to this Section and the specific County requirements listed in Attachment D, which is incorporated into this Agreement. iv.Subrecipient 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 Subrecipient 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 3.National Sex Offender Registry: http://www.nsopw.gov ii.Conduct or cause to be conducted a Central Registry (CR) check for each employee, DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 9 of 22 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 Subrecipient 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 Subrecipient. 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 Subrecipient 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 Subrecipient an opportunity to review. 3.Assurances The following assurances are hereby given to the County: A.Compliance with Applicable Laws DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 10 of 22 The Subrecipient will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this Agreement. The Subrecipient 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 Subrecipient will comply with all applicable requirements in the original grant awarded to the County. The County may determine that the Subrecipient 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 Subrecipient 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 Subrecipient shall require that the language of this assurance be included in the award documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. C.Non-Discrimination i.The Subrecipient 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 Subrecipient 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. ii.The Subrecipient will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 11 of 22 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 Subrecipient 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 Subrecipient 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 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 12 of 22 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 Subrecipient 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 Subrecipient also assures that this language will be included in any subawards which contain provisions for children’s activities. ii.The Subrecipient 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 the facility under the control of the Subrecipient. If activities are delivered in facilities or areas that are not under the control of the Subrecipient (e.g., a mall, restaurant or private work site), the activities shall be smoke-free. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 13 of 22 F.Hatch Political Activity Act and Intergovernmental Personnel Act The Subrecipient 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 Subrecipient 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 Subrecipient 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 Subrecipient 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 Subrecipient 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 i.Subrecipient 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 14 of 22 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 Subrecipient under this Agreement, the Subrecipient assures that it is in compliance with requirements of HIPAA including the following: i.The Subrecipient 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 Subrecipient will ensure that any subcontractor will have the same obligations as the Subrecipient 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 Subrecipient must only use the protected health data and information for the purposes of this Agreement. iv.The Subrecipient 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 Subrecipient’s employees. v.The Subrecipient 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 Subrecipient becomes aware. The Subrecipient will work with the County to mitigate the 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 Subrecipient must provide the same to the County. vi.Failure to comply with any of these contractual requirements may result in the DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 15 of 22 termination of this Agreement in accordance with Part II, Section 4, G. Agreement Termination. vi.In accordance with HIPAA requirements, the Subrecipient 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 Subrecipient from the State, County, or any other source. vii.The Subrecipient 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 Subrecipient’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 Subrecipient may not refer to the County on the Subrecipient'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 Subrecipient agrees that it will use Confidential Information solely for the purpose of this Agreement. The Subrecipient 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 Subrecipient must take all reasonable precautions to safeguard the Confidential Information. These precautions must be at least as great as the precautions the Subrecipient takes to protect its own confidential or proprietary information. 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 16 of 22 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 Subrecipient must notify the County within one (1) business day after discovering any unauthorized use or disclosure of Confidential Information. The Subrecipient 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 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 17 of 22 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, 2023. 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 Lisa McKay-Chiasson at mckay- chiassonl@oakgov.com. For questions, call 248-858-1395, Lisa McKay-Chiasson. 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 Subrecipient 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 Subrecipient does not reconcile, then the Subrecipient shall provide any additional documentation requested by the County in order to process payment. 1.A fully completed and signed invoice provided by Oakland County Health Division. 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 18 of 22 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 Subrecipient 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 Subrecipient 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 The Subrecipient is allowed to use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 to recover their indirect costs. G.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 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 Subrecipient or an official of the Subrecipient or an owner is convicted of any activity referenced in Part II, Section 3, D. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 19 of 22 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 Subrecipient violates or breaches any contract terms. H.Stop Work Order The County may suspend any or all activities under this Agreement at any time. The County will provide the Subrecipient with a written stop order detailing the suspension. Subrecipient must comply with the stop work order upon receipt. The County will not pay for activities, Subrecipient’s incurred expenses or financial losses, or any additional compensation during a stop work order. I.Final Reporting Upon Termination Should this Agreement be terminated by either party, within 30 days after the termination, the Subrecipient 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 Subrecipient for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Subrecipient shall immediately refund to the County any funds not authorized for use and any payments or funds advanced to the Subrecipient in excess of allowable reimbursable expenditures. J.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. K.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 Subrecipient, 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 20 of 22 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 Subrecipient 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. M.Liability The Subrecipient 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 Subrecipient 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 Subrecipient, any of its subcontractors, or anyone directly or indirectly employed by the Subrecipient. ii.Nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Subrecipient 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. N.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. Subrecipient waives any objections, such as lack of personal jurisdiction or forum non conveniens. Subrecipient must appoint an agent in Michigan to receive service of process. L. Amendments DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 21 of 22 O.Entire Agreement 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 22 of 22 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 responsible governing board or official of the Subrecipient, and hereby accepts and binds the Subrecipient to the terms and conditions of this Agreement EXECUTED: Printed Name: Susan Harding Title: CEO Oakland Livingston Human Service Agency DATE:_______________ DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 11/2/2023 Attachment A Minimum Contractor Scope of Service Requirements Subrecipient, in accordance with the general purposes and objectives of this Agreement, will provide Women, Infants and Children’s Program (WIC) and Peer Counseling services as follows: •Comply with all applicable WIC federal regulations, policy, guidance and requirements of the WIC program as prescribed in the Code of Federal Regulations (7 CFR, Part 246). •Follow the allowable expense guidelines provided by USDA FNS for the Peer Counselor Grant. •Cooperate with an annual site visit by OCHD and develop and adhere to a Corrective Action Plan developed because of audit exceptions. The program must comply with all State and Federal audit requirements as applicable. •Assure that the sub-recipients financial system meets generally accepted accounting principles and systems. The sub-recipient must provide the most recent Financial Audit or Financial Statement (if an audit was not done) and the accompanying management letter. •Coordinate with the Contract Administrator and comply with all program, financial and reporting procedures. •Provide for security of Project FRESH coupons, as applicable and WIC EBT cards stored prior to issuance. Subrecipient must notify the Oakland County Health Division WIC program and the State WIC Division in writing of any lost, stolen, inappropriately issued or otherwise unaccounted for Project FRESH coupons or EBT cards, immediately upon recognition of such condition. •Maintain an inventory of all equipment purchased with WIC program funds and maintain such inventory at each WIC clinic location. •Install and maintain WIC hardware according to guidance provided by the Department WIC Program. •Ensure each OLHSA employee authorized for or requesting access to the automated WIC system has completed and signed a security agreement. •Provide personnel possessing at least the minimum qualifications as set by MDHHS – WIC Division, to deliver WIC services to the identified target population. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 • Maintain confidentiality of records on clients served and allow for the sharing of client information between the County and Subrecipient staff. Obtain signed Release of Information forms for sharing client information with other community service agencies/providers unless mutual aid agreements are available from the State WIC agency. • Create a nutrition education, breastfeeding promotions and outreach plans per WIC policy and submit to OCHD for review and approval by the designated due date. Implement the plan to conduct outreach to identify and bring hard to reach women and children into the WIC Program from communities that have been identified as undeserved by the Oakland County Health Division WIC Program (OCHD WIC). • Provide an annual plan and corresponding budget for the delivery of WIC services and WIC Breastfeeding Peer Counseling Services, specifically dealing with timelines and expected activity and productivity. • Must participate in mandatory nutrition education and breastfeeding time studies as determined by the State Agency. • Act as a resource to additional health and human services in the community. • Responsible for all expenses incurred to support and maintain delivering WIC services. • All materials and advertising used to promote the WIC Program shall also include information about WIC services offered by Oakland County Health Division and refer clients to Oakland County Health Division WIC clinics if those clinics provide the best access to services for clients. • Refer all ante partum women to the Oakland County Health Division in partnership with OCHD Infant Mortality Reduction efforts. • Coordinate with the Contract Administrator and comply with all program, financial and reporting procedures. • Breastfeeding Peer Counseling (BFPC) funds distributed to State agencies by the Food and Nutrition Service (FNS) are to be used to develop or expand activities necessary to sustain a peer counseling program based on the FNS Loving Support Model. The primary purpose of the funds is to provide direct breastfeeding support services through peer counseling to WIC participants. The use of BFPC funds for expenditures that are not supported by the Loving Support Model are not authorized. • Funds allocated for the Breastfeeding Peer Counseling Program are exempt from the WIC Nutrition Education and Breastfeeding Time Study. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Implement WIC Breastfeeding Peer Counseling services by following these guidelines: 10 Components of Loving Support Peer Counseling Program 1. Hire staff that meets the definition of Peer Counselor 2. Designate a Breastfeeding Peer Counselor Manager at the local level 3. Establish job parameters and description for peer counselors consistent with State WIC policy 4. Establish compensation and reimbursement rates for peer counselors 5. Train appropriate WIC local peer counseling management and clinic staff 6. Establish standardized breastfeeding peer counseling program procedures at the local level as part of the Agency’s WIC Nutrition Services Plan 7. Supervise and monitor peer counselors 8. Establish community partnerships to enhance the effectiveness of the WIC peer counseling program 9. Provide: o Timely access to breastfeeding coordinators/lactation experts for assistance outside peer counselor scope of practice o Regular, systematic contact with supervisor o Participation in clinic staff Meetings and breastfeeding in-services as part of the WIC team o Opportunities to meet regularly with other peer counselors 10. Provide training and continuing education of peer counselors DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 OLHSA WIC clinic locations and dates and times of service are listed below. Any change to location must be approved by Oakland County Health Division by following the procedures described below. Clinic Location Service Days Open C.A.R.E.S. of Farmington 21840 Independence St Farmington Hills, MI 48336 1st and 3rd Friday Karl Richter Center 920 Baird St. Holly, MI 48442 Every Tuesday Madison Heights 711 West 13 Mile Rd. Madison Heights, MI 48071 Tuesday, Wednesday and Thursday OLHSA Building 196 Cesar E. Chavez Ave. Pontiac, MI 48342 Monday, Wednesday, Thursday and Friday Journey Lutheran Church 136 S. Washington Oxford, MI 48371 2nd Monday (Once a Month) Requirements for Relocating, Adding or Closing a WIC Clinic A request to move, add or close a WIC clinic shall be submitted to OCHD in writing 60 days prior the clinic change occurring. The written request must include: • The reason for the move, closure, or additional clinic • Describe how many clients are impacted by the clinic change and how they will receive information about the change in WIC services • Identification of the proposed site • Justification for the location being proposed including: o Analysis of caseload and how the move or addition of a clinic will impact caseload o Documentation of need o Number of clients estimated to be served at the location • Location of clinic including zip codes served • Frequency of the proposed clinic The Oakland County Health Division WIC Supervisor shall complete a site visit if provisional approval is granted for the proposed site. When the site visit is successfully completed and any concerns about the location addressed, final, written approval will be provided. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Use WHOLE DOLLARS Only ATTACHMENT B.1 Page Of From:To: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 16. Oakland Livingston Human Service Agency WIC Program CONTRACTOR NAME BUDGET PERIOD PROGRAM BUDGET SUMMARY For WIC Peer Counselor Funding Application View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH PROGRAM DATE PREPARED 6/12/23 Oakland Livingston Human Service Agency WIC Program 10/1/2023 9/30/2024 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # 196 Cesar E. Chavez Pontiac, Michigan 48343 EXPENDITURE CATEGORY (Use Whole Dollars) TOTAL BUDGET SALARY & WAGES FRINGE BENEFITS TRAVEL SUPPLIES & MATERIALS OTHER EXPENSES - list below Flyers, advertising, social media CONTRACTUAL (Subcontracts/Subrecipients) EQUIPMENT Telephones for staff IT Cost Pool HR Cost Pool Audit TOTAL DIRECT EXPENDITURES (Sum of Lines 1-7) INDIRECT COSTS: Rate #1 % TOTAL EXPENDITURES SOURCE OF FUNDS: COMPLETION: Is Voluntary, but is required as a condition of funding. TOTAL FUNDING $2,500 $1,000 $8,000 $2,000 $2,000 $425 DCH-0385(E) (Rev. 01/09) $47,587 $12,970 $3,580 $4,805 $84,867 $84,867 $84,867 ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT B.2 Page Of Use WHOLE DOLLARS Only DATE PREPARED From:To: 10/1/2023 9/30/2024 AMENDMENT # POSITIONS REQUIRED TOTAL SALARY 5,528$ 5,154$ 8,599$ 8,598$ 7,900$ Lactation Specialist 1@18 hours x 52 weeks 11,808$ 47,587$ 2. FRINGE BENEFITS: (Specify) Composite Rate % 45% Part Time X% Full Time 12,970$ $3,580 3. TOTAL TRAVEL:3,580$ 4,805$ 4,805$ Name Amount Audit -$ 5. TOTAL CONTRACTUAL:-$ Amount $2,500 6. TOTAL EQUIPMENT:2,500$ Amount Communication:$1,000 Space Cost:$8,000 Others (explain):$2,000 $2,000 $425 13,425$ 84,867$ Rate #1 Base $x Rate = -$ Rate #2 Base $- x Rate = -$ -$ 84,867$ DCH-0386(E) (Rev. 01/09) (EXCEL) PROGRAM BUDGET - COST DETAIL SCHEDULE Use Additional Sheets as Needed View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH OLHSA WIC PROGRAM (PEER COUNSELING) BUDGET PERIOD CONTRACTOR NAME POSITION DESCRIPTION COMMENTS Associate Director Nutrition 1@4 hours/week x 52 weeks Oakland Livingston Human Agency 1. SALARY & WAGES: Peer Counselor 1@6hours/week x 52 weeks Breastfeeding Peer Counselor 1@4 hours/week x 52 weeks Peer Counselor 1@6 hours/week x 52 weeks 1. TOTAL SALARY & WAGES: 3. TRAVEL: (Specify if category exceeds 10% of Total Expenditures) 4 Trips to Lansing for 3 staff members, local travel, conferences, and add'l trainings 2. TOTAL FRINGE BENEFITS: Lactation Specialist 1@6hours/week x 52 weeks 4. TOTAL SUPPLIES & MATERIALS: 5. CONTRACTUAL: (Subcontracts/Subrecipients) Local Mileage Rate @.58 per mile - 1,000 miles - $580 4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures) 6. EQUIPMENT: (Specify) Replace computers and equipment that are no longer functioning. Address Audit 7. TOTAL OTHER EXPENSES: 7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures) Flyers, advertising, business cards, news ads Telephones for Staff COMPLETION: Is Voluntary, but is required as a condition of funding. 10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9) 8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1-7)8. TOTAL DIRECT EXPENDITURES: 9. INDIRECT COST CALCULATIONS: 9. TOTAL INDIRECT EXPENDITURES: IT Cost Pool (X/fte/hr) HR Cost Pool )X/fte/hr) ORIGINAL AMENDMENT OTHER:specify- ORIGINAL AMENDMENT LIFE INS VISION INS HEARING INS DENTAL INS WORKERS COMP ORIGINAL AMENDMENT RETIREMENT ORIGINAL AMENDMENT UNEMPLOY INS ORIGINAL AMENDMENTORIGINALAMENDMENT HOSPITAL INS OTHER:specify- ORIGINAL AMENDMENTORIGINALAMENDMENT FICA ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Use WHOLE DOLLARS Only ATTACHMENT B.3 Page Of From:To: STATE ZIP CODE Mi 48343 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. $69,774 $519,981 $519,981 $519,981 DCH-0385(E) (Rev. 01/09) (Excel) Previous Edition Obsolete. $342,559 $94,068 $3,580 $6,000 $4,000 AUTHORITY: P.A. 368 of 1978 The Department of Community Health is an equal opportunity COMPLETION: Is Voluntary, but is required as a condition of funding. employer, services and programs provider. TOTAL FUNDING OTHER(S) FEDERAL LOCAL TOTAL DIRECT EXPENDITURES (Sum of Lines 1-7) INDIRECT COSTS: STATE AGREEMENT INDIRECT COSTS: TOTAL EXPENDITURES SOURCE OF FUNDS: FEES & COLLECTIONS OTHER EXPENSES CONTRACTUAL (Subcontracts/Subrecipients) EQUIPMENT TRAVEL SUPPLIES & MATERIALS SALARY & WAGES FRINGE BENEFITS EXPENDITURE CATEGORY (Use Whole Dollars) TOTAL BUDGET CITY FEDERAL ID NUMBER Pontiac 38-1785665 Oakland Livingston Human Service Agency WIC program 6/12/2023 CONTRACTOR NAME BUDGET PERIOD PROGRAM BUDGET SUMMARY For WIC Funding Application View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH PROGRAM DATE PREPARED 196 Cesar E. Chavez Oakland Livingston Human Service Agency 10/1/2023 9/30/2024 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT B.4 Page Of Use WHOLE DOLLARS Only DATE PREPARED From:To:9/11/2019 10/1/2023 9/30/2024 AMENDMENT # POSITIONS REQUIRED TOTAL SALARY 0.900 50,224$ 0.900 46,779$ 0.500 24,122$ 0.525 15,937$ 2.250 80,019$ 2.000 75,394$ 1.000 39,331$ HR Cost Pool HR Cost Pool (x/fte/hr)10,753$ 0.100 2,100$ 8.075 342,559$ 2. FRINGE BENEFITS: (Specify) Composite Rate % 45% full time 18% part time LTD 94,068$ 3. TOTAL TRAVEL:3,580$ 6,000$ Name Amount 5. TOTAL CONTRACTUAL: Amount 6. TOTAL EQUIPMENT:$4,000 Amount Communication:$1,000 Space Cost:$15,000 Farmington Clinic $4,000 Madision Heights Cleaning $6,000 Others (explain):$19,000 $17,191 Audit $2,583 Translation Services - Bromberg $5,000 Total $69,774 519,981$ Rate #1 Base $x Rate = Rate #2 Base $- x Rate = -$ -$ 519,981$ DCH-0386(E) (Rev. 01/09) (EXCEL) Previous Edition Obsolete COMPLETION: Is Voluntary, but is required as a condition of funding. 10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9) AUTHORITY: P.A. 368 of 1978 8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1-7)8. TOTAL DIRECT EXPENDITURES: 9. INDIRECT COST CALCULATIONS: 9. TOTAL INDIRECT EXPENDITURES: Telephones IT Cost pool (X/fte/hr.) 7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures) flyers, advertizing, business cards, news ads Madison Heights clinic 6. EQUIPMENT: (Specify) Replacement of outdated or non functioning printers, scanners, computers as needed to update technology Address 4. TOTAL SUPPLIES & MATERIALS: 5. CONTRACTUAL: (Subcontracts/Subrecipients) Conferences, required training-all staff $3,000.00 for conferences 4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures) Including gloves, controls, office/cleaning/sanitizing supplies and any materials required to run clinics Local Travel Mileage Rate @ .58 cents per mile 1,000 miles = $580.00 1. TOTAL SALARY & WAGES: 3. TRAVEL: (Specify if category exceeds 10% of Total Expenditures) 2. TOTAL FRINGE BENEFITS: Reigstered Dietitian 1@40 hours/week x 52 weeks 1@28 hours/week x 52 weeks CPA 1@40 hours/week x 52 weeks OLHSA Receptionist 1@4hours/weekx 52 weeks 1. SALARY & WAGES: Health Tech 1@21 hours/week x 52 weekds Health Tech Coordinator 2@40 hours/week x weeks 1@10 hours/week x 52 weeks Breasfeeding Coordinator 1@ 36 hours/week x 52 weeks Nutrition Education Coordinator 1@ 20/hour/week x 52 weeks PROGRAM BUDGET - COST DETAIL SCHEDULE Use Additional Sheets as Needed View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH The Department of Community Health is an equal opportunity employer, services and programs provider. OLHSA WIC ProgramPROGRAM BUDGET PERIOD CONTRACTOR NAME BUDGET AGREEMENT POSITION DESCRIPTION COMMENTS WIC Associate Director/RD 1@ 36 hours/week x 52 weeks Oakland Livingston Human Service Agency FICA UNEMPLOY RETIREME HEARING DENTAL INS ORIGINAL AMENDMENT FICA UNEMPLOY RETIREME HOSPITAL LIFE INS VISION WORK COMP OTHER:spe ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 to OHCD which is approved by MDHHS or subsequently in a written request to OCHD and approved in writing by MDHHS and provided to OCHD. A.Automated Information Systems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B.Capital Expenditures of $2,500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C.Management Studies - performed by agencies or departments other than the local Grantee or those performed by outside consultants under contract with the local Grantee. D.Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E.Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1.Contractual private physician providing certification data. 2.Contractual organization providing laboratory data. 3.Contractual translators and interpreters at the local Grantee level. F.Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out- of-service training over extended periods of time. G.Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H.Non-Fringe Insurance and Indemnification Costs - all charges to WIC must be necessary, reasonable, allowable, and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. Breastfeeding Peer Counseling Program The sub-recipient must follow the allowable expense guidelines provided by USDA FNS for the Peer Counselor grant. The use of BFPC funds for expenditures that are not supported by the Loving Support Model are not authorized. Expenses for Breastfeeding education and supplies must be charged to the normal WIC budget, not the Peer Counselor Grant. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 1 Allowable Costs for Breastfeeding Peer Counseling Programs Breastfeeding peer counseling (BFPC) funds that the Food and Nutrition Service (FNS) distributes to State agencies are to be used to develop or expand activities necessary to sustain a peer counseling program based on the FNS WIC Breastfeeding Model for Peer Counseling. The primary purpose of BFPC funds is to provide direct peer counselor to WIC mother breastfeeding support services. A State agency’s peer counseling implementation plan and annual line item budget addendum to its State Plan must demonstrate an appropriate balance between the costs of equipment, materials, and staff that manage or provide expertise to peer counselors and the costs of direct service delivery by peer counselors. The use of BFPC funds for expenditures that are not supported by the WIC Breastfeeding Model for Peer Counseling are not authorized. The table below helps to identify allowable BFPC costs.* Item or Service Allowable Costs Comments Durable Goods and Space Furniture, desktop computers/laptops/tablets, and office equipment used to provide peer counseling services and training Yes Phone lines, internet service, cell/smartphones, pagers and answering machines for contacts between peer counselors and mothers Yes Portable baby scales to weigh infants outside of the WIC clinic or scales marketed for pre- and post-breastfeeding weight checks No Nutrition Services and Administration (NSA) funds may be used to purchase scales for clinical assessment for use by staff other than peer counselors. Space and lease costs for peer counselors to provide services Yes Incentives and Educational Materials to Promote Breastfeeding Breastfeeding educational materials for mothers No NSA funds may be used to purchase participant educational material. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 2 Item or Service Allowable Costs Comments Breast pumps and breastfeeding aids for mothers Breast pumps and breastfeeding aids for demonstration purposes by peer counseling staff No Yes Refer to Breastfeeding Policy and Guidance for more information on breast pumps and allowable breastfeeding aids. Incentive items distributed to WIC participants to encourage breastfeeding (e.g., breast pumps, breastfeeding aids, breastfeeding promotion and support incentive items, written materials, etc.) No NSA funds may be used to purchase participant incentive items. Personnel and Compensation Salaries and compensation for peer counseling staff: peer counselors, designated peer counselor coordinators, and WIC Designated Breastfeeding Experts (DBE) Yes. BFPC funds may be used to fund staff to provide oversight/management of peer counseling programs and/or supervision, mentoring and referral expertise for peer counselors. BFPC funds may be used to pay for DBE time if a peer counselor refers a WIC mother to a DBE for problems that are outside of the peer counselor’s scope of practice. The DBE may be compensated using BFPC funds if the mother continues to be supported by the peer counselor and remains part of the peer counselor’s caseload. BFPC funds cannot be used to disproportionately hire WIC DBEs versus peer counselors. NSA funds must be used for consultations for WIC mothers who are not referred by peer counselors and are not part of a peer counselor’s caseload. Refer to the Nutrition Services Standards for DBE qualifications, roles and responsibilities. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3 Item or Service Allowable Costs Comments Salaries and compensation for dual-role staff (e.g., part- time WIC Nutrition Assistant and part-time peer counselor or part-time CPA and part- time DBE) Yes, but costs must be allocated between the two positions held. BFPC funds may be used for the portion of time spent as peer counselor or the DBE. See FNS Breastfeeding Policy and Guidance document for additional information on dual- role staff. State agency policies must be approved by FNS Regional Offices. Males as breastfeeding peer counselors No. The definition of peer counselor in the WIC Breastfeeding Model for Peer Counseling is based on research demonstrating the benefit of hiring peer counselors from WIC’s target population of WIC-eligible women. Father-to-Father Breastfeeding Support Group No Fathers are valuable partners of breastfeeding promotion and support in WIC. However, father-led activities are outside of those defined by the WIC Breastfeeding Model for Peer Counseling. See FNS Peer Counseling Management Curriculum for additional information. Virtual Breastfeeding Support Groups (i.e., Facebook, Zoom) Yes, only for PC/DBE staff hours for monitoring and engaging with WIC participants in a Virtual Support Group that provides breastfeeding support services. BFPC funds cannot be used for breastfeeding support to non-WIC participants. Recruitment of peer counselors and related staff Yes DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 4 Item or Service Allowable Costs Comments Staffing and expenses related to WIC Peer Counselor support to breastfeeding hotlines and call centers Yes. BFPC funds may be used to fund peer counselors to answer calls to a WIC breastfeeding hotline if the peer counselor: 1) meets the definition of peer counselor; 2) receives the appropriate training and supervision as outlined in the WIC Breastfeeding Model for Peer Counseling; and 3) does not provide services to non-WIC participants. Other expenses related to the hotline/call center (e.g., rent, phone lines, equipment, etc.) are allowable for any portion of those expenses that are for the purpose of a WIC peer counselor providing WIC participant contacts through the hotline/call center. BFPC funds cannot be used for breastfeeding hotline support to non-WIC participants. Milk Banks/Depots No. BFPC funds cannot be used for services related to milk banks/depots. Drop-In Breastfeeding Groups Yes. BFPC/DBE time may only be used for WIC participants. BFPC/DBE time may not be counted toward nutrition education contacts. Staffing and expenses related to WIC Peer Counselor support to the Buddy Program Yes. Duties such as matching buddy pairs, responding to buddy requests/inquiries, following up on buddy interactions, prompting discussions with conversation starters, and other duties as assigned by peer counselor supervisor. Staff Training and Resources Travel for WIC State- required training of peer counselors/DBE and peer counseling staff/managers Yes, only for the FNS Breastfeeding trainings or WIC State-developed approved comparable training. NSA funds may be used for attendance at a state/national breastfeeding conference. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 5 Item or Service Allowable Costs Comments Travel for home and hospital visits by peer counseling staff Yes, for visits to WIC participants; peer counselors may not provide services to non-WIC participants. Continuing education for DBEs Yes, if it relates to servicing peer counseling programs (e.g., mentoring, serving as a referral, etc.) Breastfeeding resources for peer counseling staff Breastfeeding resources for WIC staff not related to peer counseling Yes, if the resources are related to peer counseling (e.g., training materials for peer counselors). No NSA funds may be used to purchase general breastfeeding resources for WIC staff. Training and coursework for peer counselors to become International Board Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC) No. NSA funds may be used for CLC or IBCLC training and coursework. The priority use of BFPC funds is to hire and train peer counselors to provide breastfeeding peer counseling services to WIC participants. Staff with IBCLC ‘s are not considered peer counselors. The research recommends that peer counselors be provided career path training options. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 6 Item or Service Allowable Costs Comments CLC or IBCLC exam, renewal, or membership fees No At the WIC State agency’s discretion, NSA funds may be used for CLC or IBCLC training, exam fees, renewal and/or association membership fees. The State agency must determine if it is necessary and of benefit to the WIC Program for the person in a particular job position to have the certification. SAs must also determine whether the cost fits within its WIC NSA grant budget. Peer Counseling Program Advertising and Promotion Pamphlets and similar materials to promote the peer counseling program Yes Media outreach (e.g., bus placards, paid social media and digital ads to advertise BFPC programs) Yes Media outreach using BFPC funds are allowed if directly recruiting peer counselors or informing WIC participants about the PC program, including the Buddy Program, as a WIC breastfeeding benefit. FNS would not expect to see a disproportionate amount of the BFPC funds spent on advertising the program at the expense of direct services to participants. BFPC funds may not be used for ads that promote breastfeeding in general, NSA funds may be used for this purpose. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 7 Item or Service Allowable Costs Comments Name badges, buttons and similar low-cost items that identify peer counselor staff Yes Miscellaneous Indirect costs (e.g., personnel, accounting, or information technology services, etc.) Yes, but only those that are related to providing a WIC peer counseling program. Second nutrition education contacts No. BFPC funds are for activities that are in addition to current required WIC activities. NSA funds provide for at least two nutrition education contacts; therefore, BFPC funds may not be used for the “second” contact. In addition, the 1/6th nutrition education requirement and breastfeeding target must be met with regular NSA funds. Childcare No Cribs or other materials and equipment for infants of peer counselors who bring their babies to work No Monitoring and tracking of program effectiveness. Yes. Funds may be used to monitor and track program components (e.g., contacts, referrals, training, etc.) to determine effectiveness and where improvements are needed. Evaluation studies may not be paid for using BFPC funds. Peer counseling services to non-WIC participants No. Peer counselors should refer WIC-eligible women to WIC to apply for WIC benefits. Peer counselors should refer women who are not WIC-eligible to appropriate non-WIC resources. . DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 8 Item or Service Allowable Costs Comments Breastfeeding coalitions No BFPC funds can only be used for services and activities related directly to peer counseling. *Updated January 2023. This is not an exhaustive list of allowable costs. Refer to the FNS Regional Office for questions about allowable cost and to the Breastfeeding Policy and Guidance. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Attachment C Attachment C Reporting Requirements Reporting: As part of the Breastfeeding Peer Counseling Grant, Subrecipient shall maintain monthly records for each individual Peer Counselor. Specific supplemental reporting forms will be provided by MDDHS WIC program to complete this requirement. Reports are due to the Oakland County Health Division WIC Supervisor by the 5th day of January, March, July and October for review and submission to MDHHS WIC Invoicing process: Submit monthly, the actual costs incurred for the WIC grant and Breastfeeding Peer Counselor grant using the electronic invoice provided by OCHD. The invoice form reflects the Subrecipient budget approved by the County and the State WIC program. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT D SUBRECIPIENT INSURANCE REQUIREMENTS WITH COUNTY During this Agreement, the Subrecipient shall provide and maintain, at their own expense, all insurance as set forth and marked below, protecting the County against any Claims. Claims 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 Subrecipient. Primary Coverages Commercial General Liability Occurrence Form including: (a) Premises and Operations; (b) Products and Completed Operations (including On and Off Premises Coverage); (c) Personal and Advertising Injury; (d) Broad Form Property Damage; (e) Broad Form Contractual including coverage for obligations assumed in this Agreement; $1,000,000 – Each Occurrence Limit $1,000,000 – Personal & Advertising Injury $2,000,000 – Products & Completed Operations Aggregate Limit $2,000,000 – General Aggregate Limit $ 100,000 – Damage to Premises Rented to You (formally known as Fire Legal Liability) Workers’ Compensation Insurance with limits statutorily required by any applicable Federal or State Law and Employers Liability insurance with limits of no less than $500,000 each accident, $500,000 disease each employee, and $500,000 disease policy limit. 1.☒ Fully Insured or State approved self-insurer. 2.☐ Sole Proprietors must submit a signed Sole Proprietor form. 3.☐ Exempt entities, Partnerships, LLC, etc., must submit a State of Michigan form WC-337 Certificate of Exemption. Commercial Automobile Liability Insurance covering bodily injury or property damage arising out of the use of any owned, hired, or non-owned automobile with a combined single limit of $1,000,000 each accident. This requirement is waived if there are no company owned, hired or non-owned automobiles utilized in the performance of this Agreement. 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 Subrecipient provides professional services that the County relies upon. 2.Cyber Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when the Subrecipient has access to County IT systems and/or stores County data electronically. 3.Commercial Property Insurance. The Subrecipient shall be responsible for obtaining and maintaining insurance covering their equipment and personal property against all physical damage. 4.Other Insurance Coverages as may be dictated by the provided product/service and deemed appropriate by the County Risk Management Department. General Insurance Conditions The aforementioned insurance shall be endorsed, as applicable, and shall contain the following terms, conditions, and/or endorsements. All certificates of insurance shall provide evidence of compliance with all required terms, conditions and/or endorsements. 1.All policies of insurance shall be on a primary, non-contributory basis with any other insurance or self-insurance carried by the County; 2.The insurance company(s) issuing the policy(s) shall have no recourse against the County for subrogation (policy endorsed written waiver), premiums, deductibles, or assessments under any form. All policies shall be endorsed to provide a written waiver of subrogation in favor of the County; 3.Any and all deductibles or self-insured retentions shall be assumed by and be at the sole risk of the Subrecipient; 4.Subrecipient shall be responsible for their own property insurance for all equipment and personal property used and/or stored on County property; 5.The Commercial General Liability and Commercial Automobile Liability policies along with any required supplemental coverages shall be endorsed to name the County of Oakland and its officers, directors, employees, appointees and commissioners as additional insureds where permitted by law and policy form; 6.If the Subrecipient’s insurance policies have higher limits than the minimum coverage requirements stated in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the Subrecipient under contract. requirements stated in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the Subrecipient under contract. 8.The Subrecipient shall require its contractors or sub-contractors, not protected under the Subrecipient’s insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or clauses equal to those required in this Agreement; 9.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. 10.All insurance carriers must be licensed and approved to do business in the State of Michigan along with the Subrecipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A- unless otherwise approved by the County Risk Management Department. 11. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 7. The Subrecipient shall require its contractors or sub-contractors, not protected under the Subrecipient’s insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or clauses equal to those required in this Agreement; 8. Certificates of insurance must be provided no less than ten (10) Business Days prior to the County’s execution of the Agreement and must bear evidence of all required terms, conditions, and endorsements; and provide 30 days’ notice of cancellation/material change endorsement. 9. All insurance carriers must be licensed and approved to do business in the State of Michigan along with the Subrecipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A- unless otherwise approved by the County Risk Management Department. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Agreement #: 20240239-00 Agreement Between Michigan Department of Health and Human Services hereinafter referred to as the "Department" 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 1200 N. Telegraph Rd. 34 East Pontiac MI 48341 1032 Federal I.D.#: 38-6004876, Unique Entity Identifier: HZ4EUKDD7AB4 hereinafter referred to as the "Grantee" for The Delivery of Public Health Services under the Local Health Department Agreement Part 1 1.Purpose This Agreement is entered into for the purpose of setting forth a joint and cooperative Grantee/Department relationship and basis for facilitating the delivery of public health services to the citizens of Michigan under their jurisdiction, as described in the attached Annual Budget, established Minimum Program Requirements, and all other applicable federal, state and local laws and regulations pertaining to the Grantee and the Department. Public health services to be delivered under this Agreement include Essential Local Public Health Services (ELPHS) and Categorical Programs as specified in the attachments to this Agreement. 2.Period of Agreement This Agreement will commence on the date of the Grantee's signature or October 1, 2023, whichever is later, and continue through September 30, 2024. Throughout the Agreement, the date of the Grantee’s signature or October 1, 2023, whichever is later, will be referred to as the start date. This Agreement is in full force and effect for the period specified. 3.Program Budget and Agreement Amount A.Agreement Amount In accordance with Attachment IV - Funding/Reimbursement Matrix, the total State budget and amount committed for this period for the program elements covered by this Agreement is $12,096,246.00. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 1 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 B.Equipment Purchases and Title Any Grantee equipment purchases supported in whole or in part through this Agreement must be listed in the supporting Equipment Inventory Schedule which should be attached to the Final Financial Status Report. Equipment means tangible, non-expendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. Title to items having a unit acquisition cost of less than $5,000 will vest with the Grantee upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department’s proportionate interest in such equipment supports such retention or transfer of title. C.Budget Transfers and Adjustments 1.Transfers between categories within any program element budget supported in whole or in part by state/federal categorical sources of funding will be limited to increases in an expenditure budget category by $10,000 or 15% whichever is greater. This transfer authority does not authorize purchase of additional equipment items or new subcontracts with state/federal categorical funds without prior written approval of the Department. 2.Except as otherwise provided, any transfers or adjustments involving state/federal categorical funds, other than those covered by C.1, including any related adjustment to the total state amount of the budget, must be made in writing through a formal amendment executed by all parties to this Agreement in accordance with Section IX. A. of Part 2. 3.The C.1 and C.2 provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the Department will be recovered proportionately from each local Grantee that, during the course of the Agreement period, chose to reduce or transfer local funds from the Family Planning program. 4.Agreement Attachments A.The following documents are attachments to this Agreement Part 1 and Part 2 - General Provisions, which are part of this Agreement: 1. Attachment I - Annual Budget 2. Attachment III - Program Specific Assurances and Requirements 3. Attachment IV - Funding/Reimbursement Matrix Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 2 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 5.Statement of Work The Grantee agrees to undertake, perform and complete the activities described in Attachment III - Program Specific Assurances and Requirements and the other applicable attachments to this Agreement which are part of this Agreement. 6.Financial Requirements The financial requirements must be followed as described in Part 2 and Attachment I - Annual Budget and Attachment IV - Funding/Reimbursement Matrix, which are part of this Agreement. 7.Performance/Progress Report Requirements The progress reporting methods, as applicable, must be followed as described in part 2 and Attachment III, Program Specific Assurances and Requirements, which are part of this Agreement. 8.General Provisions The Grantee agrees to comply with the General Provisions outlined in Part 2, which is part of this Agreement. 9.Administration of the Agreement The person acting for the Department in administering this Agreement (hereinafter referred to as the Contract Consultant) is: Name: Carissa Reece Title: Department Analyst E-Mail Address ReeceC@michigan.gov The financial contact acting on behalf of the Grantee for this Agreement is: Karrie Jager Accountant ___________________________________________________________________ Name Title jagerk@oakgov.com (248) 858-5468 ___________________________________________________________________ E-Mail Address Telephone No. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 3 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 10.Special Conditions A.This Agreement is valid upon approval and execution by the Department which may be contingent upon approval by the State Administrative Board and signature by the Grantee. B.This Agreement is conditionally approved subject to and contingent upon availability of funding and other applicable conditions. C.Based on the availability of funding, the Department may specify the amount of funding the Grantee may expend during a specific time period within the Agreement Period. D.The Department has the option to assume no responsibility or liability for costs incurred by the Grantee prior to the start date of this Agreement. E.The Grantee is required by 2004 PA 533 to receive payments by electronic funds transfer. 11.Special Certification The individual or officer signing this Agreement certifies by their signature that they are authorized to sign this Agreement on behalf of the responsible governing board, official or Grantee. 12.Signature Section For Oakland County Department of Health and Human Services/ Health Division Andrea Powers Administrator ___________________________________________________________________ Name Title For the Michigan Department of Health and Human Services Christine H. Sanches 08/31/2023 ___________________________________________________________________ Christine H. Sanches, Director Date Bureau of Grants and Purchasing Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 4 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Part 2 General Provisions I.Responsibilities - Grantee The Grantee, in accordance with the general purposes and objectives of this Agreement, must: A.Publication Rights 1.Copyright materials only when the Grantee exclusively develops books, films or other such copyrightable materials through activities supported by this Agreement. The copyrighted materials cannot include recipient information or personal identification data. Grantee provides the Department a royalty-free, non-exclusive and irrevocable license to reproduce, publish and use such materials copyrighted by the Grantee and authorizes others to reproduce and use such materials. 2.Obtain prior written authorization from the Department’s Office of Communications for any materials copyrighted by the Grantee or modifications bearing acknowledgment of the Department's name prior to reproduction and use of such materials. The state of Michigan may modify the material copyrighted by the Grantee and may combine it with other copyrightable intellectual property to form a derivative work. The state of Michigan will own and hold all copyright and other intellectual property rights in any such derivative work, excluding any rights or interest granted in this Agreement to the Grantee. If the Grantee ceases to conduct business for any reason or ceases to support the copyrightable materials developed under this Agreement, the state of Michigan has the right to convert its licenses into transferable licenses to the extent consistent with any applicable obligations the Grantee has. 3.Obtain written authorization, at least 14 days in advance, from the Department’s Office of Communications and give recognition to the Department in any and all publications, papers and presentations arising from the Agreement activities. 4.Notify the Department’s Bureau of Grants and Purchasing 30 days before applying to register a copyright with the U.S. Copyright Office. The Grantee must submit an annual report for all copyrighted materials developed by the Grantee through activities supported by this Agreement and must submit a final invention statement and certification within 60 days of the end of the Agreement period. 5.Not make any media releases related to this Agreement, without prior written authorization from the Department’s Office of Communications. B.Fees 1.Guarantee that any claims made to the Department under this Agreement will not be financed by any sources other than the Department under the terms of this Agreement. If funding is received Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 5 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 through any other source, the Grantee agrees to budget the additional source of funds and reflect the source of funding on the Financial Status Report. 2.Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report those collections on the Financial Status Report. Any under recoveries of otherwise available fees resulting from failure to bill for eligible activities will be excluded from reimbursable expenditures. C.Grant Program Operation Provide the necessary administrative, professional and technical staff for operation of the grant program. The Grantee must obtain and maintain all necessary licenses, permits or other authorizations necessary for the performance of this Agreement. Use an accounting system that can identify and account for the funds received from each separate grant, regardless of funding source, and assure that grant funds are not commingled. D.Reporting Utilize all report forms and reporting formats required by the Department at the start date of this Agreement and provide the Department 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 Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than 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 the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. F.Authorized Access 1.Permit within 10 calendar days of providing notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Inspector Generals, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to records, papers, files, documentation and personnel related to this Agreement, to the extent authorized by applicable state or federal law, rule or regulation. 2.Acknowledge the rights of access in this section are not limited to the required retention period. The rights of access will last as long as the Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 6 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 records are retained. 3.Cooperate and provide reasonable assistance to authorized representatives of the Department and others when those individuals have access to the Grantee’s grant records. G.Audits 1.Single Audit The Grantee must submit to the Department a Single Audit consistent with the regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200, Subpart F. The Single Audit reporting package must include all components described in Title 2 Code of Federal Regulations, Section 200.512 (c) including a Corrective Action Plan, and management letter (if one is issued) with a response to the Department. The Grantee must assure that the Schedule of Expenditures of Federal Awards includes expenditures for all federally-funded grants. 2.Other Audits The Department or federal agencies may also conduct or arrange for agreed upon procedures or additional audits to meet their needs. 3.Due Date and Where to Send The required audit and any other required submissions (i.e., corrective action plan, and management letter with a corrective action plan), and/or Audit Exemption Notice must be submitted to the Department within the earlier of 30 calendar days after receipt of the auditor’s report(s) or nine months after the end of the Grantee’s fiscal year by e- mail to MDHHS-AuditReports@michigan.gov. Single Audit reports must be submitted simultaneously to the Department and Federal Audit Clearinghouse, in accordance with 2 CFR 200.512(a). The required submissions must be assembled in PDF files and compatible with Adobe Acrobat (read only). The subject line must state the agency name and fiscal year end. The Department reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. 4.Penalty a.Delinquent Single Audit or Financial Related Audit If the Grantee does not submit the required Single Audit reporting package, management letter (if one is issued) with a response, and Corrective Action Plan within nine months after the end of the Grantee’s fiscal year and an extension has not been approved by the cognizant or oversight agency for audit, the Department may withhold from the current funding an amount equal to five percent of the audit year’s grant funding (not to exceed $200,000) until the required filing is received by Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 7 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 the Department. The Department may retain the amount withheld if the Grantee is more than 120 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. The Department may terminate the current grant if the Grantee is more than 180 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. b.Delinquent Audit Exemption Notice Failure to submit the Audit Exemption Notice, when required, may result in withholding payment from Department to Grantee an amount equal to one percent of the audit year’s grant funding until the Audit Exemption Notice is received. H.Subrecipient/Contractor Monitoring 1.When passing federal funds through to a subrecipient (if the Agreement does not prohibit the passing of federal funds through to a subrecipient), the Grantee must: a.Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the information required by 2 CFR 200.332. b.Ensure the subrecipient complies with all the requirements of this Agreement. c.Evaluate each subrecipient’s risk for noncompliance as required by 2 CFR 200.332(b). d.Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with federal statutes, regulations and the terms and conditions of the subawards; that subaward performance goals are achieved; and that all monitoring requirements of 2 CFR 200.332(d) are met including reviewing financial and programmatic reports, following up on corrective actions and issuing management decisions for audit findings. e.Verify that every subrecipient is audited as required by 2 CFR 200 Subpart F. 2.Develop a subrecipient monitoring plan that addresses the above requirements and provides reasonable assurance that the subrecipient administers federal awards in compliance with laws, regulations and the provisions of this Agreement, and that performance goals are achieved. The subrecipient monitoring plan should include a risk-based assessment to determine the level of oversight and monitoring activities, such as reviewing financial and performance reports, performing site visits and maintaining regular contact with subrecipients. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 8 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3.Establish requirements to ensure compliance for for-profit subrecipients as required by 2 CFR 200.501(h), as applicable. 4.Ensure that transactions with subrecipients/contractors comply with laws, regulations and provisions of contracts or grant agreements. I.Notification of Modifications Provide timely notification to the Department, 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 activities, funding or compliance with operational procedures. J.Software Compliance Ensure software compliance and compatibility with the Department’s data systems for activities provided under this Agreement, including but not limited to stored data, databases and interfaces for the production of work products and reports. All required data under this Agreement must be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Grantee’s business operations for processing data. All information systems, electronic or hard copy, that contain state or federal data must be protected from unauthorized access. K.Human Subjects Comply with Federal Policy for the Protection of Human Subjects, 45 CFR 46. The Grantee agrees that prior to the initiation of the research, the Grantee will submit Institutional Review Board (IRB) application material for all research involving human subjects, which is conducted in programs sponsored by the Department or in programs which receive funding from or through the state of Michigan, to the Department’s IRB for review and approval, or the IRB application and approval materials for acceptance of the review of another IRB. All such research must be approved by a federally assured IRB, but the Department’s IRB can only accept the review and approval of another institution’s IRB under a formally approved interdepartmental agreement. The manner of the review will be agreed upon between the Department’s IRB Chairperson and the Grantee’s authorized official. L.Mandatory Disclosures 1.Disclose to the Department in writing within 14 days of receiving notice of any litigation, investigation, arbitration or other proceeding (collectively, “Proceeding”) involving Grantee, a subcontractor or an officer or director of Grantee or subcontractor that arises during the term of this Agreement including: a.All violations of federal and state criminal law involving fraud, bribery, or gratuity violations potentially affecting the Agreement. b.A criminal Proceeding; c.A parole or probation Proceeding; Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 9 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 d.A Proceeding under the Sarbanes-Oxley Act; e.A civil Proceeding involving: A claim that might reasonably be expected to adversely affect Grantee’s viability or financial stability; or 1. A governmental or public entity’s claim or written allegation of fraud; or 2. Any complaint filed in a legal or administrative proceeding alleging the Grantee or its subcontractors discriminated against its employees, subcontractors, vendors, or suppliers during the term of this Agreement; or 3. f.A Proceeding involving any license that Grantee is required to possess in order to perform under this Agreement. 2.Notify the Department, at least 90 calendar days before the effective date, of a change in Grantee’s ownership or executive management. M.Minimum Program Requirements Comply with Minimum Program Requirements established in accordance with Section 2472.3 of 1978 PA 368 as amended, MCL 333.2472 (3), MSA 14.15 (2472.3), for each applicable program element funded under this Agreement. N.Annual Budget and Plan Submission Submit an Annual Budget and Plan request to the Department, in accordance with instructions established by the Department, to serve as the basis for completion of specific details for Attachments I, III, and IV of this Agreement via Grantee/Department negotiated amendment(s). Failure to submit a complete Annual Budget and Plan by the due date through MI E-Grants will result in the deferral of Department payments until these documents are submitted. O.Maintenance of Effort Comply with maintenance of effort requirements for Essential Local Public Health Services (ELPHS), as defined in the current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part I. P.Accreditation 1.Comply with the local public health accreditation standards and follow the accreditation process and schedule established by the Department to achieve full accreditation status. a.Failure to meet all accreditation requirements or implement corrective plans of action within the prescribed time period will result in the status of “Not Accredited.” Grantees designated as “Not Accredited” may have their Department allocations Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 10 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 reduced for costs incurred in the assurance of service delivery. b.Submit a written request for inquiry to the Department should the Grantee disagree with on-site review findings or their accreditation status. The request must identify the disagreement and resolution sought. The inquiry participants will be comprised of Grantee staff, Department staff, the Accreditation Commission Chair, and the Accreditation Coordinator as needed. Participants will clarify facts, verify information and seek resolution. 2.Consent Agreements/Administrative Compliance Orders/Administrative Hearings for "Not Accredited" Grantees: a.If designated as “Not Accredited”, the Grantee will receive a Consent Agreement Package from the Department. Grantees and their local governing entities will be given 75 days to review the package, meet with the Department, and sign and return the Consent Agreement. b.Fulfillment of the terms and conditions of the Consent Agreement will not affect accreditation status, but impacts the Grantees’ ability to fulfill its contractual obligations under the Local Health Department Grant Agreement. Grantees designated as “Not Accredited”, will retain this designation until the subsequent accreditation cycle. c.Failure to fulfill the terms and conditions of the Consent Agreement within the prescribed time period will result in the issuance of an Administrative Compliance Order by the Department. d.Within 60 working days after receipt of an Administrative Compliance Order and proposed compliance period, a local governing entity may petition the Department for an administrative hearing. If the local governing entity does not petition the Department for a hearing within 60 days after receipt of an Administrative Compliance Order, the order and proposed compliance date will be final. After a hearing, the Department may reaffirm, modify, or revoke the order or modify the time permitted for compliance. e.If the local governing entity fails to correct a deficiency for which a final order has been issued within the period permitted for compliance, the Department may petition the appropriate circuit court for a writ of mandamus to compel correction. Q.Medicaid Outreach Activities Reimbursement Report allowable costs and request reimbursement for the Medicaid Outreach activities it provides in accordance with 2 CFR, Part 200 and the requirements Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 11 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 in Medicaid Bulletin number: MSA 05-29. Submit a Cost Allocation Plan Certification to the Department to bill for the Medicaid Outreach Activities. The Cost Allocation Plan Certification is valid until a change is made to the cost allocation plan or the Department determines it is invalid. Submit quarterly FSRs for the Medicaid Outreach activities and an annual FSR for the Children with Special Health Care Services Medicaid Outreach activities in accordance with the instructions contained in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, agree to target Medicaid outreach effort toward Department established priorities. For fiscal year 2024, the Department priorities are: lead testing, outreach and enrollment for the Family Planning waiver, and outreach for pregnant women, mothers and infants for the Maternal and Infant Health Program. The Grantee will submit a report using the MDHHS Local Health Department Medicaid Outreach form describing their outreach activities targeting the priorities 30 days after the end of a fiscal year quarter and at the same time as the final FSR is due to the Department. The Local Health Department Medicaid Outreach reports are to be sent through MI E-Grants as an attachment report to the Financial Status Report. R.Conflict of Interest and Code of Conduct Standards 1.Be subject to the provisions of 1968 PA 317, as amended, 1973 PA 196, as amended, and 2 CFR 200.318 (c)(1) and (2). 2.Uphold high ethical standards and be prohibited from the following: a.Holding or acquiring an interest that would conflict with this Agreement; b.Doing anything that creates an appearance of impropriety with respect to the award or performance of this Agreement; c.Attempting to influence or appearing to influence any state employee by the direct or indirect offer of anything of value; or d.Paying or agreeing to pay any person, other than employees and consultants working for Grantee, any consideration contingent upon the award of this Agreement. 3.Immediately notify the Department of any violation or potential violation of these standards. This section applies to Grantee, any parent, affiliate or subsidiary organization of Grantee, and any subcontractor that performs activities in connection with this Agreement. S.Travel Costs 1.Be reimbursed for travel costs (including mileage, meals, and lodging) budgeted and incurred related to services provided under this Agreement. a.If the Grantee has a documented policy related to travel Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 12 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 reimbursement for employees and if the Grantee follows that documented policy, the Department will reimburse the Grantee for travel costs at the Grantee’s documented reimbursement rate for employees. Otherwise, the State of Michigan travel reimbursement rate applies. b.State of Michigan travel rates may be found at the following website: https://www.michigan.gov/dtmb/0,5552,7-358- 82548_13132---,00.html. c.International travel must be preapproved by the Department and itemized in the budget. T.Insurance Requirements 1.Maintain at least a minimum of the insurances or governmental self- insurances listed below and be responsible for all deductibles. All required insurance or self-insurance must: a.Protect the state of Michigan from claims that may arise out of, are alleged to arise out of, or result from Grantee’s or a subcontractor’s performance; b.Be primary and non-contributing to any comparable liability insurance (including self-insurance) carried by the state; and c.Be provided by a company with an A.M. Best rating of “A-” or better and a financial size of VII or better. 2.Insurance Types a.Commercial General Liability Insurance or Governmental Self- Insurance: Except for Governmental Self-Insurance, policies must be endorsed to add “the state of Michigan, its departments, divisions, agencies, offices, 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. If the Grantee will interact with children, schools, or the cognitively impaired, the Grantee must maintain appropriate insurance coverage related to sexual abuse and molestation liability. b.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. c.Employers Liability Insurance or Governmental Self-Insurance. d.Privacy and Security Liability (Cyber Liability) Insurance: cover information security and privacy liability, privacy notification Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 13 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 costs, regulatory defense and penalties, and website media content liability. 3.Require that subcontractors maintain the required insurances contained in this Section. 4.This Section is not intended to and is not to be construed in any manner as waiving, restricting or limiting the liability of the Grantee from any obligations under this Agreement. 5.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. U.Fiscal Questionnaire 1.Complete and upload the yearly fiscal questionnaire to the EGrAMS agency profile within three months of the start of the Agreement. 2.The fiscal questionnaire template can be found in EGrAMS documents. V.Criminal Background Check 1.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. a.ICHAT: http://apps.michigan.gov/ichat b.Michigan Public Sex Offender Registry: http://www.mipsor.state.mi.us c.National Sex Offender Registry: http://www.nsopw.gov 2.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. a.Central Registry: https://www.michigan.gov/mdhhs/0,5885,7- 339-73971_7119_50648_48330-180331--,00.html 3.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 Grantee 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. 4.Determine whether to prohibit any employee, subcontractor, subcontractor employee, or volunteer from performing work directly with Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 14 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 clients or accessing client information related to clients under this Agreement, based on the results of a positive ICHAT response or reported criminal felony conviction or perpetrator identification. 5.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. 6.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. II.Responsibilities - Department The Department 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 Grantee. B.Report Forms Provide any report forms and reporting formats required by the Department at the start date of this Agreement and provide to the Grantee 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 Grantee an opportunity to review. C.Notification of Modifications Notify the Grantee in writing of modifications to federal or state laws, rules and regulations affecting this Agreement. D.Identification of Laws Identify for the Grantee relevant laws, rules, regulations, policies, procedures, guidelines and state and federal manuals, and provide the Grantee with copies of these documents to the extent they are not otherwise available to the Grantee. E.Modification of Funding Notify the Grantee in writing within 30 calendar days of becoming aware of the need for any modifications in Agreement funding commitments made necessary by action of the federal government, the governor, the legislature or the Department of Technology Management and Budget on behalf of the governor or the legislature. Implementation of the modifications will be determined jointly by the Grantee and the Department. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 15 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 F.Monitor Compliance Monitor compliance with all applicable provisions contained in federal grant awards and their attendant rules, regulations and requirements pertaining to program elements covered by this Agreement. G.Technical Assistance Make technical assistance available to the Grantee for the implementation of this Agreement. H.Accreditation Adhere to the accreditation requirements including the process for “Not Accredited” Grantees. The process includes developing and monitoring consent agreements, issuing and monitoring administrative compliance orders, participating in administrative hearings and petitioning appropriate circuit courts. I.Medicaid Outreach Activities Reimbursement Agrees to reimburse the Grantee for all allowable Medicaid Outreach activities that meet the standards of the Medicaid Bulletin: MSA 05-29 including the cost allocation plan certification and that are billed in accordance with the requirements in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, the Department will identify each fiscal year the Medicaid Outreach priorities and establish a reporting requirement for the Grantee. III.Assurances The following assurances are hereby given to the Department: A.Compliance with Applicable Laws The Grantee will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this Agreement. The Grantee will also comply with all applicable general administrative requirements, such as 2 CFR 200, covering cost principles, grant/agreement principles and audits, in carrying out the terms of this Agreement. The Grantee will comply with all applicable requirements in the original grant awarded to the Department if the Grantee is a subgrantee. The Department may determine that the Grantee 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 2, Section V. B.Anti-Lobbying Act The Grantee will comply with the Anti-Lobbying Act (31 U.S.C. 1352) as revised by the Lobbying Disclosure Act of 1995 (2 U.S.C. 1601 et seq.), Federal Acquisition Regulations 52.203.11 and 52.203.12, and Section 503 of the Departments of Labor, Health & Human Services, and Education, and Related Agencies section of the current fiscal year Omnibus Consolidated Appropriations Act. Further, the Grantee must require that the language of this Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 16 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 assurance be included in the award documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients must certify and disclose accordingly. C.Non-Discrimination 1.The Grantee must comply with the Department’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 Grantee 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. 2.The Grantee will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: a.Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination based on race, color or national origin; b.Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, 1685-1686), which prohibits discrimination based on sex; c.Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination based on disabilities; d.The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination based on age; e.The Drug Abuse Office and Treatment Act of 1972 (P.L. 92- 255), as amended, relating to nondiscrimination based on drug abuse; f.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; g.Sections 523 and 527 of the Public Health Service Act of 1944 (42 U.S.C. 290dd-2), as amended, relating to confidentiality of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 17 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 alcohol and drug abuse patient records; h.Any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and, i.The requirements of any other nondiscrimination statute(s) which may apply to the application. 3.Additionally, assurance is given to the Department 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 Grantee must include 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 Grantee will comply with federal regulation 2 CFR 180 and certifies to the best of its knowledge and belief that it, its employees and its subcontractors: 1.Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or contractor; 2.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 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; 3.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; 4.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 5.Have not committed an act of so serious or compelling a nature that it affects the Grantee’s present responsibilities. E.Federal Requirement: Pro-Children Act 1.The Grantee will comply with the Pro-Children Act of 1994 (P.L. 103- 227; 20 U.S.C. 6081, et seq.), which requires that smoking not be permitted in any portion of any indoor facility owned or leased or Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 18 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 Grantee also assures that this language will be included in any subawards which contain provisions for children’s activities. 2.The Grantee also assures, in addition to compliance with P.L. 103-227, any activity funded in whole or in part through this Agreement will be delivered in a smoke-free facility or environment. Smoking must not be permitted anywhere in the facility, or those parts of the facility under the control of the Grantee. If activities are delivered in facilities or areas that are not under the control of the Grantee (e.g., a mall, restaurant or private work site), the activities must be smoke-free. F.Hatch Act and Intergovernmental Personnel Act The Grantee will comply with the Hatch Act (5 U.S.C. 1501-1508, 5 U.S.C. 7321-7326), and the Intergovernmental Personnel Act of 1970 (P.L. 91-648) as amended by Title VI of the Civil Service Reform Act of 1978 (P.L. 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.Employee Whistleblower Protections The Grantee will comply with 41 U.S.C. 4712 and must insert this clause in all subcontracts. H.Clean Air Act and Federal Water Pollution Control Act The Grantee 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. 1251-1388), as amended. 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 Department. I.Victims of Trafficking and Violence Protection Act Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 19 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 The Grantee will comply with the Victims of Trafficking and Violence Protection Act of 2000 (P.L. 106-386), as amended. 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 Department. J.Procurement of Recovered Materials The Grantee will comply with section 6002 of the Solid Waste Disposal Act of 1965 (P.L. 89-272), as amended. 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 Department. K.Subcontracts For any subcontracted activity or product, the Grantee will ensure: 1.That a written subcontract is executed by all affected parties prior to the initiation of any new subcontract activity or delivery of any subcontracted product. Exceptions to this policy may be granted by the Department if the Grantee asks the Department in writing within 30 days of execution of the Agreement. 2.That any executed subcontract to this Agreement must require the subcontractor to comply with all applicable terms and conditions of this Agreement. In the event of a conflict between this Agreement and the provisions of the subcontract, the provisions of this Agreement will prevail. A conflict between this Agreement and a subcontract, however, will not be deemed to exist where the subcontract: a.Contains additional non-conflicting provisions not set forth in this Agreement; b.Restates provisions of this Agreement to afford the Grantee the same or substantially the same rights and privileges as the Department; or c.Requires the subcontractor to perform duties and services in less time than that afforded the Grantee in this Agreement. 3.That the subcontract does not affect the Grantee’s accountability to the Department for the subcontracted activity. 4.That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5.That the Grantee will submit a copy of the executed subcontract if requested by the Department. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 20 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 6.That subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $10,000 must contain provisions or conditions that will: a.Allow the Grantee or Department to seek administrative, contractual or legal remedies in instances in which the subcontractor violates or breaches contract terms, and provide for such remedial action as may be appropriate. b.Provide for termination by the Grantee, including the manner by which termination will be effected and the basis for settlement. 7.That all subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government of amounts in excess of $100,000 must contain a provision that requires compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970 (42 USC 1857(h)), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738 and Environmental Protection Agency regulations (40 CFR Part 15). 8.That all subcontracts and subgrants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Grantee must include a provision: a.For compliance with the Copeland "Anti-Kickback" Act (18 U.S.C. 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b.For compliance with the Davis-Bacon Act (40 U.S.C. 276a to a- 7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). c.For compliance with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-330) as supplemented by Department of Labor regulations (29 CFR, Part 5). This provision also applies to all other contracts in excess of $2,500 that involve the employment of mechanics or laborers. L.Procurement 1.Grantee will ensure that all purchase transactions, whether negotiated or advertised, are conducted openly and competitively in accordance with the principles and requirements of 2 CFR 200. 2.Funding from this Agreement must not be used for the purchase of foreign goods or services. 3.Preference must be given to goods and services manufactured or provided by Michigan businesses, if they are competitively priced and of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 21 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 comparable quality. 4.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 priced and of comparable quality. 5.Records must be sufficient to document the significant history of all purchases and must be maintained for a minimum of four years after the end of the Agreement period. M.Health Insurance Portability and Accountability Act To the extent that the Health Insurance Portability and Accountability Act (HIPAA) is applicable to the Grantee under this Agreement, the Grantee assures that it is in compliance with requirements of HIPAA including the following: 1.The Grantee must not share any protected health information provided by the Department that is covered by HIPAA except as permitted or required by applicable law, or to a subcontractor as appropriate under this Agreement. 2.The Grantee will ensure that any subcontractor will have the same obligations as the Grantee not to share any protected health data and information from the Department that falls under HIPAA requirements in the terms and conditions of the subcontract. 3.The Grantee must only use the protected health data and information for the purposes of this Agreement. 4.The Grantee 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 Grantee’s employees. 5.The Grantee must have a policy and procedure to immediately report to the Department any suspected or confirmed unauthorized use or disclosure of protected health information that falls under the HIPAA requirements of which the Grantee becomes aware. The Grantee will work with the Department to mitigate the breach and will provide assurances to the Department of corrective actions to prevent further unauthorized uses or disclosures. The Department may demand specific corrective actions and assurances and the Grantee must provide the same to the Department. 6.Failure to comply with any of these contractual requirements may result in the termination of this Agreement in accordance with Part 2, Section V. 7.In accordance with HIPAA requirements, the Grantee is liable for any claim, loss or damage relating to unauthorized use or disclosure of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 22 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 protected health data and information, including without limitation the Department’s costs in responding to a breach, received by the Grantee from the Department or any other source. 8.The Grantee will enter into a business associate agreement should the Department determine such an agreement is required under HIPAA. N.Home Health Services If the Grantee provides Home Health Services (as defined in Medicare Part B), the following requirements apply: 1.The Grantee must not use State ELPHS or categorical grant funds provided under this Agreement to unfairly compete for home health services available from private providers of the same type of services in the Grantee’s service area. 2.For purposes of this Agreement, the term “unfair competition” will be defined as offering of home health services at fees substantially less than those generally charged by private providers of the same type of services in the Grantee’s area, except as allowed under Medicare customary charge regulations involving sliding fee scale discounts for low-income clients based upon their ability to pay. 3.If the Department finds that the Grantee is not in compliance with its assurance not to use state ELPHS and categorical grant funds to unfairly compete, the Department will follow the procedure required for failure by local health departments to adequately provide required services set forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15 (2497) and (2498). O.Website Incorporation The Department is not bound by any content on Grantee’s website or other internet communication platforms or technologies, unless expressly incorporated directly into this Agreement. The Department 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 Department. The Grantee must not refer to the Department on the Grantee’s website or other internet communication platforms or technologies without the prior written approval of the Department. P.Survival The provisions of this Agreement that impose continuing obligations will survive the expiration or termination of this Agreement. Q.Non-Disclosure of Confidential Information 1.The Grantee agrees that it will use confidential information solely for the purpose of this Agreement. The Grantee 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 Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 23 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 third parties other than employees, agents, or subcontractors 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 Grantee must take all reasonable precautions to safeguard the confidential information. These precautions must be at least as great as the precautions the Grantee takes to protect its own confidential or proprietary information. 2.Meaning of Confidential Information For the purpose of this Agreement the term “confidential information” means all information and documentation that: a.Has been marked “confidential” or with words of similar meaning, at the time of disclosure by such party; b.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; c.Should reasonably be recognized as confidential information of the disclosing party; d.Is unpublished or not available to the general public; or e.Is designated by law as confidential. 3.The term “confidential information” does not include any information or documentation that was: a.Subject to disclosure under the Michigan Freedom of Information Act (FOIA); b.Already in the possession of the receiving party without an obligation of confidentiality; c.Developed independently by the receiving party, as demonstrated by the receiving party, without violating the disclosing party’s proprietary rights; d.Obtained from a source other than the disclosing party without an obligation of confidentiality; or e.Publicly available when received or thereafter became publicly available (other than through an unauthorized disclosure by, through or on behalf of, the receiving party). 4.The Grantee must notify the Department within one business day after discovering any unauthorized use or disclosure of confidential information. The Grantee will cooperate with the Department in every way possible to regain possession of the confidential information and prevent further unauthorized use or disclosure. R.Cap on Salaries None of the funds awarded to the Grantee through this Agreement will be used Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 24 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 to pay, either through a grant or other external mechanism, the salary of an individual at a rate in excess of Executive Level II. The current rates of pay for the Executive Schedule are located on the United States Office of Personnel Management web site, http://www.opm.gov, by navigating to Policy — Pay & Leave — Salaries & Wages. The salary rate limitation does not restrict the salary that a Grantee may pay an individual under its employment; rather, it merely limits the portion of that salary that may be paid with funds from this Agreement. S.State Data 1.Ownership. The Department’s data (“State Data,” which will be treated by Grantee as Confidential Information) includes: (a) the Department’s data, user data, and any other data collected, used, processed, stored, or generated as the result of this Agreement; (b) personally identifiable information (“PII“) collected, used, processed, stored, or generated as the result of this Agreement, including, without limitation, any information that identifies an individual, such as an individual’s social security number or other government-issued identification number, date of birth, address, telephone number, biometric data, mother’s maiden name, email address, credit card information, or an individual’s name in combination with any other of the elements here listed; and, (c) protected health information (“PHI”) collected, used, processed, stored, or generated as the result of this Agreement, which is defined under the Health Insurance Portability and Accountability Act (HIPAA) and its related rules and regulations. State Data is and will remain the sole and exclusive property of the Department and all right, title, and interest in the same is reserved by the Department. 2.Grantee Use of State Data. Grantee is provided a limited license to State Data for the sole and exclusive purpose of providing the activities outlined in the Agreement’s Statement of Work, including a license to collect, process, store, generate, and display State Data only to the extent necessary in the provision of the Agreement’s Statement of Work. Grantee must: (a) keep and maintain State Data in strict confidence, using such degree of care as is appropriate and consistent with its obligations as further described in this Agreement and applicable law to avoid unauthorized access, use, disclosure, or loss; (b) use and disclose State Data solely and exclusively for the purpose of providing the activities described in the Statement of Work, such use and disclosure being in accordance with this Agreement, any applicable Statement of Work, and applicable law; (c) keep and maintain State Data in the continental United States and (d) not use, sell, rent, transfer, distribute, commercially exploit, or otherwise disclose or make available State Data for Grantee’s own purposes or for the benefit of anyone other than the Department without the Department’s prior written Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 25 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 consent. Grantee's misuse of State Data may violate state or federal laws, including but not limited to MCL 752.795. 3.Extraction of State Data. Grantee must, within five business days of the Department’s request, provide the Department, without charge and without any conditions or contingencies whatsoever (including but not limited to the payment of any fees due to Grantee), an extract of the State Data in the format specified by the Department. 4.Backup and Recovery of State Data. Grantee is responsible for maintaining a backup of State Data and for an orderly and timely recovery of such data. Grantee must maintain a contemporaneous backup of State Data that can be recovered within two hours at any point in time. 5.Loss or Compromise of Data. In the event of any act, error or omission, negligence, misconduct, or breach on the part of Grantee that compromises or is suspected to compromise the security, confidentiality, or integrity of State Data or the physical, technical, administrative, or organizational safeguards put in place by Grantee that relate to the protection of the security, confidentiality, or integrity of State Data, Grantee must, as applicable: (a) notify the Department as soon as practicable but no later than 24 hours of becoming aware of such occurrence; (b) cooperate with the Department in investigating the occurrence, including making available all relevant records, logs, files, data reporting, and other materials required to comply with applicable law or as otherwise required by the Department; (c) in the case of PII or PHI, at the Department’s sole election, (i) with approval and assistance from the Department, notify the affected individuals who comprise the PII or PHI as soon as practicable but no later than is required to comply with applicable law, or, in the absence of any legally required notification period, within five calendar days of the occurrence; or (ii) reimburse the Department for any costs in notifying the affected individuals; (d) in the case of PII, provide third-party credit and identity monitoring services to each of the affected individuals who comprise the PII for the period required to comply with applicable law, or, in the absence of any legally required monitoring services, for no less than 24 months following the date of notification to such individuals; (e) perform or take any other actions required to comply with applicable law as a result of the occurrence; (f) pay for any costs associated with the occurrence, including but not limited to any costs incurred by the Department in investigating and resolving the occurrence, including reasonable attorney’s fees associated with such investigation and resolution; (g) without limiting Grantee’s obligations of indemnification as further described in this Agreement, indemnify, defend, and hold harmless the Department for any and all claims, including reasonable attorneys’ fees, Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 26 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 costs, and incidental expenses, which may be suffered by, accrued against, charged to, or recoverable from the Department in connection with the occurrence; (h) be responsible for recreating lost State Data in the manner and on the schedule set by the Department without charge to the Department; and, (i) provide to the Department a detailed plan within 10 calendar days of the occurrence describing the measures Grantee will undertake to prevent a future occurrence. Notification to affected individuals, as described above, must comply with applicable law, be written in plain language, not be tangentially used for any solicitation purposes, and contain, at a minimum: name and contact information of Grantee’s representative; a description of the nature of the loss; a list of the types of data involved; the known or approximate date of the loss; how such loss may affect the affected individual; what steps Grantee has taken to protect the affected individual; what steps the affected individual can take to protect himself or herself; contact information for major credit card reporting agencies; and, information regarding the credit and identity monitoring services to be provided by Grantee. The Department will have the option to review and approve any notification sent to affected individuals prior to its delivery. Notification to any other party, including but not limited to public media outlets, must be reviewed, and approved by the Department in writing prior to its dissemination. The parties agree that any damages relating to a breach of this section are to be considered direct damages and not consequential damages. 6.Surrender of Confidential Information upon Termination. Upon termination or expiration of this Contract or a Statement of Work, in whole or in part, each party must, within 5 Business Days from the date of termination, return to the other party any and all Confidential Information received from the other party, or created or received by a party on behalf of the other party, which are in such party’s possession, custody, or control. Upon confirmation from the State, of receipt of all data, Grantee must permanently sanitize or destroy the State’s Confidential Information, including State Data, from all media including backups using National Security Agency (“NSA”) and/or National Institute of Standards and Technology (“NIST”) (NIST Guide for Media Sanitization 800-88) data sanitization methods or as otherwise instructed by the State. If the State determines that the return of any Confidential Information is not feasible or necessary, Grantee must destroy the Confidential Information as specified above. The Grantee must certify the destruction of Confidential Information (including State Data) in writing within 5 Business Days from the date of confirmation from the State. Any requirement on the Grantee’s part to retain data beyond the end of this contract must be authorized by the State. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 27 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 T.Data Privacy and Information Security 1.Undertaking by Grantee. Without limiting Grantee’s obligation of confidentiality as further described, Grantee is responsible for establishing and maintaining a data privacy and information security program, including physical, technical, administrative, and organizational safeguards, that is designed to: (a) ensure the security and confidentiality of the State Data; (b) protect against any anticipated threats or hazards to the security or integrity of the State Data; (c) protect against unauthorized disclosure, access to, or use of the State Data; (d) ensure the proper disposal of State Data; and (e) ensure that all employees, agents, and subcontractors of Grantee, if any, comply with all of the foregoing. In no case will the safeguards of Grantee’s data privacy and information security program be less stringent than the safeguards used by the Department, and Grantee must at all times comply with all applicable State policies and standards, which are available to Grantee upon request. 2.Audit by Grantee. No less than annually, Grantee must conduct a comprehensive independent third-party audit of its data privacy and information security program and provide such audit findings to the Department. 3.Right of Audit by the State. Without limiting any other audit rights of the Department, the Department has the right to review Grantee’s data privacy and information security program prior to the commencement of the Agreement’s Statement of Work and from time to time during the term of this Agreement. During the providing of the Agreement’s Statement of Work, on an ongoing basis from time to time and without notice, the Department, at its own expense, is entitled to perform, or to have performed, an on-site audit of Grantee’s data privacy and information security program. In lieu of an on-site audit, upon request by the Department, Grantee agrees to complete, within 45 calendar days of receipt, an audit questionnaire provided by the Department regarding Grantee’s data privacy and information security program. 4.Audit Findings. Grantee must implement any required safeguards as identified by the Department or by any audit of Grantee’s data privacy and information security program. IV.Financial Requirements A.Operating Advance Under the pre-payment reimbursement method, no additional operating advances will be issued. B.Payment Method 1.Prepayments a.The Department will make monthly prepayments equal to Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 28 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 1/12th of the Agreement amount for each non-fee-for-service program contained in Attachment IV of this Agreement. One single payment covering all non-fee-for-service programs will be made within the first week of each month. The Grantee can view their monthly prepayment within the MI E-Grants system. b.Prepayments for the months of October thru January will be based upon the initial Agreement amounts in Attachment IV. Subsequent monthly prepayments may be adjusted based upon Agreement amendments or Grantee adjustment requests. c.If the sum of the prepayments does not equal at least 90% of the Grantee’s expenditures for a quarter of the contract period, the Grantee may submit documentation for an adjustment to the monthly prepayment amount via the following process: i.Submit a written request for the adjustment to the Department’s Accounting Expenditure Operations Division. ii.The adjustment request must be itemized by program and must list the amount received from the Department, the expenditure amount reported per the quarterly Financial Status Report (FSR), and the difference. The amount received from the Department and the expenditures must be for the same reporting quarterly FSR period. iii.The Department will review the requests and if an adjustment is approved, it will be included in the next scheduled monthly prepayment. iv.Adjustment requests will not be accepted prior to submission of the FSR for the quarter ending December 31. No adjustments will be made prior to the February monthly prepayment. v.The ability of the Department to approve adjustments may be limited by the quarterly allotments of spending authority in the Department’s appropriation account mandated by the Office of the State Budget Director. The quarterly allotment limits the amount of each account (program) that the Department may expend during each fiscal quarter. 2.Fixed Fee Reimbursement a.Quarterly reimbursement for fixed fee projects is based on Attachment IV and approved quarterly Financial Status Reports. C.Financial Status Report Submission 1.The Grantee must electronically prepare and submit FSRs to the Department via the EGrAMS website (http://egrams-mi.com/mdhhs). Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 29 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 A Financial Status Report (FSR) must be submitted on a quarterly basis no later than 30 days after the close of the calendar quarter for all programs listed on Attachment IV and fee for services project budgeted. Failure to meet financial reporting responsibilities as identified in this Agreement may result in withholding future payments. 2.FSR’s must report total actual program expenditures regardless of the source of funds. The Department will reimburse the Grantee for expenditures in accordance with the terms and conditions of this Agreement. Failure to comply with the reporting due dates will result in the deferral of the Grantee’s monthly prepayment. 3.The Grantee representative who submits the FSR is certifying to the best of their knowledge and belief that the report 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 FSR 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. 4.The instructions for completing the FSR form are available on the website http://egrams-mi.com/dch. Send FSR questions to FSRMDHHS@michigan.gov. D.Reimbursement Method The Grantee will be reimbursed in accordance with the reimbursement methods for applicable program elements described as follows: 1.Performance Reimbursement - A reimbursement method by which Grantees 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. Any local funds used to support program elements operated under such provisions of this Agreement may be transferred by the Grantee within, among, to or from the affected elements without Department approval, subject to applicable provisions of Sections 3.B. and 3.C.3 of Part 1. If Grantee's performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation will be reduced equivalent to actual performance in relation to the minimum performance. 2.Actual Cost Reimbursement - A reimbursement method by which Grantees are reimbursed based upon the understanding that state dollars will be paid up to total costs in relation to the state's share of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 30 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 as a source before any local funding requirement unless a specific local match condition exists. 3.Fixed Unit Rate Reimbursement - A reimbursement method by which Grantee is reimbursed a specific amount for each output actually delivered and reported. 4.Essential Local Public Health Services (ELPHS) - A reimbursement method by which Grantees are reimbursed a share of reasonable and allowable costs incurred for required services, as noted in the current Appropriations Act. E.Reimbursement Mechanism All Grantees must sign up through the on-line vendor registration process to receive all State of Michigan payments as Electronic Funds Transfers (EFT)/Direct Deposits. Vendor registration information is available through the Department of Technology, Management and Budget’s web site: http://www.michigan.gov/sigmavss F.Unobligated Funds Any unobligated balance of funds held by the Grantee at the end of the Agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. G.Final Obligation Reporting Requirements An Obligation Report, based on annual guidelines, must be submitted by the due date using the format provided by the Department through MI E-Grants. The Grantee must provide, by program, an estimate of total expenditures for the entire Agreement period (October 1 through September 30). This report must represent the Grantee’s best estimate of total program expenditures for the Agreement period. The information on the report will be used to record the Department’s year-end accounts payables and receivables by program for this Agreement. The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this Agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Grantee in the monthly prepayments and quarterly fee-for-service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of Agreement amendments, the Grantee may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 31 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 a program at fiscal year-end. Within 60 days after the Agreement fiscal year-end, the Grantee must liquidate any unpaid year-end commitments and obligations. Any obligation remaining unliquidated after 60 days from the end of the Agreement period will revert to the Department for disposition in accordance with applicable state and/or federal requirements, except as specifically authorized in writing by the Department. H.Final Financial Status Reporting Requirements Final FSRs are due on the following dates following the Agreement period end date: Project Final FSR Due Date Public Health Emergency Preparedness 11/15/2024 All Remaining Projects 11/30/2024 Upon receipt of the final FSR electronically through MI E-Grants, the Department will determine by program, if funds are owed to the Grantee or if the Grantee owes funds to the Department. If funds are owed to the Grantee, payment will be processed. However, if the Grantee underestimated their year-end obligations in the Obligation Report as compared to the final FSR and the total reimbursement requested does not exceed the Agreement amount that is due to the Grantee, the Department will make every effort to process full reimbursement to the Grantee per the final FSR. Final payment may be delayed pending final disposition of the Department’s year-end obligations. If funds are owed to the Department, it will generally not be necessary for Grantee to send in a payment. Instead, the Department will make the necessary entries to offset other payments and as a result the Grantee will receive a net monthly prepayment. When this does occur, clarifying documentation will be provided to the Grantee by the Department’s Bureau of Finance and Accounting. I.Penalties for Reporting Noncompliance For failure to submit the final total Grantee FSR report by November 30, through MI E-Grants after the Agreement period end date, the Grantee may be penalized with a one-time reduction in their current ELPHS allocation for noncompliance with the fiscal year-end reporting deadlines. Any penalty funds will be reallocated to other Local Health Department Grantees. Reductions will be one-time only and will not carryforward to the next fiscal year as an ongoing reduction to a Grantee’s ELPHS allocation. Penalties will be assessed based upon the submitted date in MI E-Grants: ELPHS Penalties for Noncompliance with Reporting Requirements: 1.1% - 1 day to 30 days late; 2.2% - 31 days to 60 days late; Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 32 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3.3% - over 60 days late with a maximum of 3% reduction in the Grantee’s ELPHS allocation. J.Indirect Costs and Cost Allocations/Distribution Plans The Grantee is allowed to use approved federal indirect rate, 10% de minimis indirect rate or cost allocation/distribution plans in their budget calculations. 1.Costs must be consistently charged as indirect, direct or cost allocated, but may not be double charged or inconsistently charged. 2.If the Grantee does not have an existing approved federal indirect rate, they may use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 to recover their indirect costs. 3.Grantees using the cost allocation/distribution method must develop certified plan in accordance with the requirements described in Title 2 CFR, Part 200 which includes detailed budget narratives and is retained by the Grantee and subject to Department review. 4.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 and subject to Department review. V.Agreement Termination This Agreement may be terminated without further liability or penalty to the Department for any of the following reasons: A.By either party by giving 30 days written notice to the other party stating the reasons for termination and the effective date. B.By either party with 30 days written notice upon the failure of either party to carry out the terms and conditions of this Agreement, provided the alleged defaulting party is given notice of the alleged breach and fails to cure the default within the 30-day period. C.Immediately if the Grantee or an official of the Grantee or an owner is convicted of any activity referenced in Part 2 Section III. D. of this Agreement during the term of this Agreement or any extension thereof. Further, this Agreement may be terminated or modified immediately upon a finding by the Department in accordance with MCL 333.2235 that the Grantee local health department for the delivery of public health services under this Agreement is unable or unwilling to provide any or all of the services as provided in this Agreement, and the Department may redirect funds as necessary to ensure that the public health services are provided within the Grantee's jurisdiction. VI.Stop Work Order The Department may suspend any or all activities under this Agreement at any time. The Department will provide the Grantee with a written stop work order detailing the suspension. Grantee must comply with the stop work order upon receipt. The Department will not pay for activities, Grantee’s incurred expenses or financial losses, or any additional compensation during a stop work period. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 33 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 VII.Final Reporting upon Termination Should this Agreement be terminated by either party, within 30 days after the termination, the Grantee must provide the Department with all financial, performance and other reports required as a condition of this Agreement. The Department will make payments to the Grantee for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Grantee must immediately refund to the Department any funds not authorized for use and any payments or funds advanced to the Grantee in excess of allowable reimbursable expenditures. VIII.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. IX.Amendments A.Except as otherwise provided, any changes to this Agreement will be valid only if made in writing and accepted by all parties to this Agreement. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Grantee's or Department's control, which reduce or otherwise interfere with the Grantee's or Department's ability to provide or maintain specified services or operational procedures, immediate written notification must be provided to the other party. Any change proposed by the Grantee which would affect the state funding of any project, in whole or in part as provided in Part 1, Section 3.C. of the Agreement, must be submitted in writing to the Department for approval immediately upon determining the need for such change. The proposed change may be implemented upon receipt of written notification from the Department. B.Except as otherwise provided, amendments to this Agreement will be made within thirty days after receipt and approval of a change proposed by the Grantee. Amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the Agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Grantee, in writing, at any time prior to June 7. The Department will provide a written response within 30 calendar days. All amendments must be submitted to the Department within three weeks of receipt through MI E-Grants to assure the amendment can be executed prior to the end of the Agreement period. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 34 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 X.Liability A.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, by the Grantee, Grantee’s subcontractors or anyone directly or indirectly employed by the Grantee in the performance of this Agreement will be the responsibility of the Grantee, and not the responsibility of the Department. Nothing herein will be construed as a waiver of any governmental immunity that has been provided to the Grantee or its employees by law. B.In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Grantee and the Department in fulfillment of their responsibilities under this Agreement, such liability, loss, or damage will be borne by the Grantee and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein will be construed as a waiver of any governmental immunity by the Grantee, the state, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. XI.Waiver Failure to enforce any provision of this Agreement will not constitute a waiver. 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 Department or the Grantee, 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. XII.State of Michigan Agreement This Agreement is governed, construed, and enforced in accordance with Michigan law, excluding choice-of-law principles, and all claims relating to or arising out of this Agreement are governed by Michigan law, excluding choice-of-law principles. Any dispute arising from this Agreement must be resolved in the Michigan Court of Claims. Complaints against the State must be initiated in Ingham County, Michigan. Grantee waives any objections, such as lack of personal jurisdiction or forum non conveniens. Grantee must appoint an agent in Michigan to receive service of process. XIII.Funding A.State funding for this Agreement will be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds will be as stated in the approved Annual Budget - Attachment I Instructions for the Annual Budget, Attachment III, Program Specific Assurances and Requirements, and as outlined in Attachment IV, Funding/Reimbursement Matrix. B.The funding provided through the Department for this Agreement will not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Grantee must advise the Department in writing by May 1, if the amount of Department funding may not Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 35 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 be used in its entirety or appears to be insufficient for any program element. ELPHS transfer requests between MDHHS, MDARD and MDEQ must also be requested in writing by May 1. All ELPHS required services must be maintained throughout the entire period of the Agreement. C.The Department may periodically redistribute funds between agencies during the Agreement period in order to ensure that funds are expended to meet the varying needs for services. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 36 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 AA Attachments A1 Attachment I - Instructions for the Annual Budget Attachment I - Instructions for the Annual Budget A2 Attachment III - Program Specific Assurances and Requirements Attachment III - Program Specific Assurances and Requirements Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 37 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Adolescent STI Screening Reg. Alloc.F 73,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Body Art Fixed Fee Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Recepient Children's Special Hlth Care Services (CSHCS) Care Coordination Calc. Amt.S 0 Fixed Unit Rate (1), (7) N/A N/A N/A N/A N/A Subrecepient Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy Reg. Alloc.F 147,201 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 147,201 CSHCS Medicaid Elevated Blood Lead Case Mgmt Calc. Amt.F 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient CSHCS Vaccine Initiative Reg. Alloc.F 18,968 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Eastern Equine Encephalitis Virus Surveillance Project Reg. Alloc.F 15,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient EGLE Drinking Water and Onsite Wastewater Management Reg. Alloc.S 985,042 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient Emerging Threats - Hepatitis C Reg. Alloc.S 166,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Fetal Infant Mortality Review (FIMR) Case Abstraction Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient FIMR Interviews Calc. Amt.S 0 Fixed Unit Rate (2), (11) N/A N/A N/A N/A N/A Subrecepient Food ELPHS Reg. Alloc.S 1,176,612 ELPHS (3), (4)N/A N/A N/A N/A N/A Recepient Gonococcal Isolate Surveillance Project Reg. Alloc.F 6,178 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 18,535 Harm Reduction Support Services Reg. Alloc.F 250,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Hearing ELPHS Reg. Alloc.L 253,969 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 38 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) HIV PrEP Clinic Reg. Alloc.F 343,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 3,500 Reg. Alloc.S 3,500 HIV Prevention Reg. Alloc.F 22,612 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 22,612 Reg. Alloc.S 407,021 Immunization Action Plan (IAP)Reg. Alloc.F 526,990 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Immunization Fixed Fees Calc. Amt.S 0 Fixed Unit Rate (2), (7) N/A N/A N/A N/A N/A Subrecepient Immunization Vaccine Quality Assurance Reg. Alloc.S 105,347 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Infant Safe Sleep Reg. Alloc.F 7,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 63,000 Integrating MPOX into STI Clinics Reg. Alloc.F 6,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Laboratory Services Bio Reg. Alloc.F 1,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient MCH - All Other Local MCH S 249,377 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MCH - Children Local MCH S 72,080 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MDHHS-Essential Local Public Health Services (ELPHS) Reg. Alloc.S 2,557,216 ELPHS (3),(6)N/A N/A N/A N/A N/A Recepient Nurse Family Partnership Services Reg. Alloc.F 405,324 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 270,216 Oral Health- Kindergarten Assessment Reg. Alloc.S 110,597 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 39 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 Reg. Alloc.F 222,449 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 Reg. Alloc.F 196,551 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Sexually Transmitted Infection (STI) Control Reg. Alloc.F 33,418 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 703 Reg. Alloc.S 36,144 Statewide Lead Case Management - Fixed Fee Calc. Amt.S 0 Fixed Unit Rate (7), (11) N/A N/A N/A N/A N/A Recepient Tuberculosis (TB) Control Reg. Alloc.F 15,426 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Vector-Borne Surveillance & Prevention Reg. Alloc.S 9,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Vision ELPHS Reg. Alloc.L 253,968 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient West Nile Virus Community Surveillance Reg. Alloc.F 10,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient WIC Breastfeeding Reg. Alloc.F 267,619 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient WIC Resident Services Reg. Alloc.F 2,615,870 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient TOTAL MDHHS FUNDING 12,096,246 *SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Attachment IV Notes Attachment IV Notes Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 40 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 Attachment V Oakland County FY Agreement Addendum A Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 41 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 PROGRAM BUDGET SUMMARY For WIC Peer Counselor Funding Application View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Use WHOLE DOLLARS Only ATTACHMENT C.1 PROGRAM DATE PREPARED 6/12/23 Page Of Oakland Livingston Human Service Agency WIC Program CONTRACTOR NAME BUDGET PERIOD Oakland Livingston Human Service Agency WIC Program From:10/1/2023 To:9/30/2024 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # 196 Cesar E. Chavez Pontiac, Michigan 48343 1 TOTAL BUDGET EXPENDITURE CATEGORY (Use Whole Dollars) 1.SALARY & WAGES $47,587 2.FRINGE BENEFITS $12,970 3.TRAVEL $3,580 4.SUPPLIES & MATERIALS $4,805 5.CONTRACTUAL (Subcontracts/Subrecipients) 6.EQUIPMENT $2,500 7.OTHER EXPENSES - list below Flyers, advertising, social media $1,000 Telephones for staff $8,000 IT Cost Pool $2,000 HR Cost Pool $2,000 Audit $425 8.TOTAL DIRECT EXPENDITURES (Sum of Lines 1-7)$84,867 9.INDIRECT COSTS: Rate #1 % 10. TOTAL EXPENDITURES $84,867 SOURCE OF FUNDS: 16.TOTAL FUNDING $84,867 COMPLETION: Is Voluntary, but is required as a condition of funding. DCH-0385(E) (Rev. 01/09) ORIGINAL AMENDMENT PROGRAM BUDGET - COST DETAIL SCHEDULE ATTACHMENT C.2 View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Page Of Use WHOLE DOLLARS Only OLHSA WIC PROGRAM (PEER COUNSELING) BUDGET PERIOD DATE PREPARED From:To: 10/1/2023 9/30/2024 CONTRACTOR NAME AMENDMENT # Oakland Livingston Human Agency 1 1. SALARY & WAGES:POSITIONS POSITION DESCRIPTION COMMENTS REQUIRED TOTAL SALARY Associate Director Nutrition 1@4 hours/week x 52 weeks $5,528 Breastfeeding Peer Counselor 1@4 hours/week x 52 weeks $5,154 Peer Counselor 1@6 hours/week x 52 weeks $8,599 Peer Counselor 1@6hours/week x 52 weeks $8,598 Lactation Specialist 1@6hours/week x 52 weeks $7,900 Lactation Specialist 1@18 hours x 52 weeks $11,808 1. TOTAL SALARY & WAGES:$47,587 2. FRINGE BENEFITS: (Specify) Composite Rate % 45% Part Time X% Full Time 2. TOTAL FRINGE BENEFITS:$12,970 3. TRAVEL: (Specify if category exceeds 10% of Total Expenditures) 4 Trips to Lansing for 3 staff members, local travel, conferences, and add'l trainings $3,580 Local Mileage Rate @.58 per mile - 1,000 miles - $580 3. TOTAL TRAVEL:$3,580 4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures) $4,805 4. TOTAL SUPPLIES & MATERIALS:$4,805 5. CONTRACTUAL: (Subcontracts/Subrecipients) Name Address Amount Audit $- 5. TOTAL CONTRACTUAL:$- 6. EQUIPMENT: (Specify)Amount Replace computers and equipment that are no longer functioning.$2,500 6. TOTAL EQUIPMENT:$2,500 7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures)Amount Communication:Flyers, advertising, business cards, news ads $1,000 Space Cost:Telephones for Staff $8,000 Others (explain):IT Cost Pool (X/fte/hr)$2,000 HR Cost Pool )X/fte/hr)$2,000 Audit $425 7. TOTAL OTHER EXPENSES:$13,425 8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1-7) 8. TOTAL DIRECT EXPENDITURES:$84,867 9. INDIRECT COST CALCULATIONS: Rate #1 Base $x Rate = $- Rate #2 Base $-x Rate = $- 9. TOTAL INDIRECT EXPENDITURES:$- 10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9)$84,867 COMPLETION: Is Voluntary, but is required as a condition of funding. DCH-0386(E) (Rev. 01/09) (EXCEL) Use Additional Sheets as Needed FICA UNEMPLOY INS RETIREMENT HEARING INS DENTAL INS ORIGINAL AMENDMENT FICA UNEMPLOY INS RETIREMENT HOSPITAL INS LIFE INS VISION WORK COMP OTHER:specify- ORIGINAL AMENDMENT FICA UNEMPLOY INS RETIREMENT LIFE INS VISION INS HEARING INS DENTAL INS WORKS COMP ORIGINAL AMENDMENT FICA UNEMPLOY INS RETIREMENT ORIGINAL AMENDMENT FICA UNEMPLOY INS ORIGINAL AMENDMENT FICA ORIGINAL AMENDMENT FICA HOSPITAL INS OTHER:specify- ORIGINAL AMENDMENT FICA ORIGINAL AMENDMENT FICA ORIGINAL AMENDMENT CHPIS/WIC ADM/OLHSA/contract amendments/FY19 FY24 Amendment 1 Contract #10010139 Oakland Livingston Human Services Agency Contract effective 6-1-24 through 9-30-24 ACCT: FND11007 CCN1060284 PGM133271 GRN-1004232 - Breastfeeding Peer Counseling Program This amendment is to add $2,500 to the OLHSA WIC Breastfeeding Grant funding for implementing IBCLC services for OLHSA WIC clients per the WIC IBCLC policy. OLHSA will notify OCHD if their ability to deliver these services changes and at that time a course of action will be determined by OCHD. ▪The updated FY24 allocation for the Breastfeeding Peer Counseling Program is $87,367. This funding is for 1.5 FTE of peer counseling time and does not include supervisor or mentor time. This includes funding of $2,500 for implementing International Board-Certified Lactation Consultant (IBCLC) services to WIC clients by a IBCLC certified staff, utilizing the guidelines and requirements per the State of Michigan WIC IBCLC services policy. OCHD has on file confirmation of the OLHSA staff IBCLC certification. ▪By accepting the WIC Breastfeeding Peer Counseling Funds, the local agency agrees to all of the following: 1. To implement/administer a peer counseling program based on research-based components of a successful peer counseling program as identified by FNS (the Loving Support model). This includes peer availability outside of standard business hours. The peer counseling program must be consistent with program guidance set forth in Using Loving Support to Manage Peer Counseling Programs and Loving Support through Peer Counseling training curricula; 2. Fulfill all financial requirements including complying with allowable costs for the breastfeeding peer counseling program as delineated in the table below and financial reporting requirements. _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 1 of 22 FY 2024 MDHHS LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Unique Entity Identifier #:J25FVSQGPKM1 This Agreement is made between Oakland County, a Constitutional Corporation, 1200 North Telegraph, Pontiac, Michigan 48341 ("County") and Oakland Livingston Human Service Agency (OLHSA), 196 Cesar E. Chavez Ave., Pontiac, Michigan 48343-0598, a Michigan Municipal Corporation ("Subrecipient"). The County and Subrecipient 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 Subrecipient to implement WIC Resident and WIC Breastfeeding Peer Counseling Services. 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. The County intends to use a portion of the Grant funds to reimburse the Subrecipient, 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 Subrecipient 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 federal award committed to the Subrecipient under this Agreement is not DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 2 of 22 to exceed $604,848 and is allocated as follows: •$84,867– WIC Breastfeeding Peer Counseling Funding to fund 1.5 FTE peer counseling time and does not include supervisor or mentor time. Oakland County Health Division WIC program will provide Oakland Livingston Human Service Agency’s IBCLC services. •$519,981 – WIC Resident Services and reflects a budget submitted by OLHSA and approved by OCHD and State WIC to achieve an average monthly caseload of 3,676. 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: X Subrecipient relationship (federal funding); or Recipient (non-federal funding). The grant Agreement is designated as: Research and development project; or X Not a research and development project. B. Identification of Federal Dollars Awarded CFDA Title: Special Supplemental Nutrition Program for Women, Infants and Children CFDA Number: 10.557 Award Name: Women Infants and Children Award Number (FAIN): 232MI003W1003 Award Date: 10/18/22 CFDA Number: 10.557 Award Name: Women Infants and Children Breastfeeding Peer Counseling Program Award Number (FAIN): 232MI013W5003 Federal Agency Name: USDA Food and Nutrition Services Awarding Official Contact Information: Cecilia Hutson, Manager, Financial Management & FMNP Section Period of Performance: October 1, 2022, through September 30, 2023 Pass Through Entity (PTE): Michigan Department of Health & Human Services (MDHHS) DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 3 of 22 MDHHS Indirect Cost Rate: 10% De Minimis C. Equipment Purchases and Title Subrecipient will not purchase capital assets or equipment using funds from this Agreement without the approval of the County. 4.Statement of Work: The Subrecipient 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 and Attachments B1 through B4, which are part of this Agreement. 6.Performance/Progress Report Requirements: The progress reporting methods shall be followed as described in Part II and Attachment C, which are part of this Agreement. 7.General Provisions: The Subrecipient agrees to comply with the General Provisions outlined in Part II, which are part of this Agreement. The Subrecipient also agrees that it will comply with all of the terms and conditions of the County’s Grant Agreement with the State (Grant Agreement), which is included and incorporated into this Agreement as Attachment E. 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: Lisa McKay-Chiasson, Public Health Administrator (248) 858-1395 mckay- chiassonl@oakgov.com 9.Subrecipient's Financial Contact for the Agreement: The person acting for the Subrecipient on the financial reporting for this Agreement is: Name: Charles Blake, Deputy Director for Financial Compliance DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 4 of 22 E-Mail Address: Charlesb@olhsa.org Telephone No.: (248) 209-2632/210-8025 10.Special Conditions: A. This Agreement is valid upon approval and execution by the County and Signature by the Subrecipient. 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 Subrecipient 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 - Subrecipient The Subrecipient 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 Subrecipient 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 Subrecipient must obtain and maintain all necessary licenses, permits, and insurances under Part II.1.L, and any other authorizations necessary for the performance of this Agreement. D.Reporting Utilize all report forms and reporting formats required by the County at the effective date of DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 5 of 22 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 Subrecipient 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 Subrecipient, any parent, affiliate, or subsidiary organization of Subrecipient, and any subcontractor that performs Agreement activities in connection with this Agreement. F.Audit and Access to Records Subrecipient certifies by signing this Agreement that it complies with regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200 and will provide notice of the completion of required audits and any adverse findings which impact this subaward as required by parts 200.501-200.521 and will 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 Subrecipient, a subcontractor, or an officer or director of Subrecipient 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. 2.A criminal Proceeding. 3.A parole or probation Proceeding. 4.A Proceeding under the Sarbanes-Oxley Act. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 6 of 22 5.A civil Proceeding involving: a.A claim that might reasonably be expected to adversely affect Subrecipient’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 Subrecipient or its subcontractors discriminated against its employees, subcontractors, vendors, or suppliers during the term of this Agreement. 6.A Proceeding involving any license that Subrecipient 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 Subrecipient’s ownership or executive management I.Statement of Work Progress Reports Reserved J.Conflict of Interest and Code of Conduct Standards i.The Subrecipient is subject to the provisions of 1968 PA 317, as amended, 1973 PA 196, as amended, and Title 2 Code of Federal Regulations, Section 200.318 (c) (1) and (2). ii.The Subrecipient 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 Subrecipient, 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 Subrecipient, any parent, affiliate, or subsidiary organization of Subrecipient, and any subcontractor that performs activities in connection with this Agreement. K.Travel Costs i.Be reimbursed for travel cost (including mileage, meals, and lodging) budgeted and incurred related to services provided under this Agreement. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 7 of 22 1.If the Subrecipient has a documented policy related to travel reimbursement for employees and if the Subrecipient follows that documented policy, the County will reimburse the Subrecipient for travel costs at the Subrecipient’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 Subrecipient 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 Subrecipient will interact with children, schools, or the cognitively impaired, the Subrecipient must maintain appropriate insurance coverage related to sexual abuse and molestation liability. 3.Workers’ Compensation Insurance or Governmental Self-Insurance: Coverage according to applicable laws governing work activities. Policies must include DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 8 of 22 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 Subrecipient shall obtain and maintain insurance according to this Section and the specific County requirements listed in Attachment D, which is incorporated into this Agreement. iv.Subrecipient 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 Subrecipient 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 3.National Sex Offender Registry: http://www.nsopw.gov ii.Conduct or cause to be conducted a Central Registry (CR) check for each employee, DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 9 of 22 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 Subrecipient 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 Subrecipient. 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 Subrecipient 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 Subrecipient an opportunity to review. 3.Assurances The following assurances are hereby given to the County: A.Compliance with Applicable Laws DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 10 of 22 The Subrecipient will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this Agreement. The Subrecipient 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 Subrecipient will comply with all applicable requirements in the original grant awarded to the County. The County may determine that the Subrecipient 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 Subrecipient 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 Subrecipient shall require that the language of this assurance be included in the award documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. C.Non-Discrimination i.The Subrecipient 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 Subrecipient 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. ii.The Subrecipient will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 11 of 22 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 Subrecipient 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 Subrecipient 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 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 12 of 22 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 Subrecipient 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 Subrecipient also assures that this language will be included in any subawards which contain provisions for children’s activities. ii.The Subrecipient 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 the facility under the control of the Subrecipient. If activities are delivered in facilities or areas that are not under the control of the Subrecipient (e.g., a mall, restaurant or private work site), the activities shall be smoke-free. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 13 of 22 F.Hatch Political Activity Act and Intergovernmental Personnel Act The Subrecipient 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 Subrecipient 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 Subrecipient 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 Subrecipient 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 Subrecipient 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 i.Subrecipient 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 14 of 22 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 Subrecipient under this Agreement, the Subrecipient assures that it is in compliance with requirements of HIPAA including the following: i.The Subrecipient 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 Subrecipient will ensure that any subcontractor will have the same obligations as the Subrecipient 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 Subrecipient must only use the protected health data and information for the purposes of this Agreement. iv.The Subrecipient 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 Subrecipient’s employees. v.The Subrecipient 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 Subrecipient becomes aware. The Subrecipient will work with the County to mitigate the 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 Subrecipient must provide the same to the County. vi.Failure to comply with any of these contractual requirements may result in the DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 15 of 22 termination of this Agreement in accordance with Part II, Section 4, G. Agreement Termination. vi.In accordance with HIPAA requirements, the Subrecipient 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 Subrecipient from the State, County, or any other source. vii.The Subrecipient 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 Subrecipient’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 Subrecipient may not refer to the County on the Subrecipient'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 Subrecipient agrees that it will use Confidential Information solely for the purpose of this Agreement. The Subrecipient 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 Subrecipient must take all reasonable precautions to safeguard the Confidential Information. These precautions must be at least as great as the precautions the Subrecipient takes to protect its own confidential or proprietary information. 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 16 of 22 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 Subrecipient must notify the County within one (1) business day after discovering any unauthorized use or disclosure of Confidential Information. The Subrecipient 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 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 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 17 of 22 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, 2023. 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 Lisa McKay-Chiasson at mckay- chiassonl@oakgov.com. For questions, call 248-858-1395, Lisa McKay-Chiasson. 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 Subrecipient 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 Subrecipient does not reconcile, then the Subrecipient shall provide any additional documentation requested by the County in order to process payment. 1.A fully completed and signed invoice provided by Oakland County Health Division. 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 18 of 22 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 Subrecipient 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 Subrecipient 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 The Subrecipient is allowed to use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 to recover their indirect costs. G.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 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 Subrecipient or an official of the Subrecipient or an owner is convicted of any activity referenced in Part II, Section 3, D. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 19 of 22 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 Subrecipient violates or breaches any contract terms. H.Stop Work Order The County may suspend any or all activities under this Agreement at any time. The County will provide the Subrecipient with a written stop order detailing the suspension. Subrecipient must comply with the stop work order upon receipt. The County will not pay for activities, Subrecipient’s incurred expenses or financial losses, or any additional compensation during a stop work order. I.Final Reporting Upon Termination Should this Agreement be terminated by either party, within 30 days after the termination, the Subrecipient 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 Subrecipient for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Subrecipient shall immediately refund to the County any funds not authorized for use and any payments or funds advanced to the Subrecipient in excess of allowable reimbursable expenditures. J.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. K.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 Subrecipient, 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 20 of 22 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 Subrecipient 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. M.Liability The Subrecipient 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 Subrecipient 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 Subrecipient, any of its subcontractors, or anyone directly or indirectly employed by the Subrecipient. ii.Nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Subrecipient 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. N.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. Subrecipient waives any objections, such as lack of personal jurisdiction or forum non conveniens. Subrecipient must appoint an agent in Michigan to receive service of process. L. Amendments DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 21 of 22 O.Entire Agreement 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 _________________________________________________________________________________________________________________ FY 2024 MDHHS LOCAL HEALH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Page 22 of 22 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 responsible governing board or official of the Subrecipient, and hereby accepts and binds the Subrecipient to the terms and conditions of this Agreement EXECUTED: Printed Name: Susan Harding Title: CEO Oakland Livingston Human Service Agency DATE:_______________ DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 11/2/2023 Attachment A Minimum Contractor Scope of Service Requirements Subrecipient, in accordance with the general purposes and objectives of this Agreement, will provide Women, Infants and Children’s Program (WIC) and Peer Counseling services as follows: •Comply with all applicable WIC federal regulations, policy, guidance and requirements of the WIC program as prescribed in the Code of Federal Regulations (7 CFR, Part 246). •Follow the allowable expense guidelines provided by USDA FNS for the Peer Counselor Grant. •Cooperate with an annual site visit by OCHD and develop and adhere to a Corrective Action Plan developed because of audit exceptions. The program must comply with all State and Federal audit requirements as applicable. •Assure that the sub-recipients financial system meets generally accepted accounting principles and systems. The sub-recipient must provide the most recent Financial Audit or Financial Statement (if an audit was not done) and the accompanying management letter. •Coordinate with the Contract Administrator and comply with all program, financial and reporting procedures. •Provide for security of Project FRESH coupons, as applicable and WIC EBT cards stored prior to issuance. Subrecipient must notify the Oakland County Health Division WIC program and the State WIC Division in writing of any lost, stolen, inappropriately issued or otherwise unaccounted for Project FRESH coupons or EBT cards, immediately upon recognition of such condition. •Maintain an inventory of all equipment purchased with WIC program funds and maintain such inventory at each WIC clinic location. •Install and maintain WIC hardware according to guidance provided by the Department WIC Program. •Ensure each OLHSA employee authorized for or requesting access to the automated WIC system has completed and signed a security agreement. •Provide personnel possessing at least the minimum qualifications as set by MDHHS – WIC Division, to deliver WIC services to the identified target population. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 • Maintain confidentiality of records on clients served and allow for the sharing of client information between the County and Subrecipient staff. Obtain signed Release of Information forms for sharing client information with other community service agencies/providers unless mutual aid agreements are available from the State WIC agency. • Create a nutrition education, breastfeeding promotions and outreach plans per WIC policy and submit to OCHD for review and approval by the designated due date. Implement the plan to conduct outreach to identify and bring hard to reach women and children into the WIC Program from communities that have been identified as undeserved by the Oakland County Health Division WIC Program (OCHD WIC). • Provide an annual plan and corresponding budget for the delivery of WIC services and WIC Breastfeeding Peer Counseling Services, specifically dealing with timelines and expected activity and productivity. • Must participate in mandatory nutrition education and breastfeeding time studies as determined by the State Agency. • Act as a resource to additional health and human services in the community. • Responsible for all expenses incurred to support and maintain delivering WIC services. • All materials and advertising used to promote the WIC Program shall also include information about WIC services offered by Oakland County Health Division and refer clients to Oakland County Health Division WIC clinics if those clinics provide the best access to services for clients. • Refer all ante partum women to the Oakland County Health Division in partnership with OCHD Infant Mortality Reduction efforts. • Coordinate with the Contract Administrator and comply with all program, financial and reporting procedures. • Breastfeeding Peer Counseling (BFPC) funds distributed to State agencies by the Food and Nutrition Service (FNS) are to be used to develop or expand activities necessary to sustain a peer counseling program based on the FNS Loving Support Model. The primary purpose of the funds is to provide direct breastfeeding support services through peer counseling to WIC participants. The use of BFPC funds for expenditures that are not supported by the Loving Support Model are not authorized. • Funds allocated for the Breastfeeding Peer Counseling Program are exempt from the WIC Nutrition Education and Breastfeeding Time Study. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Implement WIC Breastfeeding Peer Counseling services by following these guidelines: 10 Components of Loving Support Peer Counseling Program 1. Hire staff that meets the definition of Peer Counselor 2. Designate a Breastfeeding Peer Counselor Manager at the local level 3. Establish job parameters and description for peer counselors consistent with State WIC policy 4. Establish compensation and reimbursement rates for peer counselors 5. Train appropriate WIC local peer counseling management and clinic staff 6. Establish standardized breastfeeding peer counseling program procedures at the local level as part of the Agency’s WIC Nutrition Services Plan 7. Supervise and monitor peer counselors 8. Establish community partnerships to enhance the effectiveness of the WIC peer counseling program 9. Provide: o Timely access to breastfeeding coordinators/lactation experts for assistance outside peer counselor scope of practice o Regular, systematic contact with supervisor o Participation in clinic staff Meetings and breastfeeding in-services as part of the WIC team o Opportunities to meet regularly with other peer counselors 10. Provide training and continuing education of peer counselors DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 OLHSA WIC clinic locations and dates and times of service are listed below. Any change to location must be approved by Oakland County Health Division by following the procedures described below. Clinic Location Service Days Open C.A.R.E.S. of Farmington 21840 Independence St Farmington Hills, MI 48336 1st and 3rd Friday Karl Richter Center 920 Baird St. Holly, MI 48442 Every Tuesday Madison Heights 711 West 13 Mile Rd. Madison Heights, MI 48071 Tuesday, Wednesday and Thursday OLHSA Building 196 Cesar E. Chavez Ave. Pontiac, MI 48342 Monday, Wednesday, Thursday and Friday Journey Lutheran Church 136 S. Washington Oxford, MI 48371 2nd Monday (Once a Month) Requirements for Relocating, Adding or Closing a WIC Clinic A request to move, add or close a WIC clinic shall be submitted to OCHD in writing 60 days prior the clinic change occurring. The written request must include: • The reason for the move, closure, or additional clinic • Describe how many clients are impacted by the clinic change and how they will receive information about the change in WIC services • Identification of the proposed site • Justification for the location being proposed including: o Analysis of caseload and how the move or addition of a clinic will impact caseload o Documentation of need o Number of clients estimated to be served at the location • Location of clinic including zip codes served • Frequency of the proposed clinic The Oakland County Health Division WIC Supervisor shall complete a site visit if provisional approval is granted for the proposed site. When the site visit is successfully completed and any concerns about the location addressed, final, written approval will be provided. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Use WHOLE DOLLARS Only ATTACHMENT B.1 Page Of From:To: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 16. Oakland Livingston Human Service Agency WIC Program CONTRACTOR NAME BUDGET PERIOD PROGRAM BUDGET SUMMARY For WIC Peer Counselor Funding Application View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH PROGRAM DATE PREPARED 6/12/23 Oakland Livingston Human Service Agency WIC Program 10/1/2023 9/30/2024 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # 196 Cesar E. Chavez Pontiac, Michigan 48343 EXPENDITURE CATEGORY (Use Whole Dollars) TOTAL BUDGET SALARY & WAGES FRINGE BENEFITS TRAVEL SUPPLIES & MATERIALS OTHER EXPENSES - list below Flyers, advertising, social media CONTRACTUAL (Subcontracts/Subrecipients) EQUIPMENT Telephones for staff IT Cost Pool HR Cost Pool Audit TOTAL DIRECT EXPENDITURES (Sum of Lines 1-7) INDIRECT COSTS: Rate #1 % TOTAL EXPENDITURES SOURCE OF FUNDS: COMPLETION: Is Voluntary, but is required as a condition of funding. TOTAL FUNDING $2,500 $1,000 $8,000 $2,000 $2,000 $425 DCH-0385(E) (Rev. 01/09) $47,587 $12,970 $3,580 $4,805 $84,867 $84,867 $84,867 ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT B.2 Page Of Use WHOLE DOLLARS Only DATE PREPARED From:To: 10/1/2023 9/30/2024 AMENDMENT # POSITIONS REQUIRED TOTAL SALARY 5,528$ 5,154$ 8,599$ 8,598$ 7,900$ Lactation Specialist 1@18 hours x 52 weeks 11,808$ 47,587$ 2. FRINGE BENEFITS: (Specify) Composite Rate % 45% Part Time X% Full Time 12,970$ $3,580 3. TOTAL TRAVEL:3,580$ 4,805$ 4,805$ Name Amount Audit -$ 5. TOTAL CONTRACTUAL:-$ Amount $2,500 6. TOTAL EQUIPMENT:2,500$ Amount Communication:$1,000 Space Cost:$8,000 Others (explain):$2,000 $2,000 $425 13,425$ 84,867$ Rate #1 Base $x Rate = -$ Rate #2 Base $- x Rate = -$ -$ 84,867$ DCH-0386(E) (Rev. 01/09) (EXCEL) PROGRAM BUDGET - COST DETAIL SCHEDULE Use Additional Sheets as Needed View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH OLHSA WIC PROGRAM (PEER COUNSELING) BUDGET PERIOD CONTRACTOR NAME POSITION DESCRIPTION COMMENTS Associate Director Nutrition 1@4 hours/week x 52 weeks Oakland Livingston Human Agency 1. SALARY & WAGES: Peer Counselor 1@6hours/week x 52 weeks Breastfeeding Peer Counselor 1@4 hours/week x 52 weeks Peer Counselor 1@6 hours/week x 52 weeks 1. TOTAL SALARY & WAGES: 3. TRAVEL: (Specify if category exceeds 10% of Total Expenditures) 4 Trips to Lansing for 3 staff members, local travel, conferences, and add'l trainings 2. TOTAL FRINGE BENEFITS: Lactation Specialist 1@6hours/week x 52 weeks 4. TOTAL SUPPLIES & MATERIALS: 5. CONTRACTUAL: (Subcontracts/Subrecipients) Local Mileage Rate @.58 per mile - 1,000 miles - $580 4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures) 6. EQUIPMENT: (Specify) Replace computers and equipment that are no longer functioning. Address Audit 7. TOTAL OTHER EXPENSES: 7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures) Flyers, advertising, business cards, news ads Telephones for Staff COMPLETION: Is Voluntary, but is required as a condition of funding. 10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9) 8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1-7)8. TOTAL DIRECT EXPENDITURES: 9. INDIRECT COST CALCULATIONS: 9. TOTAL INDIRECT EXPENDITURES: IT Cost Pool (X/fte/hr) HR Cost Pool )X/fte/hr) ORIGINAL AMENDMENT OTHER:specify- ORIGINAL AMENDMENT LIFE INS VISION INS HEARING INS DENTAL INS WORKERS COMP ORIGINAL AMENDMENT RETIREMENT ORIGINAL AMENDMENT UNEMPLOY INS ORIGINAL AMENDMENTORIGINALAMENDMENT HOSPITAL INS OTHER:specify- ORIGINAL AMENDMENTORIGINALAMENDMENT FICA ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Use WHOLE DOLLARS Only ATTACHMENT B.3 Page Of From:To: STATE ZIP CODE Mi 48343 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. $69,774 $519,981 $519,981 $519,981 DCH-0385(E) (Rev. 01/09) (Excel) Previous Edition Obsolete. $342,559 $94,068 $3,580 $6,000 $4,000 AUTHORITY: P.A. 368 of 1978 The Department of Community Health is an equal opportunity COMPLETION: Is Voluntary, but is required as a condition of funding. employer, services and programs provider. TOTAL FUNDING OTHER(S) FEDERAL LOCAL TOTAL DIRECT EXPENDITURES (Sum of Lines 1-7) INDIRECT COSTS: STATE AGREEMENT INDIRECT COSTS: TOTAL EXPENDITURES SOURCE OF FUNDS: FEES & COLLECTIONS OTHER EXPENSES CONTRACTUAL (Subcontracts/Subrecipients) EQUIPMENT TRAVEL SUPPLIES & MATERIALS SALARY & WAGES FRINGE BENEFITS EXPENDITURE CATEGORY (Use Whole Dollars) TOTAL BUDGET CITY FEDERAL ID NUMBER Pontiac 38-1785665 Oakland Livingston Human Service Agency WIC program 6/12/2023 CONTRACTOR NAME BUDGET PERIOD PROGRAM BUDGET SUMMARY For WIC Funding Application View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH PROGRAM DATE PREPARED 196 Cesar E. Chavez Oakland Livingston Human Service Agency 10/1/2023 9/30/2024 MAILING ADDRESS (Number and Street) BUDGET AGREEMENT AMENDMENT # ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT B.4 Page Of Use WHOLE DOLLARS Only DATE PREPARED From:To:9/11/2019 10/1/2023 9/30/2024 AMENDMENT # POSITIONS REQUIRED TOTAL SALARY 0.900 50,224$ 0.900 46,779$ 0.500 24,122$ 0.525 15,937$ 2.250 80,019$ 2.000 75,394$ 1.000 39,331$ HR Cost Pool HR Cost Pool (x/fte/hr)10,753$ 0.100 2,100$ 8.075 342,559$ 2. FRINGE BENEFITS: (Specify) Composite Rate % 45% full time 18% part time LTD 94,068$ 3. TOTAL TRAVEL:3,580$ 6,000$ Name Amount 5. TOTAL CONTRACTUAL: Amount 6. TOTAL EQUIPMENT:$4,000 Amount Communication:$1,000 Space Cost:$15,000 Farmington Clinic $4,000 Madision Heights Cleaning $6,000 Others (explain):$19,000 $17,191 Audit $2,583 Translation Services - Bromberg $5,000 Total $69,774 519,981$ Rate #1 Base $x Rate = Rate #2 Base $- x Rate = -$ -$ 519,981$ DCH-0386(E) (Rev. 01/09) (EXCEL) Previous Edition Obsolete COMPLETION: Is Voluntary, but is required as a condition of funding. 10. TOTAL ALL EXPENDITURES: (Sum of lines 8-9) AUTHORITY: P.A. 368 of 1978 8. TOTAL DIRECT EXPENDITURES: (Sum of Totals 1-7)8. TOTAL DIRECT EXPENDITURES: 9. INDIRECT COST CALCULATIONS: 9. TOTAL INDIRECT EXPENDITURES: Telephones IT Cost pool (X/fte/hr.) 7. OTHER EXPENSES: (Specify if category exceeds 10% of Total Expenditures) flyers, advertizing, business cards, news ads Madison Heights clinic 6. EQUIPMENT: (Specify) Replacement of outdated or non functioning printers, scanners, computers as needed to update technology Address 4. TOTAL SUPPLIES & MATERIALS: 5. CONTRACTUAL: (Subcontracts/Subrecipients) Conferences, required training-all staff $3,000.00 for conferences 4. SUPPLIES & MATERIALS: (Specify if category exceeds 10% of Total Expenditures) Including gloves, controls, office/cleaning/sanitizing supplies and any materials required to run clinics Local Travel Mileage Rate @ .58 cents per mile 1,000 miles = $580.00 1. TOTAL SALARY & WAGES: 3. TRAVEL: (Specify if category exceeds 10% of Total Expenditures) 2. TOTAL FRINGE BENEFITS: Reigstered Dietitian 1@40 hours/week x 52 weeks 1@28 hours/week x 52 weeks CPA 1@40 hours/week x 52 weeks OLHSA Receptionist 1@4hours/weekx 52 weeks 1. SALARY & WAGES: Health Tech 1@21 hours/week x 52 weekds Health Tech Coordinator 2@40 hours/week x weeks 1@10 hours/week x 52 weeks Breasfeeding Coordinator 1@ 36 hours/week x 52 weeks Nutrition Education Coordinator 1@ 20/hour/week x 52 weeks PROGRAM BUDGET - COST DETAIL SCHEDULE Use Additional Sheets as Needed View at 100% or Larger MICHIGAN DEPARTMENT OF COMMUNITY HEALTH The Department of Community Health is an equal opportunity employer, services and programs provider. OLHSA WIC ProgramPROGRAM BUDGET PERIOD CONTRACTOR NAME BUDGET AGREEMENT POSITION DESCRIPTION COMMENTS WIC Associate Director/RD 1@ 36 hours/week x 52 weeks Oakland Livingston Human Service Agency FICA UNEMPLOY RETIREME HEARING DENTAL INS ORIGINAL AMENDMENT FICA UNEMPLOY RETIREME HOSPITAL LIFE INS VISION WORK COMP OTHER:spe ORIGINAL AMENDMENT DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 to OHCD which is approved by MDHHS or subsequently in a written request to OCHD and approved in writing by MDHHS and provided to OCHD. A.Automated Information Systems - which are required by a local Grantees except for those used in general management and payroll, including acquisition of automated data processing hardware or software whether by outright purchase or rental-purchase agreement or other method of acquisition. B.Capital Expenditures of $2,500 or More - such as the cost of facilities, equipment, including medical equipment, other capital assets and any repairs that materially increase the value or useful life of capital assets. C.Management Studies - performed by agencies or departments other than the local Grantee or those performed by outside consultants under contract with the local Grantee. D.Accounting and Auditing Services - performed by private sector firms under professional service contracts for purposes of preparation or audit of program and financial records/reports. E.Other Professional Services - rendered by individuals or organizations, not a part of the local Grantee, such as: 1.Contractual private physician providing certification data. 2.Contractual organization providing laboratory data. 3.Contractual translators and interpreters at the local Grantee level. F.Training and Education - provided for employee development, which directly or indirectly benefits the grant program, to the extent that such training is contracted for or involves out- of-service training over extended periods of time. G.Building Space and Related Facilities - the cost to buy, lease or rent space in privately or publicly owned buildings for the benefit of the program. H.Non-Fringe Insurance and Indemnification Costs - all charges to WIC must be necessary, reasonable, allowable, and allocable for the proper and efficient administration of the program. Further information and cost standards are provided in federal instructions including Title 2 CFR, Part 200 and 7 CFR Part 3015. Breastfeeding Peer Counseling Program The sub-recipient must follow the allowable expense guidelines provided by USDA FNS for the Peer Counselor grant. The use of BFPC funds for expenditures that are not supported by the Loving Support Model are not authorized. Expenses for Breastfeeding education and supplies must be charged to the normal WIC budget, not the Peer Counselor Grant. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 1 Allowable Costs for Breastfeeding Peer Counseling Programs Breastfeeding peer counseling (BFPC) funds that the Food and Nutrition Service (FNS) distributes to State agencies are to be used to develop or expand activities necessary to sustain a peer counseling program based on the FNS WIC Breastfeeding Model for Peer Counseling. The primary purpose of BFPC funds is to provide direct peer counselor to WIC mother breastfeeding support services. A State agency’s peer counseling implementation plan and annual line item budget addendum to its State Plan must demonstrate an appropriate balance between the costs of equipment, materials, and staff that manage or provide expertise to peer counselors and the costs of direct service delivery by peer counselors. The use of BFPC funds for expenditures that are not supported by the WIC Breastfeeding Model for Peer Counseling are not authorized. The table below helps to identify allowable BFPC costs.* Item or Service Allowable Costs Comments Durable Goods and Space Furniture, desktop computers/laptops/tablets, and office equipment used to provide peer counseling services and training Yes Phone lines, internet service, cell/smartphones, pagers and answering machines for contacts between peer counselors and mothers Yes Portable baby scales to weigh infants outside of the WIC clinic or scales marketed for pre- and post-breastfeeding weight checks No Nutrition Services and Administration (NSA) funds may be used to purchase scales for clinical assessment for use by staff other than peer counselors. Space and lease costs for peer counselors to provide services Yes Incentives and Educational Materials to Promote Breastfeeding Breastfeeding educational materials for mothers No NSA funds may be used to purchase participant educational material. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 2 Item or Service Allowable Costs Comments Breast pumps and breastfeeding aids for mothers Breast pumps and breastfeeding aids for demonstration purposes by peer counseling staff No Yes Refer to Breastfeeding Policy and Guidance for more information on breast pumps and allowable breastfeeding aids. Incentive items distributed to WIC participants to encourage breastfeeding (e.g., breast pumps, breastfeeding aids, breastfeeding promotion and support incentive items, written materials, etc.) No NSA funds may be used to purchase participant incentive items. Personnel and Compensation Salaries and compensation for peer counseling staff: peer counselors, designated peer counselor coordinators, and WIC Designated Breastfeeding Experts (DBE) Yes. BFPC funds may be used to fund staff to provide oversight/management of peer counseling programs and/or supervision, mentoring and referral expertise for peer counselors. BFPC funds may be used to pay for DBE time if a peer counselor refers a WIC mother to a DBE for problems that are outside of the peer counselor’s scope of practice. The DBE may be compensated using BFPC funds if the mother continues to be supported by the peer counselor and remains part of the peer counselor’s caseload. BFPC funds cannot be used to disproportionately hire WIC DBEs versus peer counselors. NSA funds must be used for consultations for WIC mothers who are not referred by peer counselors and are not part of a peer counselor’s caseload. Refer to the Nutrition Services Standards for DBE qualifications, roles and responsibilities. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3 Item or Service Allowable Costs Comments Salaries and compensation for dual-role staff (e.g., part- time WIC Nutrition Assistant and part-time peer counselor or part-time CPA and part- time DBE) Yes, but costs must be allocated between the two positions held. BFPC funds may be used for the portion of time spent as peer counselor or the DBE. See FNS Breastfeeding Policy and Guidance document for additional information on dual- role staff. State agency policies must be approved by FNS Regional Offices. Males as breastfeeding peer counselors No. The definition of peer counselor in the WIC Breastfeeding Model for Peer Counseling is based on research demonstrating the benefit of hiring peer counselors from WIC’s target population of WIC-eligible women. Father-to-Father Breastfeeding Support Group No Fathers are valuable partners of breastfeeding promotion and support in WIC. However, father-led activities are outside of those defined by the WIC Breastfeeding Model for Peer Counseling. See FNS Peer Counseling Management Curriculum for additional information. Virtual Breastfeeding Support Groups (i.e., Facebook, Zoom) Yes, only for PC/DBE staff hours for monitoring and engaging with WIC participants in a Virtual Support Group that provides breastfeeding support services. BFPC funds cannot be used for breastfeeding support to non-WIC participants. Recruitment of peer counselors and related staff Yes DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 4 Item or Service Allowable Costs Comments Staffing and expenses related to WIC Peer Counselor support to breastfeeding hotlines and call centers Yes. BFPC funds may be used to fund peer counselors to answer calls to a WIC breastfeeding hotline if the peer counselor: 1) meets the definition of peer counselor; 2) receives the appropriate training and supervision as outlined in the WIC Breastfeeding Model for Peer Counseling; and 3) does not provide services to non-WIC participants. Other expenses related to the hotline/call center (e.g., rent, phone lines, equipment, etc.) are allowable for any portion of those expenses that are for the purpose of a WIC peer counselor providing WIC participant contacts through the hotline/call center. BFPC funds cannot be used for breastfeeding hotline support to non-WIC participants. Milk Banks/Depots No. BFPC funds cannot be used for services related to milk banks/depots. Drop-In Breastfeeding Groups Yes. BFPC/DBE time may only be used for WIC participants. BFPC/DBE time may not be counted toward nutrition education contacts. Staffing and expenses related to WIC Peer Counselor support to the Buddy Program Yes. Duties such as matching buddy pairs, responding to buddy requests/inquiries, following up on buddy interactions, prompting discussions with conversation starters, and other duties as assigned by peer counselor supervisor. Staff Training and Resources Travel for WIC State- required training of peer counselors/DBE and peer counseling staff/managers Yes, only for the FNS Breastfeeding trainings or WIC State-developed approved comparable training. NSA funds may be used for attendance at a state/national breastfeeding conference. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 5 Item or Service Allowable Costs Comments Travel for home and hospital visits by peer counseling staff Yes, for visits to WIC participants; peer counselors may not provide services to non-WIC participants. Continuing education for DBEs Yes, if it relates to servicing peer counseling programs (e.g., mentoring, serving as a referral, etc.) Breastfeeding resources for peer counseling staff Breastfeeding resources for WIC staff not related to peer counseling Yes, if the resources are related to peer counseling (e.g., training materials for peer counselors). No NSA funds may be used to purchase general breastfeeding resources for WIC staff. Training and coursework for peer counselors to become International Board Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC) No. NSA funds may be used for CLC or IBCLC training and coursework. The priority use of BFPC funds is to hire and train peer counselors to provide breastfeeding peer counseling services to WIC participants. Staff with IBCLC ‘s are not considered peer counselors. The research recommends that peer counselors be provided career path training options. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 6 Item or Service Allowable Costs Comments CLC or IBCLC exam, renewal, or membership fees No At the WIC State agency’s discretion, NSA funds may be used for CLC or IBCLC training, exam fees, renewal and/or association membership fees. The State agency must determine if it is necessary and of benefit to the WIC Program for the person in a particular job position to have the certification. SAs must also determine whether the cost fits within its WIC NSA grant budget. Peer Counseling Program Advertising and Promotion Pamphlets and similar materials to promote the peer counseling program Yes Media outreach (e.g., bus placards, paid social media and digital ads to advertise BFPC programs) Yes Media outreach using BFPC funds are allowed if directly recruiting peer counselors or informing WIC participants about the PC program, including the Buddy Program, as a WIC breastfeeding benefit. FNS would not expect to see a disproportionate amount of the BFPC funds spent on advertising the program at the expense of direct services to participants. BFPC funds may not be used for ads that promote breastfeeding in general, NSA funds may be used for this purpose. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 7 Item or Service Allowable Costs Comments Name badges, buttons and similar low-cost items that identify peer counselor staff Yes Miscellaneous Indirect costs (e.g., personnel, accounting, or information technology services, etc.) Yes, but only those that are related to providing a WIC peer counseling program. Second nutrition education contacts No. BFPC funds are for activities that are in addition to current required WIC activities. NSA funds provide for at least two nutrition education contacts; therefore, BFPC funds may not be used for the “second” contact. In addition, the 1/6th nutrition education requirement and breastfeeding target must be met with regular NSA funds. Childcare No Cribs or other materials and equipment for infants of peer counselors who bring their babies to work No Monitoring and tracking of program effectiveness. Yes. Funds may be used to monitor and track program components (e.g., contacts, referrals, training, etc.) to determine effectiveness and where improvements are needed. Evaluation studies may not be paid for using BFPC funds. Peer counseling services to non-WIC participants No. Peer counselors should refer WIC-eligible women to WIC to apply for WIC benefits. Peer counselors should refer women who are not WIC-eligible to appropriate non-WIC resources. . DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 8 Item or Service Allowable Costs Comments Breastfeeding coalitions No BFPC funds can only be used for services and activities related directly to peer counseling. *Updated January 2023. This is not an exhaustive list of allowable costs. Refer to the FNS Regional Office for questions about allowable cost and to the Breastfeeding Policy and Guidance. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Attachment C Attachment C Reporting Requirements Reporting: As part of the Breastfeeding Peer Counseling Grant, Subrecipient shall maintain monthly records for each individual Peer Counselor. Specific supplemental reporting forms will be provided by MDDHS WIC program to complete this requirement. Reports are due to the Oakland County Health Division WIC Supervisor by the 5th day of January, March, July and October for review and submission to MDHHS WIC Invoicing process: Submit monthly, the actual costs incurred for the WIC grant and Breastfeeding Peer Counselor grant using the electronic invoice provided by OCHD. The invoice form reflects the Subrecipient budget approved by the County and the State WIC program. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 ATTACHMENT D SUBRECIPIENT INSURANCE REQUIREMENTS WITH COUNTY During this Agreement, the Subrecipient shall provide and maintain, at their own expense, all insurance as set forth and marked below, protecting the County against any Claims. Claims 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 Subrecipient. Primary Coverages Commercial General Liability Occurrence Form including: (a) Premises and Operations; (b) Products and Completed Operations (including On and Off Premises Coverage); (c) Personal and Advertising Injury; (d) Broad Form Property Damage; (e) Broad Form Contractual including coverage for obligations assumed in this Agreement; $1,000,000 – Each Occurrence Limit $1,000,000 – Personal & Advertising Injury $2,000,000 – Products & Completed Operations Aggregate Limit $2,000,000 – General Aggregate Limit $ 100,000 – Damage to Premises Rented to You (formally known as Fire Legal Liability) Workers’ Compensation Insurance with limits statutorily required by any applicable Federal or State Law and Employers Liability insurance with limits of no less than $500,000 each accident, $500,000 disease each employee, and $500,000 disease policy limit. 1.☒ Fully Insured or State approved self-insurer. 2.☐ Sole Proprietors must submit a signed Sole Proprietor form. 3.☐ Exempt entities, Partnerships, LLC, etc., must submit a State of Michigan form WC-337 Certificate of Exemption. Commercial Automobile Liability Insurance covering bodily injury or property damage arising out of the use of any owned, hired, or non-owned automobile with a combined single limit of $1,000,000 each accident. This requirement is waived if there are no company owned, hired or non-owned automobiles utilized in the performance of this Agreement. 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. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 Subrecipient provides professional services that the County relies upon. 2.Cyber Liability Insurance with minimum limits of $1,000,000 per claim and $1,000,000 aggregate shall be required when the Subrecipient has access to County IT systems and/or stores County data electronically. 3.Commercial Property Insurance. The Subrecipient shall be responsible for obtaining and maintaining insurance covering their equipment and personal property against all physical damage. 4.Other Insurance Coverages as may be dictated by the provided product/service and deemed appropriate by the County Risk Management Department. General Insurance Conditions The aforementioned insurance shall be endorsed, as applicable, and shall contain the following terms, conditions, and/or endorsements. All certificates of insurance shall provide evidence of compliance with all required terms, conditions and/or endorsements. 1.All policies of insurance shall be on a primary, non-contributory basis with any other insurance or self-insurance carried by the County; 2.The insurance company(s) issuing the policy(s) shall have no recourse against the County for subrogation (policy endorsed written waiver), premiums, deductibles, or assessments under any form. All policies shall be endorsed to provide a written waiver of subrogation in favor of the County; 3.Any and all deductibles or self-insured retentions shall be assumed by and be at the sole risk of the Subrecipient; 4.Subrecipient shall be responsible for their own property insurance for all equipment and personal property used and/or stored on County property; 5.The Commercial General Liability and Commercial Automobile Liability policies along with any required supplemental coverages shall be endorsed to name the County of Oakland and its officers, directors, employees, appointees and commissioners as additional insureds where permitted by law and policy form; 6.If the Subrecipient’s insurance policies have higher limits than the minimum coverage requirements stated in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the Subrecipient under contract. requirements stated in this document the higher limits shall apply and in no way shall limit the overall liability assumed by the Subrecipient under contract. 8.The Subrecipient shall require its contractors or sub-contractors, not protected under the Subrecipient’s insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or clauses equal to those required in this Agreement; 9.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. 10.All insurance carriers must be licensed and approved to do business in the State of Michigan along with the Subrecipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A- unless otherwise approved by the County Risk Management Department. 11. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 7. The Subrecipient shall require its contractors or sub-contractors, not protected under the Subrecipient’s insurance policies, to procure and maintain insurance with coverages, limits, provisions, and/or clauses equal to those required in this Agreement; 8. Certificates of insurance must be provided no less than ten (10) Business Days prior to the County’s execution of the Agreement and must bear evidence of all required terms, conditions, and endorsements; and provide 30 days’ notice of cancellation/material change endorsement. 9. All insurance carriers must be licensed and approved to do business in the State of Michigan along with the Subrecipient’s state of domicile and shall have and maintain a minimum A.M. Best’s rating of A- unless otherwise approved by the County Risk Management Department. DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Agreement #: 20240239-00 Agreement Between Michigan Department of Health and Human Services hereinafter referred to as the "Department" 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 1200 N. Telegraph Rd. 34 East Pontiac MI 48341 1032 Federal I.D.#: 38-6004876, Unique Entity Identifier: HZ4EUKDD7AB4 hereinafter referred to as the "Grantee" for The Delivery of Public Health Services under the Local Health Department Agreement Part 1 1.Purpose This Agreement is entered into for the purpose of setting forth a joint and cooperative Grantee/Department relationship and basis for facilitating the delivery of public health services to the citizens of Michigan under their jurisdiction, as described in the attached Annual Budget, established Minimum Program Requirements, and all other applicable federal, state and local laws and regulations pertaining to the Grantee and the Department. Public health services to be delivered under this Agreement include Essential Local Public Health Services (ELPHS) and Categorical Programs as specified in the attachments to this Agreement. 2.Period of Agreement This Agreement will commence on the date of the Grantee's signature or October 1, 2023, whichever is later, and continue through September 30, 2024. Throughout the Agreement, the date of the Grantee’s signature or October 1, 2023, whichever is later, will be referred to as the start date. This Agreement is in full force and effect for the period specified. 3.Program Budget and Agreement Amount A.Agreement Amount In accordance with Attachment IV - Funding/Reimbursement Matrix, the total State budget and amount committed for this period for the program elements covered by this Agreement is $12,096,246.00. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 1 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 B.Equipment Purchases and Title Any Grantee equipment purchases supported in whole or in part through this Agreement must be listed in the supporting Equipment Inventory Schedule which should be attached to the Final Financial Status Report. Equipment means tangible, non-expendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. Title to items having a unit acquisition cost of less than $5,000 will vest with the Grantee upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department’s proportionate interest in such equipment supports such retention or transfer of title. C.Budget Transfers and Adjustments 1.Transfers between categories within any program element budget supported in whole or in part by state/federal categorical sources of funding will be limited to increases in an expenditure budget category by $10,000 or 15% whichever is greater. This transfer authority does not authorize purchase of additional equipment items or new subcontracts with state/federal categorical funds without prior written approval of the Department. 2.Except as otherwise provided, any transfers or adjustments involving state/federal categorical funds, other than those covered by C.1, including any related adjustment to the total state amount of the budget, must be made in writing through a formal amendment executed by all parties to this Agreement in accordance with Section IX. A. of Part 2. 3.The C.1 and C.2 provisions authorizing transfers or changes in local funds apply also to the Family Planning program, provided statewide local maintenance of effort is not diminished in total. Any statewide diminishing of total local effort for family planning and/or any related funding penalty experienced by the Department will be recovered proportionately from each local Grantee that, during the course of the Agreement period, chose to reduce or transfer local funds from the Family Planning program. 4.Agreement Attachments A.The following documents are attachments to this Agreement Part 1 and Part 2 - General Provisions, which are part of this Agreement: 1. Attachment I - Annual Budget 2. Attachment III - Program Specific Assurances and Requirements 3. Attachment IV - Funding/Reimbursement Matrix Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 2 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 5.Statement of Work The Grantee agrees to undertake, perform and complete the activities described in Attachment III - Program Specific Assurances and Requirements and the other applicable attachments to this Agreement which are part of this Agreement. 6.Financial Requirements The financial requirements must be followed as described in Part 2 and Attachment I - Annual Budget and Attachment IV - Funding/Reimbursement Matrix, which are part of this Agreement. 7.Performance/Progress Report Requirements The progress reporting methods, as applicable, must be followed as described in part 2 and Attachment III, Program Specific Assurances and Requirements, which are part of this Agreement. 8.General Provisions The Grantee agrees to comply with the General Provisions outlined in Part 2, which is part of this Agreement. 9.Administration of the Agreement The person acting for the Department in administering this Agreement (hereinafter referred to as the Contract Consultant) is: Name: Carissa Reece Title: Department Analyst E-Mail Address ReeceC@michigan.gov The financial contact acting on behalf of the Grantee for this Agreement is: Karrie Jager Accountant ___________________________________________________________________ Name Title jagerk@oakgov.com (248) 858-5468 ___________________________________________________________________ E-Mail Address Telephone No. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 3 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 10.Special Conditions A.This Agreement is valid upon approval and execution by the Department which may be contingent upon approval by the State Administrative Board and signature by the Grantee. B.This Agreement is conditionally approved subject to and contingent upon availability of funding and other applicable conditions. C.Based on the availability of funding, the Department may specify the amount of funding the Grantee may expend during a specific time period within the Agreement Period. D.The Department has the option to assume no responsibility or liability for costs incurred by the Grantee prior to the start date of this Agreement. E.The Grantee is required by 2004 PA 533 to receive payments by electronic funds transfer. 11.Special Certification The individual or officer signing this Agreement certifies by their signature that they are authorized to sign this Agreement on behalf of the responsible governing board, official or Grantee. 12.Signature Section For Oakland County Department of Health and Human Services/ Health Division Andrea Powers Administrator ___________________________________________________________________ Name Title For the Michigan Department of Health and Human Services Christine H. Sanches 08/31/2023 ___________________________________________________________________ Christine H. Sanches, Director Date Bureau of Grants and Purchasing Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 4 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Part 2 General Provisions I.Responsibilities - Grantee The Grantee, in accordance with the general purposes and objectives of this Agreement, must: A.Publication Rights 1.Copyright materials only when the Grantee exclusively develops books, films or other such copyrightable materials through activities supported by this Agreement. The copyrighted materials cannot include recipient information or personal identification data. Grantee provides the Department a royalty-free, non-exclusive and irrevocable license to reproduce, publish and use such materials copyrighted by the Grantee and authorizes others to reproduce and use such materials. 2.Obtain prior written authorization from the Department’s Office of Communications for any materials copyrighted by the Grantee or modifications bearing acknowledgment of the Department's name prior to reproduction and use of such materials. The state of Michigan may modify the material copyrighted by the Grantee and may combine it with other copyrightable intellectual property to form a derivative work. The state of Michigan will own and hold all copyright and other intellectual property rights in any such derivative work, excluding any rights or interest granted in this Agreement to the Grantee. If the Grantee ceases to conduct business for any reason or ceases to support the copyrightable materials developed under this Agreement, the state of Michigan has the right to convert its licenses into transferable licenses to the extent consistent with any applicable obligations the Grantee has. 3.Obtain written authorization, at least 14 days in advance, from the Department’s Office of Communications and give recognition to the Department in any and all publications, papers and presentations arising from the Agreement activities. 4.Notify the Department’s Bureau of Grants and Purchasing 30 days before applying to register a copyright with the U.S. Copyright Office. The Grantee must submit an annual report for all copyrighted materials developed by the Grantee through activities supported by this Agreement and must submit a final invention statement and certification within 60 days of the end of the Agreement period. 5.Not make any media releases related to this Agreement, without prior written authorization from the Department’s Office of Communications. B.Fees 1.Guarantee that any claims made to the Department under this Agreement will not be financed by any sources other than the Department under the terms of this Agreement. If funding is received Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 5 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 through any other source, the Grantee agrees to budget the additional source of funds and reflect the source of funding on the Financial Status Report. 2.Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report those collections on the Financial Status Report. Any under recoveries of otherwise available fees resulting from failure to bill for eligible activities will be excluded from reimbursable expenditures. C.Grant Program Operation Provide the necessary administrative, professional and technical staff for operation of the grant program. The Grantee must obtain and maintain all necessary licenses, permits or other authorizations necessary for the performance of this Agreement. Use an accounting system that can identify and account for the funds received from each separate grant, regardless of funding source, and assure that grant funds are not commingled. D.Reporting Utilize all report forms and reporting formats required by the Department at the start date of this Agreement and provide the Department 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 Grantee must assure that all terms of the Agreement will be appropriately adhered to and that records and detailed documentation for the grant project or grant program identified in this Agreement will be maintained for a period of not less than 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 the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and any subcontractor that performs activities in connection with this Agreement. F.Authorized Access 1.Permit within 10 calendar days of providing notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Inspector Generals, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to records, papers, files, documentation and personnel related to this Agreement, to the extent authorized by applicable state or federal law, rule or regulation. 2.Acknowledge the rights of access in this section are not limited to the required retention period. The rights of access will last as long as the Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 6 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 records are retained. 3.Cooperate and provide reasonable assistance to authorized representatives of the Department and others when those individuals have access to the Grantee’s grant records. G.Audits 1.Single Audit The Grantee must submit to the Department a Single Audit consistent with the regulations set forth in Title 2 Code of Federal Regulations (CFR) Part 200, Subpart F. The Single Audit reporting package must include all components described in Title 2 Code of Federal Regulations, Section 200.512 (c) including a Corrective Action Plan, and management letter (if one is issued) with a response to the Department. The Grantee must assure that the Schedule of Expenditures of Federal Awards includes expenditures for all federally-funded grants. 2.Other Audits The Department or federal agencies may also conduct or arrange for agreed upon procedures or additional audits to meet their needs. 3.Due Date and Where to Send The required audit and any other required submissions (i.e., corrective action plan, and management letter with a corrective action plan), and/or Audit Exemption Notice must be submitted to the Department within the earlier of 30 calendar days after receipt of the auditor’s report(s) or nine months after the end of the Grantee’s fiscal year by e- mail to MDHHS-AuditReports@michigan.gov. Single Audit reports must be submitted simultaneously to the Department and Federal Audit Clearinghouse, in accordance with 2 CFR 200.512(a). The required submissions must be assembled in PDF files and compatible with Adobe Acrobat (read only). The subject line must state the agency name and fiscal year end. The Department reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. 4.Penalty a.Delinquent Single Audit or Financial Related Audit If the Grantee does not submit the required Single Audit reporting package, management letter (if one is issued) with a response, and Corrective Action Plan within nine months after the end of the Grantee’s fiscal year and an extension has not been approved by the cognizant or oversight agency for audit, the Department may withhold from the current funding an amount equal to five percent of the audit year’s grant funding (not to exceed $200,000) until the required filing is received by Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 7 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 the Department. The Department may retain the amount withheld if the Grantee is more than 120 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. The Department may terminate the current grant if the Grantee is more than 180 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit. b.Delinquent Audit Exemption Notice Failure to submit the Audit Exemption Notice, when required, may result in withholding payment from Department to Grantee an amount equal to one percent of the audit year’s grant funding until the Audit Exemption Notice is received. H.Subrecipient/Contractor Monitoring 1.When passing federal funds through to a subrecipient (if the Agreement does not prohibit the passing of federal funds through to a subrecipient), the Grantee must: a.Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the information required by 2 CFR 200.332. b.Ensure the subrecipient complies with all the requirements of this Agreement. c.Evaluate each subrecipient’s risk for noncompliance as required by 2 CFR 200.332(b). d.Monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with federal statutes, regulations and the terms and conditions of the subawards; that subaward performance goals are achieved; and that all monitoring requirements of 2 CFR 200.332(d) are met including reviewing financial and programmatic reports, following up on corrective actions and issuing management decisions for audit findings. e.Verify that every subrecipient is audited as required by 2 CFR 200 Subpart F. 2.Develop a subrecipient monitoring plan that addresses the above requirements and provides reasonable assurance that the subrecipient administers federal awards in compliance with laws, regulations and the provisions of this Agreement, and that performance goals are achieved. The subrecipient monitoring plan should include a risk-based assessment to determine the level of oversight and monitoring activities, such as reviewing financial and performance reports, performing site visits and maintaining regular contact with subrecipients. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 8 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3.Establish requirements to ensure compliance for for-profit subrecipients as required by 2 CFR 200.501(h), as applicable. 4.Ensure that transactions with subrecipients/contractors comply with laws, regulations and provisions of contracts or grant agreements. I.Notification of Modifications Provide timely notification to the Department, 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 activities, funding or compliance with operational procedures. J.Software Compliance Ensure software compliance and compatibility with the Department’s data systems for activities provided under this Agreement, including but not limited to stored data, databases and interfaces for the production of work products and reports. All required data under this Agreement must be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Grantee’s business operations for processing data. All information systems, electronic or hard copy, that contain state or federal data must be protected from unauthorized access. K.Human Subjects Comply with Federal Policy for the Protection of Human Subjects, 45 CFR 46. The Grantee agrees that prior to the initiation of the research, the Grantee will submit Institutional Review Board (IRB) application material for all research involving human subjects, which is conducted in programs sponsored by the Department or in programs which receive funding from or through the state of Michigan, to the Department’s IRB for review and approval, or the IRB application and approval materials for acceptance of the review of another IRB. All such research must be approved by a federally assured IRB, but the Department’s IRB can only accept the review and approval of another institution’s IRB under a formally approved interdepartmental agreement. The manner of the review will be agreed upon between the Department’s IRB Chairperson and the Grantee’s authorized official. L.Mandatory Disclosures 1.Disclose to the Department in writing within 14 days of receiving notice of any litigation, investigation, arbitration or other proceeding (collectively, “Proceeding”) involving Grantee, a subcontractor or an officer or director of Grantee or subcontractor that arises during the term of this Agreement including: a.All violations of federal and state criminal law involving fraud, bribery, or gratuity violations potentially affecting the Agreement. b.A criminal Proceeding; c.A parole or probation Proceeding; Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 9 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 d.A Proceeding under the Sarbanes-Oxley Act; e.A civil Proceeding involving: A claim that might reasonably be expected to adversely affect Grantee’s viability or financial stability; or 1. A governmental or public entity’s claim or written allegation of fraud; or 2. Any complaint filed in a legal or administrative proceeding alleging the Grantee or its subcontractors discriminated against its employees, subcontractors, vendors, or suppliers during the term of this Agreement; or 3. f.A Proceeding involving any license that Grantee is required to possess in order to perform under this Agreement. 2.Notify the Department, at least 90 calendar days before the effective date, of a change in Grantee’s ownership or executive management. M.Minimum Program Requirements Comply with Minimum Program Requirements established in accordance with Section 2472.3 of 1978 PA 368 as amended, MCL 333.2472 (3), MSA 14.15 (2472.3), for each applicable program element funded under this Agreement. N.Annual Budget and Plan Submission Submit an Annual Budget and Plan request to the Department, in accordance with instructions established by the Department, to serve as the basis for completion of specific details for Attachments I, III, and IV of this Agreement via Grantee/Department negotiated amendment(s). Failure to submit a complete Annual Budget and Plan by the due date through MI E-Grants will result in the deferral of Department payments until these documents are submitted. O.Maintenance of Effort Comply with maintenance of effort requirements for Essential Local Public Health Services (ELPHS), as defined in the current Department appropriation act, and Family Planning in accordance with federal requirements, except as noted in Section 3.C.3 of Part I. P.Accreditation 1.Comply with the local public health accreditation standards and follow the accreditation process and schedule established by the Department to achieve full accreditation status. a.Failure to meet all accreditation requirements or implement corrective plans of action within the prescribed time period will result in the status of “Not Accredited.” Grantees designated as “Not Accredited” may have their Department allocations Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 10 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 reduced for costs incurred in the assurance of service delivery. b.Submit a written request for inquiry to the Department should the Grantee disagree with on-site review findings or their accreditation status. The request must identify the disagreement and resolution sought. The inquiry participants will be comprised of Grantee staff, Department staff, the Accreditation Commission Chair, and the Accreditation Coordinator as needed. Participants will clarify facts, verify information and seek resolution. 2.Consent Agreements/Administrative Compliance Orders/Administrative Hearings for "Not Accredited" Grantees: a.If designated as “Not Accredited”, the Grantee will receive a Consent Agreement Package from the Department. Grantees and their local governing entities will be given 75 days to review the package, meet with the Department, and sign and return the Consent Agreement. b.Fulfillment of the terms and conditions of the Consent Agreement will not affect accreditation status, but impacts the Grantees’ ability to fulfill its contractual obligations under the Local Health Department Grant Agreement. Grantees designated as “Not Accredited”, will retain this designation until the subsequent accreditation cycle. c.Failure to fulfill the terms and conditions of the Consent Agreement within the prescribed time period will result in the issuance of an Administrative Compliance Order by the Department. d.Within 60 working days after receipt of an Administrative Compliance Order and proposed compliance period, a local governing entity may petition the Department for an administrative hearing. If the local governing entity does not petition the Department for a hearing within 60 days after receipt of an Administrative Compliance Order, the order and proposed compliance date will be final. After a hearing, the Department may reaffirm, modify, or revoke the order or modify the time permitted for compliance. e.If the local governing entity fails to correct a deficiency for which a final order has been issued within the period permitted for compliance, the Department may petition the appropriate circuit court for a writ of mandamus to compel correction. Q.Medicaid Outreach Activities Reimbursement Report allowable costs and request reimbursement for the Medicaid Outreach activities it provides in accordance with 2 CFR, Part 200 and the requirements Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 11 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 in Medicaid Bulletin number: MSA 05-29. Submit a Cost Allocation Plan Certification to the Department to bill for the Medicaid Outreach Activities. The Cost Allocation Plan Certification is valid until a change is made to the cost allocation plan or the Department determines it is invalid. Submit quarterly FSRs for the Medicaid Outreach activities and an annual FSR for the Children with Special Health Care Services Medicaid Outreach activities in accordance with the instructions contained in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, agree to target Medicaid outreach effort toward Department established priorities. For fiscal year 2024, the Department priorities are: lead testing, outreach and enrollment for the Family Planning waiver, and outreach for pregnant women, mothers and infants for the Maternal and Infant Health Program. The Grantee will submit a report using the MDHHS Local Health Department Medicaid Outreach form describing their outreach activities targeting the priorities 30 days after the end of a fiscal year quarter and at the same time as the final FSR is due to the Department. The Local Health Department Medicaid Outreach reports are to be sent through MI E-Grants as an attachment report to the Financial Status Report. R.Conflict of Interest and Code of Conduct Standards 1.Be subject to the provisions of 1968 PA 317, as amended, 1973 PA 196, as amended, and 2 CFR 200.318 (c)(1) and (2). 2.Uphold high ethical standards and be prohibited from the following: a.Holding or acquiring an interest that would conflict with this Agreement; b.Doing anything that creates an appearance of impropriety with respect to the award or performance of this Agreement; c.Attempting to influence or appearing to influence any state employee by the direct or indirect offer of anything of value; or d.Paying or agreeing to pay any person, other than employees and consultants working for Grantee, any consideration contingent upon the award of this Agreement. 3.Immediately notify the Department of any violation or potential violation of these standards. This section applies to Grantee, any parent, affiliate or subsidiary organization of Grantee, and any subcontractor that performs activities in connection with this Agreement. S.Travel Costs 1.Be reimbursed for travel costs (including mileage, meals, and lodging) budgeted and incurred related to services provided under this Agreement. a.If the Grantee has a documented policy related to travel Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 12 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 reimbursement for employees and if the Grantee follows that documented policy, the Department will reimburse the Grantee for travel costs at the Grantee’s documented reimbursement rate for employees. Otherwise, the State of Michigan travel reimbursement rate applies. b.State of Michigan travel rates may be found at the following website: https://www.michigan.gov/dtmb/0,5552,7-358- 82548_13132---,00.html. c.International travel must be preapproved by the Department and itemized in the budget. T.Insurance Requirements 1.Maintain at least a minimum of the insurances or governmental self- insurances listed below and be responsible for all deductibles. All required insurance or self-insurance must: a.Protect the state of Michigan from claims that may arise out of, are alleged to arise out of, or result from Grantee’s or a subcontractor’s performance; b.Be primary and non-contributing to any comparable liability insurance (including self-insurance) carried by the state; and c.Be provided by a company with an A.M. Best rating of “A-” or better and a financial size of VII or better. 2.Insurance Types a.Commercial General Liability Insurance or Governmental Self- Insurance: Except for Governmental Self-Insurance, policies must be endorsed to add “the state of Michigan, its departments, divisions, agencies, offices, 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. If the Grantee will interact with children, schools, or the cognitively impaired, the Grantee must maintain appropriate insurance coverage related to sexual abuse and molestation liability. b.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. c.Employers Liability Insurance or Governmental Self-Insurance. d.Privacy and Security Liability (Cyber Liability) Insurance: cover information security and privacy liability, privacy notification Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 13 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 costs, regulatory defense and penalties, and website media content liability. 3.Require that subcontractors maintain the required insurances contained in this Section. 4.This Section is not intended to and is not to be construed in any manner as waiving, restricting or limiting the liability of the Grantee from any obligations under this Agreement. 5.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. U.Fiscal Questionnaire 1.Complete and upload the yearly fiscal questionnaire to the EGrAMS agency profile within three months of the start of the Agreement. 2.The fiscal questionnaire template can be found in EGrAMS documents. V.Criminal Background Check 1.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. a.ICHAT: http://apps.michigan.gov/ichat b.Michigan Public Sex Offender Registry: http://www.mipsor.state.mi.us c.National Sex Offender Registry: http://www.nsopw.gov 2.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. a.Central Registry: https://www.michigan.gov/mdhhs/0,5885,7- 339-73971_7119_50648_48330-180331--,00.html 3.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 Grantee 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. 4.Determine whether to prohibit any employee, subcontractor, subcontractor employee, or volunteer from performing work directly with Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 14 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 clients or accessing client information related to clients under this Agreement, based on the results of a positive ICHAT response or reported criminal felony conviction or perpetrator identification. 5.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. 6.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. II.Responsibilities - Department The Department 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 Grantee. B.Report Forms Provide any report forms and reporting formats required by the Department at the start date of this Agreement and provide to the Grantee 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 Grantee an opportunity to review. C.Notification of Modifications Notify the Grantee in writing of modifications to federal or state laws, rules and regulations affecting this Agreement. D.Identification of Laws Identify for the Grantee relevant laws, rules, regulations, policies, procedures, guidelines and state and federal manuals, and provide the Grantee with copies of these documents to the extent they are not otherwise available to the Grantee. E.Modification of Funding Notify the Grantee in writing within 30 calendar days of becoming aware of the need for any modifications in Agreement funding commitments made necessary by action of the federal government, the governor, the legislature or the Department of Technology Management and Budget on behalf of the governor or the legislature. Implementation of the modifications will be determined jointly by the Grantee and the Department. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 15 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 F.Monitor Compliance Monitor compliance with all applicable provisions contained in federal grant awards and their attendant rules, regulations and requirements pertaining to program elements covered by this Agreement. G.Technical Assistance Make technical assistance available to the Grantee for the implementation of this Agreement. H.Accreditation Adhere to the accreditation requirements including the process for “Not Accredited” Grantees. The process includes developing and monitoring consent agreements, issuing and monitoring administrative compliance orders, participating in administrative hearings and petitioning appropriate circuit courts. I.Medicaid Outreach Activities Reimbursement Agrees to reimburse the Grantee for all allowable Medicaid Outreach activities that meet the standards of the Medicaid Bulletin: MSA 05-29 including the cost allocation plan certification and that are billed in accordance with the requirements in Attachment I. In accordance with the Medicaid Bulletin, MSA 05-29, the Department will identify each fiscal year the Medicaid Outreach priorities and establish a reporting requirement for the Grantee. III.Assurances The following assurances are hereby given to the Department: A.Compliance with Applicable Laws The Grantee will comply with applicable federal and state laws, guidelines, rules and regulations in carrying out the terms of this Agreement. The Grantee will also comply with all applicable general administrative requirements, such as 2 CFR 200, covering cost principles, grant/agreement principles and audits, in carrying out the terms of this Agreement. The Grantee will comply with all applicable requirements in the original grant awarded to the Department if the Grantee is a subgrantee. The Department may determine that the Grantee 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 2, Section V. B.Anti-Lobbying Act The Grantee will comply with the Anti-Lobbying Act (31 U.S.C. 1352) as revised by the Lobbying Disclosure Act of 1995 (2 U.S.C. 1601 et seq.), Federal Acquisition Regulations 52.203.11 and 52.203.12, and Section 503 of the Departments of Labor, Health & Human Services, and Education, and Related Agencies section of the current fiscal year Omnibus Consolidated Appropriations Act. Further, the Grantee must require that the language of this Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 16 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 assurance be included in the award documents of all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients must certify and disclose accordingly. C.Non-Discrimination 1.The Grantee must comply with the Department’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 Grantee 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. 2.The Grantee will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: a.Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination based on race, color or national origin; b.Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, 1685-1686), which prohibits discrimination based on sex; c.Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination based on disabilities; d.The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination based on age; e.The Drug Abuse Office and Treatment Act of 1972 (P.L. 92- 255), as amended, relating to nondiscrimination based on drug abuse; f.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; g.Sections 523 and 527 of the Public Health Service Act of 1944 (42 U.S.C. 290dd-2), as amended, relating to confidentiality of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 17 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 alcohol and drug abuse patient records; h.Any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and, i.The requirements of any other nondiscrimination statute(s) which may apply to the application. 3.Additionally, assurance is given to the Department 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 Grantee must include 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 Grantee will comply with federal regulation 2 CFR 180 and certifies to the best of its knowledge and belief that it, its employees and its subcontractors: 1.Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or contractor; 2.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 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; 3.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; 4.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 5.Have not committed an act of so serious or compelling a nature that it affects the Grantee’s present responsibilities. E.Federal Requirement: Pro-Children Act 1.The Grantee will comply with the Pro-Children Act of 1994 (P.L. 103- 227; 20 U.S.C. 6081, et seq.), which requires that smoking not be permitted in any portion of any indoor facility owned or leased or Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 18 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 Grantee also assures that this language will be included in any subawards which contain provisions for children’s activities. 2.The Grantee also assures, in addition to compliance with P.L. 103-227, any activity funded in whole or in part through this Agreement will be delivered in a smoke-free facility or environment. Smoking must not be permitted anywhere in the facility, or those parts of the facility under the control of the Grantee. If activities are delivered in facilities or areas that are not under the control of the Grantee (e.g., a mall, restaurant or private work site), the activities must be smoke-free. F.Hatch Act and Intergovernmental Personnel Act The Grantee will comply with the Hatch Act (5 U.S.C. 1501-1508, 5 U.S.C. 7321-7326), and the Intergovernmental Personnel Act of 1970 (P.L. 91-648) as amended by Title VI of the Civil Service Reform Act of 1978 (P.L. 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.Employee Whistleblower Protections The Grantee will comply with 41 U.S.C. 4712 and must insert this clause in all subcontracts. H.Clean Air Act and Federal Water Pollution Control Act The Grantee 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. 1251-1388), as amended. 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 Department. I.Victims of Trafficking and Violence Protection Act Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 19 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 The Grantee will comply with the Victims of Trafficking and Violence Protection Act of 2000 (P.L. 106-386), as amended. 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 Department. J.Procurement of Recovered Materials The Grantee will comply with section 6002 of the Solid Waste Disposal Act of 1965 (P.L. 89-272), as amended. 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 Department. K.Subcontracts For any subcontracted activity or product, the Grantee will ensure: 1.That a written subcontract is executed by all affected parties prior to the initiation of any new subcontract activity or delivery of any subcontracted product. Exceptions to this policy may be granted by the Department if the Grantee asks the Department in writing within 30 days of execution of the Agreement. 2.That any executed subcontract to this Agreement must require the subcontractor to comply with all applicable terms and conditions of this Agreement. In the event of a conflict between this Agreement and the provisions of the subcontract, the provisions of this Agreement will prevail. A conflict between this Agreement and a subcontract, however, will not be deemed to exist where the subcontract: a.Contains additional non-conflicting provisions not set forth in this Agreement; b.Restates provisions of this Agreement to afford the Grantee the same or substantially the same rights and privileges as the Department; or c.Requires the subcontractor to perform duties and services in less time than that afforded the Grantee in this Agreement. 3.That the subcontract does not affect the Grantee’s accountability to the Department for the subcontracted activity. 4.That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5.That the Grantee will submit a copy of the executed subcontract if requested by the Department. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 20 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 6.That subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $10,000 must contain provisions or conditions that will: a.Allow the Grantee or Department to seek administrative, contractual or legal remedies in instances in which the subcontractor violates or breaches contract terms, and provide for such remedial action as may be appropriate. b.Provide for termination by the Grantee, including the manner by which termination will be effected and the basis for settlement. 7.That all subcontracts in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government of amounts in excess of $100,000 must contain a provision that requires compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970 (42 USC 1857(h)), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738 and Environmental Protection Agency regulations (40 CFR Part 15). 8.That all subcontracts and subgrants in support of programs or elements utilizing funds provided by the Department, the State of Michigan or the federal government in excess of $2,000 for construction or repair, awarded by the Grantee must include a provision: a.For compliance with the Copeland "Anti-Kickback" Act (18 U.S.C. 874) as supplemented in Department of Labor regulations (29 CFR, Part 3). b.For compliance with the Davis-Bacon Act (40 U.S.C. 276a to a- 7) and as supplemented by Department of Labor regulations (29 CFR, Part 5) (if required by Federal Program Legislation). c.For compliance with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-330) as supplemented by Department of Labor regulations (29 CFR, Part 5). This provision also applies to all other contracts in excess of $2,500 that involve the employment of mechanics or laborers. L.Procurement 1.Grantee will ensure that all purchase transactions, whether negotiated or advertised, are conducted openly and competitively in accordance with the principles and requirements of 2 CFR 200. 2.Funding from this Agreement must not be used for the purchase of foreign goods or services. 3.Preference must be given to goods and services manufactured or provided by Michigan businesses, if they are competitively priced and of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 21 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 comparable quality. 4.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 priced and of comparable quality. 5.Records must be sufficient to document the significant history of all purchases and must be maintained for a minimum of four years after the end of the Agreement period. M.Health Insurance Portability and Accountability Act To the extent that the Health Insurance Portability and Accountability Act (HIPAA) is applicable to the Grantee under this Agreement, the Grantee assures that it is in compliance with requirements of HIPAA including the following: 1.The Grantee must not share any protected health information provided by the Department that is covered by HIPAA except as permitted or required by applicable law, or to a subcontractor as appropriate under this Agreement. 2.The Grantee will ensure that any subcontractor will have the same obligations as the Grantee not to share any protected health data and information from the Department that falls under HIPAA requirements in the terms and conditions of the subcontract. 3.The Grantee must only use the protected health data and information for the purposes of this Agreement. 4.The Grantee 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 Grantee’s employees. 5.The Grantee must have a policy and procedure to immediately report to the Department any suspected or confirmed unauthorized use or disclosure of protected health information that falls under the HIPAA requirements of which the Grantee becomes aware. The Grantee will work with the Department to mitigate the breach and will provide assurances to the Department of corrective actions to prevent further unauthorized uses or disclosures. The Department may demand specific corrective actions and assurances and the Grantee must provide the same to the Department. 6.Failure to comply with any of these contractual requirements may result in the termination of this Agreement in accordance with Part 2, Section V. 7.In accordance with HIPAA requirements, the Grantee is liable for any claim, loss or damage relating to unauthorized use or disclosure of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 22 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 protected health data and information, including without limitation the Department’s costs in responding to a breach, received by the Grantee from the Department or any other source. 8.The Grantee will enter into a business associate agreement should the Department determine such an agreement is required under HIPAA. N.Home Health Services If the Grantee provides Home Health Services (as defined in Medicare Part B), the following requirements apply: 1.The Grantee must not use State ELPHS or categorical grant funds provided under this Agreement to unfairly compete for home health services available from private providers of the same type of services in the Grantee’s service area. 2.For purposes of this Agreement, the term “unfair competition” will be defined as offering of home health services at fees substantially less than those generally charged by private providers of the same type of services in the Grantee’s area, except as allowed under Medicare customary charge regulations involving sliding fee scale discounts for low-income clients based upon their ability to pay. 3.If the Department finds that the Grantee is not in compliance with its assurance not to use state ELPHS and categorical grant funds to unfairly compete, the Department will follow the procedure required for failure by local health departments to adequately provide required services set forth in Sections 2497 and 2498 of 1978 PA 368 as amended (Public Health Code), MCL 333.2497 and 2498, MSA 14.15 (2497) and (2498). O.Website Incorporation The Department is not bound by any content on Grantee’s website or other internet communication platforms or technologies, unless expressly incorporated directly into this Agreement. The Department 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 Department. The Grantee must not refer to the Department on the Grantee’s website or other internet communication platforms or technologies without the prior written approval of the Department. P.Survival The provisions of this Agreement that impose continuing obligations will survive the expiration or termination of this Agreement. Q.Non-Disclosure of Confidential Information 1.The Grantee agrees that it will use confidential information solely for the purpose of this Agreement. The Grantee 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 Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 23 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 third parties other than employees, agents, or subcontractors 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 Grantee must take all reasonable precautions to safeguard the confidential information. These precautions must be at least as great as the precautions the Grantee takes to protect its own confidential or proprietary information. 2.Meaning of Confidential Information For the purpose of this Agreement the term “confidential information” means all information and documentation that: a.Has been marked “confidential” or with words of similar meaning, at the time of disclosure by such party; b.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; c.Should reasonably be recognized as confidential information of the disclosing party; d.Is unpublished or not available to the general public; or e.Is designated by law as confidential. 3.The term “confidential information” does not include any information or documentation that was: a.Subject to disclosure under the Michigan Freedom of Information Act (FOIA); b.Already in the possession of the receiving party without an obligation of confidentiality; c.Developed independently by the receiving party, as demonstrated by the receiving party, without violating the disclosing party’s proprietary rights; d.Obtained from a source other than the disclosing party without an obligation of confidentiality; or e.Publicly available when received or thereafter became publicly available (other than through an unauthorized disclosure by, through or on behalf of, the receiving party). 4.The Grantee must notify the Department within one business day after discovering any unauthorized use or disclosure of confidential information. The Grantee will cooperate with the Department in every way possible to regain possession of the confidential information and prevent further unauthorized use or disclosure. R.Cap on Salaries None of the funds awarded to the Grantee through this Agreement will be used Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 24 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 to pay, either through a grant or other external mechanism, the salary of an individual at a rate in excess of Executive Level II. The current rates of pay for the Executive Schedule are located on the United States Office of Personnel Management web site, http://www.opm.gov, by navigating to Policy — Pay & Leave — Salaries & Wages. The salary rate limitation does not restrict the salary that a Grantee may pay an individual under its employment; rather, it merely limits the portion of that salary that may be paid with funds from this Agreement. S.State Data 1.Ownership. The Department’s data (“State Data,” which will be treated by Grantee as Confidential Information) includes: (a) the Department’s data, user data, and any other data collected, used, processed, stored, or generated as the result of this Agreement; (b) personally identifiable information (“PII“) collected, used, processed, stored, or generated as the result of this Agreement, including, without limitation, any information that identifies an individual, such as an individual’s social security number or other government-issued identification number, date of birth, address, telephone number, biometric data, mother’s maiden name, email address, credit card information, or an individual’s name in combination with any other of the elements here listed; and, (c) protected health information (“PHI”) collected, used, processed, stored, or generated as the result of this Agreement, which is defined under the Health Insurance Portability and Accountability Act (HIPAA) and its related rules and regulations. State Data is and will remain the sole and exclusive property of the Department and all right, title, and interest in the same is reserved by the Department. 2.Grantee Use of State Data. Grantee is provided a limited license to State Data for the sole and exclusive purpose of providing the activities outlined in the Agreement’s Statement of Work, including a license to collect, process, store, generate, and display State Data only to the extent necessary in the provision of the Agreement’s Statement of Work. Grantee must: (a) keep and maintain State Data in strict confidence, using such degree of care as is appropriate and consistent with its obligations as further described in this Agreement and applicable law to avoid unauthorized access, use, disclosure, or loss; (b) use and disclose State Data solely and exclusively for the purpose of providing the activities described in the Statement of Work, such use and disclosure being in accordance with this Agreement, any applicable Statement of Work, and applicable law; (c) keep and maintain State Data in the continental United States and (d) not use, sell, rent, transfer, distribute, commercially exploit, or otherwise disclose or make available State Data for Grantee’s own purposes or for the benefit of anyone other than the Department without the Department’s prior written Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 25 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 consent. Grantee's misuse of State Data may violate state or federal laws, including but not limited to MCL 752.795. 3.Extraction of State Data. Grantee must, within five business days of the Department’s request, provide the Department, without charge and without any conditions or contingencies whatsoever (including but not limited to the payment of any fees due to Grantee), an extract of the State Data in the format specified by the Department. 4.Backup and Recovery of State Data. Grantee is responsible for maintaining a backup of State Data and for an orderly and timely recovery of such data. Grantee must maintain a contemporaneous backup of State Data that can be recovered within two hours at any point in time. 5.Loss or Compromise of Data. In the event of any act, error or omission, negligence, misconduct, or breach on the part of Grantee that compromises or is suspected to compromise the security, confidentiality, or integrity of State Data or the physical, technical, administrative, or organizational safeguards put in place by Grantee that relate to the protection of the security, confidentiality, or integrity of State Data, Grantee must, as applicable: (a) notify the Department as soon as practicable but no later than 24 hours of becoming aware of such occurrence; (b) cooperate with the Department in investigating the occurrence, including making available all relevant records, logs, files, data reporting, and other materials required to comply with applicable law or as otherwise required by the Department; (c) in the case of PII or PHI, at the Department’s sole election, (i) with approval and assistance from the Department, notify the affected individuals who comprise the PII or PHI as soon as practicable but no later than is required to comply with applicable law, or, in the absence of any legally required notification period, within five calendar days of the occurrence; or (ii) reimburse the Department for any costs in notifying the affected individuals; (d) in the case of PII, provide third-party credit and identity monitoring services to each of the affected individuals who comprise the PII for the period required to comply with applicable law, or, in the absence of any legally required monitoring services, for no less than 24 months following the date of notification to such individuals; (e) perform or take any other actions required to comply with applicable law as a result of the occurrence; (f) pay for any costs associated with the occurrence, including but not limited to any costs incurred by the Department in investigating and resolving the occurrence, including reasonable attorney’s fees associated with such investigation and resolution; (g) without limiting Grantee’s obligations of indemnification as further described in this Agreement, indemnify, defend, and hold harmless the Department for any and all claims, including reasonable attorneys’ fees, Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 26 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 costs, and incidental expenses, which may be suffered by, accrued against, charged to, or recoverable from the Department in connection with the occurrence; (h) be responsible for recreating lost State Data in the manner and on the schedule set by the Department without charge to the Department; and, (i) provide to the Department a detailed plan within 10 calendar days of the occurrence describing the measures Grantee will undertake to prevent a future occurrence. Notification to affected individuals, as described above, must comply with applicable law, be written in plain language, not be tangentially used for any solicitation purposes, and contain, at a minimum: name and contact information of Grantee’s representative; a description of the nature of the loss; a list of the types of data involved; the known or approximate date of the loss; how such loss may affect the affected individual; what steps Grantee has taken to protect the affected individual; what steps the affected individual can take to protect himself or herself; contact information for major credit card reporting agencies; and, information regarding the credit and identity monitoring services to be provided by Grantee. The Department will have the option to review and approve any notification sent to affected individuals prior to its delivery. Notification to any other party, including but not limited to public media outlets, must be reviewed, and approved by the Department in writing prior to its dissemination. The parties agree that any damages relating to a breach of this section are to be considered direct damages and not consequential damages. 6.Surrender of Confidential Information upon Termination. Upon termination or expiration of this Contract or a Statement of Work, in whole or in part, each party must, within 5 Business Days from the date of termination, return to the other party any and all Confidential Information received from the other party, or created or received by a party on behalf of the other party, which are in such party’s possession, custody, or control. Upon confirmation from the State, of receipt of all data, Grantee must permanently sanitize or destroy the State’s Confidential Information, including State Data, from all media including backups using National Security Agency (“NSA”) and/or National Institute of Standards and Technology (“NIST”) (NIST Guide for Media Sanitization 800-88) data sanitization methods or as otherwise instructed by the State. If the State determines that the return of any Confidential Information is not feasible or necessary, Grantee must destroy the Confidential Information as specified above. The Grantee must certify the destruction of Confidential Information (including State Data) in writing within 5 Business Days from the date of confirmation from the State. Any requirement on the Grantee’s part to retain data beyond the end of this contract must be authorized by the State. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 27 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 T.Data Privacy and Information Security 1.Undertaking by Grantee. Without limiting Grantee’s obligation of confidentiality as further described, Grantee is responsible for establishing and maintaining a data privacy and information security program, including physical, technical, administrative, and organizational safeguards, that is designed to: (a) ensure the security and confidentiality of the State Data; (b) protect against any anticipated threats or hazards to the security or integrity of the State Data; (c) protect against unauthorized disclosure, access to, or use of the State Data; (d) ensure the proper disposal of State Data; and (e) ensure that all employees, agents, and subcontractors of Grantee, if any, comply with all of the foregoing. In no case will the safeguards of Grantee’s data privacy and information security program be less stringent than the safeguards used by the Department, and Grantee must at all times comply with all applicable State policies and standards, which are available to Grantee upon request. 2.Audit by Grantee. No less than annually, Grantee must conduct a comprehensive independent third-party audit of its data privacy and information security program and provide such audit findings to the Department. 3.Right of Audit by the State. Without limiting any other audit rights of the Department, the Department has the right to review Grantee’s data privacy and information security program prior to the commencement of the Agreement’s Statement of Work and from time to time during the term of this Agreement. During the providing of the Agreement’s Statement of Work, on an ongoing basis from time to time and without notice, the Department, at its own expense, is entitled to perform, or to have performed, an on-site audit of Grantee’s data privacy and information security program. In lieu of an on-site audit, upon request by the Department, Grantee agrees to complete, within 45 calendar days of receipt, an audit questionnaire provided by the Department regarding Grantee’s data privacy and information security program. 4.Audit Findings. Grantee must implement any required safeguards as identified by the Department or by any audit of Grantee’s data privacy and information security program. IV.Financial Requirements A.Operating Advance Under the pre-payment reimbursement method, no additional operating advances will be issued. B.Payment Method 1.Prepayments a.The Department will make monthly prepayments equal to Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 28 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 1/12th of the Agreement amount for each non-fee-for-service program contained in Attachment IV of this Agreement. One single payment covering all non-fee-for-service programs will be made within the first week of each month. The Grantee can view their monthly prepayment within the MI E-Grants system. b.Prepayments for the months of October thru January will be based upon the initial Agreement amounts in Attachment IV. Subsequent monthly prepayments may be adjusted based upon Agreement amendments or Grantee adjustment requests. c.If the sum of the prepayments does not equal at least 90% of the Grantee’s expenditures for a quarter of the contract period, the Grantee may submit documentation for an adjustment to the monthly prepayment amount via the following process: i.Submit a written request for the adjustment to the Department’s Accounting Expenditure Operations Division. ii.The adjustment request must be itemized by program and must list the amount received from the Department, the expenditure amount reported per the quarterly Financial Status Report (FSR), and the difference. The amount received from the Department and the expenditures must be for the same reporting quarterly FSR period. iii.The Department will review the requests and if an adjustment is approved, it will be included in the next scheduled monthly prepayment. iv.Adjustment requests will not be accepted prior to submission of the FSR for the quarter ending December 31. No adjustments will be made prior to the February monthly prepayment. v.The ability of the Department to approve adjustments may be limited by the quarterly allotments of spending authority in the Department’s appropriation account mandated by the Office of the State Budget Director. The quarterly allotment limits the amount of each account (program) that the Department may expend during each fiscal quarter. 2.Fixed Fee Reimbursement a.Quarterly reimbursement for fixed fee projects is based on Attachment IV and approved quarterly Financial Status Reports. C.Financial Status Report Submission 1.The Grantee must electronically prepare and submit FSRs to the Department via the EGrAMS website (http://egrams-mi.com/mdhhs). Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 29 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 A Financial Status Report (FSR) must be submitted on a quarterly basis no later than 30 days after the close of the calendar quarter for all programs listed on Attachment IV and fee for services project budgeted. Failure to meet financial reporting responsibilities as identified in this Agreement may result in withholding future payments. 2.FSR’s must report total actual program expenditures regardless of the source of funds. The Department will reimburse the Grantee for expenditures in accordance with the terms and conditions of this Agreement. Failure to comply with the reporting due dates will result in the deferral of the Grantee’s monthly prepayment. 3.The Grantee representative who submits the FSR is certifying to the best of their knowledge and belief that the report 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 FSR 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. 4.The instructions for completing the FSR form are available on the website http://egrams-mi.com/dch. Send FSR questions to FSRMDHHS@michigan.gov. D.Reimbursement Method The Grantee will be reimbursed in accordance with the reimbursement methods for applicable program elements described as follows: 1.Performance Reimbursement - A reimbursement method by which Grantees 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. Any local funds used to support program elements operated under such provisions of this Agreement may be transferred by the Grantee within, among, to or from the affected elements without Department approval, subject to applicable provisions of Sections 3.B. and 3.C.3 of Part 1. If Grantee's performance falls short of the expectation by a factor greater than the allowed minimum performance percentage, the state maximum allocation will be reduced equivalent to actual performance in relation to the minimum performance. 2.Actual Cost Reimbursement - A reimbursement method by which Grantees are reimbursed based upon the understanding that state dollars will be paid up to total costs in relation to the state's share of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 30 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 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 as a source before any local funding requirement unless a specific local match condition exists. 3.Fixed Unit Rate Reimbursement - A reimbursement method by which Grantee is reimbursed a specific amount for each output actually delivered and reported. 4.Essential Local Public Health Services (ELPHS) - A reimbursement method by which Grantees are reimbursed a share of reasonable and allowable costs incurred for required services, as noted in the current Appropriations Act. E.Reimbursement Mechanism All Grantees must sign up through the on-line vendor registration process to receive all State of Michigan payments as Electronic Funds Transfers (EFT)/Direct Deposits. Vendor registration information is available through the Department of Technology, Management and Budget’s web site: http://www.michigan.gov/sigmavss F.Unobligated Funds Any unobligated balance of funds held by the Grantee at the end of the Agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. G.Final Obligation Reporting Requirements An Obligation Report, based on annual guidelines, must be submitted by the due date using the format provided by the Department through MI E-Grants. The Grantee must provide, by program, an estimate of total expenditures for the entire Agreement period (October 1 through September 30). This report must represent the Grantee’s best estimate of total program expenditures for the Agreement period. The information on the report will be used to record the Department’s year-end accounts payables and receivables by program for this Agreement. The report assists the Department in reserving sufficient funding to reimburse the final expenditures that will be reported on the Final FSR without materially overstating or understating the year-end obligations for this Agreement. The Department compares the total estimated expenditures from this report to the total amount reimbursed to the Grantee in the monthly prepayments and quarterly fee-for-service payments to establish accounts payable and accounts receivable entries at fiscal year-end. The Department recognizes that based upon payment adjustments and timing of Agreement amendments, the Grantee may owe the Department funding for overpayment of a program and may be due funds from the Department for underpayment of Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 31 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 a program at fiscal year-end. Within 60 days after the Agreement fiscal year-end, the Grantee must liquidate any unpaid year-end commitments and obligations. Any obligation remaining unliquidated after 60 days from the end of the Agreement period will revert to the Department for disposition in accordance with applicable state and/or federal requirements, except as specifically authorized in writing by the Department. H.Final Financial Status Reporting Requirements Final FSRs are due on the following dates following the Agreement period end date: Project Final FSR Due Date Public Health Emergency Preparedness 11/15/2024 All Remaining Projects 11/30/2024 Upon receipt of the final FSR electronically through MI E-Grants, the Department will determine by program, if funds are owed to the Grantee or if the Grantee owes funds to the Department. If funds are owed to the Grantee, payment will be processed. However, if the Grantee underestimated their year-end obligations in the Obligation Report as compared to the final FSR and the total reimbursement requested does not exceed the Agreement amount that is due to the Grantee, the Department will make every effort to process full reimbursement to the Grantee per the final FSR. Final payment may be delayed pending final disposition of the Department’s year-end obligations. If funds are owed to the Department, it will generally not be necessary for Grantee to send in a payment. Instead, the Department will make the necessary entries to offset other payments and as a result the Grantee will receive a net monthly prepayment. When this does occur, clarifying documentation will be provided to the Grantee by the Department’s Bureau of Finance and Accounting. I.Penalties for Reporting Noncompliance For failure to submit the final total Grantee FSR report by November 30, through MI E-Grants after the Agreement period end date, the Grantee may be penalized with a one-time reduction in their current ELPHS allocation for noncompliance with the fiscal year-end reporting deadlines. Any penalty funds will be reallocated to other Local Health Department Grantees. Reductions will be one-time only and will not carryforward to the next fiscal year as an ongoing reduction to a Grantee’s ELPHS allocation. Penalties will be assessed based upon the submitted date in MI E-Grants: ELPHS Penalties for Noncompliance with Reporting Requirements: 1.1% - 1 day to 30 days late; 2.2% - 31 days to 60 days late; Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 32 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 3.3% - over 60 days late with a maximum of 3% reduction in the Grantee’s ELPHS allocation. J.Indirect Costs and Cost Allocations/Distribution Plans The Grantee is allowed to use approved federal indirect rate, 10% de minimis indirect rate or cost allocation/distribution plans in their budget calculations. 1.Costs must be consistently charged as indirect, direct or cost allocated, but may not be double charged or inconsistently charged. 2.If the Grantee does not have an existing approved federal indirect rate, they may use a 10% de minimis rate in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 to recover their indirect costs. 3.Grantees using the cost allocation/distribution method must develop certified plan in accordance with the requirements described in Title 2 CFR, Part 200 which includes detailed budget narratives and is retained by the Grantee and subject to Department review. 4.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 and subject to Department review. V.Agreement Termination This Agreement may be terminated without further liability or penalty to the Department for any of the following reasons: A.By either party by giving 30 days written notice to the other party stating the reasons for termination and the effective date. B.By either party with 30 days written notice upon the failure of either party to carry out the terms and conditions of this Agreement, provided the alleged defaulting party is given notice of the alleged breach and fails to cure the default within the 30-day period. C.Immediately if the Grantee or an official of the Grantee or an owner is convicted of any activity referenced in Part 2 Section III. D. of this Agreement during the term of this Agreement or any extension thereof. Further, this Agreement may be terminated or modified immediately upon a finding by the Department in accordance with MCL 333.2235 that the Grantee local health department for the delivery of public health services under this Agreement is unable or unwilling to provide any or all of the services as provided in this Agreement, and the Department may redirect funds as necessary to ensure that the public health services are provided within the Grantee's jurisdiction. VI.Stop Work Order The Department may suspend any or all activities under this Agreement at any time. The Department will provide the Grantee with a written stop work order detailing the suspension. Grantee must comply with the stop work order upon receipt. The Department will not pay for activities, Grantee’s incurred expenses or financial losses, or any additional compensation during a stop work period. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 33 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 VII.Final Reporting upon Termination Should this Agreement be terminated by either party, within 30 days after the termination, the Grantee must provide the Department with all financial, performance and other reports required as a condition of this Agreement. The Department will make payments to the Grantee for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Grantee must immediately refund to the Department any funds not authorized for use and any payments or funds advanced to the Grantee in excess of allowable reimbursable expenditures. VIII.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. IX.Amendments A.Except as otherwise provided, any changes to this Agreement will be valid only if made in writing and accepted by all parties to this Agreement. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Grantee's or Department's control, which reduce or otherwise interfere with the Grantee's or Department's ability to provide or maintain specified services or operational procedures, immediate written notification must be provided to the other party. Any change proposed by the Grantee which would affect the state funding of any project, in whole or in part as provided in Part 1, Section 3.C. of the Agreement, must be submitted in writing to the Department for approval immediately upon determining the need for such change. The proposed change may be implemented upon receipt of written notification from the Department. B.Except as otherwise provided, amendments to this Agreement will be made within thirty days after receipt and approval of a change proposed by the Grantee. Amendments of a routine nature including applicable changes in budget categories, modified indirect rates, and similar conditions which do not modify the Agreement scope, amount of funding to be provided by the Department or, the total amount of the budget may be submitted by the Grantee, in writing, at any time prior to June 7. The Department will provide a written response within 30 calendar days. All amendments must be submitted to the Department within three weeks of receipt through MI E-Grants to assure the amendment can be executed prior to the end of the Agreement period. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 34 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 X.Liability A.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, by the Grantee, Grantee’s subcontractors or anyone directly or indirectly employed by the Grantee in the performance of this Agreement will be the responsibility of the Grantee, and not the responsibility of the Department. Nothing herein will be construed as a waiver of any governmental immunity that has been provided to the Grantee or its employees by law. B.In the event that liability to third parties, loss, or damage arises as a result of activities conducted jointly by the Grantee and the Department in fulfillment of their responsibilities under this Agreement, such liability, loss, or damage will be borne by the Grantee and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein will be construed as a waiver of any governmental immunity by the Grantee, the state, its agencies (the Department) or their employees, respectively, as provided by statute or court decisions. XI.Waiver Failure to enforce any provision of this Agreement will not constitute a waiver. 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 Department or the Grantee, 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. XII.State of Michigan Agreement This Agreement is governed, construed, and enforced in accordance with Michigan law, excluding choice-of-law principles, and all claims relating to or arising out of this Agreement are governed by Michigan law, excluding choice-of-law principles. Any dispute arising from this Agreement must be resolved in the Michigan Court of Claims. Complaints against the State must be initiated in Ingham County, Michigan. Grantee waives any objections, such as lack of personal jurisdiction or forum non conveniens. Grantee must appoint an agent in Michigan to receive service of process. XIII.Funding A.State funding for this Agreement will be provided from the applicable and available Department appropriations for the current fiscal year. The Department provided funds will be as stated in the approved Annual Budget - Attachment I Instructions for the Annual Budget, Attachment III, Program Specific Assurances and Requirements, and as outlined in Attachment IV, Funding/Reimbursement Matrix. B.The funding provided through the Department for this Agreement will not exceed the amount shown for each federal and state categorical program element except as adjusted by amendment. The Grantee must advise the Department in writing by May 1, if the amount of Department funding may not Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 35 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 be used in its entirety or appears to be insufficient for any program element. ELPHS transfer requests between MDHHS, MDARD and MDEQ must also be requested in writing by May 1. All ELPHS required services must be maintained throughout the entire period of the Agreement. C.The Department may periodically redistribute funds between agencies during the Agreement period in order to ensure that funds are expended to meet the varying needs for services. Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 36 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 AA Attachments A1 Attachment I - Instructions for the Annual Budget Attachment I - Instructions for the Annual Budget A2 Attachment III - Program Specific Assurances and Requirements Attachment III - Program Specific Assurances and Requirements Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 37 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Adolescent STI Screening Reg. Alloc.F 73,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Body Art Fixed Fee Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Recepient Children's Special Hlth Care Services (CSHCS) Care Coordination Calc. Amt.S 0 Fixed Unit Rate (1), (7) N/A N/A N/A N/A N/A Subrecepient Children's Special Hlth Care Services (CSHCS) Outreach & Advocacy Reg. Alloc.F 147,201 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 147,201 CSHCS Medicaid Elevated Blood Lead Case Mgmt Calc. Amt.F 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient CSHCS Vaccine Initiative Reg. Alloc.F 18,968 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Eastern Equine Encephalitis Virus Surveillance Project Reg. Alloc.F 15,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient EGLE Drinking Water and Onsite Wastewater Management Reg. Alloc.S 985,042 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient Emerging Threats - Hepatitis C Reg. Alloc.S 166,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Fetal Infant Mortality Review (FIMR) Case Abstraction Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient FIMR Interviews Calc. Amt.S 0 Fixed Unit Rate (2), (11) N/A N/A N/A N/A N/A Subrecepient Food ELPHS Reg. Alloc.S 1,176,612 ELPHS (3), (4)N/A N/A N/A N/A N/A Recepient Gonococcal Isolate Surveillance Project Reg. Alloc.F 6,178 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 18,535 Harm Reduction Support Services Reg. Alloc.F 250,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Hearing ELPHS Reg. Alloc.L 253,969 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 38 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) HIV PrEP Clinic Reg. Alloc.F 343,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 3,500 Reg. Alloc.S 3,500 HIV Prevention Reg. Alloc.F 22,612 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.P 22,612 Reg. Alloc.S 407,021 Immunization Action Plan (IAP)Reg. Alloc.F 526,990 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Immunization Fixed Fees Calc. Amt.S 0 Fixed Unit Rate (2), (7) N/A N/A N/A N/A N/A Subrecepient Immunization Vaccine Quality Assurance Reg. Alloc.S 105,347 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Infant Safe Sleep Reg. Alloc.F 7,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 63,000 Integrating MPOX into STI Clinics Reg. Alloc.F 6,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Laboratory Services Bio Reg. Alloc.F 1,500 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient MCH - All Other Local MCH S 249,377 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MCH - Children Local MCH S 72,080 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient MDHHS-Essential Local Public Health Services (ELPHS) Reg. Alloc.S 2,557,216 ELPHS (3),(6)N/A N/A N/A N/A N/A Recepient Nurse Family Partnership Services Reg. Alloc.F 405,324 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 270,216 Oral Health- Kindergarten Assessment Reg. Alloc.S 110,597 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 39 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTACHMENT IV - Local Health Department - 2024 CONTRACT MANAGEMENT SECTION Oakland County Department of Health and Human Services/ Health Division Program Element/Funding Source (a) MDHHS Source Fed/St Funding Amount Reimbursement Method (b) Performance Target Output Measurement Total (c) Perform Expect State (d) Funded Target Perform State Funded Minimum Performance Percent Number (e) Contractor / Subrecepient (f) Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 Reg. Alloc.F 222,449 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 Reg. Alloc.F 196,551 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Sexually Transmitted Infection (STI) Control Reg. Alloc.F 33,418 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Reg. Alloc.S 703 Reg. Alloc.S 36,144 Statewide Lead Case Management - Fixed Fee Calc. Amt.S 0 Fixed Unit Rate (7), (11) N/A N/A N/A N/A N/A Recepient Tuberculosis (TB) Control Reg. Alloc.F 15,426 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient Vector-Borne Surveillance & Prevention Reg. Alloc.S 9,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Recepient Vision ELPHS Reg. Alloc.L 253,968 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient West Nile Virus Community Surveillance Reg. Alloc.F 10,000 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient WIC Breastfeeding Reg. Alloc.F 267,619 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient WIC Resident Services Reg. Alloc.F 2,615,870 Actual Cost Reimbursement N/A N/A N/A N/A N/A Subrecepient TOTAL MDHHS FUNDING 12,096,246 *SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT Attachment IV Notes Attachment IV Notes Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 ________________________________________________________________________________________________________________ Page: 40 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 Contract # 20240239-00 Date: 08/31/2023 Attachment V Oakland County FY Agreement Addendum A Date: 08/31/2023 Contract # 20240239-00, Oakland County Department of Health and Human Services/ Health Division, Local Health Department - 2024 __________________________________________________________________________ Page: 41 of 210 DocuSign Envelope ID: D64280E4-E3C3-4709-B022-21E6E181B1C9 FY 2024 MDHHS LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT SUBRECIPIENT AGREEMENT BETWEEN OAKLAND COUNTY AND OAKLAND LIVINGSTON HUMAN SERVICE AGENCY (OLHSA) Amendment 1 The Parties agree to amend the subrecipient agreement (“Agreement”) between Oakland County (“County”) and Oakland Livingston Human Service Agency (“OLHSA”) as follows: 1. The first sentence on page 2 of the Agreement shall be deleted and replaced with the following: “to exceed $607,348 and is allocated as follows:”. 2. The first bullet on page 2 of the Agreement shall be deleted and replaced with the following: •$87,367 – WIC Breastfeeding Peer Counseling Funding to fund 1.5 FTE peer counseling time and does not include supervisor or mentor time. This includes implementing International Board-Certified Lactation Consultant (IBCLC) services to WIC clients by IBCLC certified staff, utilizing the guidelines and requirements per the State of Michigan WIC IBCLC services policy. The Oakland County Health Division has confirmation of the OLHSA staff IBCLC certification on file. 3. Attachments B.1 (Program Budget Summary for WIC Peer Counselor Funding Application) and B.2 (Program Budget – Cost Detail Schedule) to the Agreement will be deleted and replaced with the attachments attached to this Amendment as Exhibit A. 4. The purpose of this Amendment is increase OLHSA’s funding by $2,500 to implement IBCLC services to WIC clients by an IBCLC certified staff as described above. 5. This Amendment will be effective when it is executed by both Parties. 6. All contractual provisions of the Agreement not otherwise affected by this Amendment shall remain in full force and effect. 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 to execute this Amendment on behalf of Oakland County and hereby accepts and binds the County of Oakland to the terms and conditions of this Amendment. EXECUTED: _________________________________________ DATE:___________________ David T. Woodward, Chairperson Oakland County Board of Commissioners IN WITNESS WHEREOF, Susan Harding, Chief Executive Officer, Oakland Livingston Human Services Agency, acknowledges that she has been authorized to sign this Amendment on behalf of the responsible governing board or official of OLHSA and hereby accepts and binds OLHSA to the terms and conditions of this Amendment. EXECUTED: _________________________________________ DATE:___________________ Susan Harding, CEO Oakland Livingston Human Services Agency EXHIBIT A Oakland County, Michigan HEALTH AND HUMAN SERVICES DEPARTMENT/HEALTH DIVISION - FY 2024 LOCAL HEALTH DEPARTMENT (COMPREHENSIVE) AGREEMENT AMENDMENT #3 Schedule "A" DETAIL R/E Fund Name Division NameFund # (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 R Greenall Fund - Grants Health FND10101 CCN1060237 RC615571 PRG133300 GRN-1004201 615000 State Operating Grants $6,000 - R Greenall Fund - Grants Health FND10101 CCN1060237 RC615571 PRG133310 GRN-1004202 615000 State Operating Grants 6,000 - Total Revenues $12,000 $- R General Fund Non-DepartmentalFND10100 CCN9010101 RC615571 PRG196030 665882 Planned Use of Fund Balance $15,933 - Total Revenues $15,933 $- E General Fund Non-DepartmentalFND10100 CCN9010101 SC788001 PRG196030 BFA11007 788001 Transfers Out $15,933 - Total Expenditures $15,933 $- R Human Services Grants Health FND11007 CCN1060290 RC615571 PRG115035 GRN-1004181 615000 State Operating Grants $22,966 $- R Human Services Grants Health FND11007 CCN1060290 RC695500 PRG115035 GRN-1004181 615000 Transfers In 2,297 - Total Revenues $25,263 $- E Human Services Grants Health FND11007 CCN1060290 SC702010 PRG115035 GRN-1004181 702000 Salaries Regular $(5,082)$- E Human Services Grants Health FND11007 CCN1060290 SC722740 PRG115035 GRN-1004181 722000 Fringe Benefits (4,002)- E Human Services Grants Health FND11007 CCN1060290 SC730926 PRG115035 GRN-1004181 730000 Indirect Costs (420)- E Human Services Grants Health FND11007 CCN1060290 SC731780 PRG115035 GRN-1004181 730000 Software Support Maintenance 13,624 - E Human Services Grants Health FND11007 CCN1060290 SC732018 PRG115035 GRN-1004181 730000 Travel and Conference (1,431)- E Human Services Grants Health FND11007 CCN1060290 SC750294 PRG115035 GRN-1004181 750000 Material and Supplies 7,607 - E Human Services Grants Health FND11007 CCN1060290 SC770631 PRG115035 GRN-1004181 770000 Bldg Space Cost Allocation 2,297 - E Human Services Grants Health FND11007 CCN1060290 SC774636 PRG115035 GRN-1004181 770000 Info Tech Operations 13,259 - E Human Services Grants Health FND11007 CCN1060290 SC774677 PRG115035 GRN-1004181 770000 Insurance Fund 91 - E Human Services Grants Health FND11007 CCN1060290 SC778675 PRG115035 GRN-1004181 770000 Telephone Communications (680)- Total Expenditures $25,263 $-