HomeMy WebLinkAboutResolutions - 2026.06.11 - 42997
AGENDA ITEM: Amendment #4 to the FY 2026 Local Health Department Agreement from the
Michigan Department of Health and Human Services
DEPARTMENT: Health & Human Services - Health Division
MEETING: Board of Commissioners
DATE: Thursday, June 11, 2026 6:00 PM - Click to View Agenda
ITEM SUMMARY SHEET
COMMITTEE REPORT TO BOARD
Resolution #2026-6568
Motion to approve amendment #4 to the FY 2026 Local Health Department Agreement from the
Michigan Department of Health and Human Services in the amount of $200,565; further, delete
three (3) positions as follows: one (1) GF/GP PTNE 1,000 hours per year Auxiliary Health Clerk
position (P00017358), one (1) GF/GP PTNE 1,000 hours per year Public Health Nurse III position
(P00012877), and one (1) GF/GP PTNE 1,000 hours per year Public Health Nurse II position
(P00017355); further, create six (6) new positions as follows: one (1) General Fund/ General
Purpose (GF/GP) Full-Time Eligible (FTE) H&HS Contract Compliance Supervisor position, one (1)
GF/GP Part-Time Non-Eligible 1,000 hours per year Medical Director position in the Health Division
Medical Services Unit, one (1) GF/GP FTE Public Health Nurse IV position, one (1) GF/GP FTE
Auxiliary Health Clerk position in the Children’s Village Medical Unit, one (1) GF/GP PTNE 1,000
hours per year Community Health Worker position in the Oakland Connects Unit and one (1) SR
PTNE, 1,000 hours per year Public Health Educator III; further, authorize the Chair of the Board of
Commissioners to execute the attached agreement after final review by Corporation Counsel and
Risk Management; further, amend the FY 2026 budget as detailed in the attached Schedule A.
ITEM CATEGORY SPONSORED BY
Grant Penny Luebs
INTRODUCTION AND BACKGROUND
The Health Division received Amendment #4 to the Michigan Department of Health and Human
Services Fiscal Year 2026 Local Health Department Comprehensive Agreement in the amount of
$200,656. The Amendment provides additional funding in the amount of $200,565 for the Public
Health Infrastructure project and budget category adjustments for administrative activities that
support the Michigan Medicaid Outreach Program.
The Public Health Infrastructure project provides funding to support critical public health
infrastructure needs such as public health workforce, foundational capabilities, and data
modernization. Funding will be used for staffing, mileage, supplies, and wrap-around services.
The Michigan Medicaid Outreach program provides funding for Medicaid Outreach activities
performed to inform Medicaid beneficiaries or potential beneficiaries about Medicaid, enroll
individuals in Medicaid, and improve access and utilization of Medicaid covered services. The
Michigan Department of Health and Human Services provides 50% reimbursement of gross cost of
eligible outreach activities that are not part of direct services. The Health Division is estimating a
cost of $2,200,000 for eligible outreach activities beginning October 1, 2025.
The Health Division has reviewed its operations and determined efficiencies could be achieved with
additional support for administrative and clinic support, and tuberculosis and infectious disease
caseloads. It is requested to create six (6) new positions; one (1) General Fund/ General Purpose
(GF/GP) Full-Time Eligible (FTE) H&HS Contract Compliance Supervisor position to support
increasing Health Division financial and operational needs and one (1) GF/GP Part-Time Non-
Eligible (PTNE) 1,000 hours per year Medical Director position to provide care associated with
tuberculosis and other infectious disease cases within the Health Division Medical Services unit,
one (1) GF/GP FTE Public Health Nurse IV position to support clinical services, one (1) GF/GP FTE
Auxiliary Health Clerk position to provide essential clerical and clinical support within the Children’s
Village Medical Unit, one (1) GF/GP PTNE 1,000 hours per year Community Health Worker position
to be assigned to Oakland Connects to assist families from non-traditional referrals and assist with
referrals from the Medical Examiners Office and Sheriff's Office, and one (1) Special Revenue (SR)
PTNE, 1,000 hours per year Public Health Educator III position to support the Regional Health
Advisory Councils grant project funded though the FY2026 Local Health Department Agreeement.
The General Fund/General Purpose position costs will be offset through Medicaid Outreach
reimbursement funds and the deletion of one (1) vacant GF/GP PTNE 1,000 hours per year
Auxiliary Health Clerk position (P00017358), one (1) vacant GF/GP PTNE 1,000 hours per year
Public Health Nurse III position (P00012877), and one (1) vacant GF/GP PTNE 1,000 hours per
year Public Health Nurse II position (P00017355).
POLICY ANALYSIS
• At the time of the June 2 PHS meeting, this item will not have completed grant review, a sign-
off will not be attached. When it is complete, the item will be updated accordingly.
o As of June 9, this item has completed the grant review process. A sign-off is
now attached.
• Grant Acceptance was accepted via resolution #2025-5775 in the amount of $13,599,406.
• Amendment #1 was issued and executed internally by MDHHS. This amendment did not
involve any fiscal or legal changes, so it did not require Board approval.
• Amendment #2 was approved via resolution #2025-5991.
• Amendment #3 was completed administratively, as it was under 15%.
• Amendment #4 is a four (4) part request to;
o Adds funding in the amount of $200,565 for the Public Health Infrastructure project,
the original amount for this project was $122,738 and with this addition the project
budget is now $323,303. This takes the total grant award from $15,662,418 to
$15,862,983.
o Requests additional budget allocation of $597,000 for Medicaid outreach
reimbursement.
o Create six (6) positions.
o Delete three (3) positions.
• The Medicaid Outreach Program is a reimbursement program from Medicaid outreach
activities performed by the Oakland County Health Department, on behalf of the Michigan
Department of Health and Human Services. The following activities qualify as eligible
reimbursement activities;
o Referral, coordination, and/or monitoring of Medicaid services,
o Arranging transportation for clients to access Medicaid services,
o Arranging for translation services for clients to access Medicaid services,
o Medicaid outreach and public awareness,
o Facilitating Medicaid program eligibility determination,
o Program planning, policy development, and /or inter-agency coordination related to
Medicaid services,
o Training activities related to the Medicaid program.
• The Health Department has received the following annual Medicaid reimbursement amounts
from MDHHS;
o FY 2022- $608,756
o FY 2023 - $773,320
o FY 2024 - $864,828
o FY 2025 - $615,255
FISCAL IMPACT: Budget Amendment Attached
Committee members can contact Barbara Winter, Policy and Fiscal Analysis Supervisor at
248.821.3065 or winterb@oakgov.com or the department contact persons listed for additional
information.
CONTACT
Kate Guzman, Health Officer
ITEM REVIEW TRACKING
Aaron Snover, Board of Commissioners Created/Initiated - 6/11/2026
AGENDA DEADLINE: 05/28/2026 4:30 PM
ATTACHMENTS
1. HHS-Health FY26 LHD Amendment 4 Sched A
2. Grant Amendment Sign-Off #4 LHDA
3. Amendment #4 Draft contract
4. Amendment #4 ATT IV
5. Amendment #4 Annual Budget Instructions
6. Amendment #4 ATT III
COMMITTEE TRACKING
2026-06-02 Public Health & Safety - Forward to Finance
2026-06-03 Finance - Recommend to Board
2026-06-11 Full Board - Adopt
Motioned by: Commissioner Michael Gingell
Seconded by: Commissioner Robert Hoffman
Yes: Charles Cavell, Ann Erickson Gault, Michael Gingell, Marcia Gershenson, Robert Hoffman,
Brendan Johnson, Karen Joliat, Christine Long, Penny Luebs, Gwen Markham, William Miller III,
Kristen Nelson, Angela Powell, Robert Smiley, Yolanda Smith Charles, Michael Spisz, Linnie
Taylor, Philip Weipert, David Woodward (19)
No: None (0)
Abstain: None (0)
Absent: (0)
Passed
Oakland County, Michigan
HEALTH AND HUMAN SERVICES DEPARTMENT/HEALTH DIVISION - FY 2026 LOCAL HEALTH DEPARTMENT COMPREHENSIVE AGREEMENT AMENDMENT #4
Schedule "A" DETAIL
R/E Fund Name Division Name
Fund #
(FND)
Cost Center
(CCN) #
Account #
(RC/SC)
Program #
(PRG)Grant ID (GRN) #
Project ID #
(PROJ)
Region
(REG)
Budget
Fund
Affiliate
(BFA)
Ledger
Account
Summary Account Title
FY 2026
Amendment
FY 2027
Amendment
FY 2028
Amendment
R Human Service Grants Health FND11007 CCN1060201 RC615571 PRG133150 GRN-1004737 615000 State Operating Grants 200,565 --
Total Revenues 200,565
E Human Services Grants Health FND11007 CCN1060201 SC702010 PRG133150 GRN-1004737 702000 Salaries Regular 17,895 --
E Human Services Grants Health FND11007 CCN1060201 SC722740 PRG133150 GRN-1004737 722000 Fringe Benefits (22,810)--
E Human Services Grants Health FND11007 CCN1060201 SC730926 PRG133150 GRN-1004737 730000 Indirect Costs 5,087 --
E Human Services Grants Health FND11007 CCN1060201 SC731346 PRG133150 GRN-1004737 730000 Personal Mileage 134 --
E Human Services Grants Health FND11007 CCN1060201 SC774636 PRG133150 GRN-1004737 770000 IT Operations 98,526 --
E Human Services Grants Health FND11007 CCN1060201 SC730982 PRG133150 GRN-1004737 730000 Interpreter Fees (2,000)--
E Human Services Grants Health FND11007 CCN1060201 SC731941 PRG133150 GRN-1004737 730000 Training (2,000)--
E Human Services Grants Health FND11007 CCN1060201 SC750245 PRG133150 GRN-1004737 750000 Incentives 89,823 --
E Human Services Grants Health FND11007 CCN1060201 SC750399 PRG133150 GRN-1004737 750000 Office Supplies (1,999)--
E Human Services Grants Health FND11007 CCN1060201 SC778675 PRG133150 GRN-1004737 770000 Telephone Communications 640 --
E Human Services Grants Health FND11007 CCN1060201 SC773630 PRG133150 GRN-1004737 770000 IT Development 17,269 -
Total Expenditures 200,565 --
R Human Service Grants Health FND10100 CCN1060234 RC610313 PRG133990 610000 Federal Operating Grants (503,000)(503,000)(503,000)
R Human Service Grants Health FND10100 CCN1060201 RC610313 PRG134425 610000 Federal Operating Grants 1,100,000 1,100,000 1,100,000
Total Revenues 597,000 597,000 597,000
E General Fund Health FND10100 CCN1060234 SC702010 PRG133990 702000 Salaries Regular -(40,200)(43,852)
E General Fund Health FND10100 CCN1060234 SC722790 PRG133990 722000 Social Security -(359)(413)
E General Fund Health FND10100 CCN1060234 SC722770 PRG133990 722000 Retirement -(378)(436)
E General Fund Health FND10100 CCN1060234 SC722820 PRG133990 722000 Unemployment -(12)(14)
E General Fund Health FND10100 CCN1060234 SC722750 PRG133990 722000 Workers Compensation -(151)(174)
E General Fund Non Departmental FND10100 CCN9010101 SC788001 PRG112700 BFA20293 788001 Transfers Out (30,383)(32,182)(34,748)
E General Fund Non Departmental FND10100 CCN9090101 SC730359 PRG196030 730000 Contingency 424,384 136,400 123,103
E General Fund Health FND10100 CCN1060201 SC702010 PRG134425 702000 Salaries Regular 31,149 97,681 102,004
E General Fund Health FND10100 CCN1060201 SC722790 PRG134425 722000 Social Security 2,383 7,473 7,803
E General Fund Health FND10100 CCN1060201 SC722770 PRG134425 722000 Retirement 7,205 22,594 23,593
E General Fund Health FND10100 CCN1060201 SC722810 PRG134425 722000 Disability 467 1,465 1,530
E General Fund Health FND10100 CCN1060201 SC722820 PRG134425 722000 Unemployment 16 49 51
E General Fund Health FND10100 CCN1060201 SC722760 PRG134425 722000 Group Life 69 215 224
E General Fund Health FND10100 CCN1060201 SC722750 PRG134425 722000 Workers Compensation 190 596 622
E General Fund Health FND10100 CCN1060201 SC722780 PRG134425 722000 Hospitalization 15,370 15,370 15,370
E General Fund Health FND10100 CCN1060201 SC722800 PRG134425 722000 Dental 844 844 844
E General Fund Health FND10100 CCN1060201 SC722850 PRG134425 722000 Optical 36 36 36
E General Fund Health FND10100 CCN1060201 SC702010 PRG134425 702000 Salaries Regular 29,067 91,178 95,234
E General Fund Health FND10100 CCN1060201 SC722790 PRG134425 722000 Social Security 2,383 7,473 7,803
E General Fund Health FND10100 CCN1060201 SC722770 PRG134425 722000 Retirement 7,205 22,594 23,593
E General Fund Health FND10100 CCN1060201 SC722810 PRG134425 722000 Disability 467 1,465 1,530
E General Fund Health FND10100 CCN1060201 SC722820 PRG134425 722000 Unemployment 16 49 51
E General Fund Health FND10100 CCN1060201 SC722760 PRG134425 722000 Group Life 69 215 224
E General Fund Health FND10100 CCN1060201 SC722750 PRG134425 722000 Workers Compensation 190 596 622
E General Fund Health FND10100 CCN1060201 SC722780 PRG134425 722000 Hospitalization 15,370 15,370 15,370
E General Fund Health FND10100 CCN1060201 SC722800 PRG134425 722000 Dental 844 844 844
E General Fund Health FND10100 CCN1060201 SC722850 PRG134425 722000 Optical 36 36 36
E General Fund Health FND10100 CCN1060201 SC702010 PRG134425 702000 Salaries Regular 16,519 51,802 54,094
E General Fund Health FND10100 CCN1060201 SC722790 PRG134425 722000 Social Security 2,383 7,473 7,803
E General Fund Health FND10100 CCN1060201 SC722770 PRG134425 722000 Retirement 7,205 22,594 23,593
E General Fund Health FND10100 CCN1060201 SC722810 PRG134425 722000 Disability 467 1,465 1,530
E General Fund Health FND10100 CCN1060201 SC722820 PRG134425 722000 Unemployment 16 49 51
E General Fund Health FND10100 CCN1060201 SC722760 PRG134425 722000 Group Life 69 215 224
E General Fund Health FND10100 CCN1060201 SC722750 PRG134425 722000 Workers Compensation 190 596 622
E General Fund Health FND10100 CCN1060201 SC722780 PRG134425 722000 Hospitalization 15,370 15,370 15,370
E General Fund Health FND10100 CCN1060201 SC722800 PRG134425 722000 Dental 844 844 844
E General Fund Health FND10100 CCN1060201 SC722850 PRG134425 722000 Optical 36 36 36
E General Fund Health FND10100 CCN1060201 SC702010 PRG134425 702000 Salaries Regular 35,575 112,632 116,216
E General Fund Health FND10100 CCN1060201 SC722790 PRG134425 722000 Social Security 516 1,633 1,685
E General Fund Health FND10100 CCN1060201 SC722770 PRG134425 722000 Retirement 544 1,723 1,778
E General Fund Health FND10100 CCN1060201 SC722820 PRG134425 722000 Unemployment 18 56 58
E General Fund Health FND10100 CCN1060201 SC722750 PRG134425 722000 Workers Compensation 217 687 709
E General Fund Health FND10100 CCN1060201 SC702010 PRG134425 702000 Salaries Regular 8,359 26,465 27,307
E General Fund Health FND10100 CCN1060201 SC722790 PRG134425 722000 Social Security 516 1,633 1,685
E General Fund Health FND10100 CCN1060201 SC722770 PRG134425 722000 Retirement 544 1,723 1,778
E General Fund Health FND10100 CCN1060201 SC722820 PRG134425 722000 Unemployment 18 56 58
E General Fund Health FND10100 CCN1060201 SC722750 PRG134425 722000 Workers Compensation 217 687 709
Total Expenditures 597,000 597,000 597,000
R Child Care Fund Non Departmental FND20293 CCN9010101 RC615359 PRG112700 610000 Child Care Subsidy (30,383)(32,183)(34,749)
R Child Care Fund Non Departmental FND20293 CCN9010101 RC695500 PRG112700 BFA10100 695500 Transfer In (30,383)(32,182)(34,748)
Total Revenues (60,766)(64,365)(69,497)
E Child Care Fund Health FND20293 CCN1060505 SC702010 PRG112100 702000 Salaries Regular (22,724)(24,725)(28,481)
E Child Care Fund Health FND20293 CCN1060505 SC722790 PRG112100 722000 Social Security (329)(359)(413)
E Child Care Fund Health FND20293 CCN1060505 SC722770 PRG112100 722000 Retirement (348)(378)(436)
E Child Care Fund Health FND20293 CCN1060505 SC722820 PRG112100 722000 Unemployment (11)(12)(14)
E Child Care Fund Health FND20293 CCN1060505 SC722750 PRG112100 722000 Workers Compensation (139)(151)(174)
E Child Care Fund Health FND20293 CCN1060505 SC702010 PRG112100 702000 Salaries Regular (36,388)(37,840)(38,942)
E Child Care Fund Health FND20293 CCN1060505 SC722790 PRG112100 722000 Social Security (329)(359)(413)
E Child Care Fund Health FND20293 CCN1060505 SC722770 PRG112100 722000 Retirement (348)(378)(436)
E Child Care Fund Health FND20293 CCN1060505 SC722820 PRG112100 722000 Unemployment (11)(12)(14)
E Child Care Fund Health FND20293 CCN1060505 SC722750 PRG112100 722000 Workers Compensation (139)(151)(174)
Total Expenditures (60,766)(64,365)(69,497)
R Human Service Grants Health FND11007 CCN1060101 RC615571 PRG133170 GRN-1004819 615000 State Operating Grants 13,057 41,338 42,654
Total Revenues 13,057 41,338 42,654
E Human Service Grants Health FND11007 CCN1060101 SC702010 PRG133170 GRN-1004819 702000 Salaries Regular 11,762 37,239 38,424
E Human Service Grants Health FND11007 CCN1060101 SC722790 PRG133170 GRN-1004819 722000 Social Security 516 1,633 1,685
E Human Service Grants Health FND11007 CCN1060101 SC722770 PRG133170 GRN-1004819 722000 Retirement 544 1,723 1,778
E Human Service Grants Health FND11007 CCN1060101 SC722750 PRG133170 GRN-1004819 722000 Workers Compensation 18 56 58
E Human Service Grants Health FND11007 CCN1060101 SC722790 PRG133170 GRN-1004819 722000 Social Security 217 687 709
Total Expenditures 13,057 41,338 42,654
GRANT REVIEW SIGN-OFF – Health & Human Services/Health
GRANT NAME: FY2026 Local Health Department (Comprehensive) Agreement AWD00692
FUNDING AGENCY: Michigan Department of Health & Human Services (MDHHS)
DEPARTMENT CONTACT PERSON: Stacey Sledge 248-452-2151
STATUS: Amendment #4 (create/delete positions)
DATE: 06/08/2026
Original grant contract authorized by Resolution#2025-5775
DEPARTMENT REVIEW
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Contract #: 20260430-03
Amendment Number: 4 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 $15,662,418 to $15,862,983,
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 in Attachment III - Program
Specific Assurance and Requirements:
Local Health Department - 2026, Date: 04/28/2026
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NEW:
MIHP Staffing Cost Assistance
REPLACED IN FULL:
Fetal Infant Mortality Review (FIMR) Case Abstraction
Local Public Health Nursing Case Management Expansion
MDHHS Essential Local Public Health Services (ELPHS)
STI Prepaid Testing
C) The following projects include additions/revisions as highlighted in Attachment IV
Notes:
No Change
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
Public Health Infrastructure 122,738 200,565 323,303
Total Comprehensive Funding 122,738 200,565 323,303
Performance Level Adjustments
N/A
Budget category Adjustments
Contract #Project Title
E20263317-00 Medicaid Outreach
E20264871-00 STI Prepaid Testing
It is understood and agreed that all other conditions of the original agreement remains
the same.
Local Health Department - 2026, Date: 04/28/2026
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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
Leigh_Anne Stafford Director 04/01/2026
___________________________________________________________________
Name Title Date
For the Michigan Department of Health and Human Services
Terri Smith 03/31/2026
___________________________________________________________________
Terri Smith, Director Date
Bureau of Grants and Purchasing
Local Health Department - 2026, Date: 04/28/2026
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Attachments
Attachment I - Instructions for the Annual Budget
Attachment III - Program Specific Assurances and Requirements
Local Health Department - 2026, Date: 04/28/2026
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Contract # Date: 04/28/2026
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTACHMENT IV - Local Health Department - 2026
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.S 359,174 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Combating Antimicrobial
Resistant Gonorrhea and Other
STIs
Reg. Alloc.S 166,906 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Recepient
CSHCS Medicaid Elevated Blood
Lead Case Mgmt
Calc. Amt.S 0 Fixed Unit Rate (2)N/A N/A N/A N/A N/A Subrecepient
CSHCS Medicaid Outreach Calc. Amt.S 0 Staffing (6)N/A N/A N/A N/A N/A Subrecepient
Disease Intervention Specialist
Workforce
Reg. Alloc.F 41,667 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 191,000 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
Harm Reduction Supply Support Reg. Alloc.S 47,500 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Recepient
Harm Reduction Support Match Reg. Alloc.F 328,500 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Hearing ELPHS Reg. Alloc.L 408,063 ELPHS (3), (6)N/A N/A N/A N/A N/A Recepient
Local Health Department - 2026, Date: 04/28/2026
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Contract # Date: 04/28/2026
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTACHMENT IV - Local Health Department - 2026
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 505,841 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
HIV Prevention Reg. Alloc.F 425,000 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
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 70,000 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
Lead Education and Faucet
Replacement
Reg. Alloc.S 103,636 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Recepient
Local Health Department (LHD)
Sharing Support
Reg. Alloc.S 70,000 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
MCH - All Other Reg. Alloc.S 0 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient
MCH - All Other Local MCH S 251,758 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient
MCH - Children Reg. Alloc.S 0 Local MCH (3), (6)N/A N/A N/A N/A N/A Subrecepient
MCH - Children Local MCH S 69,699 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 3,265,697 ELPHS (3),(6)N/A N/A N/A N/A N/A Recepient
Medicaid Outreach Reg. Alloc.F 0 Reimbursement-
Medicaid
N/A N/A N/A N/A N/A Subrecepient
Nurse Family Partnership
Services
Reg. Alloc.F 1,144,080 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Oral Health- Kindergarten
Assessment
Reg. Alloc.S 179,979 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 223,526 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
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MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTACHMENT IV - Local Health Department - 2026
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) CRI 10/1 -
6/30
Reg. Alloc.F 324,250 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Public Health Infrastructure Reg. Alloc.F 122,738 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Regional Health Advisory
Councils
Reg. Alloc.S 55,000 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Sexually Transmitted Infection
(STI) Control
Reg. Alloc.F 70,265 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
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
STI Prepaid Testing Reg. Alloc.S 25,000 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Recepient
Tuberculosis (TB) Control Reg. Alloc.F 13,061 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Subrecepient
Vector-Borne Surveillance &
Prevention
Reg. Alloc.S 11,000 Actual Cost
Reimbursement
N/A N/A N/A N/A N/A Recepient
Vision ELPHS Reg. Alloc.L 408,063 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 15,662,418
*SPECIFIC OUTPUT PERFORMANCE MEASURES WILL BE INCORPORATED VIA AMENDMENT
Attachment IV Notes
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Contract # Date: 04/28/2026
Project Budgets
1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2026 / Medicaid Outreach
DATE PREPARED
4/28/2026
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2025 To : 9/30/2026
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
Original Amendment
AMENDMENT #
4
CITY
Pontiac
STATE
MI
ZIP CODE
48341-1032
FEDERAL ID NUMBER
38-6004876
Category Total Amount
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 534,375.00 534,375.00
2 Fringe Benefits 299,250.00 299,250.00
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
Total Program Expenses 833,625.00 833,625.00
TOTAL DIRECT EXPENSES 833,625.00 833,625.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 201,940.00 201,940.00
Total Indirect Costs 201,940.00 201,940.00
TOTAL INDIRECT EXPENSES 201,940.00 201,940.00
TOTAL EXPENDITURES 1,035,565.00 1,035,565.00
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Contract # Date: 04/28/2026
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 166,725.00 0.00 166,725.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 1,035,565.00 434,420.00 601,145.00 0.00
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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 534375.000 0.000 FTE 534,375.00
2 Fringe Benefits
Composite Rate
Notes : FICA
UNEMPLOY
RETIREMENT
HOSPITAL
LIFE INSURANCE
VISION
DENTAL
WORKERS COMP
SHORT/LONG TERM
DISABILITY
0.0000 56.000 534375.000 299,250.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Total Program Expenses 833,625.00
TOTAL DIRECT EXPENSES 833,625.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 6.59%
0.0000 0.000 0.000 201,940.00
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Line Item Qty Rate Units UOM Total
ICR 20%
Total Indirect Costs 201,940.00
TOTAL INDIRECT EXPENSES 201,940.00
TOTAL EXPENDITURES 1,035,565.00
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1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2026 / Public Health
Infrastructure
DATE PREPARED
4/28/2026
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2025 To : 9/30/2026
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
Original Amendment
AMENDMENT #
4
CITY
Pontiac
STATE
MI
ZIP CODE
48341-1032
FEDERAL ID NUMBER
38-6004876
Category Total Amount
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 54,746.00 54,746.00
2 Fringe Benefits 29,015.00 29,015.00
3 Cap. Exp. for Equip & Fac.0.00 0.00
4 Contractual 0.00 0.00
5 Supplies and Materials 7,799.00 7,799.00
6 Travel 201.00 201.00
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.)26,829.00 26,829.00
Total Program Expenses 119,130.00 119,130.00
TOTAL DIRECT EXPENSES 119,130.00 119,130.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 20,360.00 20,360.00
Total Indirect Costs 20,360.00 20,360.00
TOTAL INDIRECT EXPENSES 20,360.00 20,360.00
TOTAL EXPENDITURES 139,490.00 139,490.00
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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 122,738.00 122,738.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 16,752.00 0.00 16,752.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 139,490.00 122,738.00 16,752.00 0.00
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3 Program Budget - Cost Detail
Line Item Qty Rate Units UOM Total
DIRECT EXPENSES
Program Expenses
1 Salary & Wages
Community Health Worker
Notes : P00016945 - Community
Health Worker
1.0000 54746.000 0.000 FTE 54,746.00
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 53.000 54746.000 29,015.00
3 Cap. Exp. for Equip & Fac.
4 Contractual
5 Supplies and Materials
Office Supplies 0.0000 0.000 0.000 2,799.00
Incentives 0.0000 0.000 0.000 5,000.00
Total for Supplies and Materials 7,799.00
6 Travel
Mileage
Notes : 287 miles @ 0.70 per
mile
0.0000 0.000 0.000 201.00
7 Communication
Telephone 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 21,530.00
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Line Item Qty Rate Units UOM Total
Insurance 0.0000 0.000 0.000 1,299.00
Interpretation Fees 0.0000 0.000 0.000 2,000.00
Training 0.0000 0.000 0.000 2,000.00
Total for All Others (ADP, Con. Employees, Misc.)26,829.00
Total Program Expenses 119,130.00
TOTAL DIRECT EXPENSES 119,130.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Cost Allocation Plan
Notes : 6.59%
ICR 20%
0.0000 0.000 0.000 20,360.00
Total Indirect Costs 20,360.00
TOTAL INDIRECT EXPENSES 20,360.00
TOTAL EXPENDITURES 139,490.00
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1 Program Budget Summary
PROGRAM / PROJECT
Local Health Department - 2026 / STI Prepaid Testing
DATE PREPARED
4/28/2026
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2025 To : 9/30/2026
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
Original Amendment
AMENDMENT #
4
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 25,000.00 25,000.00
6 Travel 0.00 0.00
7 Communication 0.00 0.00
8 County-City Central Services 0.00 0.00
9 Space Costs 0.00 0.00
10 All Others (ADP, Con. Employees, Misc.)0.00 0.00
Total Program Expenses 25,000.00 25,000.00
TOTAL DIRECT EXPENSES 25,000.00 25,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 0.00 0.00
2 Cost Allocation Plan / Other 0.00 0.00
Total Indirect Costs 0.00 0.00
TOTAL INDIRECT EXPENSES 0.00 0.00
TOTAL EXPENDITURES 25,000.00 25,000.00
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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 25,000.00 25,000.00 0.00 0.00
MCH Funding 0.00 0.00 0.00 0.00
Local Funds - Other 0.00 0.00 0.00 0.00
Inkind Match 0.00 0.00 0.00 0.00
MDHHS Fixed Unit Rate
Totals 25,000.00 25,000.00 0.00 0.00
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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
Materials and Supplies 0.0000 0.000 0.000 25,000.00
6 Travel
7 Communication
8 County-City Central Services
9 Space Costs
10 All Others (ADP, Con. Employees, Misc.)
Total Program Expenses 25,000.00
TOTAL DIRECT EXPENSES 25,000.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs
2 Cost Allocation Plan / Other
Total Indirect Costs 0.00
TOTAL INDIRECT EXPENSES 0.00
TOTAL EXPENDITURES 25,000.00
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Summary of Budget
PROGRAM / PROJECT
Local Health Department - 2026 / Local Health Department -
2026
DATE PREPARED
4/28/2026
CONTRACTOR NAME
Oakland County Department of Health and Human Services/
Health Division
BUDGET PERIOD
From : 10/1/2025 To : 9/30/2026
MAILING ADDRESS (Number and Street)
1200 N. Telegraph Rd.
34 East
BUDGET AGREEMENT
Original Amendment
AMENDMENT #
4
CITY
Pontiac
STATE
MI
ZIP CODE
48341-1032
FEDERAL ID NUMBER
38-6004876
Category Total Amount
DIRECT EXPENSES
Program Expenses
1 Salary & Wages 25,805,703.00 25,805,703.00
2 Fringe Benefits 13,183,439.00 13,183,439.00
3 Cap. Exp. for Equip & Fac.30,000.00 30,000.00
4 Contractual 772,259.00 772,259.00
5 Supplies and Materials 2,710,041.00 2,710,041.00
6 Travel 484,457.00 484,457.00
7 Communication 276,897.00 276,897.00
8 Space Costs 2,172,364.00 2,172,364.00
9 All Others (ADP, Con. Employees, Misc.)3,231,518.00 3,231,518.00
Total Program Expenses 48,666,678.00 48,666,678.00
TOTAL DIRECT EXPENSES 48,666,678.00 48,666,678.00
INDIRECT EXPENSES
Indirect Costs
1 Indirect Costs 997,702.00 997,702.00
2 Cost Allocation Plan / Other 2,292,615.00 2,292,615.00
Total Indirect Costs 3,290,317.00 3,290,317.00
TOTAL INDIRECT EXPENSES 3,290,317.00 3,290,317.00
TOTAL EXPENDITURES 51,956,995.00 51,956,995.00
SOURCE OF FUNDS
Category Total Amount Cash Inkind
1 Fees and Collections - 1st and 2nd
Party
5,217,793.00 0.00 5,217,793.00 0.00
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2 Fees and Collections - 3rd Party 241,000.00 0.00 241,000.00 0.00
3 Federal or State (Non MDHHS)0.00 0.00 0.00 0.00
4 Federal or State (Non MDHHS)3,165,689.00 0.00 3,165,689.00 0.00
5 Federal Cost Based Reimbursement 0.00 0.00 0.00 0.00
6 Federally Provided Vaccines 1,442,644.00 0.00 1,442,644.00 0.00
7 Federal Medicaid Outreach 517,927.00 517,927.00 0.00 0.00
8 Required Match - Local 572,705.00 0.00 572,705.00 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 Local Non-ELPHS 0.00 0.00 0.00 0.00
12 Other Non-ELPHS 0.00 0.00 0.00 0.00
13 MDHHS Non Comprehensive 0.00 0.00 0.00 0.00
14 MDHHS Comprehensive 15,340,961.00 15,340,961.00 0.00 0.00
15 MCH Funding 321,457.00 321,457.00 0.00 0.00
16 Local Funds - Other 24,758,173.00 0.00 24,758,173.00 0.00
17 Inkind Match 0.00 0.00 0.00 0.00
18 MDHHS Fixed Unit Rate 378,646.00 378,646.00 0.00 0.00
TOTAL 51,956,995.00 16,558,991.00 35,398,004.00 0.00
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FOOTNOTES: FY 2025/2026
a) Refer to Plan and Budget Framework for element definitions.
b) Refer to master comprehensive agreement and program and budget instructions package for further explanation of appl icability
of these reimbursement methods.
c) Negotiated starting from the average of the past two complete years' actual number where available.
d) Calculated by multiplying the "Total Performance Expectation" column by the ratio of the elements total State funding (DCH
0410, Line 24) to "Total Expenditures” DCH 0410, Line 17). Prior to calculation, adjustments will be made for unallowable cost,
equipment funded by local funds and MDHHS reimbursement not performance based (I.E., fixed unit rate, staffing).
e) Calculated by multiplying the "State Funded Element Target Performance" column by the "Percent" column.
f) Refer to master comprehensive agreement and budget instructions package for further explanation regarding these
designations.
1. CSHCS Care Coordination
A. Case Management
1. Maximum of six (6) services per year
2. Reimbursement - $221.74 per service provided face-to -face in the home setting.
2. CARE COORDINATION
A. LEVEL I PLAN OF CARE
1. Annual Plan of Care in the home or home-like setting that requires the Care Coordinator
to travel to a non-LHD site - $165
2. Annual Plan of Care over the telephone -$110
B. LEVEL II CARE COORDINATION
1. Level II Care Coordination is reimbursed at $33.00 per unit
2. A maximum of 15 units per beneficiary per eligibility year will be reimbursed.
(2) Reimbursement Chart for Fixed Rates
Body Art Calendar Year 2025
$328.49 / appl. annual license prior to July 1
$164.25 / appl. annual license after July 1
$147.81 / appl. temporary license
$328.49 / appl. renewal prior to December 1
$492.74 / appl. renewal after December 1
$32.84 / duplicate license
CSHCS-Medicaid Elevated Blood Lead Case
Management
$221.74 per home visit, for up to 6 home visits
Fetal Infant Mortality Review (FIMR) Case
Abstractions
$270.00 per case, not to exceed the maximum set for each Grantee
Fetal Infant Mortality Review (FIMR) Interviews $125 for each family support visit. A maximum of six (6) visits per infant death is
reimbursable
Informed Consent $50 per patient served, for each patient that expressly states that they are seeking
a pregnancy test or confirmation of a pregnancy for the purpose of obtaining an
abortion and is provided the services.
Vaccines for Children (VFC) Enrollment Site
Visit
$175
Vaccines for Children (VFC) Site Visit $175
Adult Vaccine Program (AVP) Site Visit $175
Unannounced Storage & Handling Site Visit $100
Birthing Hospital Site Visit $350
Immunization Quality Improvement Provider
(IQIP) Site Visit
$200
IQIP 12 -month Follow-Up Complete $100
Nurse Education Regular Session $200
Statewide Lead Case Management $221.74 per home visit. A maximum of six (6) visits per home.
$110 per community health worker visit, A maximum of 2.
(3) Allocation to be reflected in individual programs during budgeting process.
(4) Funding Source (not a single element). Hearing and Vision are single elements.
(5) Subject to Statewide Maintenance of Effort requirement for Title X.
(6) State funding is first source (after fees and other earmarked sources).
(7) Fixed unit rate subject to actual costs.
(8) The performance reimbursement target will be the base target caseload established by MDHHS.
(9) Subject to a match requirement (hard or in-kind) of $1 for each $3 of MDHHS agreement funding for Coordination.
(10) Fixed rate limited to contract amount.
(11) Up to six (6) visits per family.
(12) Non-categorically funded Health Departments will be reimbursed at $11.00 per HIV test conducted up to a maximum of $2,000
annually.
(13) Each delegate agency must serve a minimum percentage of Title X users to access their total allocated funds. Semi-annual FPAR
data will be used to determine total Title X users.
(14) Public Health Emergency Preparedness (PHEP) funding BP1 must be expended by June 30 and is subject to a 10% match
requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs must
submit a nine-month budget and a quarterly Financial Status Report (FSR) column for this program element.
(15) Public Health Emergency Preparedness (PHEP) funding for October 1–June 30, and July 1–September 30, is subject to a 10%
match requirement as specified in the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Guidance. LHDs
must submit a three-month budget and a quarterly Financial Status Report (FSR) column for this program element.
(16) Project meets the Research and Development criteria as defined by Title 2 CFR, Section 200.87.
(17) Not Applicable
(18) Subject to match requirement as specified in Attachment III - Program Assurances and Specific Requirements.
NOTE: Some footnotes may not apply to this agency.
ATTACHMENT I
MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
Local Health Department Agreement
October 1, 2025- September 30, 2026
Fiscal Year 2026
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…………………………………………………………………………….……..14
SPECIAL BUDGET and REPORTING INSTRUCTIONS…………………………………………….17
1. Public Health Emergency Preparedness (PHEP) .................................................... 18
2. WIC ......................................................................................................................... 18
3. Family Planning ..................................................................................................... 20
4. Breast and Cervical Cancer ................................................................................... 21
5. WISEWOMAN……………………………………………………………………………...22
6. Medicaid Outreach Activities Reimbursement Procedures ..................................... 23
Medicaid…………………………………………………………………………………..23
Nurse Family Partnership Services Medicaid Outreach…………………………….24
CSHCS Medicaid Outreach…………………………………………………………….24
7. Immunization 317 and VFC Allowable Expenditures .............................................. 28
8. Michigan Department of Health and Human Services (MDHHS) Essential Local
Public Health Services (ELPHS) ……………………………………………………….28
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INTRODUCTION
The Annual Budget for Local Health Services is completed on a state fiscal year basis and is used
to establish budgets for many Department programs. In the Annual Budget, the Department
consolidates many of its categorical programs’ funding and Essential Local Public Health Services
(ELPHS) into a single, Comprehensive Agreement for local health departments. The
Department's Plan and Budget Framework serves as a principal reference point for budget
development.
The Annual Budget for Local Health Services must be completed in accordance with and adhere
to the established requirements as specified in these instructions and submitted to the Department
as required by the agreement.
The MI E-Grants System is an on-line application, including the budget entry forms, are utilized to
develop a budget summary for each program element administered by the local Grantee. The
system is designed to accommodate any number of local program elements including those
unique to a particular local Grantee. Applications, including budget forms, are completed for all
program elements, regardless of the reimbursement mechanism, including Agency
administration(s) fee for service program elements, categorical program elements, performance-
based program elements and Medicaid Outreach associated program elements. Budget entry is
required for each major expenditure and source of fund categories for which costs/funds are
identified.
MINIMUM BUDGETING REQUIREMENTS
Cost Principles
Types or items of cost which will be considered for reimbursement are generally consistent with
definitions contained in Title 2 Code of Federal Regulations CFR, Part 200 Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards.
Federal Block Grant Funds
Maternal & Child Health and Preventive Health Block Grant funds may not be used to: provide
inpatient services; make cash payments to intended recipients of health services; purchase or
improve land; purchase, contract or permanently improve (other than minor remodeling defined as
work required to change the interior arrangements or other physical characteristics of any existing
facility or installed equipment when the cost of the remodeling incident does not exceed $2,000)
any building or other facility; or purchase major medical equipment (any item of medical
equipment having a unit cost of over $10,000 and used in the diagnosis or treatment of patients,
excluding equipment typically used in a laboratory); satisfy any requirement for the expenditure of
non-federal 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.
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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
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
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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.
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
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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:
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
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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.
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).
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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.
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.
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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
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.
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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
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.
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3) When the Grantee’s definition and threshold differs from the definition above, the
Grantee will budget and report only those equipment purchases of $5,000 or more, on
the Capital Expenditures – Equipment and Other line item.
4) Equipment purchases must have prior written approval from MDHHS if the item will be
expensed in the year of purchase. The approved Budget does not qualify as prior
written approval. When equipment purchases are not expensed in the year of purchase,
the Grantee may only expense the deprecation calculated in accordance with its written
policy.
b. Capital Expenditures – Other
1) This category includes capital outlay for capital assets other than equipment.
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CAPITAL ASSETS AND DEPRECIATION
Title 2 CFR 200.1 defines capital assets as tangible or intangible assets used in
operations having a useful life of more than one year which are capitalized in
accordance with Generally Accepted Accounting Principles and includes:
• Land, buildings (facilities), equipment, and intellectual property (including
software) whether acquired by purchase, construction, manufacture, exchange,
or through a lease accounted for as financial purchase under GASB or a finance
lease under FASB.
Additions, improvements, modifications, replacements, rearrangements, reinstallations,
renovations, or alterations to capital assets that materially increase their value or useful
life.
Title 2 CFR 200.439(b) includes the following rules of allowability for equipment and
other capital expenditures.
1. Capital expenditures for general purpose equipment, building, and land are
unallowable as direct charges, except with the prior written approval of the
Federal awarding agency or the pass-through entity.
2. Capital expenditures for special purpose equipment are allowable as direct costs,
provided that items with a cost of $5,000 or more have prior written approval of
the Federal awarding agency or the pass-through entity.
3. Capital expenditures for improvements to land, buildings, or equipment which
materially increase their value or useful life are unallowable as a direct cost
except with prior written approval from the Federal awarding agency or the pass-
through entity.
4. When approved as a direct charge, capital expenditures will be charged in the
period in which the expenditure is incurred.
5. The unamortized portion of any equipment written off as a result of a change in
capitalization levels may be recovered by continuing to claim the otherwise
allowable depreciation on the equipment or by amortizing the amount to be
written off over a period of years negotiated with the Federal cognizant agency
for indirect cost.
6. Cost of equipment disposal is allowable if the non-Federal entity is instructed by
the Federal awarding agency to otherwise dispose or transfer the equipment.
7. Equipment and other capital assets are unallowable as indirect costs.
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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.
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.
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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 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. This cost category does not include indirect expenses which are included below.
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
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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.
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.
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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 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.
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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.
b. Revenues will be reported when earned (accrual basis of accounting) or when
received (cash basis of accounting).
4. Local Funds
All local support in the appropriate element, project, or service group column. This may
include local property tax, and other local revenue. Does not include fees.
5. Federal or State (Non MDHHS)
Funds provided to directly to the Grantee from the State of Michigan or the Federal
government (other than MDHHS) to support the program.
6. Other
Funding provided by foundation grants, United Way grants, private donations, fund-
raising, charitable contributions, etc. that provide support to the program.
7. In-Kind Match
Represents the value of donated services (e.g., accounting, legal, medical, etc.),
donated materials and supplies, donated space, etc. that support the program.
8. MDHHS Fixed Unit Rate
Select the type of fee-for-services from the lookup button to correspond with the
program element.
9. MCH Funding
This section includes all the funding projected to be due under Comprehensive
Agreement specific to the CMH eligible program elements. Please note: the MI E-
Grants System validates the MCH budgeted funds across the appliable program
elements to assure the agreement does not exceed the MCH allocation.
10. Required Match – Local
Funds projected to be local contribution for programs that have a match contribution
requirement (Please note: for Medicaid Outreach, CSHCS Medicaid Outreach, or
Nurse Family Partnership Medicaid Outreach, this amount represents the 50% matching
local contribution for allocable Medicaid Outreach Activities. Federal Medicaid Outreach
and Required Local match amounts should equal each other.)
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12. Federal Medicaid Outreach
(Please note: to be used only for Medicaid Outreach, CSHCS Medicaid Outreach or
Nurse Family Partnership Medicaid Outreach program elements.) Funds projected to
be received from the federal government for allowable Medicaid Outreach activities.
This amount represents the anticipated 50% federal administrative match of local
contributions.
13. Federally Provided Vaccines
The projected value of federally provided vaccines.
14. Local Non-ELPHS (Local funds budgeted for the following expenditures)
1. Expenditures for services not designated as required and allowable for ELPHS
funding (e.g., medical examiner and inpatient maternity services); expenditures
determined not to be reasonable; and expenditures in excess of the maximum
state share of funds available.
2. Any losses arising from uncollectible accounts and other related claims. Under-
recovery of reimbursable expenditures from, or failure to bill, available funding
sources that would otherwise result in exclusions from ELPHS funding, if
recovered.
3. However, no exclusion is required where the local jurisdiction has made and
documented a decision to have local funds underwrite:
a. The cost of uncollectible accounts or bad debts incurred in support of
providing required or allowable health services. An example of this
condition would be for services provided to indigents who are billed as a
matter of procedure with little chance for receipt of payment.
b. Potential recoveries or under-recoveries from other sources for the
principal purpose of providing required and allowable health services at
free or reduced cost to the public served by the Grantee. An example
would be keeping fees for services at a reduced level for the benefit of the
people served by the Grantee while recognizing that to do so limits
recovery from third parties for the same types of services.
4. Contributions to a contingency reserve or any similar provisions for unforeseen
events.
5. Charitable contributions and donations.
6. Salaries and other incidental expenditures of the chief executive of a political
subdivision (i.e., county executive and mayor). Legislative expenditures, such as,
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salaries and other incidental 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
Preparedness
Advocacy
In general, subgrantee budgets must provide sufficient budget detail to support grantee
budget requests and be in a format consistent with grantor Contractor requirements.
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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 25/26 allocation of the CDC Public
Health Emergency Preparedness (PHEP) funds in nine equal prepayments for the period
October 1, 2025 through June 30, 2026. 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.
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
19
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 $5,000 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.
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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
• Capital Expense for Equipment and Facilities
• Contractual
• Construction
• Supplies and Materials
• Travel
• Communication.
• County-City Central Services
• Space Costs
• 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. For Capital Single item purchases (including but not limited to; service
contracts, equipment, insurance, publication/printing costs, alterations and
renovations) of $10,000 or more, the Grantee must seek Program Approval
from the Grantor before the purchase can take place. The Program Grantor
will seek approval from the Federal awarding entity in order to authorize the
purchase. A formal request to the MDHHS Family Planning Program is
required, and applicable information (quote, documentation, etc.) based on
the Family Planning Capital Purchase Guidance Manual will be required.
Requests and information will be sent to the Title X Federal awarding entity
for final approval. Grantees will be notified in writing if it is approved or
denied.
Ensure that no mobile health unit(s) or other vehicle(s), even if proposed in the
application for the Title X award, is purchased with award funds without prior
written approval from the grants management officer. Requests for approval of
such purchases must include a justification with a cost-benefit analysis
comparing both purchase and lease options. Such requests must be submitted
21
as a Budget Revision Amendment in Grant Solutions (Notice of Award Special
Terms and Requirements).
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 2 CFR Part 200 Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards; Final Rule.
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 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, assisting the client to obtain cancer treatment if cancer
diagnosed, 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 $195-$215 per woman is based on the components
an agency implements according to the BC3NP Tiered Funding formula and
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 Local Community Partners (LCPs) – LCPs are
responsible for implementing strategies to identify and recruit clients eligible for
22
the BC3NP, enroll clients into the program, arrange for provision of screening
and diagnostic clinical services through contracted providers and assist the client
to obtain cancer treatment if cancer diagnosed. 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
in 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 $195/client with
additional administrative funding (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 information posted for LHD’s, LCPs, and
direct service providers on https://michigan.gov/BC3NP. 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 posted
on https://michigan.gov/BC3NP.
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 funds should be used to budget costs associated
with management of the program and delivery of the initial clinical assessment
and risk reduction counseling to WISEWOMAN participants. This includes
recruitment, enrollment, collecting answers to health intake questions,
WISEWOMAN clinical assessment (height, weight, body mass index, 2 blood
pressure readings, total cholesterol, HDL cholesterol, and fasting glucose or
A1C), and delivery of risk reduction counseling. Funds allocated for barrier
reduction tools should be used to purchase approved items for participants
enrolled in the WISEWOMAN program.
2. 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
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Screening amount is $165 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.
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 EGrAMS 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.
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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)
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.
25
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.
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 cost allocation/distribution plan
26
Most Health Departments will use the cost allocation plan for indirect costs. For
further detail, go to VI. Form Preparation, L. Indirect Cost section 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.
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.
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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
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
28
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.
8. Michigan Department of Health and Human Services (MDHHS) Essential Local
Public Health Services (ELPHS)
MDHHS ELPHS funds can be used to support the following projects:
•
•
• Vision ELPHS
• HIV ELPHS
Sexually Transmitted Disease ELPHS
General Communicable Disease ELPHS
The budget can be completed by cost distributing from the supported grant programs or
by entering the budget with individual expense lines. Grantees should review their
internal accounting procedures for clarity when determining how to complete entry;
MDHHS cannot advise on which method is appropriate for a particular grantee.
29
Whichever way the budget is entered in the application, will determine how the
expenses are reported in the FSR.
Funds can be shifted in an amendment between the MDHHS ELPHS, EGLE Drinking
Water and Onsite Wastewater Management, and Food ELPHS projects. Funds cannot
be moved in or out of Hearing and Vision, unless Vision funds are being moved to
Hearing, and vice versa. These funding shifts will need to be formally requested and
approved by all State departments. Details regarding requests are found in Attachment
III.
ATTACHMENT III
MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
LOCAL HEALTH DEPARTMENT AGREEMENT
October 1, 2025 – September 30, 2026
Fiscal Year 2026
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 NA - Program Only Requests New Projects Only
Amendment #2 November 19, 2025 Allocation and Budget Category
Changes
Amendment #3 February 18, 2026 Allocation and Budget Category
Changes
Amendment #4 (Final) May 6, 2026 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 Beverly Haske haskeb@michigan.gov
Body Art Fixed Fee Candice Lee leec@michigan.gov
Breast & Cervical Cancer Control (BCCCP) Coordination Polly Hager hagerp@michigan.gov
CAHC Renovation - All Locations Taggert Doll dollt@michigan.gov
Child and Adolescent Health Center Program - All Locations Taggert Doll dollt@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
Combating Antimicrobial Resistant Gonorrhea and Other STIs Beverly Haske haskeb@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
Diabetes Health Equity Advancement Lauren Neely NeelyL1@michigan.gov
Disease Intervention Specialist Workforce Beverly Haske haskeb@michigan.gov
Eastern Equine Encephalitis Virus Surveillance Project Mary G 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 Austin Munro munroa1@michigan.gov
Emerging Threats - Hepatitis C Macey Ladisky ladiskym@Michigan.gov
Empowering Youth Today Robyn Corey CoreyR1@michigan.gov
Ending the HIV Epidemic Implementation Beverly Haske haskeb@michigan.gov
Ending the HIV Epidemic - WCJ Testing Beverly Haske haskeb@michigan.gov
Family Planning Services Steve Utter utters@michigan.gov
Fetal Alcohol Spectrum Disorders Community Projects Kim Kovalchick KovalchickK@michigan.gov
Fetal Infant Mortality Review (FIMR) Case Abstraction Kim Kovalchick KovalchickK@michigan.gov
FFPSA HV Expansion Charisse Sanders sandersc2@michigan.gov
FIMR Interviews Kim Kovalchick KovalchickK@michigan.gov
Food ELPHS Loren Hilts HiltsL@michigan.gov
Harm Reduction Capacity Expansion Macey Ladisky ladiskym@Michigan.gov
Harm Reduction Support Match Macey Ladisky ladiskym@Michigan.gov
Harm Reduction Supply Support Macey Ladisky ladiskym@Michigan.gov
Healthy Community Zones Krystal Quartermus QuartermusK@michigan.gov
Hearing ELPHS Jennifer Dakers dakersj@michigan.gov
HIV & STI Testing and Prevention Beverly Haske haskeb@michigan.gov
HIV / STI Partner Services Beverly Haske haskeb@michigan.gov
HIV Care Coordination Beverly Haske haskeb@michigan.gov
HIV Centers for Cluster and Outbreak Response Enhancement Beverly Haske haskeb@michigan.gov
HIV Data to Care Beverly Haske haskeb@michigan.gov
HIV Housing Assistance Beverly Haske haskeb@michigan.gov
HIV/AIDS Linkage to Care Project Beverly Haske haskeb@michigan.gov
HIV PrEP Clinic Beverly Haske haskeb@michigan.gov
HIV PrEP Mobile Clinic Beverly Haske haskeb@michigan.gov
HIV Prevention Beverly Haske haskeb@michigan.gov
HIV Prevention - Forest Community Health Beverly Haske haskeb@michigan.gov
HIV Ryan White Part B Beverly Haske haskeb@michigan.gov
HIV Ryan White Part B MAI Beverly Haske haskeb@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 Fixed Fees Heidi Loynes loynesh@michigan.gov
Immunization Vaccine Quality Assurance Heidi Loynes loynesh@michigan.gov
Infant Safe Sleep Kim Kovalchick KovalchickK@michigan.gov
Infection Prevention and Healthcare- Associated Infections Response Support Brenda Brennan brennanb@michigan.gov
Informed Consent Laura de la Rambelje delarambeljel@michigan.gov
Laboratory Services Bio Marty Soehnlen soehnlenm@michigan.gov
Lactation Consultant Kim Kovalchick KovalchickK@michigan.gov
Lead Education and Faucet Replacement Program Samantha Crisci CrisciS@michigan.gov
Lead Education and Faucet Replacement Program Allocated Samantha Crisci CrisciS@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
MCH - All Other Jessica Hamel HamelJ5@michigan.gov
MCH - Children Jessica Hamel HamelJ5@michigan.gov
MDHHS-Essential Local Public Health Services (ELPHS)Laura de la Rambelje delarambeljel@michigan.gov
Medicaid Outreach Kyle Norman NormanK3@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
Neighborhood Wellness Centers Carry Tarry tarryc@michigan.gov
Nurse Family Partnership Medicaid Outreach Charisse Sanders sandersc2@michigan.gov
Nurse Family Partnership Services Charisse Sanders sandersc2@michigan.gov
Opioid Affected Youth Iniative Charisse Sanders sandersc2@michigan.gov
Oral Health- Kindergarten Assessment Michele Kawabe KawabeM@michigan.gov
Public Health Emergency Preparedness (PHEP) 10/1 - 6/30 Janis Tipton tiptonj2@michigan.gov
Public Health Emergency Preparedness (PHEP) CRI 10/1 - 6/30 Janis Tipton tiptonj2@michigan.gov
Public Health Infrastructure Laura de la Rambelje delarambeljel@michigan.gov
Regional Health Advisory Councils Yesenia Murillo murilloy@michigan.gov
Regional Perinatal Care System Deanna Charest charestd@michigan.gov
SDOH Hub Pilot Ninah Sasy sasyn@michigan.gov
SEAL! Michigan Dental Sealant Christine Farrell farrellc@michigan.gov
Sexually Transmitted Infection (STI) Control Beverly Haske haskeb@michigan.gov
Shepard Schools CAHS Taggert Doll dollt@michigan.gov
Statewide Lead Case Management - Fixed Fee Carin Speidel speidelc@michigan.gov
STI Prepaid Testing Marty Soehnlen soehnlenm@michigan.gov
STI Specialty Services Beverly Haske haskeb@michigan.gov
Substance Use Home Visiting Charisse Sanders sandersc2@michigan.gov
Tobacco Control Grant Program Julia Hitchingham hitchinghamj@michigan.gov
Treatment without Borders DIS Intervention Workforce Beverly Haske haskeb@michigan.gov
Tuberculosis (TB) Control Peter Davidson davidsonp@michigan.gov
Vector-Borne Surveillance & Prevention Mary G Stobierski stobierskim@michigan.gov
Vision ELPHS Taggert Doll dollt@michigan.gov
West Nile Virus Community Surveillance Mary G 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:
Adolescent Sexually Transmitted Infection (STI) Screening
Sexually Transmitted Infection (STI) Specialty Services
Sexually Transmitted Infection (STI) Control
Project Synopsis
A. 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. 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.
B. Adolescent Sexually Transmitted Infection (STI) Screening (Project Code –
ADOLSTD): 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):
Adolescent Sexually Transmitted Infection (STI) Screening
Quarterly report of
screening and Quarterly 15 days after the
end of the quarter
Email to MDHHS contract
liaison
Quarterly Progress
Data Report Quarterly 30 days after the
end of the quarter HIVSTIOperations@michi
Rapid STI/POC
Testing - CRF
the event of
a reactive
Within 24 hours of
confirmed positive
case
Contact local health
department via fax or
phone to report the case
Lab STI Specimen –
CRF
the event of
a reactive
Within 7 days of
confirmed positive
case
Contact local health
department via fax or
phone to report the case
Grantee Specific Requirements
A. 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.
Grant Program Operation
A. 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.
B. Participate in technical assistance/capacity development, quality assurance, and
STI 340B
Utilization/Inventory
Report
Quarterly
Within 10 days
after the end of
the quarter
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will
be transferred
automatically to
program evaluation activities as directed by Bureau of HIV and STI
Programs/Sexually Transmitted Infections (BHSP/STI).
C. Implement program standards and practices to ensure the delivery of culturally,
linguistically, and developmentally appropriate services. Standards and practices
must address sexual minorities.
D. 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.
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your
contract monitor.
Mandatory Disclosures
A. Inform BHSP at least two weeks prior to changes in clinic operations (i.e., key
staff, hours of operation, scope of service).
B. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days.
C. All notifications should be made to BHSP MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov
Any additional requirements (if applicable)
A. 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.
B. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
1. Ensure timely entry of client encounter information into Aphirm
C. Conduct community awareness building activities to increase STI and HIV
knowledge, including points of access for service.
D. By September 30, distribute MDHHS determined allocation worth of condoms,
lube, dental dams, and display equipment/materials.
E. Participate in MDHHS convened meetings regarding chlamydia and gonorrhea
screening as requested.
Technical Assistance
A. 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: SHOARS support.
B. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov.
PROJECT: Body Art Fixed Fee
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
The Department will reimburse the Grantee on a quarterly basis according to the
following criteria:
Facility License for 2025 Reimbursement Rates
1. Initial annual license for a Body Art Facility prior to July 1
• $328.49 (50% of state fee)
2. Initial annual license for a Body Art Facility on or after July 1
• $164.25 (50% of state fee)
3. Issue a temporary license for a Body Art Facility
• $147.81 (75% of state fee)
4. License renewal prior to or on December 1
• $328.49 (50% of state fee)
5. License renewal after December 1
• $492.74 (50% of state fee + 50% late fee penalty)
6. Duplicate license
• $32.84
Facility License for 2026 Reimbursement Rates
7. Initial annual license for a Body Art Facility prior to July 1
• $332.76 (50% of state fee)
8. Initial annual license for a Body Art Facility on or after July 1
• $166.38 (50% of state fee)
9. Issue a temporary license for a Body Art Facility
• $149.73 (75% of state fee)
10. License renewal prior to or on December 1
• $332.76 (50% of state fee)
11. License renewal after December 1
• $499.14 (50% of state fee + 50% late fee penalty)
12. Duplicate license
• $33.26
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 2025 and
2026 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
Project Synopsis
The Breast and Cervical Cancer Control Navigation Program (BC3NP) 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 that have limited access to cancer screening services.
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.
Additional Reporting Requirements
A statewide database called the Michigan Breast and Cervical Information System
(MBCIS) is maintained by MDHHS and the Cancer Prevention and Control Section
(CPCS). Instructions for use of MBCIS will be provided to agencies that contribute data
to this database. The CPCS will exchange relevant program reports with appropriate
contractors through encrypted email or a secure file transfer system.
Any additional requirements (if applicable)
For specific BC3NP requirements, refer to the most current BC3NP Policies and
Procedures or visit www.michigan.gov/BC3NP.
PROJECT: Child and Adolescent Health Center Program – All Locations
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 and year end Program Data Report: Due 30 days after the end of the
reported quarter
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)
• Quarterly and year end Program Report: 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.
Other trainings as required by MDHHS.
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
(Effective October 1, 2025)
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 conditions; confidential/minor consented
services 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) Comprehensive mental health services shall include, at minimum: mental
health care in prevention, intervention, and referral for other services not
available at the site location. Consented services are provided to the
individual population, with the option of group therapy. Minor consented
confidential mental health care should be provided as allowed by state
and/or federal law (See Attachment 1: Service Detail).
2. Clinical and 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.
* Indicates services may be provided, if desired and with appropriate training, for 3- and
4-year-old clients and up to age 26 for individuals that are eligible for Special Education
services.
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 18-41.
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. This shall be signed by appropriate parties representing the school(s)
and sponsoring agency.
Written approval by the school administration (e.g., Superintendent, Principal) 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 one 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.
9. 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.
10. 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 shall have a mental health provider licensed to practice in
Michigan who has a minimum master’s level degree in an appropriate
discipline (Social Work-Clinical (MSW), Marriage and Family Therapist
(MFT), Licensed Professional Counselor (LPC), or psychologist - limited
licenses are accepted with proper supervision). Clinical supervision must be
provided for all fully licensed mental health providers. For those master’s
level providers that hold a limited license working towards full licensure,
clinical supervision must be in accordance with licensure laws/mandates and
be provided by a fully licensed provider of the same degree while completing
hours toward full licensure.
11. The health center shall establish and implement processes for
notification to parents/guardians, school staff (when allowable and
appropriate), primary care provider (PCP) and/or other health care
providers.
a) Communication must not breach the confidentiality of the client
regarding notification and exchange of information while complying
with all applicable laws (e.g., HIPAA, FERPA and Michigan statutes
governing minors’ rights to access care).
b) Communication with the client’s parent/guardian and identified PCP
(if applicable) will be based on criteria established by the provider
(clinical or mental health) and Medical Director/fiduciary.
12. The health center shall implement continuous quality improvement (CQI) for
medical and mental health services. Components of CQI shall include:
a) Practice and client record review shall be conducted at least twice
annually by an appropriate peer and/or other peer-level staff within or
outside 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.
b) 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.
c) Completing, updating, or having access to a needs assessment process
conducted within the last five years to determine the health needs of the
population served including, at a minimum, a risk behavior survey when
for adolescents are served by the health center.
d) Conducting a client satisfaction survey, at a minimum, annually.
e) At minimum, one CQI project shall be conducted annually.
13. 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 Area Intervention).
14. A local community advisory council (CAC) 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/guardians/caregivers 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 separate youth advisory council
where feedback is shared with the CAC; or through other formalized
mechanisms of involvement and input.
15. 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, safe,
confidential, welcoming, and comfortable and reflect the ages of the
population(s) served.
16. The health center staff shall follow all Occupational Safety and Health Act
guidelines to ensure protection of health center personnel and the public.
17. The health center shall conform to the regulations determined by the Department
of Health and Human Services for laboratory standards.
18. 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. The sponsoring agency(s) are responsible to
offset any outstanding balances for direct health services to avoid collection notices
and/or referrals to collection agencies for payment.
19. The health center shall establish and implement a process for billing Medicaid,
Medicaid Health Plans and other third-party payers.
20. The billing and fee collection processes do not breach the confidentiality of the client.
21. Revenue generated from the health center must be used to support health center
operations and programming.
22. The health center shall have processes in place and identify staff responsibilities
for handling emergencies on and off-site that define:
a) Site-specific building emergency instructions that are posted, readily accessible,
reviewed, and updated regularly.
b) Medical and mental health emergencies within the health center (onsite).
c) School district responsibilities related to emergencies and how the CAHC staff
may be involved in limited capacities within the school/offsite.
CHILD AND ADOLESCENT HEALTH CENTERS CLINICAL AND ALTERNATIVE
CLINICAL MODELS
Attachment 1: Services Detail
The following health services are required (unless otherwise noted) as part of the Child
and Adolescent Health Center service delivery plan:
PRIMARY CARE SERVICES
Required:
• Comprehensive physical exams
• Preventative care visits
• AAP periodicity schedule/EPSDT screenings and exams
• Hearing and vision screening
• Comprehensive health screening/risk assessment/other screening and
anticipatory guidance
• Individual health education per assessments, condition and normal development
• Laboratory services:
1. CLIA Waived testing
2. Specimen collection for outside lab testing Recommended:
• Other diagnostic, screening and/or preventive services
o Tympanometry
o Preventive oral applications
o Spirometry
o Telehealth capabilities
o EKG
o Office microscopy
MENTAL HEALTH SERVICES
Required:
• Mental Health services provided by a master’s level mental health provider.
• Services provided are intended to assist children and adolescents experiencing
mild to moderate severity of need.
• Services include, screening, assessing, diagnosing, treatment planning,
discharge, follow up, education and referrals (as needed).
Recommended:
• Treatment groups using evidence-based curricula and interventions.
• School staff training and professional development relevant to mental health.
• Building level promotion, such as school climate initiatives, bullying prevention,
suicide prevention programs, etc.
• Classroom education related to mental health topics.
• Case management to and partnerships with other private/public social service
agencies.
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 routine and seasonal immunizations stocked onsite
for the target population utilizing Vaccine for Children and private
stock
• Administration of immunizations
• Appropriate protocols, equipment, medication to handle vaccine reactions
HEALTH EDUCATION
• Group health education on preventive health topics or other related to the
population/s served
ON-SITE TELEHEALTH (if provided)
• If telehealth services are offered, they can be used as a supplemental service to
the required face-to-face and cannot be done at a full-time capacity.
• When providing any services by telehealth, the provider(s) must be physically
located at the funded program location.
• Utilize telehealth equipment
• Follow-up as appropriate
• Follow established guidelines for telehealth practices and documentation
STI, HIV, and REPRODUCTIVE HEALTH SERVICES
• Education and counseling appropriate for age, other demographics of
the target population, and needs assessment data
• Onsite testing and treatment for STIs
• Onsite HIV counseling and testing (rapid or blood draw); and referral for treatment
• Onsite pregnancy testing and reproductive health services; and referral for
prenatal/pregnancy related care, if not provided by the health center (abortion
services, counseling and referral prohibited per state law)
• Contraceptive prescribing, dispensing, and distributing are not allowed on school
property.
MINOR-CONSENTED SERVICES AS DEFINED BY MICHIGAN AND/OR FEDERAL
LAW
• Mental health counseling (14 years or older) 12 visits or 4 months
(whichever comes first)
• Pregnancy testing
• STI counseling, testing and treatment
• HIV counseling and testing
REFERRALS
Referral for services not provided in the CAHC is required.
• Onsite (e.g., CAHC medical provider to CAHC mental health provider or vice
versa)
• There is a process in place for internal and external referrals for initiation, follow up
(tracking), and close-out.
CHILD AND ADOLESCENT HEALTH CENTERS CLINICAL AND
ALTERNATIVE CLINICAL MODELS
Attachment 2: Focus Areas Intervention
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 AREA TOPICS
• 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.
MINIMUM PROGRAM REQUIREMENTS
SCHOOL WELLNESS PROGRAM
(Effective 10/1/2025)
ELEMENT DEFINITION:
Services provided through the School Wellness 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.
MINIMUM PROGRAM REQUIREMENTS:
1. The School Wellness Program (SWP) 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) Individual health services provided by the nurse shall include
screening/nursing assessments, case finding, immunization assessment and
administration (administration optional), care for minor illnesses or injuries,
chronic care interventions, confidential/minor consented services, basic lab
testing (optional), health education/counseling, case management and/or
referral to other SWP staff and external partners (See Attachment 1: Services
Detail).
b) Comprehensive mental health services shall include, at minimum: mental
health care in prevention, intervention, and referral for other services not
available at the site location. Consented services are provided to the individual
population, with the option of group therapy. Minor consented confidential
mental health care should be provided as allowed by state and/or federal law
(See Attachment 1: Service Detail).
2. Nursing and mental health services shall meet the recognized standards of
practice for care and treatment of the population served.
3. The SWP shall not provide abortion counseling, services, or make referrals
for abortion services.
4. The SWP shall not prescribe, dispense, or otherwise distribute family
planning drugs and/or devices.
5. The SWP shall provide Medicaid outreach services to eligible youth and
families and shall adhere to Child and Adolescent Health Centers and
Programs outreach activities 1 and 2 as outlined in MSA 18-41.
* Indicates services may be provided, if desired and with appropriate training, for 3-
and 4-year-old clients.
6. There shall be a current interagency agreement defining roles and
responsibilities between the sponsoring agency and the local school
district. This shall be signed by appropriate parties representing the
school(s) and sponsoring agency.
Written approval by the school administration (e.g., Superintendent,
Principal) and local school board exists for the following:
a) Location of the SWP.
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 SWP.
c) Parental consent policy.
d) Services rendered through the SWP.
7. The SWP must be located on school property and shall provide services in no
more than two school buildings.
8. The SWP shall provide clinical and mental health services a minimum of five (5)
days a week when school is in session, and during hours accessible to the target
population. Total clinical time for the nurse and mental health provider should be
full- time (or full time equivalent) when school is in session. Summer hours are
optional for the SWP and determined at the discretion of the sponsoring agency.
The SWP shall designate specific hours for services to be provided to
adolescents only (when the SWP serves both children aged 5* to 10 -year- olds
and adolescents), and a policy exists to this effect. These provisions shall be
posted and explained to clients.
The SWP shall have a written plan for after-hours and weekend care, which shall
be posted in the SWP including external doors and a plan to explain after-hours
care to clients. An after-hours answering service and/or voicemail with
instructions on accessing after-hours care is required.
9. The SWP shall have a licensed physician as a medical director who
supervises the medical/clinical services provided, during hours of SWP
operation, and who reviews and approves clinical policies, procedures,
protocols, and standing orders.
10. The SWP staff shall operate within their scope of practice as determined by
certification and applicable agency policies:
a) The SWP shall have a registered nurse licensed to practice in the state
of Michigan (bachelor’s level nurse preferred).
b) The SWP shall have a mental health provider licensed to practice in the state
of Michigan who has a minimum master’s level degree in an appropriate
discipline (Social Work – Clinical (MSW), Marriage and Family Therapist
(MFT), Licensed Professional Counselor (LPC), or psychologist - limited
licenses are accepted with proper supervision). Clinical supervision must be
provided for all fully licensed mental health providers. For those master’s
level providers that hold a limited license working towards full licensure,
clinical supervision must be in accordance with licensure laws/mandates and
be provided by a fully licensed provider of the same degree while completing
hours toward full licensure.
11. The SWP shall establish and implement processes for notification to
parents/guardians, school staff (when allowable and appropriate), primary
care provider (PCP) and/or other health care providers.
a) Communication must not breach the confidentiality of the client regarding
notification and exchange of information while complying with all
applicable laws (e.g., HIPAA, FERPA and Michigan statutes governing
minors’ rights to access care).
b) Communication with the client’s parent/guardian and identified PCP (if
applicable) will be based on criteria established by the provider (clinical or
mental health) and Medical Director/fiduciary.
12. The SWP shall implement a continuous quality improvement (CQI) plan for
nursing and mental health services. Components of the plan shall include at a
minimum:
a) Practice and client record review shall be conducted at least twice annually
by peer-level staff within or outside 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.
b) A CQI Coordinator shall be identified. CQI meetings, that include all staff
associated with the SWP program, shall be held at least quarterly. These
meetings shall include discussion of reviews, client satisfaction survey and
any identified clinical issues.
c) Completing, updating, or having access to a needs assessment process
conducted within the last five years to determine the health needs of the
population served including, at a minimum, a risk behavior survey when
adolescents are served by the SWP.
d) Conducting client satisfaction surveys, at a minimum, annually.
e) At minimum, one CQI project shall be conducted annually.
13. The SWP shall implement one evidence-based program with fidelity and/or
clinical interventions in at least one of the approved focus areas, as
determined through needs assessment data (for approved focus areas,
see Attachment 2: Focus Areas Intervention).
14. A local community advisory council (CAC) 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/guardians/caregivers 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 SWP 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 separate
youth advisory council where feedback is shared with the CAC;
or through other formalized mechanisms of involvement and
input.
15. The SWP shall have space and equipment adequate for private visits, private
counseling, secure storage for supplies and equipment (including laboratory
and immunizations services if applicable), and secure paper and/or electronic
client records. The physical facility must be barrier-free, clean, safe,
confidential, welcoming, and comfortable and reflect the ages of the
population(s) served.
16. The SWP shall follow all Occupational Safety and Health Act guidelines to
ensure protection of SWP personnel and the public.
17. For SWPs participating in laboratory services, the SWP shall conform to the
regulations determined by the Department of Health and Human Services for
laboratory standards.
18. The SWP 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. SWP funding is in place to support overall
program operations including provider time. The sponsoring agency(s) are
responsible to offset any outstanding balances for direct health services to
avoid collection notices and/or referrals to collection agencies for payment.
19. The SWP shall establish and implement a process for billing mental health
services to Medicaid, Medicaid Health Plans, and other third-party payers.
20. The billing and fee collection processes do not breach the confidentiality of
the client.
21. Revenue generated from the SWP must be used to support SWP operations
and programming.
22. The SWP staff (depending on type of emergency) shall coordinate with school
administration/school emergency team to clarify the monitoring and storage of
emergency devices and medications and the process for requesting assistance
in an emergency response.
The SWP shall have processes in place and identify staff responsibilities for
handling emergencies on and off site that define:
a) Site-specific building emergency instructions that are posted, readily
accessible, reviewed, and updated regularly.
b) Medical and mental health emergencies within the SWP (onsite).
c) School district responsibilities related to emergencies and how the SWP staff
may be involved in limited capacities within the school/offsite.
The SWP staff may support school administration and school staff for both
medical and mental health emergencies on school grounds, including the
following:
d) Participate in the school-wide crisis team for mental health and medical
emergencies but not lead the response team.
e) Participate in school-wide trainings for mental health crisis response and
medical emergency response but not lead the training process for response
teams.
f) Train school staff for both mental health and medical emergencies.
23. The SWP must provide at least one staff training and/or professional
development for teachers and school staff per year. The training is
developed in conjunction with appropriate school administration and
personnel, is relevant to school-specific needs, follows current standards of
care, and includes an evaluation component.
24. The SWP nurse provider shall adhere to medical orders/treatment plans written
by the prescribing physician and/or standing orders/medical protocols written by
the medical director or other health care providers for individuals requiring health
supervision while in school.
25. The SWP nurse shall administer stock medications in the SWP with a medical
director standing order. Medication administration of student specific medications
brought to school by the parent for the child/adolescent is a school district
responsibility and cannot be supplanted/replaced by the SWP nurse role.
The SWP nurse may provide support to the school administration for medication
administration, including the following:
a) Training school staff on how to safely administer medications in the school
setting and serve as backup for consented students occasionally when
necessary.
b) Supporting the school process of medication intake and verification (e.g.
reviewing forms, medication dosages, assuring the medication brought to
school is the medication identified on the medication form).
c) Assist in the training and administration of emergency medication brought to
school for students to be used in emergency situations and for chronic
conditions (e.g., asthma, severe allergic reaction, drug overdose, diabetes,
seizures etc.).
SCHOOL WELLNESS PROGRAM MODEL
Attachment 1: Services Detail
The following health services are required (unless otherwise noted) as part of the
School Wellness Program service delivery plan:
NURSING ASSESSMENTS AND SCREENINGS
Required:
• Nursing intake and history
• Comprehensive health screening/risk assessment/other screening and anticipatory
guidance
• Physical assessment (e.g., Vital Signs, Height, Weight, Pulse Oximetry, other
physical examination per symptoms and/or standing orders)
• Hearing and vision screening
Recommended:
• Developmental screening
• Oral health screening
• Physical assessment (Blood Glucose)
MENTAL HEALTH SERVICES
Required:
• Mental Health services provided by a master’s level mental health provider.
• Services provided are intended to assist children and adolescents experiencing
mild to moderate severity of need.
• Services include screening, assessing, diagnosing, treatment planning, education
and referrals (as needed).
Recommended:
• Treatment groups using evidence-based curricula and interventions
• School staff training and professional development relevant to mental health
• Building level promotion, such as school climate initiatives, bullying prevention,
suicide prevention programs, etc.
• Classroom education related to mental health topics
• Case management to and partnerships with other private/public social service
agencies
ILLNESS/INJURY CARE
• Minor injury assessment, interventions per standing order, follow up and/or referral
• Acute illness assessment, interventions per standing order, follow up and/or
referral
CHRONIC CONDITIONS CARE
• Assessment and care coordination with parent/guardian and provider(s)
• Care coordination with school staff with appropriate release of information
• Obtain and update Medical Management Plans and Emergency Action Plans
• Develop Individualized Health Care plans as needed
• Chronic conditions may include asthma, diabetes, sickle cell, hypertension,
seizures, obesity, depression, allergy, or other specific to a population
• Chronic care medical interventions per standing orders and medical management
plans
IMMUNIZATIONS
Required:
• Screening and assessment utilizing the MCIR and other data
• Referral for immunizations when deficiencies are found and follow-up
• Appropriate protocols, equipment, and medication to manage vaccine reactions (if
immunizations are administered on-site)
Recommended:
• Administration of immunizations through on-site stock or pop-up clinics
HEALTH EDUCATION
• Individual health education per assessments, condition and normal development
• Group health education on preventive health topics or other related to the
population served
ON-SITE TELEHEALTH (if provided)
• If telehealth services are offered, they can be used as a supplemental service to
the required face-to-face and cannot be done at a full-time capacity.
• When providing any services by telehealth, the provider(s) must be physically
located at the funded program location.
• Utilize telehealth equipment
• Follow-up as appropriate
• Follow established guidelines for telehealth practices and documentation
STI, HIV, and REPRODUCTIVE HEALTH SERVICES
Required:
• Education and counseling appropriate for age, other demographics of the target
population, and needs assessment data.
• Contraceptive prescribing, dispensing and distributing are not allowed on school
property.
Recommended:
• Onsite testing and treatment for STIs
• Onsite HIV counseling and testing (rapid or blood draw); and referral for treatment
• Onsite pregnancy testing and reproductive health services, including referral for
prenatal care (abortion services, counseling and referral prohibited by the SWP
per state law)
MINOR-CONSENTED SERVICES—AS DEFINED BY MICHIGAN AND/OR FEDERAL
LAW
Required:
• Mental health counseling (14 years and older) 12 visits or 4 months (whichever
comes first)
• STI counseling
Recommended:
• Pregnancy testing
• STI testing, STI treatment
• HIV counseling and testing
• Substance Use disorder services
REFERRALS
Referral for services not provided in the SWP is required.
• Onsite (e.g., CAHC medical provider to CAHC mental health provider or vice
versa)
• There is a process in place for internal and external referrals for initiation, follow up
(tracking), and close-out.
LABORATORY SERVICES (if provided)
• Point of care CLIA Waived testing
• Specimen collection for outside lab testing
SCHOOL WELLNESS PROGRAM MODEL
Attachment 2: Focus Area Intervention
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 or SWP is
required to implement at least one evidence-based program or clinical intervention to
begin to address the needs within the selected focus area(s).
FOCUS AREAS TOPICS
• 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 interventions 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.
REV 10/2025
PROJECT: Childhood Lead Poisoning Prevention
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. The overall goal of the grant is to increase testing for children under the
age of 6, specifically capillary to venous testing rates for children with a blood lead
level above 3.5 µg/dL.
Michigan’s governor signed legislation in FY23 to make Michigan a universal testing
state. Physicians must test, or order a test, for lead in blood for all children at 12 and
24 months of age, or between age 24 and 72 months if there is no record of a previous
test. Children living in geographic areas of the state determined by MDHHS to pose a
high risk for lead poisoning must be tested additionally at age 4. Grantees are in a
unique position to positively influence the implementation of universal testing. Their
position in the community and established relationships with families, providers, and
community partners are invaluable to the success of universal testing. This grant
provides funding for local health departments to implement one of three strategic
objectives to fill gaps in capacity and address challenges within their region, while
contributing to the overall goal of increasing lead testing and capillary to venous blood
lead testing rates.
Strategic objectives that grantees may address using CLPPP grant funds include:
1. Support and expand nursing case management services within the health
department jurisdiction.
2. Develop strategies and implement activities to improve and expand education
for providers related to harmful effects of lead exposure, lead poisoning
prevention and blood lead testing.
3. Develop strategies and implement activities to increase blood lead testing
among children under the age of 6.
Grantees can achieve project goals through the ABCs:
1. Assess current state of the relevant objective in the jurisdiction, this can include:
• Survey community partners, providers, other agencies to establish
baseline data
• Identify gaps
• Identify barriers
• Identify Medicaid Health Plans serving the community
• Identify partners and collaborators
2. Bolster current project 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
• Support non-reimbursable NCM activities
3. Coordinate strategies to achieve project goals, 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
• Utilize baseline data to develop and implement expanded strategies for
provider education and outreach
• Pilot promising practices around blood lead testing to increase screening and
confirmatory testing rates
Additional Reporting Requirements
• Workplan – submitted according to due dates set by CLPPP
• Quarterly Reports – submitted no later than thirty (30) days after the close of
the quarter.
Any additional requirements (if applicable)
• Identify priority populations and geographic areas with lower testing rates,
using CLPPP weekly data reports. Grantees will make data-informed
decisions that will direct activities toward populations that are at risk for
experiencing worse health outcomes.
• Provide a workplan with objectives and metrics that outline how testing rates
will be increased within the grantee region. Metrics for success will be
specific, measurable, achievable, relevant, time-bound, inclusive, and
equitable. MDHHS CLPPP will provide technical assistance as needed to
support development of the workplan.
• Submit a quarterly report on progress related to the objectives and measures
in the workplan. Any necessary revisions can be made to the workplan at this
time.
• Attend quarterly grantee meetings.
• 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
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) Support staffing for Nurse Case Managers and Community Health Workers to provide
NCM services to all children with EBLLs
Additional Reporting Requirements
• 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
• Provide a workplan with objectives and metrics that outline how education, NCM
and linkage to care will be expanded within the grantee region. The workplan will
include target populations and geographic areas. Metrics for success should be
specific, measurable, achievable, relevant, time-bound, inclusive, and equitable.
MDHHS CLPPP will provide technical assistance as needed to support
development of the workplan.
• Submit quarterly rereports.
• CLPPP support will include:
• Nursing and Public Health Consultant technical assistance as requested
• Website (miclppp.org) with educational materials re: testing, cleaning
• Online training module for health care providers.
Any additional requirements (if applicable)
Attend quarterly calls/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: Combating Antimicrobial Resistant Gonorrhea and Other STIs
Project Synopsis
A. This project aims to strengthen public health capacity in four strategy areas. The
1st is to monitor trends in antimicrobial susceptibilities in N. gonorrhea via
collecting specimens and associated patient data at STI clinics; isolating bacterial
cultures; and submitting isolates to the Centers for Disease Control and
Prevention. The 2nd is for local and state public health to rapidly detect and
respond to threats of antimicrobial resistance. The 3rd strategy is for the Oakland
laboratory to develop onsite capability for antibiotic susceptibility testing. The 4th
strategy is to enhance coordination between local and state epidemiology,
laboratory, and clinical approaches.
Reporting Requirements
Report Period Due Date(s)
Collect and submit N.
gonorrhea isolates from
urethral and pharyngeal Monthly Second Monday of
the following month
Ship to
designated
ARLN
Monthly
Submit laboratory specimen
data to MDHHS Monthly The 15th of the
following month.
Transfer or
other secure
Submit clinical and
demographic data to MDHHS Monthly The 15th of the
following month
Transfer or
other secure
specimens and submitted Monthly 10th of the following
month. kentj3@michig
data to MDHHS for clients with
GC positive isolates utilizing
the CDC required format.
Quarterly January 15, April 15,
July 15, October 15
Report to
kentj3@michig
an.gov;
Complete and submit annual
progress report Annually grant period, or as Collaborate
with
kentj3@michig
an.gov
Report any specimen
exceeding the alert criteria:
Ceftriaxone MIC ≥ 0.125 µg/ml
Cefixime MIC ≥ 0.25 µg/ml
24 hours
Specimen with
medium-level
resistance
to Jim Kent
517-243-4932,
kentj3@michig
exceeding the quick-send alert
criteria:
Ceftriaxone MIC ≥ 0.5 µg/ml
Cefixime MIC ≥ 1.0 µg/ml
Immediate Specimen with high-
level resistance
Phone or email
to Jim Kent
517-243-4932,
kentj3@michig
an.gov
A. Note: These indicators are to be included in the monthly data summaries
1. Number of specimens collected for culture, by anatomic site and gender.
2. Number of cultures positive by anatomic site and gender.
3. Number of isolates tested by gradient strip AST (Etest™) by anatomic site
and gender.
4. Number of cases meeting “alert” (i.e., elevated MICs) status.
5. Number of cases meeting “alert” criteria that were followed up with
field/case investigations.
Grant Program Operation
A. The required activities of this project, for both state and local staff, are spelled out
in the ELC CARGOS Milestones monitoring report. There are no additional
required activities beyond those required to achieve these milestones.
B. The specific steps outlining the required steps for accomplishing these various
milestones are spelled out in the protocols and training materials provided by
CDC.
C. In this collaborative project, Oakland CHD project staff will engage with MDHHS
project staff in ongoing communications for:
1. All project staff,
2. the Laboratory team,
3. the Data team, and
4. the Outbreak Response Team
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your contract
monitor.
Mandatory Disclosures
A. Inform BHSP at least two weeks prior to changes in clinic operations (i.e., key
staff, hours of operation, scope of service).
B. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days.
C. All notifications should be made to BHSP MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov
Technical Assistance
A. 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: SHOARS support
B. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov
PROJECT: Community Blood Lead Testing
Project Synopsis
In response to Michigan’s universal blood lead testing law going into effect in 2025,
local health departments need additional support to implement innovative strategies in
their jurisdictions to ensure access to and completion of blood lead testing for children.
A community-based approach to blood lead testing is necessary to address their unique
needs. This 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 blood lead testing locations
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 high priority
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:
• Sample workplan for grantee to complete including a checklist of
recommend community partners
• Nursing and Public Health Consultant technical assistance as requested
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.
PROJECT: CSHCS Care Coordination
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.
Additional Reporting Requirements
1. 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.
2. 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
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
“Nursing 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 MICLEAR NCM database.
Additional Reporting Requirements
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 $221.74 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.
Due Dates for Quarterly Spreadsheet,
January 30
January 1 April 30
June 30 July 30
July 1 September 30 October 30
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 signed care coordination agreements with all Medicaid Health Plans in their
jurisdiction. Use template developed and agreed upon by MDHHS Medicaid and
CLPPP.
• Identify and initiate contact with families of all Medicaid-enrolled children with
EBLLs.
• Complete case management activities according to the MDHHS CLPPP Nursing
Case Management Guide for Children with Elevated Blood Lead Levels. If your
local policies and procedures vary from MDHHS CLPPP Guide and/or
procedures, please submit in writing to MDHHS CLPPP.
• Document all required case management activities in the child’s electronic file in
the MICLEAR NCM database, as outlined in the Nursing Case Management
Documentation Standards Procedure document.
PROJECT: CSHCS Medicaid Outreach
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.
Additional Reporting Requirements
See Attachment I for specific budget and financial requirements.
Any additional requirements (if applicable)
N/A
PROJECT: CSHCS Outreach and Advocacy
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
Additional Reporting Requirements
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: Diabetes Health Equity Advancement
Project Synopsis
The Diabetes Health Equity Advancement (DHEA) will address the needs of service
population with diabetes by initiating Diabetes Self-Management Education Support
(DSMES) services, including the following: developing the framework necessary to apply for
ADA-recognition or ADCES-accreditation and apply for it; conduct provider outreach; recruit and
enroll one or more participants in DSMES; participate as needed in with MDHHS in calls,
meetings, site visits and evaluation planning to plan and implement the program; and schedule
an MDHHS certification audit.
Additional Reporting Requirements
Quarterly workplan reports are required using the template provided. Reports will be
sent via email to Kim Lombard, Diabetes Prevention and Control Program at:
LombardK@michigan.gov
Any additional requirements (if applicable)
Cap on Salaries (Div. G, Title II, Sec. 203): None of the funds appropriated in this title
shall be used to pay the salary of an individual, through a grant or other extramural
mechanism, at a rate in excess of Executive Level II.
Note: The salary rate limitation does not restrict the salary than an organization may
pay an individual working under an HHS contract or order; it merely limits the portion of
that salary that may be paid with Federal funds.
Required Disclosures for Federal Awardee Performance and Integrity Information
System (FAPIIS): Consistent with 45 CFR 75.113, applicants and recipients must
disclose in a timely manner, in writing to the CDC, with a copy to the HHS Office of
Inspector General (OIG), all information related to violations of federal criminal law
involving fraud, bribery, or gratuity violations potentially affecting the federal award.
Subrecipients must disclose, in a timely manner in writing to the prime recipient (pass
through entity) and the HHS OIG, all information related to violations of federal criminal
law involving fraud, bribery, or gratuity violations potentially affecting the federal award.
Disclosures must be sent in writing to the CDC and to the HHS OIG at the following
addresses:
CDC, Office of Grants Services
Keisha Thompson, Grants Management Specialist
Centers for Disease Control and Prevention
Branch 5
2939 Flowers Road
Atlanta, GA 30341
Email: dwt6@dc.gov (Include “Mandatory Grant Disclosures” in subject line)
AND
U.S. Department of Health and Human Services
Office of the Inspector General
ATTN: Mandatory Grant Disclosures, Intake Coordinator
330 Independence Avenue, SW
Cohen Building, Room 5527
Washington, DC 20201
Fax: (202)-205-0604 (Include “Mandatory Grant Disclosures” in subject line) or
Email: MandatoryGranteeDisclosures@oig.hhs.gov
Recipients must include this mandatory disclosure requirement in all subawards
and contracts under this award.
Failure to make required disclosures can result in any of the remedies described in 45
CFR 75.371. Remedies for noncompliance, including suspension or debarment (See 2
CFR parts 180 and 376, and 31 U.S.C. 3321).
PROJECT: Eastern Equine Encephalitis Virus Surveillance
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.
Additional Reporting Requirements
The recipient shall submit bi-weekly (once every two weeks) tables of surveillance data
(template provided) documenting trap rates and disease detections to Emily Dinh
(dinhe@michigan.gov) and Rachel Burkholder (burkholderr@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 (for a total of 10 trap-nights/week) from
approximately 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 2026)
• Trapping equipment necessary to collect mosquitos
• 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
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).
Additional Reporting Requirements
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
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
Onsite 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.
Additional Reporting Requirements
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.
• Review all engineered or alternative System plans. Conduct adequate inspections
during the various phases of construction to ensure proper installation.
• 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 or database/document management
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 land divisions under one acre in size for site suitability according to the
applicable statutes and Administrative Rules for Onsite Water Supply and Sewage
Disposal for Land Divisions and Subdivisions. Provide electronic copies of
approvals with supporting documentation and/or rejection letters to the State within
30 days after issuance of written approval or rejection.
• Utilize the State’s “Michigan Criteria for Subsurface Sewage Disposal” (Criteria) for
review of sanitary sewage Systems serving other than private single- or private
two-family homes discharging less than 10,000 gallons per day. Systems treating
less than 1,000 gallons per day may be approved in accordance with the
requirements of the Grantee’s regulation, if that regulation is as stringent as the
Criteria. When a new or increased use of an existing System(s) serving existing or
new structures is proposed to the Grantee, conduct reviews for conformance with
the Criteria or the requirements of the Grantee’s regulation (for systems treating
less than 1,000 gallons per day) if that regulation is as stringent as the Criteria.
Advise and obtain support from the State prior to granting a variance from the
Criteria. Variances are only to be granted by the Director of Environmental Health
or that Director’s designated representative 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 in the form of a groundwater
discharge permit.
• 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,
number of sewage complaints received and investigated for each residential (single
and two-family homes) and non-residential properties, and number of plan reviews
conducted and approved under the applicable statutes and Administrative Rules for
Onsite Water Supply and Sewage Disposal for Land Divisions and Subdivisions for
proposed subdivisions, condominiums or divisions under the Land Division Act after
July 28, 1997 resulting in a parcel under one acre in size. The report forms
EQP2057a.1 (Non-Residential) and EQP2057b.1 (Residential) or other approved
means of reporting are available on the EGLE website. All quarterly reports are to
be submitted electronically directly to EGLE, to the location noted on the form,
within fifteen (15) days following the end of each quarter.
• 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 or database/document management
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)
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.
Additional Reporting Requirements
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 Anita Miko (MikoA@michigan.gov)
*Additional budget detail is provided in Attachment I
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: ELPHS Hearing and Vision
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 agreement, 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 2023 MPR Indicator Guide.
PROJECT: MDHHS Essential Local Public Health Services (ELPHS)
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 25/26 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 25/26, the FY 92/93 Local Maintenance of Effort Level must
be met.
Additional Reporting Requirements
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 Anita Miko (MikoA@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
Project Synopsis
Funds are provided to grantees to increase local capacity to make improvements in
hepatitis C virus (HCV) testing, case management, linkage to care and treatment.
Hepatitis C case management is defined as following a case from initial point of contact
until the case achieves sustained virologic response (SVR), defined as having
undetectable HCV RNA levels 12 weeks after the cessation of treatment, or SVR12.
Effective case management is vital within the hepatitis C continuum of care and has been
demonstrated to reduce rates of cases being lost to follow up.
Additional Reporting Requirements
• 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 offer hepatitis C antibody with reflex to RNA testing through their
public health clinics.
• Grantees will collect and submit specimens to the MDHHS Bureau of Laboratories
for HCV testing through their public health clinics.
• Grantees will provide clinic hours and information on where patients can get tested
and treated for hepatitis C on local health department website or provide link to
MDHHS We Treat Hep C provider directory.
• Grantees will provide written document outlining their process of investigating
hepatitis C cases, including contact attempt protocol, case management protocol
and treatment referral process.
Target Requirements
Grantees will meet the following objectives for hepatitis C, chronic and acute case follow-
up:
Target 1: Interview attempted on 100% of hepatitis C, chronic and acute cases (defined
as "Contact Type" field is not blank)
Target 2: Race and ethnicity data completed on 100% of hepatitis C, chronic and acute
cases
Target 3: Age data completed on 100% of hepatitis C, chronic and acute cases
Target 4: “Has the patient ever injected drugs not prescribed by a doctor even if only
once or a few times?” question completed on 100% of hepatitis C, chronic and acute
cases
Target 5: “Is or has the patient’s hepatitis C infection been treated?” question completed
on 100% of hepatitis C, chronic and acute cases, with special emphasis on marking
cases treated at the local health department having “Select treatment provider specialty”
field marked “LHD”
Target 6: “Lost to follow-up" question marked on 100% of hepatitis C, chronic and acute
cases that do not have a “completed” contact attempt in the Case Management section in
MDSS.
Target 7: Insurance Status (Check all that apply)” field marked on 100% of hepatitis C,
chronic and acute cases that have “completed” contact attempt in the Case Management
Section in MDSS.
Target 8: “Was the client provided with viral hepatitis education?” question marked on
100% of hepatitis C, chronic and acute cases that have a “Completed” contact attempt in
the Case Management section in MDSS.
Target 9: “Does the patient have a provider of care for Hepatitis C?” question marked on
100% of hepatitis C, chronic and acute cases.
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 may collaborate with the MDHHS 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
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.
Additional Reporting Requirements
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
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
Participant
Level Data
(Youth)
October 1 - December 31 January 5
REDCap
https://chc.mphi.org
July 1 - September 30 October 5
Program
Level Data
(Performance
October 1 - September 30
(MPHI will open this data
section in REDCap in June)
July 15* REDCap
https://chc.mphi.org
PROJECT: Ending the HIV Epidemic – WCJ Testing
Project Synopsis
The purpose of this project is to support sexual health services and screening services
within the Wayne County Jail to help promote Ending the HIV Epidemic in Wayne County
and reduce the incidence of HIV. This includes, but is not limited to, providing integrated
screenings and testing for HIV, HCV, and Syphilis conducted by program and medical
staff at intake; providing linkage to care services including Partner Service interviews,
communicating with external agencies for referrals, and setting up appointments; provide
regular updates on program measures including monthly submission of aggregate data
reports, quarterly progress reports, weekly APHIRM data entry, and regular check-ins
with MDHHS and other partners.
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) Report submission
Quality Control Reports Monthly Department Staff
Daily Client Logs Monthly Department Staff
Test Kit Inventory Log Monthly Department Staff
Bi- annually Department Staff
HIV Testing
Competencies Annually SHOARS before the
end of the calendar Department Staff
EMR testing** Monthly Department Staff
Reactive Results As needed APHIRM
Case Report Forms
As needed in
the event of a
reactive result
Within 24 hours of
positive screening
and confirmatory
Confidential Case Report
Form
Fax: (313) 456-1580 Attn:
Partner Services & Linkage to Care (as applicable)
Partner Services As needed Within 30 days of
service APHIRM
Internet Partner
Services (IPS) and
Partner Services Ongoing Within 30 days of
service APHIRM
Ongoing 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 MDHHS-340B PrEP PT
Billing Revenue Report Quarterly month Department Staff
STI 340B
Utilization/Inventory
Report
Quarterly
Within 10 days after
the end of the
quarter
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will be
transferred automatically
to ScriptGuide/BHSP
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
Additional 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 & Daily Client Logs may be sent to the Contract Manager via:
1. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS
CTR inbox (MDHHS-HIV-CTR@michigan.gov)
2. Fax - (517) 241-5922
3. Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
D. BHSP shall evaluate the reports submitted as described in Attachment C, Items
A. and B. for their completeness and accuracy.
E. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by BHSP.
F. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
Any additional Requirements
A. 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.
B. 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.
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
iii. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the
MDHHS CTR inbox (MDHHS-HIV-CTR@michigan.gov)
iv. Fax - (517) 241-5922
v. 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.
vi. In the event of a confirmed case of HIV, an Adult Case
Report form must be sent to the BHSP HIV Surveillance
department via fax within 24 hours as referenced in the
reporting table.
c. If conducting blood draws, the grantee must conduct the
packaging and shipping training via Bureau of Laboratories.
BashoreM@michigan.gov
i. 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.
ii. Develop, implement, and monitor protocol and procedures to
ensure that patients receive confirmatory test results.
iii. 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:
a. 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.
b. 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.
c. Any revenue or income generated via billing from this agreement
must be reinvested into this project.
8. If conducting Social Marketing activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
a. Prior to implementation of any marketing activities the Grantee
will submit a proposal as outlined in the Social Marketing Plan
Attachment.
b. If the proposal is approved, the Grantee will work with BHSP
contract staff in regularly scheduled meetings, to ensure all
activities are in line with program requirements.
c. Grantee will submit detailed social marketing campaign data (ex:
impressions, website analytics, population groups reached, etc.)
with quarterly progress reports.
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your
contract monitor.
Record Maintenance/Retention
A. 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
A. The Grantee and its subcontractors are required to use APHIRM to enter HIV
client and service data into the centrally managed database on a secure server.
B. The Grantee and its subcontractors are required to use APHIRM to enter PrEP
Cascade Data into the centrally managed database on a secure server.
C. 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.
D. The Grantee and its subcontractors are required to use APHIRM to enter Partner
Services interview, linkage to care data, and identified dating apps through the
use of Internet Partner Services (IPS) where appropriate.
E. The Grantee and its subcontractors are required to use SHOARS to request
amendments, supplies, data, technical assistance and to register for trainings.
F. New staff needing access to APHIRM are required to submit the APHIRM user
request form through SHOARS.
G. The Grantee shall notify MDHHS immediately via email at MDHHS-SHOARS-
SUPPORT@michigan.gov of APHIRM users who are separated from the agency
for deactivation.
Mandatory Disclosures
A. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days.
B. All notifications should be made to BHSP MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov.
Technical Assistance
A. 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: SHOARS support
B. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov .
C. 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.
D. 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
A. The Grantee should adhere to all Federal and Michigan laws pertaining to
HIV/AIDS treatment, disability accommodations, non-discrimination, and
confidentiality.
PROJECT: Ending the HIV Epidemic Implementation
Project Synopsis
A. The purpose of this project is to implement activities to support the objectives of
the CDC PS24-0047 High-Impact HIV Prevention and Surveillance Programs for
Health Departments. The purpose of these objectives is to reduce the incidence
of HIV in and improve the overall health and well-being of residents of Detroit-
Wayne County.
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) Report submission
Quality Control Reports Monthly Department Staff
Daily Client Logs Monthly Department Staff
Test Kit Inventory Log Monthly Department Staff
Bi- annually Department Staff
HIV Testing
Competencies Annually SHOARS before the
end of the calendar Department Staff
EMR testing** Monthly Department Staff
Reactive Results As needed APHIRM
Case Report Forms
As needed in
the event of a
reactive result
Within 24 hours of
positive screening
and confirmatory
Confidential Case Report
Form Fax: (313) 456-
1580 Attn: HIV
Partner Services & Linkage to Care (as applicable)
Partner Services As needed Within 30 days of
service APHIRM
Services (IPS) and
Partner Services Ongoing Within 30 days of
service APHIRM
Disposition on Partners
of HIV Cases Ongoing 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 MDHHS-340B PrEP PT
Billing Revenue Report Quarterly month Department Staff
STI 340B
Utilization/Inventory
Report
Quarterly
Within 10 days after
the end of the
quarter
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will be
transferred automatically
to ScriptGuide/BHSP
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
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:
1. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS
CTR inbox (MDHHS-HIV-CTR@michigan.gov)
2. Fax - (517) 241-5922
3. Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
D. BHSP shall evaluate the reports submitted as described in Attachment C, Items
A. and B. for their completeness and accuracy.
E. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by BHSP.
F. Monitoring and evaluation of targeted screening and referrals provided internally
and supported via contractual agreements.
Any additional Requirements
A. 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.
B. 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.
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 acts.”
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. In the event of a confirmed case of HIV, an Adult Case
Report form must be sent to the BHSP HIV Surveillance
department via fax within 24 hours as referenced in the
reporting table.
c. If conducting blood draws, the grantee must conduct the
packaging and shipping training via Bureau of Laboratories.
BashoreM@michigan.gov
i. 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.
ii. Develop, implement, and monitor protocol and procedures to
ensure that patients receive confirmatory test results.
iii. 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, 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:
a. 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.
b. 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.
c. Any revenue or income generated via billing from this agreement
must be reinvested into this project.
8. If conducting Social Marketing activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
a. Prior to implementation of any marketing activities the Grantee
will submit a proposal as outlined in the Social Marketing Plan
Attachment.
b. If the proposal is approved, the Grantee will work with BHSP
contract staff in regularly scheduled meetings, to ensure all
activities are in line with program requirements
c. Grantee will submit detailed social marketing campaign data (ex:
impressions, website analytics, population groups reached, etc.)
with quarterly progress reports
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your
contract monitor.
Record Maintenance/Retention
A. 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
A. The Grantee and its subcontractors are required to use APHIRM to enter HIV
client and service data into the centrally managed database on a secure server.
B. The Grantee and its subcontractors are required to use APHIRM to enter PrEP
Cascade Data into the centrally managed database on a secure server.
C. 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.
D. The Grantee and its subcontractors are required to use APHIRM to enter Partner
Services interview, linkage to care data, and identified dating apps through the
use of Internet Partner Services (IPS) where appropriate.
E. The Grantee and its subcontractors are required to use SHOARS to request
amendments, supplies, data, technical assistance and to register for trainings.
F. New staff needing access to APHIRM are required to submit the APHIRM user
request form through SHOARS.
G. The Grantee shall notify MDHHS immediately via email at MDHHS-SHOARS-
SUPPORT@michigan.gov of APHIRM users who are separated from the agency
for deactivation.
Mandatory Disclosures
A. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days.
B. All notifications should be made to BHSP MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov.
Technical Assistance
A. 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: SHOARS support.
B. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov.
C. 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.
D. 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
A. 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)
Project Synopsis
The E3 program funds mental health staff in schools to provide one on one therapy and
small group therapy. The required number of unduplicated users is 50 annually.
Additional Reporting Requirements
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. 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. Training
• At least one staff member from each site/center 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.
• New mental health providers delivering services in the CAHC Program-E3 Model, are required to take a one-time Risk Assessment – Motivational Interviewing Training. This training does not need to be completed prior to offering services at the E3 site location. 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
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).
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
MINIMUM PROGRAM REQUIREMENTS
October 1, 2025 - September 30, 2026
ELEMENT DEFINITION:
Services provided by the mental health provider within the E3 site location 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.
MIMINUM PROGRAM REQUIREMENTS:
1. The E3 site location will provide a range of support services based on the needs
of the target population/community. The services shall be of high quality,
accessible, and acceptable to children and youth in the target population. Age-
appropriate prevention guidelines and screening tools must be utilized.
a) Comprehensive mental health services shall include, at minimum: mental health
care in prevention, intervention, and referral for other services not available at the
E3 site location. Consented services are provided to the individual population,
with the option of group therapy. Minor consented confidential mental health care
should be provided as allowed by state and/or federal law (See Attachment 1:
Service Detail).
2. Mental health services shall meet the recognized, current standards of
practice for care and treatment for the population served.
3. The E3 program model shall not provide abortion counseling, services, or make
referrals for abortion services.
4. The E3 program model, if on school property, shall not prescribe, dispense, or
otherwise distribute family planning drugs and/or devices.
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. There shall be a current signed interagency agreement defining the roles and
responsibilities of the sponsoring agency and the local school district/building.
Written approval by the school administration (ex: superintendent, principal
and/or school board*) exists for the following:
a) Location of the E3 program model within the school building.
b) Parental Consent policy.
c) Services rendered through the E3 program model.
*If local School Board approval is required for new grants and/or mental health
programming within your district, MDHHS will require evidence of this approval both
prior to commencing service provision and at site reviews.
* Indicates services may be provided, if desired and with appropriate training, for 3- and
4-year-old clients and up to age 26 for individuals that are eligible for Special Education
services.
7. The E3 program model shall provide services year-round and be open to the primary
target location in one school building.
8. The E3 program model 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.
E3 Site Location: Full time (or full time equivalent) mental health counseling and/or
services must be provided as part of this program model at a minimum of five days
per week. Hours of operation must be posted in areas frequented by the target
population.
9. The E3 site location staff shall operate within their scope of practice as determined
by certification and applicable agency policies as well as Michigan law: E3 site
location shall have a mental health provider licensed to practice in Michigan who has
a minimum master’s level degree in an appropriate discipline (Social Work-Clinical
(MSW), Marriage and Family Therapist (MFT), Licensed Professional Counselor
(LPC), or psychologist - limited licenses are accepted with proper
supervision). Clinical supervision must be provided for all fully licensed mental health
providers. For those master’s level providers that hold a limited license working
towards full licensure, clinical supervision must be in accordance with licensure
laws/mandates and be provided by a fully licensed provider of the same degree
while completing hours toward full licensure.
10. The E3 site location shall establish and implement processes for
notification to parents/guardians, school staff (when allowable and
appropriate), primary care provider (PCP) and/or other health care
providers.
a) Communication must not breach the confidentiality of the client
regarding notification and exchange of information while complying
with all applicable laws (e.g., HIPAA, FERPA and Michigan statutes
governing minors’ rights to access care).
b) Communication with the client’s parent/guardian, school staff,
identified PCP (if applicable) and/or other health care providers will be
based on criteria established by the fiduciary.
11. The E3 program model shall implement a continuous quality improvement (CQI)
plan for mental health services. Components of the plan CQI shall include:
a) Practice and client record review shall be conducted at least twice annually by an
appropriate peer and/or other peer-level staff within or outside 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.
b) 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.
c) Conducting a client satisfaction survey, at a minimum, annually.
d) At minimum, one CQI project shall be conducted annually.
12. The E3 program model must have the following approved 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 mental health services as allowed by state and/or federal law.
d. Disclosure by clients or evidence of child physical or sexual abuse, and/or
neglect.
13. The E3 site location shall have space and equipment adequate for, private
counseling, reception (if applicable), secured storage for supplies and
equipment, and secure paper and/or electronic client records. The physical
facility must be barrier-free, clean, safe, confidential, welcoming, and
comfortable and reflect the ages of the population(s) served.
14. 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.
15. The E3 program model shall have processes in place and identify staff
responsibilities for handling emergencies on and off-site that define:
a) Site-specific building emergency instructions that are posted, readily accessible,
reviewed, and updated regularly.
b) Mental health emergencies within the E3 site location (onsite).
c) School district responsibilities related to emergencies and how the E3 staff may
be involved in limited capacities within the school/offsite.
CHILD AND ADOLESCENT HEALTH CENTERS
EXPANDING, ENHANCING EMOTIONAL HEALTH (E3) MODEL
ATTACHMENT 1: SERVICES DETAIL
The following health services are required (or recommended) as part of the Expanding,
Enhancing Emotional Health service delivery plan:
MENTAL HEALTH
REQUIRED
• Mental Health services provided by a master’s level mental health provider
• Services provided are intended to assist children and adolescents experiencing
mild to moderate severity of need
• Services include, screening, assessing, diagnosing, treatment planning,
discharge, follow up, education and referrals (as needed)
• An up-to-date Behavioral Health Screen and/or Risk Assessment will be
completed for unduplicated users at least once annually
• The use of an Electronic Medical Records system
RECOMMENDED
• Treatment groups using evidence-based curricula and interventions
• School staff training and professional development relevant to mental health
• Building level promotion, such as school climate initiatives, bullying prevention,
suicide prevention programs, etc.
• Classroom education related to mental health topics
• Case management to and partnerships with other private/public social service
agencies
ON-SITE TELEHEALTH (IF PROVIDED)
• If telehealth services are offered, they can be used as a supplemental service to
the required face-to-face and cannot be done at a full-time capacity.
• When providing any services by telehealth, the provider(s) must be physically
located at the funded program location.
• Utilize telehealth equipment
• Follow-up as appropriate
• Follow established guidelines for telehealth practices and documentation
EMERGENCY REPONSE
The E3 staff may support school administration and school staff for mental health
emergencies on school grounds, including the following:
• Participate in the school-wide crisis team for mental health emergencies,
but not lead the response team
• Participate in school-wide trainings for mental health crisis response, but
not lead the training process for response teams
• Train school staff for mental health emergencies
MINOR-CONSENTED SERVICES AS DEFINED BY MICHIGAN AND/OR
FEDERAL LAW
• Mental health counseling (14 years or older) 12 visits or 4 months
(whichever comes first)
REFERRALS
Referral for services not provided in the E3 site location is required.
• Onsite (e.g. other providers/case manager to mental health provider or vice versa)
• Internal within the organization (e.g., PCP, women’s health, health center, etc.)
• External (e.g., PCPs, specialists, dental services, community agencies, etc.)
• There is a process in place for internal and external referrals for initiation, follow-
up (tracking), and close-out
School (if primary source of referral):
• There is a system in place between the school and the site location
PROJECT: Family Planning Program
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.
Additional Reporting Requirements
Each grantee shall submit the required reporting on the following dates:
Report Time Period
FPAR 2.0 Year-End Encounter Level Report
Family Planning Encounters (Table 13) &
Family Planning Revenue Report (Table 14)
January 1 – December
31 January 9
FPAR 2.0 Quarterly and Mid-Year Data
Reports Encounter Level (Calendar Year
2026)
January 1 – June 30
(mid-year)
January 1 – September
April 10
July 10
October 9
(Table 13) & Family Planning Revenue January 1 – June 30 July 10
Annual Health Care Plan October 1 – September
30
September
15
Teen/Adult Consumer Survey October 1 – March 31 April 17
Each grantee shall indicate the following project outputs:
Target Measure Performance Minimum Performance
Unduplicated Number of Title
X Clinic Users for FY26
Original Agreement Funding 95%
Unduplicated Number of Title
X Clinic Users for FY26
Additional Geographic Service
35%
A. Reports and information shall be submitted to the Contract Administrator at:
Report Submit To
FPAR 2.0 Year-End Encounter Level Report
(Calendar Year 2025)
MILogin via Family Planning Transfer
Area
Reports Encounter-Level (Calendar Year MILogin via Family Planning Transfer
Area
(Table 13) & Family Planning Revenue mdhhs-
Annual Health Care Plan mdhhs-
Teen/Adult Consumer Survey mdhhs-
B. The Contract Administrator shall evaluate the reports submitted as described for
their completeness and adequacy.
C. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by the Contract Administrator.
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. Orientation must include tenets of the Title X Program.
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 the current version of the Providing
Quality Family Planning Services in the United States: Recommendations of the
U.S. Office of Population Affairs 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) 2.0 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
2.0 reporting, and will be responsible for updating their system, as needed, to be in
compliance with OPA and MDHHS FPAR 2.0 data collection and reporting
standards and deadlines.
40. Each grantee will use FPAR 2.0 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. 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.
42. 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.
43. 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.
44. 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.
45. Grantee’s funding cannot be used for fundraising activities and/or political education
or lobbying, including membership costs for advocacy or lobbying organizations.
46. Grantee’s funding cannot be used to supplant funding for an existing program
supported with another source of funds.
47. 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 35% of their additional GSA contracted caseload performance
expectation in Fiscal Year 2026 (FY26). Each grantee’s FPAR data will be used to
monitor contracted caseload performance. Year-end FPAR 2.0 will be used to
assess whether grantee has met the 35% contracted caseload performance
expectation.
48. Grantees awarded contraceptive access funding in FY25 will receive the equivalent
allocation in FY26 to be used in FY26 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 2.0, comprehensive site reviews)
mechanisms.
PROJECT TITLE: Fetal Alcohol Spectrum Disorder Community Project
Project Synopsis
Grantee will implement alcohol screening and FASD prevention education among women
of reproductive age and refer affected infants, children, and their families to a FASD
Diagnostic Center for evaluation and intervention.
Additional Reporting Requirements
The Grantee will report in EGrAMS the status of each objective listed in the FASD
Workplan Narrative Report. In addition, the grantee will also submit Data
Evaluation Reports. Please see the following tables listing the report type, time
period, and due date of specified report:
The Grantee shall submit reports by the following dates:
1) EGrAMS Workplan Reports
October 1 – December 31 January 31
Nilesm2@Michigan.gov
2) Data Evaluation Reports (The Contract Manager will email project lead the report
template)
October 1, 2025 – March 31, 2025 April 30, 2026
Nilesm2@michigan.gov April 1, 2026 – September 30, 2026 October 31, 2026
Contract Manager:
Michele F. Niles, MSN, RN, RNC-MNN
Elliott-Larsen Building, 320 S. Walnut St, 5th Floor,
Lansing, Michigan 48933
Nilesm2@michigan.gov
PROJECT: Fetal Infant Mortality Review (FIMR) Case Abstraction
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 Local Recommendations.
• 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.
Additional Reporting Requirements
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 (brummela@michigan.gov).
Reporting Time Period Due Date
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
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
and Human Services/Health Division
PROJECT TITLE: Fetal Infant Mortality Review (FIMR) Interviews
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.
Additional Reporting Requirements
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 (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 FIMR Case Review Team (CRT) Recommendation Form and the Log
of Local FIMR Recommendations.
• Utilize Michigan FIMR resources and National Center for Fatality Review
resources.
Additional Requirements for Detroit Health Department (DHD) and Kent County
Health Department (KCHD) only:
• DHD: At least 1 MMMS next of kin interviews will be completed by September 30,
2026. Each completed MMMS next of kin interview will be compensated at
$250.00 per interview. A maximum of 8 visits are reimbursable per case up to the
contract allocation.
• KCHD: At least 1 MMMS next of kin interviews will be completed by September
30, 2026. Each completed MMMS next of kin interview will be compensated at
$250.00 per interview. A maximum of 4 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
Community Services Department
and Human Services/Health Division
PROJECT: FFPSA HV EXPANSION
Project Synopsis
The Family First Prevention Services Act (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. Additionally, home visiting programs that are funded through FFPSA
can serve families impacted by substance use regardless of their child welfare
involvement. Each HV Model is implemented in accordance with the standards and
tenants of that particular model. FFPSA is known within funded programs and
communities as Thriving Futures.
Additional Reporting Requirements
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 Section Guidance Manual (MDHHS HVS
Contract Supports) for details about what must be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the Model
Consultant via e-mail and incorporate the change(s) into the budget and face
sheet during the next amendment cycle as appropriate. The face sheet 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
face sheet changes once the agreement is available to be amended.
b. Work Plan: Due annually by May 30 to the HVS Model Consultant for
preapproval then uploaded to Groupsite. See the MDHHS Home Visiting Section
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 and/or their model data system by Thursday each week. This data
includes:
• Family Model ID#
• Funding Source
• How substance use was identified if the family has substance use impact
• Family demographic information (including MiSACWIS IDs) if the family is
FFPSA eligible
e. HVS and FFPSA data collection requirements due in REDCap and appropriate
model data system by the 5th business day of each month. PAT programs must
use Visit Tracker, 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 using the HVS required QI Summary Template (QI Annual Summary
Report Template). 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
Section Guidance Manual.
Grantee Specific Requirements:
Home visitors funded through Thriving Futures will serve families referred from local
Child Welfare agencies or those who are impacted by substance use, in proportion to
their Thriving Futures FTE.
HFA: 13 FFPSA families per 1.0 FTE
NFP: 20 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 Section 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 Section 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 Section 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 Section 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 Section 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.
• PAT: Minimum of two hours per month of individual reflective supervision per 1.0 FTE as well as a minimum of two hours per month of group supervision. 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 relationships with local community providers who serve families
impacted by substance use.
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 Section Guidance Manual for requirements related to
engagement with community partners.
Data Collection:
The LIA shall comply with all model and MDHHS HVS data training, collection, entry,
and submission requirements. See the MDHHS Home Visiting Section 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 Section 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 Section Guidance Manual.
PROJECT: Food Delivery Service Pilot (FDSP)
Project Synopsis
The Food Delivery Service Pilot (FDSP) project seeks to mitigate transportation
barriers, increase grocery access, and address food security needs of Supplemental
Nutrition Assistance Program (SNAP) recipients in Wayne and Kent Counties, whose
populations disproportionately experience barriers to food access. Funded partners
include the Heart of West Michigan United Way for Kent County, and the United Way for
Southeastern Michigan, and Wayne County Health Department for Wayne County.
Additional Requirements
Grantees are required to submit a quarterly status report with information on the
following areas:
1. Section 1: FDSP Supplemental Projects: The Food Delivery Service Program
was funded in two rounds; the first round of funding included $500,000 per
grantee to implement a supplemental project, with community-driven objectives.
Please answer questions related to these activities and objectives for the
reporting period.
2. Section 2: FDSP Boilerplate Projects: The second round of funding included
$1.5 million per county to directly support food delivery services to Food
Assistance Program eligible residents in Kent and Wayne counties, in alignment
with boilerplate language. Please answer questions related to these activities and
objectives for reporting period.
3. Increasing SNAP/FAP Enrollment: Please answer questions related to these
activities and objectives for reporting period.
Surveys will be completed through Qualtrics and must be submitted by 15th of the
month following the respective reporting period.
• January 15, 2026 (reporting period of October-December 2025)
• April 15, 2026 (reporting period of January-March 2026)
• July 15, 2026 (reporting period of April-June 2026)
• October 15, 2026 (reporting period of July-September 2026)
Any additional requirements (if applicable)
Grantee participation in quarterly Learning Community meetings and quarterly Regional
Partner meetings to share updates, best practices, and barriers will be required.
PROJECT: Harm Reduction Capacity Expansion
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.
Additional Reporting Requirements
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on bimonthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices.
Information on changes in hours of operation and/or location of service delivery must be
communicated to MDHHS Harm Reduction Unit immediately for updating of SSP
directories.
Any additional requirements (if applicable)
• Funds may not be used to buy sterile needles or syringes.
• Funds may not be used to purchase sterile smoking supplies.
• 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.
o Grantees are encouraged to work with the MDHHS Viral Hepatitis Unit
(MDHHS-Hepatitis@Michigan.gov) to purchase hepatitis C rapid test kits at
no cost.
• 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 Supply Support
Project Synopsis
The purpose of this project is to prevent transmission of infectious diseases and reduce
harm among persons who are injecting drugs.
Additional Reporting Requirements
Grantees will submit service delivery data to MDHHS via the SSP Utilization
Platform (SUP). SUP data is expected to be entered in near real time and shall not
be reported later than 30 days from the end of the month. Grantees that are not yet
open for services, or did not provide service delivery during a month, must submit a
qualitative report of activities to MDHHS no later than 30 days from the end of the
month.
Grantees will participate on bimonthly conference calls to discuss the state of SSP
in Michigan, share successes, challenges, and best practices.
Information on changes in hours of operation and/or location of service delivery
must be communicated to MDHHS immediately for updating of SSP directories.
Any additional requirements (if applicable)
• Grantees must ensure that program activities abide by state and local law, and
must coordinate with local stakeholders (e.g. law enforcement, elected officials,
health department) when implementing services.
• Funds may be used to purchase syringes and other sterile works for injecting
substances.
• Funds may be used to purchase sterile smoking supplies.
• Funds may not be used to purchase Narcan, as grantees can order this through the
MDHHS Narcan Direct portal at no cost.
• Grantees will be required to complete monthly incentive log provided by MDHHS
and submit no later than 30 days from the end of the month. Grantees must seek
written agreement on incentive type to be approved by MDHHS and must directly
align with their "incentive line item" outlined in their fiscal budget. Additionally,
grantees will be required to submit proof of purchase receipt to funder each
month.
• 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. Grantees are encouraged to work with the MDHHS Viral
Hepatitis Unit (MDHHS-Hepatitis@Michigan.gov) to purchase hepatitis C
rapid test kits at no cost.
• 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 Match
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.
Additional Reporting Requirements
Grantees will be enrolled and submitting service delivery data to the Syringe Service
Program Utilization Platform (SUP)
Grantees will participate on bimonthly conference calls to discuss the state of SSP in
Michigan, share successes, challenges, and best practices
Any additional requirements (if applicable)
• 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: Healthy Community Zones
Project Synopsis
The focus of the program is to reduce racial disparities in health and to develop
comprehensive long-term strategies that address access to healthy foods, healthy built
environments, opportunities for youth to thrive, and support social cohesion. The initial
pilot is to be implemented in Chippewa and Saginaw Counties, and the City of Detroit.
Reporting Requirements
Quarterly Workplan Report submissions submitted via email: MDHHS-
HCZ@michigan.gov
Report Due Dates
Quarter 1 Oct-Dec: due Jan 15th
Quarter 2 Jan-March: due April 15th
Quarter 3 April-June: due July 15th
Quarter 4 July-Sept: due Oct 15th
Program Specific Requirements
Funding will support communities in initiatives that do one or more of the following:
• Increase food security
• Create a healthy built environment and active communities
• Support healthy, thriving children and youth
• Enhance social cohesion
Unallowable expenses
The following expenses are unallowable and should not be included in project budgets:
• Lobbying and political activities
• Individual assistance such as tuition, cash stipends, emergency aid, etc.
Funding cannot be used to supplant other funding or as a substitute for funds currently
being used to support similar activities.
Match Requirements
Match is not required for this grant funding opportunity.
Credentials
The Grantee shall assure that appropriately credentialed or trained staff under its
control, including Grantee employees and/or subcontractors, shall perform functions
under this Agreement.
Expected Performance Outcomes
Communities will be supported to define success and impact and to identify metrics to
capture systemic change and success stories.
A state level evaluation plan with quantitative and qualitative data will measure reach for
local interventions, community level Policy, Systems, Environmental (PSE) changes and
state level actions to support PSE and outcomes such as increased walkability, healthy
food access and breastfeeding support.
Subcontracting
Subcontractors shall be subject to all conditions and provisions of any resulting
agreement.
If subcontracting, the Grantee must obligate the subcontractors to maintain the
confidentiality of MDHHS’ client information in conformance with state and federal
requirements.
If portions of the services are being subcontracted, the applicant must identify the
services the subcontractor will perform and provide all information requested, as it
applies to both the applicant and the subcontractor(s). A subcontractor budget and
statement of work must be provided for subcontractor services for $50,000 or more. If
the subcontractor’s price is based on a fee schedule, the fee schedule must be
included.
MDHHS may, at its discretion, require information on the process of an awarded
subcontractor application.
A Grantee is responsible for the performance of any subcontractors. Subcontractors
shall be held to the same standard of quality and performance as the Grantee.
Evaluators of applications will consider the qualifications of both the Applicant and
subcontractor when making agreement award recommendations.
PROJECT:
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
Project Synopsis
A. 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.
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)
Quarterly
Progress Report end of the quarter MDHHS-
HIVSTIoperations
All Agencies:
services delivered to HIV-following month CAREWare
All Agencies:
Services Report (RSR)
Grantee
submission will
open in early
February and
must be complete
by the first week
HRSA through
Electronic
Handbook (EHB)
funded agencies providing
Annual (if
applicable) Site Visit
Report Period Due Date(s)
Quality Management
Plan
funded agencies: Complete
and submit at least one Plan-
Do-Study-Act worksheets
correlated to Quality
applicable) over contract year MDHHS-
HIVSTIoperations
@michigan.gov
All Agencies
expenditures by service
category, program income,
and administrative costs
through the RW Reporting
the end of the
budget period
quarterly FSR
All Agencies:
RW Program Income
Questionnaire when
during the Annual
Audit Visit
All Agencies:
Case Report Form
As needed
for newly
diagnosed
HIV cases
or PWH
new to
care in
days of test or
care
HIV Confidential
Case Report Form
Fax: (313) 456-
1580 Attn: HIV
Surveillance
Reporting Requirements
A. 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.
B. The BHSP shall evaluate the reports submitted for their completeness and
accuracy.
C. The Grantee shall permit the BHSP or its designee to conduct site visits and to
formulate an evaluation of the project.
Publication Rights
A. 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 and Collections (Program Income)
A. 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. Adhere to 340B Shared Client Arrangement – Michigan AIDS Drug Assistance
(MIDAP) clients that receive services from Ryan White 340B grantee – to avoid
duplicate discounts. See Appendix A for process flowchart and detailed
description of expectations.
7. Ryan White 340B grantees coordinate with their contract pharmacies to assure
compliance with HRSA 340B rules and MDHHS 340B policies.
8. Program income is added to funding provided by the State of Michigan for the
budget period and used to advance eligible program objectives.
9. Provide a report detailing the expenditure and reinvestment of program income
in the program (template will be provided by MDHHS).
Grant Program Operation
A. The Grantee must adhere to the National Monitoring Standards for Ryan White
Part A and Part B Grantees: Universal Part A and B.
B. The Grantee will participate in the Department needs assessment and planning
activities, as requested.
C. 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.
D. 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.
E. 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:
1. Have policies and procedures to ensure time and effort reporting.
2. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
3. Denote accurately the percentage of effort to the project. The percentage 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.
4. Submit a budget modification to the Department in instances where the
percentage of effort of contract staff changes (FTE changes) during the
contract period.
F. The Grantee must submit all details on advertising campaigns (print and social
media) completed via the quarterly workplan progress report submission in
EGrAMS.
G. The Grantee must include the following language in all Client Consent and
Release of Information forms used for services in this agreement:
1. “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.”
H. The Grantee must notify the BHSP 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. Approval from BHSP is required prior to the
change being implemented.
I. The Grantee must adhere to security measures when working with client
information and must:
1. Not email individual health information either internally or externally.
2. Keep all printed materials in locked storage cabinets in locked rooms.
3. 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.
4. Maintain the standards of CDC’s Data Security and Confidentiality Guidelines
for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis
Programs.
5. CDC Website: Program Collaboration and Service Integration | CDC
J. 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.
K. Subrecipient quality management program should:
1. 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.
2. 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.
3. 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.
L. 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 as compliant with Policy
Clarification Notice (PCN) #15-02 established by Health Resources and Services
Administration (HRSA). QM Plans must contain these eleven components:
1. Quality statement
2. Quality infrastructure
3. Annual quality goals
4. Capacity building
5. Performance measurement
6. Quality improvement
7. Engagement of stakeholders
8. Procedures for updating the QM plan
9. Communication
10. Evaluation
11. Work Plan
M. Grantee quality management activities should:
1. 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
2. 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.
N. 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.
O. 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.
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your contract
monitor.
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
A. New staff needing access to CAREWare are required to submit the CAREWare
user request form through SHOARS.
B. 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.
1. The Grantee shall notify MDHHS immediately via email at MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov of CAREWare users who are separated from the
agency for deactivation.
Record Maintenance/Retention
A. 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.
B. 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
A. 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.
B. The Grantee must:
1. Enter all Ryan White services delivered to HIV-infected and affected clients.
2. Enter all data by the 10th of the following month.
3. 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:
a. Missing records as depicted in the RSR Viewer module in CAREWare
b. A list of alert, warning, and error messages as depicted in the RSR
Validation Report module in CAREWare
c. Efforts or decisions (including collaboration with MDHHS) to resolve
missing data or error messages as applicable
4. 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.
C. 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:
1. Regular back-up of client records with back-up files stored in a secure location.
2. Use of passwords to prevent unauthorized access to the computer or Client
Level Data program.
3. Use of virus protection software to guard against computer viruses.
D. 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.
E. 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:
1. 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.
2. The Grantee is required to provide access to all staff and personnel
responsible for reviewing and completing the RSR.
3. 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.
4. 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.
5. 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.
6. 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.
7. The Grantee shall in these circumstances contact Ryan White Data Support by
email at ryanwhitedatasupport@wrma.com 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:
a. Issues with account lockouts, lost credentials, or account creation
b. Issues with accessing the GCMS through the HRSA EHB
c. Issues with accessing the Provider Report through the HRSA
d. Technical issues regarding functionality of the EHB portal
8. 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:
a. TargetHIV/DISQ webinars regarding the RSR
b. HRSA produced documentation and manuals on RSR reporting
requirements for the calendar year
c. Manuals on utilizing CAREWare for completing the RSR
d. PowerPoint presentations on aspects of the RSR
e. Staff invitations to Teams meetings and breakout sessions to answer
questions regarding the RSR
f. CAREWare custom reports and financial reports designed to assess:
i. The number of eligible clients
ii. The number of eligible clients that need to be marked as such
iii. Services provided by the Grantee
iv. CLD on ZIP codes, ethnicity, and other features
g. Emails from MDHHS staff regarding the above but also including:
i. Updates on HRSA reporting requirements
ii. New information provided from HRSA
iii. Other resources HRSA is providing/will provide
9. 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
A. The Grantee will provide immediate notification to the Department, in writing, in the
event of any of the following:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days. All notifications
should be made to BHSP by MDHHS-HIVSTIoperations@michigan.gov and
MDHHS-SHOARS-SUPPORT@michigan.gov.
Technical Assistance
A. 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: SHOARS support.
B. Grantee must register an Authorized Official, Financial Officer 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@michigan.gov.
C. Technical assistance will be provided 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.
Assurances
A. 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.
4. Grantees and their contractors are expected to vigorously pursue enrollment
into health care coverage for which their clients may be eligible (e.g., Medicaid,
CHIP, Medicare, state-funded HIV/AIDS programs, employer sponsored health
insurance coverage, and/or other private health insurance) to extend finite
RWHAP grant resources to new clients and/or needed services.
APPENDIX A
340B Process Flow
Individuals meeting an MIDAP’s financial and medical eligibility criteria and are enrolled
as active MIDAP clients are deemed “patients” of MIDAP for the purposes of 340B
Program Guidelines. ADAPs are categorically eligible for the 340B Drug pricing Program.
This means that all clients eligible for and enrolled in an individual ADAP meet the 340B
Patient Definition and thus MDHHS must develop and ensure compliance to assure
MDHHS achieves the benefits of these clients meeting the 340B Patient Definition.
MDHHS will monitor to assure compliance.
INSURANCE PREMIUM ASSISTANCE and COST SHARING
MIDAP Claiming Rebates When Paying Premium Payments and/or Cost Sharing for
Insured Clients: Because MIDAP uses federal funds to cover premium costs associated
with insurance plans required for prescription drug coverage and/or deductible, co-
payment, or co-insurance expenditures, MIDAP is the entity that will receive the statutory
340B rebate/discount. MIDAP will claim all statutory 340B discount/rebating on 340B
eligible medications prescribed or dispensed by the non-MIDAP 340B covered entity’s
pharmacy because it is the primary payer of the insurance policy, providing both
prescription drug coverage and reimbursement of medical and lab services provided by
the non-MIDAP 340B covered entity, and/or is the payer of cost-sharing requirements
associated with the client’s prescription drug coverage.
Non-MIDAP 340B Covered Entities Claiming All Discounts When Premium
Payments Are Not Made by MIDAP: For clients that have private or employer-
sponsored insurance that is not paid by MIDAP, the non-MIDAP 340B covered entity can
submit for reimbursement to the commercial insurer at the higher usual and customary
rate and generate program income. The claim should still be submitted to MIDAP as a
secondary claim to cover any cost-sharing, with the sub-clarification code of “20” in the
field 420-DK, so MIDAP knows the claim was filled with 340B stock. This allows MIDAP
to still claim voluntary supplemental rebates in accordance with manufacturer allowances.
Sharing Insured Clients Meeting Out-of-Pocket Maximum: If a MIDAP-funded
insurance client’s maximum out-of-pocket for the plan year has been reached and no
additional partial-pay claims can be submitted to manufacturers, the non-MIDAP covered
entity is permitted to claim the statutory 340B discount.
UNINSURED CLIENTS and MEDICATIONS NOT COVERED BY INSURER
MIDAP Will Claim All Discounts or Rebates When Paying 100% of Drug Costs for
Full-Pay MIDAP Clients: For clients for whom MIDAP is paying 100% of the client’s drug
costs (i.e., full-pay clients who have no public or private insurance, or insured clients
requiring medications not covered by their public or private insurer), MIDAP will be the
entity that receives the statutory 340B rebate/discount. Non-MIDAP 340B covered
entities must either:
a) forego taking the statutory 340B discount OR
b) accept reimbursement based on the dispensed (or administered) drug’s
acquisition costs, in accordance with MIDAP’s policy. MIDAP is not to be billed for
ingredient costs more than the dispensed (or administered) drug’s acquisition cost
in this instance.
Non-MIDAP 340B Covered Entities Claiming All Discounts When Paying 100% of
Drug Costs: For clients for whom the non-MIDAP 340B covered entity is paying 100% of
the client’s drug costs (i.e., uninsured clients requiring medication that is not covered by
MIDAP), the non-MIDAP 340B covered entity will receive the statutory 340B discount.
MIDAP will forego claiming or receiving the statutory 340B rebate/discount, as the
rebate/discount must not be duplicated by the two entities. MIDAP will also forego
claiming or receiving voluntary supplemental rebates/discounts where no expenditures
for a client’s drugs accrued to MIDAP.
PROJECT: HIV Centers for Cluster and Outbreak Response Enhancement
Project Synopsis
This project aims to decrease the number of new HIV infections through network
detection and outreach. A playbook of options is available to sites that outlines various
approaches that will be utilized for this project.
Grant Program Operation
1. The required activities of this project, for both state and local staff, are spelled out
in the ELC MiCore Milestones monitoring report. BHSP will connect with local
staff to notate additional required activities beyond those required to achieve
these milestones.
2. Quarterly Progress Reports are required to be completed at the end of each
quarter and sent to MDHHS-HIVSTIOperations@michigan.gov to stay in
compliance with grant deliverables.
3. The Grantee will participate in BHSP needs assessment and planning activities,
as requested.
4. 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.
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 funds must
match the percentage claimed on the FSR for the same period.
6. Submit a budget modification to BHSP in instances where the percentage of
effort of contract staff changes (FTE changes) during the contract period.
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.
Mandatory Disclosures
1. Inform BHSP at least two weeks prior to changes in agency operations (i.e., key
staff, hours of operation, scope of service).
2. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
i. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
ii. 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.
iii. Any staff vacancies funded for this project that exceed 30 days.
3. All notifications should be made to MDHHS-HIVSTIOperations@michigan.gov
and MDHHS-SHOARS-Support@michigan.gov.
Meeting Requirements
1. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
2. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
3. Meetings notifications are shared via contact monitors, through SHOARS and will
be listed on the MDHHS Training Calendar.
4. For in-person meetings, grant funds should be utilized to support travel.
5. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
6. For any special accommodations or needs please communicate with your
contract monitor.
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: SHOARS support
2. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov.
3. BHSP will provide TA, as requested, on the implementation of the MiCore
program. This may include issues related to: data entry into systems, Programs,
Budget/Fiscal, Grants and Contracts, Training, or other activities related to
carrying out activities.
PROJECT:
HIV Prevention
HIV Prevention- Forest Community Health
HIV PrEP Clinic
HIV/STI Partner Services
HIV & STI Testing and Prevention
Project Synopsis
A. The purpose of this project is to implement a comprehensive HIV surveillance and
prevention program. The funding aims to prevent new HIV infections, improve HIV-
related health outcomes of people with HIV, and 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 proper and by current CDC guidelines and recommendations.
The Grantee shall submit the following reports on the following dates:
Report Period Due Date(s) Report submission
Quality Control Reports Monthly Department Staff
Quarterly Progress
Report Quarterly 30 days after the
end of the quarter HIVSTIoperations@michi
Daily Client Logs Monthly Department Staff
Test Kit Inventory Log Monthly Department Staff
Bi- annually Department Staff
HIV Testing
Competencies Annually SHOARS before the
end of the calendar Department Staff
EMR testing** Monthly Department Staff
Reactive Results As needed APHIRM
Case Report Forms
As needed in
the event of a
reactive result
Within 24 hours of
positive screening
and confirmatory
Confidential Case Report
Form
Fax: (313) 456-1580 Attn:
Partner Services & Linkage to Care (as applicable)
Partner Services As needed Within 30 days of
service APHIRM
Services (IPS) and
Partner Services Ongoing Within 30 days of
service APHIRM
Ongoing APHIRM
Evidence Based Risk Reduction Activities (as applicable)
EBI Data Report Quarterly Within 30 days of
the following month Stigler
PrEP Navigation Monthly 10th of the following APHIRM
Clinical HIV/STI services (as applicable)
340b PrEP Prescription
Log Weekly Every Friday by the
close of business MDHHS-340B PrEP PT
Billing Revenue Report Quarterly month Department Staff
STI 340B
Utilization/Inventory
Report,
Quarterly
Within 10 days after
the end of the
quarter
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will be
transferred automatically
to ScriptGuide/BHSP
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
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, Inventory, and Daily Client Logs may be sent to the Contract
Manager via:
1. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS CTR inbox
(MDHHS-HIV-CTR@michigan.gov)
2. Fax - (517) 241-5922
3. Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727, Lansing, MI
48909
D. BHSP shall evaluate the reports submitted as described in Attachment C, Items A.
and B. for their completeness and accuracy.
E. The Grantee shall permit the Department or its designee to visit and to make an
evaluation of the project as determined by BHSP.
F. Monitoring and evaluation of targeted screening and referrals provided internally and
supported via contractual agreements.
G. Upon completion of a project, the Grantee will provide data related to funded
activities to BHSP within 45 days of the end of the project
Publication Rights
A. 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:
1. The percentage of the total costs of the program or project that will be financed
with Federal funds.
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.
B. 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
A. The Grantee will participate in BHSP needs assessment and planning activities, as
requested.
B. 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.
C. 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:
1. Have policies and procedures to ensure time and effort reporting.
2. Assure the staff member clearly identifies the percentage of time devoted to
contract activities in accordance with the approved budget.
3. Denote accurately the percentage of effort to the project. The percentage 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.
4. Submit a budget modification to BHSP in instances where the percentage of
effort of contract staff changes (FTE changes) during the contract period.
D. If conducting HIV testing using rapid HIV testing, the Grantee will comply with
guidelines and standards issued by BHSP and:
1. 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
a. “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”.
2. 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.”
a. Ensure provision of Clinical Laboratory Improvement Amendments (CLIA)
certificate.
b. Report discordant test results to BHSP
i. Email – Bry Fryczynski (FryczynskiB@michigan.gov) and the MDHHS
CTR inbox (MDHHS-HIV-CTR@michigan.gov)
ii. Fax - (517) 241-5922
iii. Mailed - HIV Prevention Unit, Attn: CTR Coordinator, PO Box 30727,
Lansing, MI 48909
c. 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.
d. In the event of a confirmed case of HIV, an Adult Case Report form must be
sent to the BHSP HIV Surveillance department via fax within 24 hours as
referenced in the reporting table.
e. If conducting blood draws, the grantee must conduct the packaging and
shipping training via Bureau of Laboratories. BashoreM@michigan.gov
i. 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.
ii. Develop, implement, and monitor protocol and procedures to ensure that
patients receive confirmatory test results.
iii. To maintain active test counselor certification, each HIV test counselor
must submit one competency per test device per year to the appropriate
departmental staff.
E. 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.
1. Grantees will participate on monthly or quarterly conference calls to discuss best
practices and identify barriers.
F. 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:
1. Provide Confidential PS follow-up to infected clients and their at-risk partners to
ensure disease management and education is offered to reduce transmission.
2. Effectively link infected clients and/or at-risk partners to HIV care and other
support services.
3. Work with Early Intervention Specialist to ensure infected clients are retained in
HIV care.
4. If applicable,
a. Procure TLO or a TLO-like search engine.
b. Ensure staff that are utilizing TLO or TLO-search engine complete the TLO
training to maintain and understand the confidential use of the system.
c. 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.
d. Ensure staff and site supervisors successfully complete the Internet Partner
Services Training.
e. Ensure staff conducting Internet Partner Services participant in monthly, bi-
monthly meetings, webinars or calls to discuss best practices and identify
barriers.
G. If conducting 340 B STI/PrEP clinical activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
1. 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.
a. 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.
b. Any revenue or income generated via billing from this agreement must be
reinvested into this project.
H. If conducting Social Marketing activities, the Grantee will comply with
guidelines and standards issued by BHSP and:
1. Prior to implementation of any marketing activities the Grantee will submit a
proposal as outlined in the Social Marketing Plan Attachment.
2. If the proposal is approved, the Grantee will work with BHSP contract staff in
regularly scheduled meetings, to ensure all activities are in line with program
requirements
3. Grantee will submit detailed social marketing campaign data (ex: impressions,
website analytics, population groups reached, etc.) with quarterly progress
reports
Meeting Requirements
A. BHSP requires one person from each agency to attend required subrecipient
meetings each contract year. Meetings may be either virtual or in person.
B. The guiding principle of these meetings is to keep Grantees informed and in
compliance with state and federal policies and procedures.
C. Meetings notifications are shared via contact monitors, through SHOARS and will be
listed on the MDHHS Training Calendar.
D. For in-person meetings, grant funds should be utilized to support travel.
E. The Grantee, as per BHSP standards and compliance, are mandated to require
relevant staff members to attend the meetings.
F. For any special accommodations or needs please communicate with your contract
monitor.
Record Maintenance/Retention
A. 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
A. 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.
B. The Grantee and its subcontractors are required to use APHIRM to enter PrEP
Cascade Data into the centrally managed database on a secure server.
C. 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.
D. 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.
E. The Grantee and its subcontractors are required to use SHOARS to request
amendments, supplies, data, technical assistance and to register for trainings.
F. New staff needing access to APHIRM are required to submit the APHIRM user
request form through SHOARS.
G. The Grantee shall notify MDHHS immediately via email at MDHHS-SHOARS-
SUPPORT@michigan.gov of APHIRM users who are separated from the agency for
deactivation.
Mandatory Disclosures
A. The Grantee will provide immediate notification to BHSP, in writing, including but not
limited to the following events:
1. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
2. 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.
3. Any staff vacancies funded for this project that exceed 30 days.
B. All notifications should be made to BHSP by MDHHS-
HIVSTIOperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov.
Technical Assistance
A. 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 SHOARS support.
B. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov.
C. BHSP will provide TA, 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.
D. Training and TA will be provided in support of implementation of HIV testing as a
standard of care and use of rapid HIV tests.
E. The Bureau of HIV/STI Programs values the implementation of sexual orientation,
gender identity and expression (SOGIE) standards for all contractors of the Bureau
of HIV/STI Programs to assure the safety, privacy, and person-first service of those
of the LGBTQIA+ community. We want to deliver high quality care for lesbian, gay,
bisexual, transgender, queer, intersex, asexual and all sexual and gender diverse
people by ensuring training, policies and data collection standards are responsive to
the needs of LGBTQ+ community and provide assuring, affirming, and inclusive
environments.
1. All existing staff funded at 25% or more associated with this contract (yearly) or
cumulatively across all BHSP contracts and all new staff funded at 25% or more
associated with this contract or cumulatively across all BHSP contracts are
required to attend trainings to ensure culturally appropriate communication and
interactions with the LGBTQ+ community. This training can be accomplished
through the Ruth Ellis Center (Ruth Ellis Center), SOGIE Trainings on MDDHS’s
Website (SOGIE trainings (michigan.gov)), or the National LGBTQIA+ Health
Education Center (https://www.lgbtqiahealtheducation.org/resources/type/video/).
Please ensure all training certifications are attached for new employees in
SHOARS on the agency dashboard under “Program Requirements” within 90
days of hire and all existing employees by the end of the fiscal year (September
30, 2025).
2. Submit a narrative or agency policy language documenting how person first
language is addressed on intake forms, patient interactions and program
materials. Report by September 30, 2025, via EGrAMS attachment.
Compliance with Applicable Laws
A. The Grantee should adhere to all Federal and Michigan laws pertaining to HIV/AIDS
treatment, disability accommodations, non-discrimination, and confidentiality.
PROJECT: Housing Opportunities for Persons with AIDS (HOPWA)
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.
Additional Reporting Requirements
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
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,
school employees, and childcare employees).
• Develop and implement strategies to improve jurisdictional and Local Health
Department (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/outreach with WIC, Family Planning,
Communicable Disease, Children’s Special Health Care Services (CSHCS) and
STI programs. Also, work with other community groups to promote immunizations
and services with Federally Qualified Health Centers (FQHC), tribal, rural health
centers, pharmacies and dental providers.
• Collaboratively work with regional MCIR staff to ensure providers are using MCIR
appropriately.
• Develop strategies to identify and target local pocket of need areas.
Additional Reporting Requirements
1. Develop an Immunization Action Plan (IAP) and submit the information by the due
date established by the Division of Immunization.
2. Submit biannual IAP reports by the due dates established by the Division of
Immunization.
Any additional requirements (if applicable)
1. Ensure that Vaccines for Children (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 VFC
Operations Guide, Michigan’s VFC Provider Manual for VFC Providers, and
documents that are updated throughout the year pertaining to the 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
Alaska 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 an FQHC as
defined by current state program requirements.
6. Ensure that all providers receiving federally or state-funded vaccine 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, MedWatch, and
MCIR/SIRS school and childcare/daycare reporting.
9. Coordinate the submission of immunization data from schools and childcare
centers within the jurisdiction and follow-up with programs providing incomplete or
inaccurate data. Assure compliance levels are met according to the Michigan
Public Health Code (PHC) and coordinate with schools and childcares to promote
vaccines to facilitate public protection against vaccine preventable diseases.
10. Provide education to and guide schools and childcares within the jurisdiction on
reporting of immunization data to meet PHC requirements.
11. Provide education to parents or guardians of children seeking a non-medical
exemption.
12. Monitor any provider receiving federally procured vaccine including but not limited
to VFC/QI site visit.
13. Conduct VFC and QI site visits according to VFC programmatic requirements.
14. Monitor VFC provider enrollment and participation and implement strategies to
maintain enrolled providers.
15. LHD staff involved in VFC site visits must complete the site visit training webinar
from the Division of Immunization prior to conducting any VFC site visit.
16. Ensure in-person attendance of at least 1 LHD immunization program staff to two
(2) Immunization Action Plan (IAP) meetings each year.
17. Ensure that federally procured vaccine is stored and handled according to
guidelines outlined in the CDC Storage and Handling Toolkit, VFC Provider
Manual, and in accordance with VFC programmatic requirements and Vaccine
Quality Assurance Project guidelines.
18. 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 PHC.
• Coordinate Perinatal Hepatitis B case management activities between LHD,
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 birth, 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.
19. Provide education to birthing hospitals regarding Respiratory Syncytial Virus
(RSV) antibody (nirsevimab) program and work to establish an RSV program at
the birthing hospital to offer nirsevimab to newborns.
20. Surveillance of vaccine preventable disease (VPD) activities.
• Conduct active surveillance when indicated (i.e., during an outbreak) and
contact hospitals, laboratories, school/childcare, and/or other providers on a
regular basis.
21. Collaborate and engage with community partners on vaccine promotion activities.
PROJECT: Immunization Fixed Fee (VFC, AVP, and IQIP Site Visits)
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 IAP meetings, web-training
with MDHHS VFC and IQIP coordinators, in-person training with Immunization Field
Representatives and the site visit guidance documents provided by the department and
the CDC. All site visit information shall be entered into the appropriate database as
required by CDC (PEAR and IQIP database system) within 10 business days of the site
visit by the site reviewer/consultant who conducted the site visit. VFC site visit
documentation must be entered online within PEAR (except for MI-AVP visits) 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).
Each FSR submission requires, as an attachment, the details for all site visits during the
quarter that are included in the reimbursement request. The attachment template that
must be used for this purpose is the ‘Immunization Fixed Fees Quarterly Summary
Worksheet’ provided by the Division of Immunization. The Immunization Fixed Fees
Quarterly Summary Worksheet is required on each Quarterly FSR submission, even if
there are no requests for reimbursement.
Rates of Reimbursement
Visit Type
VFC Enrollment Site Visit $175
Vaccines for Children (VFC) Site Visit $175
Adult Vaccine Program (AVP) Site Visit $175
Unannounced Storage & Handling Site Visit $100
Birthing Hospital Site Visit $350
IQIP Site Visit $200
IQIP 12-month Follow-Up Complete $100
Reimbursement requests (i.e., FSRs) may exceed the LHD’s fiscal year allocation, so
long as funds are available through MDHHS and the expenses are allowable.
• NOTE: Reimbursement for all site visits 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)
• A VFC Enrollment site visit is required for all newly enrolled VFC provider sites.
• After completion of each VFC visit type (VFC enrollment site visits, VFC site visits,
AVP site visits, unannounced storage and handling site visits, and birthing hospital
site visits), the LHD must contact their Immunization Field Representative to notify
them of a need for an initial Quality Assurance (QA) check of the visit. Only site
visits with a passed QA are eligible for reimbursement. Any FSR that is submitted
with site visits that have not been QA’d is subject to being held until the site visits
have been QA’d and approved by the Immunization Field Representative.
• VFC providers who have experienced a vaccine loss equal to or exceeding a VFC
dollar amount of $2500 must conduct participate in an Unannounced Storage and
Handling site visit performed by their Local Health Department (LHD) in
conjunction with additional immunization education through CDC ‘You Call the
Shots’ and/or Immunization Education Sessions required for VFC Providers. LHDs
who do not have any VFC providers experiencing a loss equal to or exceeding a
VFC dollar amount of $2500 within the current fiscal year are required to conduct
at least one Unannounced Storage and Handling Site Visit per fiscal year. MDHHS
Division of Immunization staff can assist the LHD in selecting the provider to
perform this site visit on. These site visits can only be completed if eligible
according to current CDC requirements (e.g., site visits cannot be performed for
providers who have any site visit that is either in “In Progress” or “Submitted”
status). Notify MDHHS VFC staff for approval prior to performing these site visits.
MDHHS VFC will monitor the number of Unannounced Storage and Handling site
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 IQIP Coordinator, prior to
conducting any site visits. Annual VFC and IQIP site visit guidance and review
materials will be provided to each LHD at the start of each new fiscal year and as
needed. In-person training and consultations 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
Vaccines 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 IQIP site visit performed for a VFC-eligible provider may receive an IQIP site
visit within the same site visit cycle. Per CDC and MDHHS guidelines, VFC and
IQIP site visits can be performed on the same day or on separate visit dates. An
IQIP site visit can only be conducted within a cycle in which a VFC site visit has
also been conducted for the same provider. LHDs are expected to conduct an
IQIP visit on at least 25% of VFC-eligible providers annually.
• LHDs must complete an in-person VFC site visit for every VFC provider at least
every 11 months and not to exceed 24 months, using the date of their previous
site visit as a starting point. Site visits will vary in time an average of 1 hour for
IQIP and 2 hours for VFC Compliance and must not exceed the two-year time
frame. Annual site visits are encouraged but must not be conducted sooner than
11 months from the previous site visit date.
• IQIP site visits will be conducted using MCIR QI reports and IQIP tools developed
by the Department. All VFC and IQIP 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 site 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, review of the CDC-
PEAR and the CDC-IQIP database systems at the most recent IAP meeting,
training webinar with MDHHS VFC and IQIP coordinators, consult and in-person
training with Field Reps and the current site visit guidance documents (VFC and
IQIP) provided by the department and the CDC. All site visit information shall be
entered into the appropriate database as required by CDC (PEAR and IQIP
database system) within 10 business days of the site visit by the individual who
conducted the site visit. VFC site visit documentation must be entered online
within PEAR (except for MI-AVP visits) during the time of the site visit.
PROJECT: Immunization Vaccine Quality Assurance
Project Synopsis
This project provides guidance to Local Health Departments (LHDs) on management
activities for Vaccines for Children (VFC) providers. Under this program, LHDs monitor,
review and approve providers’ vaccine orders and ensure providers are string and
handling vaccines appropriately in accordance with VFC programmatic requirements.
LHDs also work with providers who experience a vaccine loss by providing education,
technical assistance, and guidance on corrective action plans.
Additional Reporting Requirements
1. Follow-up on vaccine losses and replacement for compromised vaccines for
immunization providers within the jurisdiction.
2. Monitor, review, and approve all temperature logs, doses administered reports and
ending inventory reports received from participating VFC providers within the
jurisdiction.
3. Monitor, review, 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 or excess of 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: Infant Safe Sleep
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.
Additional Reporting Requirements
1. LHD will attach the completed “Infant Safe Sleep 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. The work plan must incorporate SMARTIE
(Specific, Measurable, Achievable, Relevant, Time-phased, Inclusive and Equitable)
objectives, where possible.
2. LHD will submit the “Infant Safe Sleep 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.
Any additional requirements:
1. Grantee must provide safe sleep educational activities, conduct safe sleep
community outreach/awareness efforts and engage community leaders to guide
programming.
2. Programming must adhere to the policy statement titled “Sleep-Related Infant
Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep
Environment” issued by the American Academy of Pediatrics or any subsequent
updates to that policy statement.
3. 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.
4. 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.
5. Activities of the grantee must align with 2024-2028 Advancing Healthy Births: An
Equity Plan for Michigan Families & Communities, or subsequent plan, to address
preventable infant deaths and disparities through evidence-based infant safe sleep
program activities.
6. 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, sheets, 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.
7. Grantee must adhere to the approved work plan. Deviations to the work plan must
be approved by the Program Coordinator.
8. LHD will participate in regular meetings (in-person, virtual or call) as determined by
the Infant Safe Sleep Program to review progress, provide updates, coordinate
activities statewide, and to receive technical assistance and consultation.
9. LHD will designate a staff person to serve as the contact with the Infant Safe Sleep
Program.
10. Any staff member working on grant activities must provide documentation of
completion of the following trainings (available at:
https://mihealth.coursemill.com/html/PUBLIC/):
a. Infant Safe Sleep for Professionals Working with Families
b. Helping Families Practice Infant Safe Sleep.
c. Introduction to Health Equity
d. Systemic Racism
Program Coordinator
Colleen Nelson
nelsonc7@michigan.gov
517-243-1796
PROJECT: Informed Consent
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.
Additional Reporting Requirements
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: Laboratory Services Bio
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.
Additional Reporting Requirements
Provide the Bureau of Laboratories records and reports as required, at least once per
year or upon special request.
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
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.
Additional Reporting Requirements
1. In anticipation of the FY26 contract, grantees must submit a Lactation Consultant
work plan to McDonaldE1@michigan.gov by 9/1/2025. 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, 2025.
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.
PROJECT: Lead Education and Faucet Replacement
Project Synopsis
The Lead Education and Faucet Replacement Program prevents lead
exposure from drinking water to households with a Medicaid enrolled child under 19
years old or Medicaid enrolled pregnant person. This program will fund recipients to
perform a lead education home visit and plumbing assessment and assist the family in
completing a Lead Services application if needed. These activities will allow Michigan
Department of Health and Human Services to distribute drinking water filters and install
a new primary drinking water faucet for residents residing in 11 identified communities
if their faucet is older than 2014.
Additional Reporting Requirements
A. Grantees must complete monthly Financial Status Reports in EGrAMS by the 30th
of each month for the prior month, as specified in the Grant Agreement.
• Grantees shall provide their detailed general ledger attached to the monthly
Financial Status Report in an Excel or PDF format for review and analysis.
B. Grantees must submit quarterly Work Plan reports in EGrAMS by the 15th of the
month following the end of each quarter, as specified in the Grant Agreement which
outlines progress in the areas of applications approved, home visit plumbing
assessments completed and health education provided.
C. Grantees must keep data entry up to date for engagement attempts and home visit
plumbing assessments in the provided MDHHS data systems and/or forms.
MDHHS will complete a quarterly review of benchmarks and develop a
management plan on a quarterly basis for grantees who are not meeting program
goals and expectations. If management plan does not achieve projected results,
grantee must revise portions of contract including benchmarks and/or total contract
award in the next amendment cycle.
D. Reports and information with Protected Health Information (PHI) shall be submitted
through the MDHHS File Transfer Protocol shared area and EGrAMS.
Any additional requirements (if applicable)
E. Grantee must adhere to the following program application eligibility criteria:
• The property must be located in the grantee service area.
• Applicant must have application approved for eligibility by MDHHS-Lead
Service Section.
F. Training and Data Collection
• Grantees must use data system defined by MDHHS to collect, maintain, and
assure data integrity. Grantee must record data necessary to document,
report, and evaluate program outputs and outcomes. In addition to online
data system, grantee must save and provide all hard-copy supporting
information including photos if requested by MDHHS.
• Grantees are required to attend the Lead Education and Faucet Program
trainings provided by MDHHS throughout the fiscal year.
• Grantee must use home and plumbing assessment template forms as well
as educational materials provided by MDHHS. Forms are required to be
completed and shared during home visit with program participant.
• Grantee must take appropriate plumbing component pictures during
plumbing assessment for record and to be shared with MDHHS if
requested.
• Grantees must document how PII or PHI data will be securely shared with
partnering entities, including, but not limited to, the following components:
• Data source, purpose, and use
• Specific data elements (e.g., age, gender, etc.)
• Time periods (e.g. October 1, 2025 through September 30, 2026)
• Identify what data transfer medium will be used (e.g., electronic through
secured FTP, hard copy via facsimile, encrypted email, etc.)
• Identify who will have access to the data (e.g., project director, intake
specialist, etc.), and how access will be controlled.
• 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.
• Identify where data will be stored and how access will be restricted to
authorized individuals (e.g. encrypted or password protected)
• 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.
• Grantees are required to immediately notify MDHHS if a staff member who
has access to MDHHS sponsored data system (FTP, RedCap, etc.) is no
longer employed with the agency and/or permitted to have access to PHI.
MDHHS will revoke their access immediately.
G. Grantee shall enter and maintain program and project data in RedCap data system
provided by MDHHS.
H. Grantee must obtain Data Use Agreement with MDHHS if the program is receiving
and/or sharing PHI.
I. Communication. Grantee must attend MDHHS training on home and plumbing
assessment protocol and lead education training prior to implementing program and
engaging with program participants.
• Any promotional/outreach materials and communication to list of eligible
Medicaid enrolled applicants provided by MDHHS in form of emails, letters,
etc. is required to be approved by MDHHS in advance of distribution to
ensure alignment of messaging.
J. Procurement Requirements. Recipients must follow State of Michigan or
established grantee policies and procedures.
K. 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 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:
• Home visits - Staff, scheduling, documentation, and reporting.
• Plumbing assessment - Staff, documentation, and reporting.
• Application outreach - Staff, outreach methods, documentation, and
reporting.
• Quality assurance of program data collection and data entry
• Financial controls
L. Grantees must have at least one representative participate in additional monitoring
and information conference calls as requested by MDHHS.
M. Grantees are required to retain all project records in a secured location for seven
(7) years after project closeout.
N. 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 MDHHS 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.
O. The Grantee can choose to use one of the approved methods outlined below in
their budget to support their indirect rate. In any method, grantee must provide
appropriate documentation of proof.
• Federal approved rate
• State approved rate
• Cost allocation plans
• 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.
P. Equipment purchase is an unallowable expense. Equipment is defined as an article
of non expendable tangible personal property having a useful life of more than one
(1) year and an acquisition cost of $5,000 or more per unit.
PROJECT: Local Health Department Sharing
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.
Additional Reporting Requirements
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: Local Maternal Child Health (LMCH)
MCH -Children
MCH – All Other
Project Synopsis
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, state, and/or a local MCH
performance measure(s) identified through a needs assessment process. Local health
departments complete an annual LMCH plan and a year-end report. Service delivery
populations are women of childbearing age, infants, and children aged 1-21 years and
their families, with low-income families prioritized. The LMCH allocated funds are to be
budgeted as a funding source in two project categories for FY 2026.
LMCH
Local Maternal and Child Health (MCH)
ESCMCH MCH – Children
OTHERMCHV MCH – All Other
Additional Reporting Requirements
1. The LMCH Plan submission and due date will be communicated through a
notification mailing. Annually, the LMCH program will provide the guidance and
format. The LMCH Plan, once approved by the program, is to be uploaded with the
budget application in EGrAMS. Approval of the LMCH Plan and any Plan
amendments must occur in advance of the budget application and any budget
amendments.
2. The FY 2026 LMCH Year-End Report submission and due date will be
communicated through a notification mailing. Annually, the LMCH program will
provide the guidance and format. The LMCH Year-End Report, once approved by
the program, is to be uploaded with the final FSR in EGrAMS. The Year-End
Report must be approved in advance of the final FSR submission.
Any additional requirements (if applicable):
1. LMCH 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 LMCH funds must be evidence-
based/informed. Exceptions must be submitted in writing and pre-approved by the
LMCH program.
3. LMCH 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 WIC funding requirements.
4. LMCH funds must 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 funds. LMCH
funds are to be used for services and supplies that cannot be paid for through
another funding source or as gap filling, when services and supplies are not fully
covered by insurance and/or another allowable program. For billable services and
supplies, third-party fees should be listed in other funding sources of the budget. If
no third-party fees are listed, an explanation must be noted.
6. The project amount(s) included in the approved LMCH Plan allocation table must
match the budget application MCH source of funds amount(s). If a local health
department needs to move funds between projects, an amended LMCH Plan must
be approved in advance of the budget amendment request period by the LMCH
program. 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 performance measures
aimed at children 1 to 21 years old, an amended LMCH Work Plan and budget is
required.
8. LMCH is unable to accept cost distributions from MDHHS-ELPHS due to the
nature of the Title V Maternal and Child Health Services 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 funds must be budgeted separately using the two project categories, MCH-
Children and MCH-All Other. Agencies can no longer budget LMCH grant funds in
one LMCH project and cost distribute to the second LMCH project (e.g. from MCH-
Children to MCH-All Other).
10. LMCH is supported by the Title V Maternal and Child Health Services Block Grant
and as such adheres to the Uniform Guidance at 2 CFR Part 200 for federal
awards.
PROJECT: Local Public Health Nursing Case Management Expansion
Project Synopsis
The purpose of this project is to fund nursing case management support for children 6-16
years of age with elevated lead levels in Berrien County, as well as children under 6
years of age with an elevated blood lead level who are not enrolled in a Medicaid Health
Plan in Berrien County. This project also supports funding to InterCare FQHC, as
needed, for reimbursement blood lead sample analysis. Finally, this project supports
efforts to increase blood lead testing within Berrien County, with high priority to Benton
Harbor. This funding can support Berrien County in identifying barriers to blood lead
testing, reduction strategies for these identified barriers and methods to increase access
to blood lead testing, focusing messaging on blood lead testing for
children.
Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source documentation,
to support program activities and all expenditures made under the terms of this
Agreement, as required. The Grantee must assure that all terms of the Agreement will be
appropriately adhered to and that records and detailed documentation for the grant
project or grant program identified in this Agreement will be maintained for a period of not
less than seven years from the date of termination, the date of submission of the final
expenditure report or until litigation and audit findings have been resolved. This section
applies to the Grantee, any parent, affiliate, or subsidiary organization of the Grantee and
any subcontractor that performs activities in connection with this Agreement.
PROJECT: MATERNAL INFANT CHILDHOOD HOME VISITING
PROGRAM (MIECHVP) HEALTHY FAMILIES AMERICA EXPANSION
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.
Additional Reporting Requirements
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 Section (HVS) Guidance Manual (MDHHS
HVS Contract Supports) for details about what must be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HVS Model Consultant via e-mail and incorporate the change(s) into the budget and face sheet during the next amendment cycle as appropriate. The face sheet 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 face sheet changes once the agreement is available to be amended.
b. Work Plan: Due annually on May 30 to the HVS Model Consultant for
preapproval. Upon approval, upload the Work Plan to Groupsite. See the MDHHS
Home Visiting Section 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. HVS 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 Model Consultant by
April 30 using the HVS required QI Summary Template (QI Annual Summary
Report Template).
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 Section
Guidance Manual.
Grantee Specific Requirements
The LIA shall serve families as a result of outreach efforts based on the findings of their
MDHHS-HVS Outreach Toolkit.
a. In general, across all counties, the home visitor-to-family ratio should agree with
the following:
16 families or a case weight 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.
FY26 Home Visiting Compensation Rates
The Local Implementing Agency (LIA) shall utilize MDHHS-Home Visiting Section (HVS)
funding to compensate home visitors at no less than the current MDHHS-HVS minimum
hourly salary requirement for a standard home visitor as identified below. The minimum
hourly salary is set utilizing the MIT Living Wage scale and may be subject to change.
Programs should not decrease compensation if home visitors are currently paid at a higher
hourly rate.
It is recommended, but not required, that programs compensate home visiting program
supervisors based on the hourly rate identified below.
FY 26 Home Visiting Compensation Rates
The expectation to meet this goal began FY2025 (i.e., October 1, 2024). The HVS will work
with all LIAs to achieve this goal through a phase-in process as needed.
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 Section 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 Section 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 Section 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 Section 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 Section 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 Section
Guidance Manual for requirements related to professional development and training
activities.
Supervision
The LIA shall adhere to the HFA model standards for reflective supervision.
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 Section 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 Section 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 Section 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 Section Guidance Manual.
PROJECT: MATERNAL, INFANT, AND EARLY CHILDHOOD HOME
VISITING INITIATIVE RURAL LOCAL HOME VISITING LEADERSHIP
GROUP (MHVRLH) and MATERNAL, INFANT, AND EARLY
CHILDHOOD HOME VISITING INITIATIVE RURAL LOCAL HOME
VISITING GROUP 3 (MHVRLH3)
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.
Additional Reporting Requirements
The LLG shall submit all required reports in accordance with the Department 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 face
sheet during the next amendment cycle as appropriate. The face sheet 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
face sheet changes once the agreement is available to be amended.
b. LLG Work Plan: Due annually by May 30 for preapproval from the LLG State
Coordinator then uploaded to Groupsite upon approval. See the Michigan
Department of Health and Human Services’ (MDHHS) Home Visiting Section
Guidance Manual for requirements related to Work Plan development and
reporting.
c. Work Plan Reports: Must be submitted within 30 days of the end of each quarter
(January 30, April 30, July 30, and October 30).
d. See the MDHHS Home Visiting Section Guidance Manual for specific Continuous
Quality Improvement (CQI) reporting requirements.
e. Annual summary of QI activities will be submitted to the State LLG Coordinator by
April 30 using the HVS required QI Summary Template (QI Annual Summary
Report Template).
f. The Contract Manager or his/her designee shall evaluate the reports submitted
as described for their completeness and adequacy.
g. 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.
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 Section Guidance Manual.
The LLG will work with the State LLG Coordinator and the Michigan Public Health
Institute (MPHI) Quality Improvement Coach. See the MDHHS Home Visiting Section
Guidance Manual (MDHHS HVS Contract Supports) for details.
1. 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 Section
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 two HVS Grantee Meetings held
annually is also required.
c. Learn how the local home visiting is connected through the annual
facilitation of a local Systems Coordination Planning Process 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 noting sustainability efforts
in the annual impact report due September 1.
See the MDHHS Home Visiting Section 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. In some instances, pay for food at meetings. See Guidance Manual for
more information.
e. Carry out MDHHS Home Visiting Section 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 Section Guidance Manual. Promotional item expenditures such as pens,
water bottles, diaper bags, etc. are not allowed under this funding.
PROJECT: Medicaid Outreach
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.
Additional Reporting Requirements
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 Financial Status
Report (FSR). If the due date falls on a weekend or holiday, the report is due 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 the FSR using
the reporting format and deadlines as required by the Michigan Department of
Health and Human Services through EGrAMS.
Anu 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 Local Health Department (LHD).
2. Name and contact information of the individual completing the report.
3. Time period the report covers (e.g., FY 2026: 1st quarter, or October-
December).
4. Types of services provided during the quarter.
Note: Do not 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., A school board member attended the Infant Mortality
Reduction Coalition meeting, for the first time.) or to describe any challenges
encountered during the quarter (e.g., The health advocate accepted a new position, and
the lactation consultant went on maternity leave, so we are short two team members.)
PROJECT TITLE: MI Adolescent Pregnancy and Parenting Program
Project Synopsis
The goal of MI-APPP (Michigan Adolescent Pregnancy and Parenting Program) 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
Additional Reporting Requirements
Program
Narrative
October 1- December 31 January 15
Program
Coordinator
Evaluation/Data
Submission Monthly Submit the 10th of
every month REDcap
Any additional requirements
• 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: MI HOME VISITING INITIATIVE RURAL EXPANSION GRANT
(MHVIRE)
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.
Additional Reporting Requirements
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 Section (HVS) Guidance Manual (MDHHS
HVS Contract Supports) for details about what must be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the HVS Model Consultant via e-mail and incorporate the change(s) into the budget and face sheet during the next amendment cycle as appropriate. The face sheet 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 face sheet changes once the agreement is available to be amended.
b. Work Plan: Due annually on May 30 to the HVS Model Consultant for preapproval.
Upload approval, upload Work Plan to Groupsite. See the MDHHS Home Visiting
Section 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. HVS 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 Model Consultant by
April 30 using the HVS required QI Summary Template (QI Annual Summary
Report Template).
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 Section
Guidance Manual.
Grantee Specific Requirements
The LIA shall serve families as a result of outreach efforts based on the findings of their
MDHHS- HVS Outreach Toolkit.
In general, across all regions, the home visitor-to-family ratio should agree with the
following:
16 families or a case weight 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 Section 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 Section 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 Section 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 Section 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 Section Guidance Manual for requirements related to
program monitoring, quality assessment, support and TA.
Professional Development and Training
All 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 Section Guidance Manual for
requirements related to professional development and training activities.
Supervision
The LIA shall adhere to the HFA model standards for reflective supervision.
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 Section 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 Section 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 Section 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 Section Guidance Manual.
PROJECT: Michigan Hubs
Project Synopsis
Michigan Hubs is a network of community partners and collaboratives working together
to understand and address the social, economic, and environmental factors that
influence health and well-being. Through strong local partnerships, each Hub tailors
efforts to the unique needs of its community, enhancing both social and health care
service delivery. By strengthening collaboration between health care and social care
organizations, Michigan Hubs aim to build the technological, human, and organizational
capacities necessary for coordinated, community-centered care that improves overall
health outcomes across the state.
Additional Reporting Requirements
Grantees are required to submit a quarterly status report with information on the
following areas:
1. Michigan Hub Infrastructure: Report on developments related to governance
and other foundational elements of Hub’s operations.
2. Additional Activities within Work Plan: Describe any additional activities
undertaken within those outlined in the work plan.
3. Technical Assistance Needs: Outline any support or resources required to
overcome challenges, enhance the Hub’s impact, or address emerging needs.
4. Progress Toward Intended Outcomes/Impact: Reflect on progress toward
achieving the intended outcomes and impacts of programs and projects.
Surveys will be completed through Qualtrics and must be submitted by 15th of the
month following the respective reporting period
• January 15, 2026 (baseline reporting)
• April 15, 2026 (reporting period of January-March 2026)
• July 15, 2026 (reporting period of April-June 2026)
• October 15, 2026 (reporting period of July-September 2026)
Any additional requirements (if applicable)
Grantee participation in quarterly Learning Community meetings and quarterly Regional
Partner meetings to share updates, best practices, and barriers will be required.
PROJECT: MIHP Staffing Cost Assistance
Project Synopsis
Supplemental funding to be utilized to assist with staffing costs of the Maternal Infant
Health Program (MIHP). Funded staff must directly support Medicaid beneficiaries
enrolled in the MIHP.
Additional Reporting Requirements
NA
PROJECT: Neighborhood Wellness Centers
(Ingham County Health Department)
Project Synopsis
To reduce health and economic disparities in the Lansing community by offering
accessible healthcare services and personalized, coordinated referrals to community
resources that address social determinants of health. By partnering with the Michigan
Department of Health and Human Services (MDHHS), the Ingham County Health
Department (ICHD) will promote its programs and services through Neighborhood
Wellness Centers. These centers will build upon the successful infrastructure
established by the Neighborhood Testing Site program and the Racial Disparities Task
Force during the pandemic. This initiative will help ICHD lower barriers to care and
resources, combat disease, and improve the overall health and wellbeing of the
community. ICHD will offer these services at the following Neighborhood Wellness
Center location:
• Epicenter of Worship
Additional Reporting Requirements:
• Grantee must adhere to all reporting requirements described in Standard
Operating Procedures (SOP) and report data to MDHHS.
Additional Requirements:
1. Grantee must offer COVID-19 testing, blood pressure, cholesterol, and diabetes
screenings to visitors unless/until otherwise directed by MDHHS, in writing.
a. Grantee is responsible for providing all medical devices and required
medical supplies to support blood pressure, cholesterol, and diabetes
screenings to implement a complete Point of Care (POC) wellness clinic
experience. This includes but is not limited to: Scales, BP cuffs (in multiple
sizes), glucometers, HgbA1c Clinical Laboratory Improvement
Amendments (CLIA-Waived analyzers), lipid CLIA-waived analyzers, etc.).
b. Grantee is responsible for providing the necessary PPE and other medical
supplies necessary to support COVID-19 testing.
2. Grantee must staff each NWC location with a dedicated Community Health
Worker (CHW).
3. Grantee’s CHW staff must be on-site at their assigned work location at least 3x a
week unless otherwise authorized by MDHHS in writing. Additionally, Grantee
must identify back-up coverage for CHWs in the event of planned vacations or
unexpected circumstances to ensure CHW support is maintained for each NWC
location.
4. Grantee must ensure all CHWs assigned to the NWC project have capacity to
fulfill NWC-specific activities whether part-time or full time according to the NWC
SOP and the accompanying Community Health Worker SOP.
5. Grantee is responsible for developing a “referral resource database”. This
database must include resources such as, but not limited to, community
organizations that can aid individuals in meeting one or more of their Social
Determinants of Health needs, clinics or providers offices that can aid individuals
with medical needs, mental health service providers/resources, and more.
a. Grantee is responsible for continually updating and vetting resources that
are included in the referral resource database to ensure the
organization/initiative/individual is active and able to provide aid to
individuals who may be referred to the resource by the CHW.
6. Grantee must develop a library of health education materials that can be shared
with NWC visitors including topics that span the Social Determinants of Health
and other health or mental health conditions.
7. Grantee is responsible for directing and managing the full scope of CHW work
activities. Some of these duties are outlined below and a full list of CHW
responsibilities can be found within the CHW SOP:
a. Engaging with NWC visitors, site partners, and NWC testing/diagnostic
vendors for continuous rapport building.
b. Conducting SDoH intakes to identify client needs and providing referrals to
service providers capable of aiding clients in meeting those needs.
c. Connecting with local organizations about NWC services to establish
referral partners that can be added to the referral resource database.
CHWs must utilize grantee designated resources, MDHHS resources, and
collaborate with NWC stakeholders to promote NWC services.
d. Participating in ongoing training and professional development trainings as
designated by the grantee or MDHHS.
e. Adhering to data capturing and reporting requirements as defined by
MDHHS. This includes but is not limited to the daily tracking of SDoH
intakes, client engagements, outreach activity, and client follow-up support
using MDHHS-designated platform or approved external platform.
f. Data is to be submitted to MDHHS/MDHHS designated vendor(s) by 7PM
daily. For additional details, see the CHW reporting Work Aid and
example follow-up word aid provided by MDHHS).
8. Grantee must develop a mechanism to support pre-registration and on-site
service registration electronically. Refer to Standard Operating Procedures
(SOP*) provided by MDHHS for more information about data elements to
incorporate into registration processes
a. Pre-registration links to be provided to MDHHS to support advertising of
site services (Refer to SOP).
9. Grantee must provide testing/screening results and accompanying resources on-
site (printed) and via email and or text message per the visitor’s preferences.
Testing/screening results must be retained for 7 years for auditing purposes
10. Grantee must provide testing/screening results as described within the provided
SOP (NWC diagnostics and Testing SOPs).
11. Grantee must follow all emergency protocols described within SOP.
12. If telehealth is available, Grantee must adhere to telehealth guidance and
reporting requirements as described in SOP.
13. Grantee will implement special projects as directed by MDHHS.
**Standard Operating Procedures are subject to change as they are continually updated
as more information is learned through project implementation efforts. MDHHS will
provide updated SOPs to Grantee(s) as they are updated and will work with Grantees to
establish timelines to make adjustments to operations on a case-by-case basis
*** MDHHS reserves the right to reduce the project award or terminate the project in the
event of the Grantee’s failure to meet stated project requirements.
PROJECT: Neighborhood Wellness Centers
(Detroit Health Department)
Project Synopsis
To reduce health and economic disparities in the Detroit community by offering
accessible healthcare services and personalized, coordinated referrals to community
resources that address social determinants of health. By partnering with the Michigan
Department of Health and Human Services (MDHHS), the Detroit Health Department
(DHD) will promote its programs and services through Neighborhood Wellness Centers.
These centers will build upon the successful infrastructure established by the
Neighborhood Testing Site program and the Racial Disparities Task Force during the
pandemic. This initiative will help DHD lower barriers to care and resources, combat
disease, and improve the overall health and wellbeing of Detroit residents. DHD will
offer these services at the following Neighborhood Wellness Center locations:
• Bethel Baptist Church East
• Historic King Solomon Church
• The Open Door Church of God in Christ
• Wayne County Community College District Northwest Campus
• Southwestern Church of God
• Hartford Memorial Baptist Church
• Triumph Church
Additional Reporting Requirements
• Grantee must adhere to all reporting requirements described in Standard
Operating Procedures (SOP) and report data to MDHHS.
Any additional requirements (if applicable)
1. Grantee must offer COVID-19 testing, blood pressure, cholesterol, and diabetes
screenings to visitors unless/until otherwise directed by MDHHS, in writing.
a. Grantee is responsible for providing all medical devices and required
medical supplies to support blood pressure, cholesterol, and diabetes
screenings to implement a complete Point of Care (POC) wellness clinic
experience. This includes but is not limited to: Scales, BP cuffs (in multiple
sizes), glucometers, HgbA1c Clinical Laboratory Improvement
Amendments (CLIA-Waived analyzers), lipid CLIA-waived analyzers, etc.).
b. Grantee is responsible for providing the necessary PPE and other medical
supplies necessary to support COVID-19 testing.
2. Grantee must staff each NWC location with a dedicated Community Health
Worker (CHW).
3. Grantee’s CHW staff must be on-site at their assigned work location at least 3x a
week unless otherwise authorized by MDHHS in writing. Additionally, Grantee
must identify back-up coverage for CHWs in the event of planned vacations or
unexpected circumstances to ensure CHW support is maintained for each NWC
location.
4. Grantee must ensure all CHWs assigned to the NWC project have capacity to
fulfill NWC-specific activities whether part-time or full time according to the NWC
SOP and the accompanying Community Health Worker SOP.
5. Grantee is responsible for developing a “referral resource database”. This
database must include resources such as, but not limited to, community
organizations that can aid individuals in meeting one or more of their Social
Determinants of Health needs, clinics or providers offices that can aid individuals
with medical needs, mental health service providers/resources, and more.
a. Grantee is responsible for continually updating and vetting resources that
are included in the referral resource database to ensure the
organization/initiative/individual is active and able to provide aid to
individuals who may be referred to the resource by the CHW.
6. Grantee must develop a library of health education materials that can be shared
with NWC visitors including topics that span the Social Determinants of Health
and other health or mental health conditions.
7. Grantee is responsible for directing and managing the full scope of CHW work
activities. Some of these duties are outlined below and a full list of CHW
responsibilities can be found within the CHW SOP:
a. Engaging with NWC visitors, site partners, and NWC testing/diagnostic
vendors for continuous rapport building.
b. Conducting SDoH intakes to identify client needs and providing referrals to
service providers capable of aiding clients in meeting those needs.
c. Connecting with local organizations about NWC services to establish
referral partners that can be added to the referral resource database.
CHWs must utilize grantee designated resources, MDHHS resources, and
collaborate with NWC stakeholders to promote NWC services.
d. Participating in ongoing training and professional development trainings as
designated by the grantee or MDHHS.
e. Adhering to data capturing and reporting requirements as defined by
MDHHS. This includes but is not limited to the daily tracking of SDoH
intakes, client engagements, outreach activity, and client follow-up support
using MDHHS-designated platform or approved external platform.
f. Data is to be submitted to MDHHS/MDHHS designated vendor(s) by 7PM
daily. For additional details, see the CHW reporting Work Aid and
example follow-up word aid provided by MDHHS).
8. Grantee must develop a mechanism to support pre-registration and on-site
service registration electronically. Refer to Standard Operating Procedures
(SOP*) provided by MDHHS for more information about data elements to
incorporate into registration processes
a. Pre-registration links to be provided to MDHHS to support advertising of
site services (Refer to SOP).
9. Grantee must provide testing/screening results and accompanying resources on-
site (printed) and via email and or text message per the visitor’s preferences.
Testing/screening results must be retained for 7 years for auditing purposes.
10. Grantee must provide testing/screening results as described within the provided
SOP (NWC diagnostics and Testing SOPs).
11. Grantee must follow all emergency protocols described within SOP.
12. If telehealth is available, Grantee must adhere to telehealth guidance and
reporting requirements as described in the SOP.
13. Grantee will implement special projects as directed by MDHHS.
**Standard Operating Procedures are subject to change as they are continually updated
as more information is learned through project implementation efforts. MDHHS will
provide updated SOPs to Grantee(s) as they are updated and will work with Grantees to
establish timelines to make adjustments to operations on a case-by-case basis
*** MDHHS reserves the right to reduce the project award or terminate the project in the
event of the Grantee’s failure to meet stated project requirements.
PROJECT: NURSE-FAMILY PARNERSHIP (NFP) SERVICES
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.
Additional Reporting Requirements
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 Section Guidance Manual (MDHHS HVS
Contract Supports) for details about what must be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the NFP Model
Consultant via e-mail and incorporate the change(s) into the budget and face
sheet during the next amendment cycle as appropriate. The face sheet 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
face sheet 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. NFP Work Plan: Due annually by May 30 to the HVS Model Consultant for
preapproval then uploaded into Groupsite. See the MDHHS Home Visiting Section
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. HVS 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 Model Consultant
by April 30 using the HVS required QI Summary Template (QI Annual
Summary Report Template).
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
Section Guidance Manual.
FY26 Home Visiting Compensation Rates
The Local Implementing Agency (LIA) shall utilize MDHHS-Home Visiting Section (HVS)
funding to compensate home visitors at no less than the current MDHHS-HVS minimum
hourly salary requirement for a standard home visitor as identified below. The minimum
hourly salary is set utilizing the MIT Living Wage scale and may be subject to change.
Programs should not decrease compensation if home visitors are currently paid at a
higher hourly rate.
It is recommended, but not required, that programs compensate home visiting program
supervisors based on the hourly rate identified below.
FY 26 Home Visiting Compensation Rates
The expectation to meet this goal began FY25 (i.e., October 1, 2024). The HVS will
work with all LIAs to achieve this goal through a phase-in process as needed.
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 Repots, 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 MDHHS based on
the agreement executed in E-GrAMS and the conditions as outlined in the MDHHS
Home Visiting Section 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 have 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-HVS Outreach Toolkit to enroll families from those outreach
efforts.
The MDHHS expects LIAs to maintain a caseload capacity of 20 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 Section 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 Section 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 Section 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 regard 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 Section 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 Section 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 Section 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 Section 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
See the MDHHS Home Visiting Section 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 Section Guidance Manual.
PROJECT TITLE: OPIOID AFFECTED YOUTH INITIATIVE (OAYI)
Project Synopsis
The purpose of the Peer Navigator Pilot Project is to increase support for pregnant
and postpartum people who are impacted by substance use by placing Peer
Navigators in Healthcare or Behavioral Health settings. Peer Navigators will work
to support families in their recovery journey while also supporting connections to
resources within their community.
Project Title: Oral Health Kindergarten Assessment
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
• Results of each dental assessment conducted by the LHD or a subcontracted dental
agency conducting dental assessments on its behalf shall be entered in the MDHHS
KOHA database no later than 30 days following the close of the respective quarter.
Any additional requirements (if applicable)
• 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 Kindergarten Oral Health Assessment Program policies and
procedures.
• 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.
PROJECT: Public Health Emergency Preparedness (PHEP)
and Cities Readiness Initiative (CRI) as applicable
9 Month Projects – BIONINE & CRININE
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 BP1(2024-2025) 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.
Additional Reporting Requirements
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 Specialist, Janis Tipton at tiptonj2@michigan.gov with
a cc to MDHHS-BETP-DEPR-PHEP@michigan.gov by April 12, 2024.
2. ALL activities funded through the PHEP cooperative agreement must be
completed between July 1, and June 30, and all BP1 funding must be obligated
by June 30, 2025, and activity completed by the July 31, 2025 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 BP1 work plan.
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 BP1 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 BP1 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,
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 Specialist, 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.
• 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 $199,300 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.
• 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:
• Update risk assessment to include people who are disproportionately impacted by
public health emergencies (HE-A).
• Include critical response and recovery partners in required plans and exercises
(PAR-A).
• Identify and implement communication surveillance, media relations, and digital
communication strategies in exercises (RSK-B).
• Further guidance related to specific preparedness deliverables will be included in
the LHD workplan.
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
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.
Additional Reporting Requirements
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: Regional Health Advisory Councils
Project Synopsis
The Regional Health Advisory Councils (RHACs) have been established using a
framework adapting elements of collective impact and community social capital model
to drive power sharing and co-created decision-making models in addressing
community health. These councils are required to have a mix of community members
and organizational representation to ensure the voice of community members was not
just uplifted but also had influence in decision making processes.
The RHACs are tasked with addressing the disparate impacts of upstream or
downstream social and economic factors on health in their regions. Council members
come together to identify levers with the potential to improve health and/or close gaps
within their region. Levers/activities can include data collection, community health
worker programs, listening sessions, translation and interpretation, health literacy, and
more. Once identified activities and action steps are developed by the council, an
impact statement must be made to detail the connection.
The expected impact of the councils in communities of Michigan includes:
1. Fulfilling MDHHS’s desire to establish a bilateral advisory infrastructure between
MDHHS and the community across the 5 regions of Michigan.
2. Prioritize decision-making power within communities and in the hands of those with
the lived experience to shift the imbalance of power in addressing direct needs of
high-risk populations with limited access, including lesser represented populations,
rural communities, and racial/ethnic communities.
Grantees will engage their council in these project goals:
1. Planned reduction of community identify priority risk factors.
2. Development and implementation of practices and policies to promote fair
opportunities to reduce health differences in outcomes between different
communities.
3. Fair distribution and efficient use of resources to support affected communities
including organizations, community leaders, both existing and emerging.
4. Establish pathways for bidirectional communication and relationship building
between traditional and non-traditional partners such as but not limited to
healthcare, grassroots organizations, business, education, transportation, etc.
Additional Reporting Requirements
• Workplan – submitted according to due dates set by MI-TEACH
• Quarterly Reports – submitted no later than thirty (30) days after the close of
the quarter.
Any additional requirements (if applicable)
• Submit a quarterly report on progress related to the objectives and measures
in the workplan. Any necessary revisions can be made to the workplan at this
time.
• Attend quarterly collaborative meetings.
• Submit success stories upon request.
• Ensure all communication materials that are developed and distributed by
the grantee using the MDHHS funds acknowledge the funding source.
PROJECT: Regional Perinatal Care System
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 Advancing Healthy Births: An Equity Plan for Michigan Families and
Communities and are tasked with addressing disparities in birth outcomes and health
inequities. Each RPQC engages cross-sector, diverse partners and implements evidence-
based, or promising practice, interventions utilizing quality improvement methodology.
Additional Reporting Requirements
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’.
• Additional funding sources may be acquired to support specific efforts and activities
of the RPQC. RPQCs are encouraged to report on the efforts and activities of
these outside funding sources in their quarterly narrative reports.
• Grantees will be required to submit quarterly progress reports by the 15th day of the
month following the end of the quarter, with the fourth quarter report due no later
than October 15, 2026.
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 partners, 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. RPQC membership must include family
representation.
• 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 Michigan’s 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.
• RPQCs will specifically be required to:
1. Include updates on region-specific MI AIM efforts and best practices at a
minimum of two (2) 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 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
Michigan’s 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 incorporate project focus
as directed by MDHHS.
• All appropriated funding must support efforts specifically impacting individuals in
the perinatal period, postpartum up to one year and/or infants up to one year of
age.
• Funding cannot be used to support efforts that are duplicative of existing state
resources or efforts
• 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. At least two members of the RPQC leadership team are required to attend the
quarterly State Perinatal Quality Collaborative meetings (i.e., RPQC Leadership
Meeting).
2. Each region will be required to report on their efforts, challenges, successes
and etcetera at one of the quarterly MIHEC meetings.
3. RPQCs will host regional Town Hall meetings in collaboration with MDHHS, as
requested.
Budget Allowances
To ensure most of the awarded funding is funneled into the community for quality
improvement efforts:
• Total staffing budgets, inclusive of fringe benefits, will be capped based on the
RPQC’s ongoing funding amount.
o Under $300,000 must cap staffing budgets at 65% of ongoing funding
allocation.
o Between $300,000 - $400,000 must cap staffing budgets at 50% of
ongoing funding allocation.
o Between $400,000 - $700,000 must cap staffing budgets at 40% of
ongoing funding allocation.
o Above $700,000 must cap staffing budgets at 25% of ongoing funding
allocation.
• ‘Staffing budget’ is defined as those individuals hired to carry out the leadership,
project coordination, and quality improvement tasks of the RPQC.
o External consultants hired to provide support/lead work groups (including
those formed as the result of assessments, strategic planning and the
like), and those who were previously referred to as ‘subject matter
experts’, will also be included in the staffing budget umbrella.
o Individuals or companies hired to provide a specific service, or create a
specific product, are not included under the staffing budget. Examples of
these exceptions include:
• Marketing agencies contracted to design RPQC logos, assist
with social media and website design, newsletters, etc.
• Agencies contracted to create videos as part of a specific effort
of the RPQC and/or its workgroups.
• Stipends to local health departments and/or birthing hospitals to
encourage participation in the RPQC.
• Parent/community member stipends for participation in the
RPQC, its workgroups and related efforts.
• Agencies or individuals contracted to provide a specific training
or series of trainings.
• Staff hired to provide strategic planning, birth equity
assessments, etc.
o Implementation or ongoing workgroup activities resulting
from strategic planning or assessment activities will fall
under the staffing budget.
• RPQCs are required to participate in activities supportive of, and related to, efforts
outlined in the Centers for Disease Control and Prevention (CDC) Perinatal Quality
Collaborative (PQC) grant, as requested.
• 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.
• Grantees are prohibited from awarding funds provided under this agreement to any
subrecipient organization where any staff member of the Grantee, their immediate
family members, or other members of their household has a financial or personal
interest. Failure to adhere to this provision may result in the suspension or
termination of funding. Consult the information contained in your contract language
regarding Conflicts of Interest and Code of Conduct Standards.
PROJECT: SDOH Hub Pilot
Project Synopsis
SDOH Hubs are a network of community partners and collaboratives that work together
to understand and address the social, economic, and environmental factors influencing
health and well-being. Local SDOH Hub partners work collectively to enhance social and
health care service delivery, tailored to the specific needs of their community. The local
health departments will serve as lead organizations for SDOH Hubs, responsible for
administering funds, communicating with partners, and ensuring that community
members guide the work of the hub.
Additional Reporting Requirements
Grantees are required to submit a quarterly status report with information on the following
areas:
1. Supplemental Programs/Projects
a. Share updates on activities and initiatives tied to supplemental programs or
projects.
b. Highlight notable successes and any challenges encountered.
2. SDOH Hub Infrastructure
a. Report on developments related to governance and other foundational
elements of the Hub’s operations.
3. Additional Activities within Work Plan
a. Describe any additional activities undertaken within those outlined in the
work plan.
4. Technical Assistance Needs
a. Outline any support or resources required to overcome challenges,
enhance the Hub’s impact, or address emerging needs.
5. Progress Toward Intended Outcomes/Impact
a. Reflect on progress toward achieving the intended outcomes and impacts
of programs and projects.
Surveys will be completed through Qualtrics and must be submitted by 15th of the month
following the respective reporting period (e.g. due date of April 15 for the quarter
spanning January -March).
• January 15, 2026 (reporting period of October-December)
• April 15, 2026 (reporting period of January-March)
• July 15, 2026 (reporting period of April-June)
• October 15, 2026 (reporting period of July-September)
Any additional requirements (if applicable)
Grantee participation in quarterly Learning Community meetings and quarterly Regional
Partner meetings to share updates, best practices, and barriers will be required.
PROJECT: SEAL! Michigan Dental Sealant
Project Synopsis
SEAL! MI is the School Based Dental Sealant Program, providing oral health prevention
to students in Michigan schools.
Additional Reporting Requirements
• Program shall submit program quarterly progress reports on tracking form provided
by the School Oral Health Consultant.
• The above report shall be submitted via email directly to the School Oral
Health Consultant no later than 15 days following the end of each quarter:
Andre Whittaker, RDH, BS, MPA
School Oral Health Consultant
whittakera@michigan.gov
• Program shall input student data information quarterly into the data capturing
platform – Qualtrics.
• The above information shall be completed no later than 15 days following the
end of each quarter.
• The School Oral Health Consultant shall evaluate reports and student data
submitted for completeness and adequacy.
Any additional requirements (if applicable)
• 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 portable equipment or dental mobile unit 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
Infection Prevention and Control
• Infection control policies must be followed in all SEAL! Michigan events.
• This includes:
Weekly sterilization spore testing - If your program is not operational,
note the reason for the missed testing.
Quarterly dental unit waterline testing
• Maintain dental unit waterline testing log
Yearly dental unit waterline shocking
• Maintain dent unit waterline shocking log
• One program representative must complete CDC’s Foundations: Building the Safest
Dental Visit Training and provide certificate of completion confirmation by July 31,
2026 to School Oral Health Consultant..
Performance
• The LHD shall attend scheduled meetings, calls, site visits, etc. as requested by
MDHHS School Oral Health Consultant.
• The LHD shall permit School Oral Health Consultant or its designee to visit and
make an evaluation of the program performance.
PROJECT: Statewide Lead Case Management
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 (nursing case management services to children enrolled in Medicaid is
reimbursed through the CSHCS Medicaid Elevated Blood Lead Case Management
Project), as well as reimbursement for community health workers (CHWs) to complete
case management activities for all children regardless of insurance status. NCM visits
will be reimbursed at a rate of $221.74 and community health worker visits at a rate of
$110. 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.
Additional Reporting Requirements
Quarterly FSR and FSR Supplemental Attachment
Submit request for reimbursement through EGrAMS based on the “fixed unit rate”
method. The fixed rate for nursing case management services is $221.74 per home
visit, for up to 6 home visits. The fixed rate for community health worker services is
$110 per home visit, for up to 2 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.
Any additional requirements (if applicable)
Continuation of this project is contingent upon funding availability.
The local health department shall:
• Have CM conducted by a registered nurse trained by MDHHS CLPPP. To be
reimbursed for a nursing case management home visit, the visit must be
completed by a registered nurse. To be reimbursed for a community health
worker home visit, the visit must be completed by a certified community health
worker.
• Sign up for the DCH-File Transfer Site available through MiLogin. This site will be
used for data sharing of confidential information.
• Have signed care coordination agreements with all Medicaid Health Plans in their
jurisdiction. Use template developed and agreed upon by MDHHS Medicaid and
CLPPP.
• Document all required case management activities in the child’s electronic file in
the MICLEAR NCM database, as outlined in the Nursing Case Management
Documentation Standards Procedure document.
• Complete case management activities according to the MDHHS CLPPP Nursing
Case Management Guide for Children with Elevated Blood Lead Levels. If your
local policies and procedures vary from MDHHS CLPPP Guide and/or
procedures, please submit in writing to MDHHS CLPPP.
PROJECT: STI Prepaid Testing
Project Synopsis
The STI Prepaid Testing project will provide funding back to a regional lab system
partner that has performed testing of risk category patients that meet state STD
Program Office criteria to utilize a pre-paid test form. The test performed will be
reimbursed at the current national CPT code approved rate or in special approval
situations (i.e. Children’s Village) at a rate of $14.19. Since this is a pay-back of testing
performed, sites may utilize the returned funds in whatever manner they deem
necessary.
Additional Reporting Requirements
October-December: numbers due by January 15
January-March: numbers due by April 15
April-June: numbers due by July 15
July-September: numbers due by October 15
Reports should be sent by email to:
Dr. Marty Soehnlen (soehnlenm@michigan.gov)
Gwen Murphy (murphyg1@michigan.gov)
Heather Blankenship (blankenshiph@michigan.gov)
Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source
documentation, to support program activities and all expenditures made under the terms
of this Agreement, as required. The Grantee must assure that all terms of the
Agreement will be appropriately adhered to and that records and detailed
documentation for the grant project or grant program identified in this Agreement will be
maintained for a period of not less than seven years from the date of termination, the
date of submission of the final expenditure report, or until litigation and audit findings
have been resolved. This section applies to Grantee, any parent, affiliate, or subsidiary
organization of the Grantee and any subcontractor that performs activities in connection
with this Agreement.
PROJECT: Substance Use Home Visiting Program
Project Synopsis
The focus of the Substance Use Home Visiting Program is to increase support for
families who have been impacted by substance use and/or families who are eligible for
FFPSA through the expansion of home visiting services and Peer Navigator services
that connect families to resources.
Additional Reporting Requirements
(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 Section Guidance Manual for details
about what must be included in each report.
a. Staffing Changes: Within 10 days of a staffing change, notify the 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 ongoing funding tracking data used for federal billing and reporting through
REDCap and/or their model data system by Thursday each week. This data
includes:
• Family Model ID#
• Funding Source
• How substance use was identified if the family has substance use impact
• Family demographic information (including MiSACWIS IDs) if the family is
FFPSA eligible
c. Work Plan: Due annually on May 30 to the HVS Model Consultant for
preapproval then uploaded to Groupsite. See the MDHHS Home Visiting Section
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. HVS 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. PAT programs must use Visit Tracker, 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 using the HVS required QI Summary Template (QI Annual
Summary Report Template).
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
Section Guidance Manual.
Grantee Specific Requirements for Home Visiting Model Implementation
Home visitors funded through Thriving Futures will serve families referred from local
Child Welfare agencies or those who are impacted by substance use, in proportion to
their Thriving Futures FTE.
HFA: 13 FFPSA families per 1.0 FTE (or maximum case weight of 30)
NFP: 20 FFPSA families per 1.0 FTE
PAT: 12-16 (monitoring for 14) families per 1.0 FTE
Branding
The Healthy Moms Healthy Babies Substance Use Programs are known within funded
programs and communities as Thriving Futures.
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 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 Section 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 Section
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 Section 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 Section 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 Section 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.
• PAT: Minimum of two hours per month of individual reflective supervision per 1.0
FTE as well as a minimum of two hours per month of group supervision.
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 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 build relationships with local community providers who serve families
impacted by substance use.
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 Section Guidance Manual for requirements related to
engagement with community partners.
Data Collection
The LIA shall comply with all model and MDHHS HVS data training, collection, entry,
and submission requirements. See the MDHHS Home Visiting Section 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 Section 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 Section Guidance Manual.
Peer Navigator Program
(Only applies to grantees implementing the Peer Navigator Program)
Comply with MDHHS Peer Navigator 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
Program 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 Program as a specialized service strategy for
pregnant and postpartum people impacted by substance use. The LIA will conduct
outreach activities to the families impacted by substance use identified 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 Program 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 Program 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. This data includes:
o Referrals
o Enrollments
o Exits
o Every Family Contact
o Plan of Safe Care Completion
o Community Service referrals
o Referral Follow-Up
o Engagement in Home Visiting
o Child Welfare Involvement
o BARC-10 assessment
o Substance Use History Form
o Hospital discharge status of the infant
Work Plan Requirements
Annually, by May 30, the grantee must submit a Work Plan for the next fiscal year to the
MDHHS Home Visiting Section Substance Use Coordinator for preapproval. The
approved Work Plan must be submitted via E-GrAMS at the time of application.
PROJECT: Tobacco Control Grant Program
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, commercial tobacco-free spaces, and health equity by working
with populations who are the most negatively affected by tobacco use disparities.
Additional Reporting Requirements
The Grantee shall submit the following reports on the following dates:
1. Evaluation data tracking tool bi-annually on April 30 and October 30 (format to be
provided by MDHHS TCP).
2. Quarterly progress reports are due January 15, April 15, July 15, and October 15
3. Quarterly financial status reports (FSR’s) are due January 30, April 30, July 30, and
November 30. These are submitted to the TCP Contract Manager via URL
http://egrams-mi.com/mdhhs/.
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.
Media & Communications Approval
All media and communications products developed, including but not limited to,
brochures, advertisements, and other promotional or education materials, must receive
final written approval from your designated Public Health Consultant prior to its
publication or distribution. Your consultant reserves the right to request revisions to
ensure alignment with grant requirements, media or public health best practices, and/or
program objectives.
To support the timely development of media materials, technical assistance is available,
and contractors are encouraged to consult with the Tobacco Control Program’s
Communications Specialist at the beginning of any media project. Early collaboration can
help ensure compliance and prevent delays.
Media Guidelines Include
Readability
• Use sans-serif fonts for readability.
• Use accessible and appropriate font sizes (font sizes will vary based on media
vehicle).
• Limit the use of decorative fonts, reserving for accents only in some cases.
• Use high contrast color combinations (dark text on light background or light text
with dark background).
• Ensure compliance with ADA accessibility standards.
• Limit color palette to 3-5 colors.
Messaging
• Tailor message to the media format (e.g., short message for billboard, detailed
information for brochure).
• Avoid jargon or technical language (based on your target audience)
• Use clear, concise, and action-oriented language.
• Use culturally tailored language and images (e.g. include explanation of traditional
vs commercial tobacco).
Ethically sourced images and data
• Follow all copyright laws when securing images for materials.
• Include citations, acknowledgements, and disclaimers when appropriate.
• Receive permission to use logos owned by other organizations and follow any
brand guidelines as required by said organization.
PROJECTS:
Treatment without Borders - DIS Intervention Workforce
Disease Intervention Specialist (DIS) Workforce
Project Synopsis:
Treatment without Borders - DIS Intervention Workforce: To address the increased
number of congenital syphilis cases in Michigan, MDHHS/BHSP and the Detroit Health
Department (DHD) will implement a protocol to pair a Pediatric Disease Intervention
Specialist (DIS) with a DHD nurse to provide syphilis treatment in the home of pregnant
persons diagnosed with syphilis, and their partners.
Disease Intervention Specialist (DIS) Workforce: This project is to build and enhance a
Disease Intervention Specialist workforce that responds to COVID, STI's and other
emerging threats.
Reporting Requirements
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.
Report Period Due Date(s) How to Submit Report
STI 340B
Utilization/Inventory
Report
Quarterly
Within 10 days
after the end of
the quarter
SGRX340BFlex.com
website, generate a
quarterly report on the
reporting tab, and it will
be transferred
automatically to
Data Report end of the quarter liaison & MDHHS-
HIVSTIOperations@michi
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.
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.
Mandatory Disclosures
1. Inform BHSP at least two weeks prior to changes in clinic operation (hours,
scope of service, etc.).
2. The Grantee will provide immediate notification to BHSP, in writing, including but
not limited to the following events:
i. Any formal grievance initiated by a client and subsequent resolution of that
grievance.
ii. 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.
iii. Any staff vacancies funded for this project that exceed 30 days.
3. All notifications should be made to BHSP MDHHS-
HIVSTIoperations@michigan.gov and MDHHS-SHOARS-
SUPPORT@michigan.gov .
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.
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: SHOARS support
2. Recipient agency must register an Authorized Official, Financial Officer 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@michigan.gov
PROJECT: Tuberculosis Control
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 Module #6: Self-Study Modules on Tuberculosis
Module 6 Managing Tuberculosis Patients and Improving Adherence (cdc.gov).
Additional Reporting Requirements
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 not 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
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 (once 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.
Additional Reporting Requirements
The subrecipient shall submit bi-weekly (once every two weeks) tables of surveillance
data (template provided) documenting trap rates and disease detections to Emily Dinh
(dinhe@michigan.gov) and Rachel Burkholder (burkholderr@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
o Mosquitos – target vector species may be submitted to MDHHS BOL for
pathogen testing.
o Ticks –
Ixodes scapularis (blacklegged) nymph and adult ticks must be
submitted to MDHHS EZID staff at the end of the project period
Detections of Amblyomma americanum (lone star) and
Haemaphysalis longicornis (Asian longhorned) ticks must be
promptly reported to MDHHS EZID staff
• 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 (once every two weeks) reporting of surveillance results to
MDHHS EZID Section (see contact information above).
• 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. Intended mosquito
trapping plans must be approved by MDHHS EZID staff prior to beginning collections.
placed for 24-hour period
placed for 24-hour period in
with local municipalities / other
PROJECT: West Nile Virus Community Surveillance
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 bi-weekly (once every two weeks) reporting to MDHHS
EZID of surveillance results.
Additional Reporting Requirements
The Grantee shall submit bi-weekly (once every two weeks) tables of surveillance data
(template provided) documenting trap rates and disease detections to Emily Dinh
(dinhe@michigan.gov), and Rachel Burkholder (burkholderr@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.
• Submit target vector species to MDHHS BOL for pathogen testing.
• Provide bi-weekly (once every two weeks) reporting of surveillance results to the
MDHHS EZID Section (see contact information above).
• 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
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 to the Program Director, Courtney Cole, at ColeC13@michigan.gov.
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
• 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 Local Coordinating Agencies (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
as an attachment via email to Courtney Cole at ColeC13@michigan.gov by
November 1.
Any additional requirements (if applicable)
• Under this agreement WISEWOMAN LCAs commit to:
o Screen 95% of assigned caseload and provide eligible participants
assistance to reduce risk of heart disease and stroke according to
WISEWOMAN program policies and procedures.
o Encourage 100% of participants to set a health goal and receive at least
one health coaching contact or participate in an evidence-based lifestyle
program.
• A statewide database called the Michigan Breast and Cervical Information
System (MBCIS) is maintained by MDHHS and the Cancer Prevention and
Control Section (CPCS). Instructions for contractor use of MBCIS are provided in
manuals for programs 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, 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.
Kent County Health Department Only:
Kent County Health Department (KCHD) will provide a 15% match on the Michigan
Department of Health and Human Services (MDHHS) funded amount. These matching
funds will be tracked on the KCHD WISEWOMAN Matching Funds Report and due back
to MDHHS by November 1. Please see the KCHD WISEWOMAN Matching Funds
Report spreadsheet for additional details.
PROJECT: Women Infant Children (WIC)
WIC Breastfeeding
WIC Migrant
WIC Resident
Project Synopsis
Women, Infants, and Children (WIC) is a federally funded Special Supplemental
Nutrition Program of the Food and Nutrition Service (FNS) of the United States
Department of Agriculture (USDA) and is administered by the Michigan Department of
Health and Human Services (MDHHS) 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.
Additional Reporting Requirements
A Financial Status Report (FSR) must be submitted to MDHHS 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 MDHHS 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 Counselor (BFPC) 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.
Any additional requirements (if applicable)
• 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.
• Work completed by breastfeeding staff funded under the BFPC grant is not eligible
for inclusion in the time study. Work completed by breastfeeding staff funded under
the WIC Resident grant is to be included in the time study.
• The Grantee must follow guidelines provided by USDA FNS for the Breastfeeding
Peer Counselor grant, including those for allowable expenses.
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 specified in both the WIC Breastfeeding Model Components for Peer
Counseling and allocation letter for the Breastfeeding Peer Counselor 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 Grant 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 the indirect line item on the budget.
Additional local funds can be supplemented to cover indirect costs exceeding 30%.
• The grantee must 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:
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
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.
• 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 Produce Connection (formerly known as
Project FRESH) Program within the guidelines as laid out in the “WIC Produce
Connection Local Agency Guidebook.”
• The Grantee is required to abide by the Dissemination License Agreement between
Michigan State University (MSU) and MDHHS for “Mothers in Motion,” and the
Dissemination License Agreement between MSU, Ohio State Innovative
Foundation and MDHHS for “Communicate to Motivate.” 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.
• The Grantee is required to follow the basic standards for processing and tracking
covered complaints of discrimination as indicated in the Memorandum of
Understanding between USDA and MDHHS, which is included in Addendum 2, as
reference.
• The Grantee is required to provide written assurance that it will operate in
compliance with applicable nondiscrimination laws, regulations, instructions,
policies, and guidelines. A signed copy of these assurances must also be submitted
by the Grantee to MDHHS-WicFinance@michigan.gov by September 30.
WIC Resident Services/Migrant/Breastfeeding Training and Education
Requirements:
The Grantee is required to comply with MI-WIC Policies 1.07 Local Agency Staffing and
Training, and 1.07A Staff Training Plan, requirements for WIC staff training and
education.
PROJECT: Youth & Schools Tobacco Project
Project Synopsis
The focus of the program is to expand work with districts and schools for alternatives to
suspension policy, treatment resources, staff training. This work includes partnerships
with school health clinics and school social workers.
Additional Reporting Requirements
The Grantee shall submit the following reports on the following dates:
1. Evaluation data tracking tool bi-annually on April 30 and October 30 (format to be
provided by MDHHS TCP).
2. Quarterly progress reports are due January 15, April 15, July 15, and October 15.
3. Quarterly financial status reports (FSR’s) are due January 30, April 30, July 30,
and November 30. These are submitted to the Contract Manager via URL
http://egrams-mi.com/mdhhs/.
Any additional requirements (if applicable)
• Grantee will create action plans for any recommendation of the MDHHS Contract
Manager. Grantee will meet every other month or more frequently, as needed, with
the MDHHS Contract Manager.
• Grantee will communicate every other month or more frequently, as needed, with
their consultant about budget projections.
Media & Communications Approval
All media and communications products developed, including but not limited to,
brochures, advertisements, and other promotional or education materials, must receive
final written approval from your designated Public Health Consultant prior to its
publication or distribution. Your consultant reserves the right to request revisions to
ensure alignment with grant requirements, media or public health best practices, and/or
program objectives.
To support the timely development of media materials, technical assistance is available,
and contractors are encouraged to consult with the Tobacco Control Program’s
Communications Specialist at the beginning of any media project. Early collaboration can
help ensure compliance and prevent delays.
Media Guidelines Include
Readability
• Use sans-serif fonts for readability.
• Use accessible and appropriate font sizes (font sizes will vary based on media
vehicle).
• Limit the use of decorative fonts, reserving for accents only in some cases.
• Use high contrast color combinations (dark text on light background or light text
with dark background).
• Ensure compliance with ADA accessibility standards.
• Limit color palette to 3-5 colors.
Messaging
• Tailor message to the media format (e.g., short message for billboard, detailed
information for brochure).
• Avoid jargon or technical language (based on your target audience)
• Use clear, concise, and action-oriented language.
• Use culturally tailored language and images (e.g. include explanation of traditional
vs commercial tobacco).
Ethically sourced images and data
• Follow all copyright laws when securing images for materials.
• Include citations, acknowledgements, and disclaimers when appropriate.
• Receive permission to use logos owned by other organizations and follow any
brand guidelines as required by said organization.