HomeMy WebLinkAboutMinutes - 2010.01.20 - 70701
OAKLAND COUNTY
BOARD OF COMMISSIONERS
REPUBLICAN CAUCUS MINUTES
January 20, 2010
Meeting called to order by Republican Caucus Chairperson Bradford Jacobsen at 6:24 p.m. in the
Courthouse Committee Room A, 1200 N. Telegraph Road, Pontiac, Michigan.
Roll called.
REPUBLICAN COMMISSIONERS PRESENT: Bullard, Capello, Douglas, Gingell, Gosselin,
Jacobsen, Long, Middleton, Potter, Potts, Runestad, Scott, Taub. (13)
EXCUSED ABSENCE WITH NOTICE: None. (0)
Quorum present.
There was no public comment.
Commissioner Capello announced that he will seek re-election.
Republican Caucus Chairperson Bradford Jacobsen introduced Tony Albensi, who is on the Oxford
Village Council and interested in running for County Commissioner.
Moved by Middleton supported by Scott the minutes of the December 9, 2009 Republican Caucus be
approved.
A sufficient majority having voted in favor, the minutes were approved.
The members of the Republican Caucus discussed the Board Agenda.
Commissioner Gingell stated that there will not be a motion to discharge Miscellaneous Resolution
#09129 at tonight’s Board meeting, as indicated on the Agenda.
Republican Caucus Chairperson Bradford Jacobsen stated that the State of the County address will be
on February 3, 2010.
Commissioner Taub introduced two proposed resolutions entitled Board of Commissioners – Recognition
of the National Association of Counties’ (NACo) 75th Anniversary; and Board of Commissioners –
Designating April 1, 2010 as Census Day in Oakland County.
Larry Doyle, Board of Commissioners Administrative Director, reminded everyone that there is limited
seating at the State of the County address and to contact the County Executive’s office for reservations.
Commissioner Bill Bullard addressed the Caucus.
The Republican Caucus adjourned at 6:40 p.m. to the call of the Chair or February 2, 2010 at 6:00 p.m.
RUTH JOHNSON BRADFORD JACOBSEN
Clerk Caucus Chairperson
2
OAKLAND COUNTY
BOARD OF COMMISSIONERS
MINUTES
January 20, 2010
Meeting called to order by Chairperson Bill Bullard, Jr. at 7:03 p.m. in the Courthouse Auditorium, 1200 N.
Telegraph Road, Pontiac, Michigan.
Roll called.
PRESENT: Bullard, Burns, Capello, Coleman, Coulter, Douglas, Gershenson, Gingell, Gosselin,
Greimel, Hatchett, Jackson, Jacobsen, Long, McGillivray, Middleton, Nash, Potter, Potts,
Runestad, Schwartz, Scott, Taub, Woodward, Zack. (25)
EXCUSED ABSENCE WITH NOTICE: None. (0)
Quorum present.
Invocation given by David Potts.
Pledge of Allegiance to the Flag.
Moved by Hatchett supported by Long the minutes of the December 9, 2009 and December 15, 2009
Board Meetings be approved.
A sufficient majority having voted in favor, the minutes were approved as printed.
Moved by Jacobsen supported by Coulter the agenda be approved as presented.
AYES: Bullard, Burns, Capello, Coleman, Coulter, Douglas, Gershenson, Gingell, Gosselin,
Greimel, Hatchett, Jackson, Jacobsen, Long, McGillivray, Middleton, Nash, Potter, Potts,
Runestad, Schwartz, Scott, Taub, Woodward, Zack. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the agenda was approved as presented.
Commissioner Coulter stated that he will not request to discharge MR #09129 – Board of Commissioners
– Authorizing Intergovernmental Transfer to Expand Access to Health Care for Oakland County
Residents, and Contracting Administration of County’s Indigent Hospitalization Program with Oakland
Health Plan, Inc. from the General Government and Finance Committees.
The County Clerk’s office received a communication from Chairperson Bill Bullard, Jr. appointing various
County Commissioners to corresponding lake boards as listed in the communication for a term ending
December 31, 2010. The communication was received for filing and a copy is on file in County Clerk’s
office.
Commissioners Minutes Continued. January 20, 2010
3
Chairperson Bill Bullard, Jr., together with the entire Board of Commissioners presented proclamations to
Judge Linda S. Hallmark, Judge Elizabeth M. Pezzetti, Judge James M. Alexander, and Judge Wendy L.
Potts honoring them for their contributions and leadership. Each Judge addressed the Board.
Chairperson Bill Bullard, Jr., along with Judge Michael D. Warren and Commissioner Tom Middleton,
presented a proclamation to Brooke Huisman, who was the winner of the Patriot Week Essay Award for
her eloquent expression of the meaning of Patriot Week.
The following people addressed the Board during public comment: Alice Benbow of Rochester Hills,
Bruce Fealk of Rochester Hills, Jim Reed, Carolyn Wood, Tom Stone, Douglas Lanyk, Sue Julian, Jay
Wenko, Gwen Thomas of West Bloomfield, and Commissioner Sue Ann Douglas.
Moved by Coleman supported by Potter the resolutions (with fiscal notes attached) on the Consent
Agenda be adopted (with accompanying reports being accepted). The vote for this motion appears on
page 29. The resolutions on the Consent Agenda follow (annotated by an asterisk {*}):
*MISCELLANEOUS RESOLUTION #10001
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/CHILDREN’S VILLAGE DIVISION –
2009/2010 FRESH FRUIT AND VEGETABLE PROGRAM GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Michigan Department of Education (MDE) has awarded the Oakland County Children’s
Village Division funding in the amount of $3,075.00; and
WHEREAS the Oakland County Children’s Village Division was one of 68 Michigan recipients chosen out
of a pool of approximately 1500 schools; and
WHEREAS this amount is for the purchase and provision of fresh fruits and vegetables to K-6 enrolled
residents; and
WHEREAS a fresh fruit and vegetable delivery and education program will be provided within the K-6
self-contained Children’s Village School classroom each day that class is in session; and
WHEREAS the Fresh Fruit and Vegetable Program operates through the National School Lunch
Program; and
WHEREAS this funding is for the period of October 1, 2009 through June 30, 2010; and
WHEREAS the award acceptance has been submitted through the County Executive Review Process
and is recommended for approval.
NOW THEREFORE BE IT RESOLVED that the future level of service, including personnel, be contingent
upon the level of funding for this program.
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute this agreement, any
changes and extensions to the agreement not to exceed fifteen percent (15%), which is consistent with
the agreement as originally approved.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Grant Review Sign Off – Children’s Village and Letter from Mike Flanagan, Superintendent,
Department of Education on file in County Clerk’s office.
Copy of Fresh Fruit and Vegetable Program Grant on pages 43-57.
FISCAL NOTE (MISC. #10001)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/CHILDREN’S VILLAGE DIVISION –
2009/2010 FRESH FRUIT AND VEGETABLE PROGRAM GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Commissioners Minutes Continued. January 20, 2010
4
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The Michigan Department of Education (MDE) has awarded the Oakland County Children’s
Village Division funding in the amount of $3,075.
2. The Fresh Fruit and Vegetable Program operates through the National School Lunch Program.
This agreement provides for the purchase and provision of fresh fruits and vegetables to enrolled
self-contained residents, grades K-6, at the Children’s Village School classroom each day that
class is in session.
3. Funding period is October 1, 2009 thru June 30, 2010.
4. There is no county match or additional positions required.
5. The Fiscal Year 2010 budget is amended as specified below:
FUND 20293
Revenue:
1060501-112195-610313 Federal Operating Grants $3,075
Expense:
1060501-112195-750462 Provisions $3,075
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10002
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION – 2009/2010
SUBSTANCE USE DISORDER GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Michigan Department of Community Health (MDCH) has awarded the Health Division
Substance Use Disorder Grant Funds for the period of October 1, 2009 through September 30, 2010; and
WHEREAS the 2008/2009 Substance Use Disorder Grant award included a total funding amount of
$4,792,578 in grant revenue and expenditures for this program; and
WHEREAS the 2009/2010 Substance Use Disorder Grant award reflects grant funding in the amount of
$4,634,746, a decrease of $157,832 from the previous year; and
WHEREAS these funds are used to subcontract with agencies to prevent and reduce the incidence of
drug and alcohol abuse and dependency; and
WHEREAS these contracts were awarded through the County’s competitive bidding process; and
WHEREAS acceptance of this grant does not obligate the County to any future commitment; and
WHEREAS the grant agreement has been submitted through the County Executive’s Contract Review
Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the
2009/2010 Substance Use Disorder Grant from the Michigan Department of Community Health in the
amount of $4,634,746.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to
execute the grant agreement and to approve minor changes and grant extensions, not to exceed fifteen
(15) percent variance from the original award.
BE IT FURTHER RESOLVED that the future level of service, including personnel, be contingent upon the
level of funding for this program.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Grant Review Sign Off – Health Division on file in County Clerk’s office.
Copy of Grant Agreement between Michigan Department of Community Health and Oakland County
Health Division/Office of Substance Abuse Services on pages 58-429.
Commissioners Minutes Continued. January 20, 2010
5
FISCAL NOTE (MISC. #10002)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION – 2009/2010
SUBSTANCE USE DISORDER GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The Department of Health and Human Services/Health Division has been awarded $4,634,746 in
Substance Abuse Grant funds by the Michigan Department of Community Health (MDCH).
2. The previous 2008/2009 award was $4,792,578, for a total reduction of funding in the amount of
($157,832).
3. Funds will be used to subcontract with agencies to prevent and reduce the incidence of drug and
alcohol abuse and dependency.
4. The grant period extends from October 1, 2009 through September 30, 2010.
5. The Fiscal Year 2010 budget is amended as follows:
FY2010
FY 2010 FY 2010 Amended
FUND #28249 GR#0000000203 Adopted Adjustment Budget
Office of Substance Abuse Services (OSAS)
Revenue
1060261-134790-610313 Federal $4,792,578 $(1,411,493) $3,381,085
1060261-134790-615571 State 1,253,661 1,253,661
$4,792,578 $( 157,832) $4,634,746
Expense
1060261-133685-730373 Contract Svs. $ 150,333 $( 147,878) $ 2,455
1060261-134790-730926 Indirect Costs 22,221 ( 2,455) 19,766
1060261-133405-730373 Contract Svs. 630,700 -0- 630,700
1060261-133950-730366 Contract Adm. 239,498 -0- 239,498
1060261-134790-730366 Contract Adm. 337,754 -0- 337,754
1060261-134790-730373 Contract Svs. 2,881,547 ( 7,499) 2,874,048
1060261-134800-730366 Contract Adm. 522,720 -0- 522,720
1060261-134800-730373 Contract Svs. 7,805 -0- 7,805
$4,792,578 $( 157,832) $4,634,746
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10003
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - FISCAL YEAR
2009/2010 MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY (MDEQ) REIMBURSEMENT
AGREEMENT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS for Fiscal Year 2009/2010, the Michigan Department of Environmental Quality (MDEQ) has
awarded a reimbursement agreement to the Oakland County Health Division for services related to Non-
community – Type II Water Supply, Long-Term Drinking Water Monitoring, Radon, Public Swimming Pool
Inspections, Septage, On-Site Sewer and Campground Inspection; and
WHEREAS the services referenced above are on-going; and
WHEREAS the Fiscal Year 2008/2009 MDEQ Reimbursement Agreement reflected a total funding
amount of $276,438; and
WHEREAS the Fiscal Year 2009/2010 MDEQ Reimbursement Agreement reflects a total funding amount
of $295,582, which is a potential $19,144 increase from the previous agreement; and
WHEREAS no personnel changes have been requested for the reimbursement programs at this time; and
Commissioners Minutes Continued. January 20, 2010
6
WHEREAS this Reimbursement Agreement has been submitted through the County Executive's Contract
Review Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the
Michigan Department of Environmental Quality Reimbursement Agreement in the total amount of
$295,582, beginning October 1, 2009 through September 30, 2010.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners approval of the above-
referenced contract is specifically conditioned and premised upon the Department’s concurrence in the
terms and conditions contained in Addendum A of the Agreement, as mutually agreed to by the County
and the Michigan Department of Environmental Quality.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its
Chairperson to execute this Agreement subject to the following additional condition: That the County’s
approval for entering into this Agreement is specifically conditioned and premised upon the acceptance,
approval and execution of the Agreement and Addendum A by the Michigan Department of
Environmental Quality, and that the failure of the Michigan Department of Environmental Quality to
execute the Agreement as specified shall, without any further act of the Oakland County Board of
Commissioners, automatically negate and void the County’s approval and/or acceptance of this
agreement as provided for in this resolution.
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute the Reimbursement
Agreement and approve changes and extensions not to exceed fifteen percent (15%), which is consistent
with the agreement as originally approved.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Grant Review Sign Off – Health Division and Department of Health and Human Services/Health
Division FY 2009/2010 Michigan Department of Environmental Quality Reimbursement Agreement
Acceptance on file in County Clerk’s Office.
Copy of Local Health Department Grant Contract Between the Michigan Department of Environmental
Quality and Oakland County Health Division on pages 430-490.
FISCAL NOTE (MISC. #10003)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION – FISCAL YEAR
2009/2010 MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY (MDEQ) REIMBURSEMENT
AGREEMENT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The Michigan Department of Environmental Quality (MDEQ) has awarded $295,582 to the
Oakland County Health Division for services related to Non-Community (Type II) Water Supply,
Long-Term Drinking Water Monitoring, Radon Program, Swimming Pool Program, Septage
Program, and Campground Inspections.
2. The grant award of $295,582 is a $19,144 increase from the previous agreement.
3. Due to fewer operators requiring certification this Fiscal Year for Public Water the Health Division
estimates actual reimbursements to be $277,055.
4. The estimated reimbursement of $277,055 is $617 more than the FY 2010 budget of $276,438.
5. This reimbursement agreement does not obligate the County to any future commitment.
6. The FY 2010 budget is amended as follows:
FY 2010
Amendment
HEALTH FUND #20221
9090100-134860-695500-10100 Non-Dept Transfer (Gen Fund) $( 617)
1060220-134190-615571 DEQ 09/10 Water Supp. Require. 3,067
1060220-134210-615571 DEQ 09/10 Public Swimming Pool (2,300)
Commissioners Minutes Continued. January 20, 2010
7
1060220-134230-615571 DEQ 09/10 Campground Require. ( 150)
Total Health Fund Revenues $ -0-
GENERAL FUND #10100
9010101-134860-788001-20221 Non-Dept Transfer to Health $( 617)
9090101-196030-730359 Contingency 617
Total General Fund Expenditures $ -0-
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10004
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES – HOMELAND SECURITY DIVISION –
ACCEPTANCE FOR 2008 MICHIGAN CITIZEN CORPS PROGRAM GRANT – OAKLAND COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS funding was released under the U.S. Department of Homeland Security for the 2008 State of
Michigan Citizen Corps Grant Program for funding for programs to increase domestic preparedness
among members of the community; and
WHEREAS the State of Michigan has awarded Oakland County reimbursement for qualified expenses up
to, but not exceeding $11,321 for the period of October 1, 2009 to September 30, 2010; and
WHEREAS the funds are to be used for training, planning, educational outreach, exercise and equipment
for the Citizen Corps Program Partners of Community Emergency Response Teams, Medical Reserve
Corps, Neighborhood Watch, Volunteer in Police Service, and Fire Corps; and
WHEREAS the Michigan Department of State Police Emergency Management and Homeland Security
Division will serve as the administrating agency for this grant; and
WHEREAS the grant agreement has been reviewed and approved through the County Contract Review
Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accept the
grant funding from the State of Michigan in an amount up to $11,321.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to
execute the grant agreement and to approve any grant extensions or changes, within fifteen percent
(15%) of the original award, which are consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the County to any future
commitment.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Grant Review Sign Off – Homeland Security on file in County Clerk’s office.
Copy of State of Michigan 2008 Homeland Security Grant Program Grant Agreement for Citizen’s Corps
Program on pages 541-549.
FISCAL NOTE (MISC. #10004)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES – HOMELAND SECURITY DIVISION –
ACCEPTANCE FOR 2008 MICHIGAN CITIZEN CORPS PROGRAM GRANT – OAKLAND COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The State of Michigan has awarded Oakland County reimbursement for qualified expenses up to,
but not exceeding $11,321 for the period of October 1, 2009 through September 30, 2010. Prior
year funding was $30,785 a decrease of ($19,464). Funding is for programs to increase domestic
preparedness among members of the community.
2. The funds will be used to establish Citizen Corps Councils to support the oversight and outreach
Commissioners Minutes Continued. January 20, 2010
8
functions of the councils and to expand CERT training essential for developing the Citizen Corps.
3. The Michigan Department of State Police Emergency Management Division will serve as the
administrating agency for this grant.
4. The FY 2010 Budget is amended for the acceptance of the Michigan Citizen Corps Program
(CERT) for the period of October 1, 2009 through September 30, 2010 as follows:
FUND 29330 GR0000000479
Revenue
1060601-115096-610210 Federal Grants Operating $11,321
Expense
1060601-115096-750154 Expendable Equip. $11,321
$ -0-
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10005
BY: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES – HOMELAND SECURITY DIVISION –
ACCEPTANCE FOR 2008 MICHIGAN CITIZEN CORPS PROGRAM GRANT – MONROE COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS funding was released under the U.S. Department of Homeland Security for the 2008 State of
Michigan Citizen Corps Grant Program for funding for programs to increase domestic preparedness
among members of the community; and
WHEREAS the County of Monroe has requested that Oakland County serve as fiduciary for that county’s
State Homeland Security Grant Award; and
WHEREAS the State of Michigan has awarded Oakland County as fiduciary for Monroe County
reimbursement for qualified expenses up to, but not exceeding $3,327 during the period of October 1,
2009 through September 30, 2010.
WHEREAS the funds are to be used for training, planning, educational outreach, exercise and equipment
for the Citizen Corps Program Partners of Community Emergency Response Teams, Medical Reserve
Corps, Neighborhood Watch, Volunteer in Police Service, and Fire Corps; and
WHEREAS the Michigan Department of State Police Emergency Management and Homeland Security
Division will serve as the administrating agency for this grant; and
WHEREAS the grant agreement has been reviewed and approved through the County Contract Review
Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the
position of Fiduciary and Subgrantee for Monroe County for the 2008 Citizen Corps Grant and accepts
the grant funds in an amount up to $3,327 with no county match or in-kind contribution required.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to
execute the grant agreement and to approve any grant extensions or changes, within fifteen percent
(15%) of the original award, which are consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the County to any future
commitment.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Grant Review Sign Off – Homeland Security, E-mail regarding Grant Review: Homeland Security
Division – 1008 Citizens Corps Grant Program and Monroe County Fiduciary Grant Acceptance on file in
County Clerk’s office.
Copy of State of Michigan 2008 Homeland Security Grant Program Grant Agreement for Citizen’s Corps
Program on pages 491-499.
Commissioners Minutes Continued. January 20, 2010
9
FISCAL NOTE (MISC. #10005)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES – HOMELAND SECURITY DIVISION –
ACCEPTANCE FOR 2008 MICHIGAN CITIZEN CORPS PROGRAM GRANT – MONROE COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The State of Michigan has awarded Oakland County as fiduciary for Monroe County
reimbursement for qualified expenses up to, but not exceeding $3,327 for the period of October 1,
2009 through September 30, 2010. Funding is for programs to increase domestic preparedness
among members of the community.
2. The funds will be used for training, planning, educational outreach, exercise and equipment for
the Citizen Corps Program partners of Community Emergency Response Teams, Medical
Reserve Corps, Neighborhood Watch, Volunteer in Police Service, and Fire Corps.
3. The Michigan Department of State Police Emergency Management Division will serve as the
administering agency for this grant.
4. The FY 2010 Budget is amended to recognize Oakland County as the Fiduciary and Subgrantee
for Monroe County and accepts the grants funds for the period of October 1, 2009 through
September 30, 2010 as follows:
FUND 29330 GR0000000478
Revenue
1060601-115096-610210 Federal Grants Operating $3,327
Expense
1060601-115096-750154 Expendable Equip. $3,327
$ -0-
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10006
BY: General Government Committee, Christine Long, Chairperson
IN RE: BOARD OF COMMISSIONERS - SUPPORT OF THE FINAL REPORT OF THE LEGISLATIVE
COMMISSION ON STATUTORY MANDATES, DECEMBER 2009
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the electorate of the State of Michigan passed an amendment in November 1978 to the
State’s Constitution that required the State to fund mandates imposed on local units of government (often
referred to as the “Headlee Amendment”); and
WHEREAS the Headlee Amendment (Article IX, Section 29) states:
“The state is hereby prohibited from reducing the state financed proportion of the necessary
costs of any existing activity or service required of units of Local Government by state law. A
new activity or service or an increase in the level of any activity or service beyond that
required by existing law shall not be required by the Legislature or any state agency of units
of Local Government, unless a state appropriation is made and disbursed to pay the unit of
Local Government for any necessary increased costs. The provision of this section shall not
apply to costs incurred pursuant to Article VI, Section 18.”; and
WHEREAS the Headlee Amendment became effective on December 23, 1978; and
WHEREAS the State Legislature established the Legislative Commission on Statutory Mandates (LCSM)
through P.A. 98 of 2007, as amended by P.A. 356 of 2008 and assigned the LCSM to identify mandates
(including those involving reports) and the related cost of the mandates to local units of government,
along with recommendations to resolve the unfunded mandates; and
WHEREAS the LCSM worked with the Citizens Research Council (issued an analysis of other state’s
statutes and constitutional requirements similar to the Headlee Amendment) and local units of
government associations, including:
Michigan Association of Counties.
Commissioners Minutes Continued. January 20, 2010
10
Michigan Municipal League.
Michigan Township Association.
Michigan School Business Officials and Michigan Association of School Administrators.
Michigan Community College Association.
County Road Association of Michigan; and
WHEREAS the LCSM issued a report in June 2009 entitled “Interim Report of the Legislative Commission
on Statutory Mandates” that indicated, among other matters, that the State had failed to enact legislation
enabling the Headlee Amendment and has not complied with the Headlee Amendment since its adoption
in 1978; and
WHEREAS the LCSM has completed its report in December 2009 entitled “Final Report of the Legislative
Commission on Statutory Mandates” that reaffirms the Interim Report results and provides
recommendations, including but not limited to:
Drafted legislation and court rules that would mitigate unfunded mandates imposed on local units
of government in the future.
Proposed procedures that will prevent new unfunded mandates from being imposed on local units
of government.
Proposed procedures that would be corrective should unfunded mandates be imposed that
include, among other requirements:
o A submission of an action before the Court of Appeals to be heard by a special master in
order to rule on whether the matter is a mandate and if the mandate is underfunded.
o Require the Court of Appeals to rule on the above within six months of the filing.
o Should the Court of Appeals not rule on the above within six months, the local unit of
government would have no obligation to continue to provide the services until such time
as the State complies with the Headlee Amendment; and
WHEREAS the Michigan Association of Counties adopted a resolution of support for the
recommendations contained in the final LCSM report in December 2009.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners supports the
findings and recommendations in the interim and final reports of the Legislative Commission on Statutory
Mandates and encourages the Governor, Legislature and Supreme Court to adopt and enact the
recommendations cited in the final report.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners approves the release of
this resolution to be distributed to the Governor, Legislators, Supreme Court and local units of
government legislative boards and executives located within Oakland County.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
Copy of Interim Report of the Legislative Commission on Statutory Mandates and Final Report of the
Legislative Commission on Mandates on file in County Clerk’s office.
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09315
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: THE PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES
MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND ELECTRIC SERVICE
TO THE DETROIT EDISON COMPANY – SPRINGFIELD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Springfield Oaks County Park located in Springfield
Township; and
WHEREAS pursuant to Miscellaneous Resolution No. 08217 the Oakland County Board of
Commissioners entered into a Telecommunications License Agreement with New Par/Verizon Wireless to
place telecommunication antennae and related equipment on the water tower at Springfield Oaks County
Park; and
WHEREAS various utilities including electric service are required to make the antenna operational; and
Commissioners Minutes Continued. January 20, 2010
11
WHEREAS the Detroit Edison Company has requested that the County of Oakland grant a 12-ft. wide
easement for underground electric service; and
WHEREAS the Oakland County Parks and Recreation staff and the Detroit Edison Company have
agreed upon a route for the said underground electric service, which will provide electric service to the
base of the water tower at Springfield Oaks County Park; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the granting of the easement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
authorizes and approves the granting of the attached easement for underground electric service and related
appurtenances to the Detroit Edison Company for the sum of one dollar.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or designee to execute the attached easement for underground electric service and related
appurtenances.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Request to Grant Easement to Detroit Edison Company Springfield Oaks County Park and Grant of
Non-Exclusive Underground Easement in Gross on file in County Clerk’s office.
FISCAL NOTE (MISC. #09315)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND ELECTRIC
SERVICE TO THE DETROIT EDISON COMPANY – SPRINGFIELD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Board of Commissioners and the Parks and Recreation Commission
entered into a Telecommunications License Agreement with New Par/Verizon Wireless to place
telecommunication antennae and related equipment on the water tower at Springfield Oaks
County Park.
2. Various utilities including electric service are required to make the antennae operational.
3. The Detroit Edison Company has requested Oakland County grant a 12-foot wide easement for
underground electric service from an existing transformer located on the park property to the
base of the water tower.
4. The resolution authorizes and approves the granting of an easement for underground electric
service to the Detroit Edison Company for the sum of one (1) dollar.
5. No General Fund/General Purpose or Parks and Recreation funding is required.
6. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09316
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: THE PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES
MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND COMMUNICATION
UTILITY SERVICE TO THE AT&T CORPORATION – SPRINGFIELD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Springfield Oaks County Park located in Springfield
Township; and
WHEREAS pursuant to Miscellaneous Resolution No. 08217 the Oakland County Board of
Commissioners entered into a Telecommunications License Agreement with New Par/Verizon Wireless to
Commissioners Minutes Continued. January 20, 2010
12
place telecommunication antennae and related equipment on the water tower at Springfield Oaks County
Park; and
WHEREAS various utilities including telephone line service are required to make the antenna operational;
and
WHEREAS the AT&T Corporation has requested that the County of Oakland grant a 12-ft. wide
easement for underground communication utility service; and
WHEREAS the Oakland County Parks and Recreation staff and the AT&T Corporation have agreed upon
a route for the said easement, which will provide underground communication utility service to the base of
the water tower at Springfield Oaks County Park; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the granting of the easement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
authorizes and approves the granting of the attached easement for underground communication utility
service and related appurtenances to the AT&T Corporation for the sum of one dollar.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or designee to execute the attached easement document.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Request to Grant Easement to AT&T Corporation Springfield Oaks County Park and Grant of
Non-Exclusive Underground Easement in Gross on file in County Clerk’s office.
FISCAL NOTE (MISC. #09316)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND
COMMUNICATION UTILITY SERVICE TO THE AT&T CORPORATION – SPRINGFIELD OAKS
COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Board of Commissioners and the Parks and Recreation Commission
entered into a Telecommunications License Agreement with New Par/Verizon Wireless to place
telecommunication antennae and related equipment on the water tower at Springfield Oaks
County Park.
2. Various utilities including underground communication utility service are required to make the
antennae operational.
3. The AT&T Corporation has requested Oakland County grant a 12-foot wide easement for
underground communication utility service from Hall Road easterly to the base of the water tower.
4. The resolution authorizes and approves the granting of an easement for underground
communication utility service to the AT&T Corporation for the sum of one (1) dollar.
5. No General Fund/General Purpose or Parks and Recreation funding is required.
6. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
Commissioners Minutes Continued. January 20, 2010
13
*MISCELLANEOUS RESOLUTION #09317
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: THE PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES
MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND COMMUNICATION
UTILITY SERVICE TO NEW PAR, A DELAWARE PARTNERSHIP, D/B/A VERIZON WIRELESS, LLC –
SPRINGFIELD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Springfield Oaks County Park located in Springfield
Township; and
WHEREAS pursuant to Miscellaneous Resolution No. 08217 the Oakland County Board of
Commissioners entered into a Telecommunications License Agreement with New Par/Verizon Wireless to
place telecommunication antennae and related equipment on the water tower at Springfield Oaks County
Park; and
WHEREAS various utilities including telephone line service are required to make the antenna operational;
and
WHEREAS New Par, a Delaware Partnership, d/b/a Verizon Wireless, LLC has requested that the County
of Oakland grant a 12-ft. wide easement for underground communication utility service; and
WHEREAS the Oakland County Parks and Recreation staff and New Par, a Delaware Partnership, d/b/a
Verizon Wireless, have agreed upon a route for the said easement, which will provide underground
communication utility service to the base of the water tower at Springfield Oaks County Park; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the granting of the easement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
authorizes and approves the granting of the attached easement for underground communication utility
service and related appurtenances to New Par, a Delaware Partnership, d/b/a Verizon Wireless, for the
sum of one dollar.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or designee to execute the attached easement document.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Request to Grant Easement to New par, a Delaware Partnership d/b/a Verizon Wireless, LLC
Springfield Oaks County Park and Grant of Non-Exclusive Underground Easement in Gross on file in
County Clerk’s office.
FISCAL NOTE (MISC. #09317)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST TO GRANT EASEMENT FOR UNDERGROUND
COMMUNICATION UTILITY SERVICE TO NEW PAR, A DELAWARE PARTNERSHIP, D/B/A VERIZON
WIRELESS, LLC – SPRINGFIELD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Board of Commissioners and the Parks and Recreation Commission
entered into a Telecommunications License Agreement with New Par/Verizon Wireless to place
telecommunication antennae and related equipment on the water tower at Springfield Oaks
County Park.
2. Various utilities including underground communication utility service are required to make the
antennae operational.
3. New Par, a Delaware Partnership, d/b/a Verizon Wireless, LLC has requested Oakland County
grant a 12-foot wide easement for underground communication utility service from Hall Road
easterly to the base of the water tower.
Commissioners Minutes Continued. January 20, 2010
14
4. The resolution authorizes and approves the granting of an easement for underground
communication utility service to New Par, a Delaware Partnership, d/b/a Verizon Wireless, LLC
for the sum of one (1) dollar.
5. No General Fund/General Purpose or Parks and Recreation funding is required.
6. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09318
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION AND DEPARTMENT OF FACILITIES
MANAGEMENT – APPROVAL AND ACCEPTANCE OF PURCHASE AGREEMENT PARCEL NO. 06-
34-327-001, VACANT MUNGER ROAD FOR EXPANSION OF HIGHLAND OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS pursuant to the authorization of the Oakland County Planning and Building Committee, the
Oakland County Parks and Recreation Commission and the Department of Facilities Management, with
the assistance of Oakland County Corporation Counsel, have negotiated the terms and conditions of the
attached Purchase Agreement with the Highland Equestrian Conservancy, for the purchase of
approximately 4.0-acres of vacant land located on the south side of Munger Road adjacent to the north
property line of Highland Oaks County Park; and
WHEREAS pursuant to the terms and conditions of said Purchase Agreement the County of Oakland
shall pay the Highland Equestrian Conservancy the sum of $10,000 via a cash sale for the purchase of
said property conditioned upon the County performing its required due diligence investigation of the
subject property; and
WHEREAS sufficient funding for said purchase is available in the Oakland County Parks and Recreation
Land Acquisition Fund; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached Purchase Agreement and recommend its
approval.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
approves and accepts the terms and conditions of the attached Purchase Agreement between the County
of Oakland, as purchaser, and the Highland Equestrian Conservancy, seller, via a cash sale purchase.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Purchase Agreement and all other related documents,
which may be required to complete the purchase of said property.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Purchase Agreement Highland Equestrian Conservancy Property
and Purchase Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09318)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – APPROVAL AND ACCEPTANCE OF PURCHASE AGREEMENT
PARCEL NO. 06-34-327-001, VACANT MUNGER ROAD FOR EXPANSION OF HIGHLAND OAKS
COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
purchase agreement between the County of Oakland and the Highland Equestrian Conservancy
Commissioners Minutes Continued. January 20, 2010
15
for the purchase of property parcel no. 06-34-327-001 at vacant Munger Road, Highland,
Michigan.
2. The negotiated price is in the amount of $10,000. The land purchase will expand the current
acreage of Highland Oaks County Park.
3. The purchase agreement was recommended for approval by the Oakland County Parks and
Recreation Commission on November 4, 2009.
4. No Oakland County General Fund/General Purpose funding is required for this acquisition.
5. Sufficient funding is available in the Oakland County Parks and Recreation Commission’s Fiscal
Year 2010 Capital Improvement Program Budget. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09319
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT WITH KATHY RENAUD, GLEN
OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Glen Oaks County Park; and
WHEREAS a one bedroom apartment identified as second floor 30500 Thirteen Mile Road is located on
the grounds of Glen Oaks County Park; and
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said
apartment located at 30500 Thirteen Mile Road to Ms. Kathy Renaud for a period of five years
commencing January 1, 2010; and
WHEREAS under the terms and conditions of the attached Lease Agreement Ms. Renaud will pay rent in
the amount of $343.00 per month during the first year with annual increases as described in the lease,
pay all utility costs and provide after hours security, coordinate all emergency activities with local police
and fire agencies and arrange for after hours emergency maintenance as necessary; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Ms. Kathy Renaud.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue Fund line item.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Kathy Renaud, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Lease Agreement Glen Oaks County Park, PR09-012 Resolution and
Residential Lease Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09319)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT
WITH KATHY RENAUD, GLEN OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Commissioners Minutes Continued. January 20, 2010
16
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
residential lease agreement between the County of Oakland and Kathy Renaud for the rental of
an apartment located on the second floor of the clubhouse at 30500 Thirteen Mile Road on the
grounds of Glen Oaks County Park.
2. The residential lease agreement with Kathy Renaud stipulates she will pay rent in the amount of
$343 per month in the first year with annual increases for a period of five years and pay all utility
costs, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. In addition to rent and utilities; Kathy Renaud will provide after hours security, contact and
coordinate all emergency activities with local police and fire agencies, and coordinate emergency
maintenance as necessary for Glen Oaks County Park.
5. The residential lease agreement was recommended for approval by the Oakland County Parks
and Recreation Commission on November 4, 2009.
6. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
Glen Oaks Rent House revenue line item.
7. No General Fund/General Purpose or Parks and Recreation funding is required.
8. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09320
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT WITH PATRICK T. OGG,
INDEPENDENCE OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Independence Oaks County Park; and
WHEREAS a ranch-style, three bedroom house, identified as 9489 Sashabaw Road, is located on the
grounds of Independence Oaks County Park; and
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said house
located at 9489 Sashabaw Road to Patrick T. Ogg for a period of five years commencing January 1,
2010; and
WHEREAS under the terms and conditions of the attached Lease Agreement Mr. Ogg will pay rent in the
amount of $880.00 per month during the first year with annual increases as described in the lease, pay all
utility costs and provide after hours security, coordinate all emergency activities with local police and fire
agencies and arrange for after hours emergency maintenance as necessary; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Patrick T. Ogg.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue Fund line item.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Patrick T. Ogg, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Commissioners Minutes Continued. January 20, 2010
17
Copy of Approval and Acceptance of Lease Agreement Independence Oaks County Park, PR09-012
Resolution, and Residential Lease Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09320)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT
WITH PATRICK T. OGG, INDEPENDENCE OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
residential lease agreement between the County of Oakland and Patrick T. Ogg for the rental of a
house identified as 9489 Sashabaw Road and located on the grounds of Independence Oaks
County Park.
2. The residential lease agreement with Patrick T. Ogg stipulates he will pay rent in the amount of
$880 per month in the first year with annual increases for a period of five years and pay all utility
costs, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. In addition to rent and utilities; Patrick T. Ogg will provide after hours security, contact and
coordinate all emergency activities with local police and fire agencies, and coordinate emergency
maintenance as necessary for Independence Oaks County Park.
5. The residential lease agreement was recommended for approval by the Oakland County Parks
and Recreation Commission on November 4, 2009.
6. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
Independence Oaks Rent House revenue line item.
7. No General Fund/General Purpose or Parks and Recreation funding is required.
8. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09321
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT WITH ADAM VOGEL AND
RYAN ERNST, WATERFORD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Waterford Oaks County Park; and
WHEREAS a ranch style two bedroom house identified as 1580 Scott Lake Road is located on the
grounds of Waterford Oaks County Park; and
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said house
located at 1580 Scott Lake Road to Adam Vogel and Ryan Ernst for a period of five years commencing
January 1, 2010; and
WHEREAS under the terms and conditions of the attached Lease Agreement Mr. Vogel and Mr. Ernst will
pay rent in the amount of $682.50 per month during the first year with annual increases as described in
the lease, pay all utility costs and provide after hours security, coordinate all emergency activities with
local police and fire agencies and arrange for after hours emergency maintenance as necessary; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
Commissioners Minutes Continued. January 20, 2010
18
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Mr. Adam Vogel and
Mr. Ryan Ernst.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue fund line item.
BE IT FURTHER RESOLVED that the County of Oakland Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Adam Vogel and Ryan Ernst, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Lease Agreement Waterford Oaks County Park, PR09-012
Resolution, and Residential Lease Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09321)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT
WITH ADAM VOGEL AND RYAN ERNST, WATERFORD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
residential lease agreement between the County of Oakland and Adam Vogel and Ryan Ernst for
the rental of a house identified as 1580 Scott Lake Road and located on the grounds of Waterford
Oaks County Park.
2. The residential lease agreement with Adam Vogel and Ryan Ernst stipulates they will pay rent in
the amount of $682.50 per month in the first year with annual increases for a period of five years
and pay all utility costs, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. In addition to rent and utilities; Adam Vogel and Ryan Ernst will provide after hours security,
contact and coordinate all emergency activities with local police and fire agencies, and coordinate
emergency maintenance as necessary for Waterford Oaks County Park.
5. The residential lease agreement was recommended for approval by the Oakland County Parks
and Recreation Commission on November 4, 2009.
6. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
Waterford Oaks Rent House revenue line item.
7. No General Fund/General Purpose or Parks and Recreation funding is required.
8. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09322
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT WITH ILA ROWLAND,
WATERFORD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Waterford Oaks County Park; and
WHEREAS a ranch style two bedroom house, identified as 2866 Watkins Lake Road, is located on the
grounds of Waterford Oaks County Park; and
Commissioners Minutes Continued. January 20, 2010
19
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said house
located at 2866 Watkins Lake Road to Ila Rowland for a period of five years commencing January 1,
2010; and
WHEREAS under the terms and conditions of the attached Lease Agreement Ms. Ila Rowland will pay
rent in the amount of $703.00 per month during the first year with annual increases as described in the
lease, pay all utility costs and provide after hours security, coordinate all emergency activities with local
police and fire agencies and arrange for after hours emergency maintenance as necessary; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Ms. Ila Rowland.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue Fund line item.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Ila Rowland, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Lease Agreement Waterford Oaks County Park, PR 09-012
Resolution and Residential Lease Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09322)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT
WITH ILA ROWLAND, WATERFORD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
residential lease agreement between the County of Oakland and Ila Rowland for the rental of a
house identified as 2866 Watkins Lake Road and located on the grounds of Waterford Oaks
County Park.
2. The residential lease agreement with Ila Rowland stipulates she will pay rent in the amount of
$703 per month in the first year with annual increases for a period of five years and pay all utility
costs, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. In addition to rent and utilities; Ila Rowland will provide after hours security, contact and
coordinate all emergency activities with local police and fire agencies, and coordinate emergency
maintenance as necessary for Waterford Oaks County Park.
5. The residential lease agreement was recommended for approval by the Oakland County Parks
and Recreation Commission on November 4, 2009.
6. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
Waterford Oaks Rent House revenue line item.
7. No General Fund/General Purpose or Parks and Recreation funding is required.
8. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
Commissioners Minutes Continued. January 20, 2010
20
*MISCELLANEOUS RESOLUTION #09323
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF LEASE AGREEMENT WITH STEVEN ERNST, WATERFORD OAKS
COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of Waterford Oaks County Park; and
WHEREAS an older barn is located easterly of 1580 Scott Lake Road on the grounds of Waterford Oaks
County Park; and
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said barn
and a small plot of land located at 1580 Scott Lake Road to Steven Ernst for a period of five years
commencing January 1, 2010; and
WHEREAS under the terms and conditions of the attached Lease Agreement Mr. Ernst will pay rent in the
amount of $75.00 per month during the term of the lease; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Mr. Steven Ernst.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue Fund line item.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Steve Ernst, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Lease Agreement Waterford Oaks County Park, PR09-013
Resolution, and Lease on file in County Clerk’s office.
FISCAL NOTE (MISC. #09323)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF LEASE AGREEMENT WITH STEVEN
ERNST, WATERFORD OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
lease agreement between the County of Oakland and Steven Ernst for the rental of a barn and
10’ X 50’ plot of land located easterly of 1580 Scott Lake Road on the grounds of Waterford Oaks
County Park.
2. The residential lease agreement with Steven Ernst stipulates he will pay rent in the amount of $75
per month, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. The lease agreement was recommended for approval by the Oakland County Parks and
Recreation Commission on November 4, 2009.
5. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
Waterford Oaks Rent House revenue line item.
6. No General Fund/General Purpose or Parks and Recreation funding is required.
Commissioners Minutes Continued. January 20, 2010
21
7. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #09324
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION/DEPARTMENT OF FACILITIES MANAGEMENT –
REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT WITH BRIAN RATLEDGE,
WHITE LAKE OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the County of Oakland is the owner of White Lake Oaks County Park; and
WHEREAS a ranch style two bedroom house, identified as 1540 Orchard Street, is located on the
grounds of White Lake Oaks County Park; and
WHEREAS it is the desire of the Oakland County Parks and Recreation Commission to lease said house
located at 1540 Orchard Street to Brian Ratledge for a period of five years commencing January 1, 2010;
and
WHEREAS under the terms and conditions of the attached Lease Agreement Mr. Ratledge will pay rent in
the amount of $405.00 per month during the first year with annual increases as described in the lease,
pay all utility costs and provide after hours security, coordinate all emergency activities with local police
and fire agencies and arrange for after hours emergency maintenance as necessary; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached lease agreement; and
WHEREAS it is the recommendation of the Oakland County Parks and Recreation Commission and the
Department of Facilities Management that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement between the County of Oakland and Brian Ratledge.
BE IT FURTHER RESOLVED that the rent amount received be deposited in the Oakland County Parks and
Recreation Rental House Revenue Fund line item.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Brian Ratledge, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Approval and Acceptance of Lease Agreement White Lake Oaks County Park, PR09-012
Resolution, and Residential Lease Agreement on file in County Clerk’s office.
FISCAL NOTE (MISC. #09324)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION COMMISSION AND DEPARTMENT OF
FACILITIES MANAGEMENT – REQUEST FOR APPROVAL OF RESIDENTIAL LEASE AGREEMENT
WITH BRIAN RATLEDGE, WHITE LAKE OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
Miscellaneous Resolution and finds:
1. The Oakland County Parks and Recreation Commission is seeking approval and acceptance of a
residential lease agreement between the County of Oakland and Brian Ratledge for the rental of
a house identified as 1540 Orchard Street and located on the grounds of White Lake Oaks
County Park.
2. The residential lease agreement with Brian Ratledge stipulates he will pay rent in the amount of
$405 per month in the first year with annual increases for a period of five years and pay all utility
Commissioners Minutes Continued. January 20, 2010
22
costs, commencing January 1, 2010.
3. A late fee of $25 will be paid for each monthly rent not received within five days of its due date
and will be considered additional rent to compensate for costs incurred because of late payments.
4. In addition to rent and utilities; Brian Ratledge will provide after hours security, contact and
coordinate all emergency activities with local police and fire agencies, and coordinate emergency
maintenance as necessary for White Lake Oaks County Park.
5. The residential lease agreement was recommended for approval by the Oakland County Parks
and Recreation Commission on November 4, 2009.
6. The monthly rent amount will be deposited in the Oakland County Parks and Recreation Fund,
White Lake Oaks Rent House revenue line item.
7. No General Fund/General Purpose or Parks and Recreation funding is required.
8. No budget amendment is recommended.
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*REPORT (MISC. #10007)
BY: Human Resources Committee, Sue Ann Douglas, Chairperson
IN RE: DEPARTMENT OF PUBLIC SERVICES/COMMUNITY CORRECTIONS DIVISION – FY 2010
COMMUNITY CORRECTIONS COMPREHENSIVE PLAN GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The Human Resources Committee having reviewed the above referenced resolution on January 13, 2010
reports with the recommendation the resolution be adopted.
Chairperson, on behalf of the Human Resources Committee, I move the acceptance of the foregoing
report.
HUMAN RESOURCES COMMITTEE
MISCELLANEOUS RESOLUTION #10007
BY: Public Services Committee, Jeff Potter, Chairperson
IN RE: DEPARTMENT OF PUBLIC SERVICES/COMMUNITY CORRECTIONS DIVISION – FY 2010
COMMUNITY CORRECTIONS COMPREHENSIVE PLAN GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Department of Public Services Community Corrections Division applied to the Michigan
Department of Corrections (MDOC) for $3,806,197 in grant funds for the period of October 1, 2009,
through September 30, 2010; and
WHEREAS the MDOC has awarded Oakland County a 2009/2010 Community Corrections grant in the
amount of $3,793,536 which is a .3% variance or $12,661 less than requested in the application; and
WHEREAS the MDOC now holds the contracts for all residential services meaning that $2,110,841 of the
$3,793,536 award has been allocated for Oakland County Residential Services but will not be recorded
as income; and
WHEREAS the remaining amount of $1,682,695 is the County’s responsibility as shown on Schedule A;
and
WHEREAS the grant funds the following Community Corrections Division positions ten (10) Community
Corrections Specialist IIs (positions # 07425, 07426, 07429, 07432, 07433, 09243, 09247, 09291, 09648,
09649); one (1) PTNE Community Corrections Specialist II (position 9292), one (1) Office Assistant II
(position 09295), one half (.5) Community Corrections User Support Specialist (position 07834), one (1)
Community Corrections Specialist III (position 07428), and one half (.5) Supervisor-Community
Corrections (position 09396); and
WHEREAS the grant funds the following Sheriff’s Department positions; three (3) Inmate Caseworkers
(positions 07418, 07419, and 07420), one (1) Office Assistant I which is a FTE but is under filled with a
PTNE (position 07417), one (1) FTE Inmate Substance Abuse Tech (position 07421) and one (1) PTE
Inmate Substance Abuse Tech (position 09397); and
Commissioners Minutes Continued. January 20, 2010
23
WHEREAS to reflect funding changes and utilization of positions the Sheriff is requesting to decrease
position #4030320-07417 from full-time eligible to part-time non-eligible and position #4030320-09397 be
decreased from part-time eligible to part-time non-eligible; and
WHEREAS the grant acceptance requires no additional personnel to fulfill the grant agreement; and
WHEREAS there is no County match required with this grant; however, it should be noted that the FY
2010 Budget of this grant includes two (2) positions (#1070403-07834 and #1070410-09396) partially
General Fund/General Purpose funded in Community Corrections; and
WHEREAS the grant agreement has been approved by the County Executive's Contract Review Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the
Fiscal Year 2009 Community Corrections grant from the Michigan Department of Corrections in the
amount of $3,793,536.
BE IT FURTHER RESOLVED that the County is financially responsible for $1,682,695 and that the State
contracts directly for residential services of $2,110,841. The future level of service, including personnel
(except the portion of Pretrial Services currently funded by the General Fund/General Purpose Fund) will
be contingent upon the level of funding available from the State.
BE IT FURTHER RESOLVED that the following Special Revenue (SR) positions be continued in
Community Corrections: #1070402-07425, 07426, 07429, 07432, 07433, & 09247; 1070410-9243, 9291,
9648 & 9649; 1070410-09292 & 9295, 1070402-7834; 1070401-07428, and 1070410-09397.
BE IT FURTHER RESOLVED that the following SR positions be continued in the Sheriff’s Office:
4030320-07418, 07419, 07420, 07421 & 09397.
BE IT FURTHER RESOLVED that one (1) SR Office Assistant II (Pos. #4030320-07417) in the Sheriff’s
Office be decreased from full-time eligible to part-time non eligible 1,000 hours/year retroactive to October
1, 2009.
BE IT FURTHER RESOLVED that one (1) SR Inmate Substance Abuse Technician (Pos. #4030320–
09397) in the Sheriff’s Office be decreased from part-time eligible 1,400 hours/year to part-time non
eligible 1,000 hours/year retroactive to October 1, 2009.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
Copy of Grant Review Sign Off – Community Corrections on file in County Clerk’s office.
Copy of Agreement Between the State of Michigan Department of Corrections and Oakland County
Comprehensive Corrections Plans on pages 500-527.
FISCAL NOTE (MISC. #10007)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENT OF PUBLIC SERVICES/COMMUNITY CORRECTIONS DIVISION – FY 2010
COMMUNITY CORRECTIONS COMPREHENSIVE PLAN GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The Michigan Department of Corrections (MDOC) has awarded the Oakland County Community
Corrections Division a Community Corrections Comprehensive Plan Grant in the amount of
$3,793,536, which is a .3% variance or $12,661 less than requested in the application.
2. The grant award is $86,687 greater than the previous award of $3,706,849.
3. The MDOC now holds the contracts for all residential services, meaning that $2,110,841 of the
$3,793,536 award has been allocated for Oakland County residential services but will not be
recorded as income. The $2,110,841 will be paid by the State directly to residential centers.
4. The remaining amount of $1,682,695 is the County’s program as detailed on Schedule A.
5. This is the sixteenth (16th) year of the grant application with the Michigan Department of
Corrections, Office of Community Corrections.
6. The grant period is October 1, 2009 through September 30, 2010.
7. The grant provides funding for positions in the Community Corrections Division and the Sheriff’s
Office.
Commissioners Minutes Continued. January 20, 2010
24
8. The Sheriff’s Office is requesting to change the status of Special Revenue (SR) position
#4030320-07417 from full-time eligible to part-time non-eligible and position #4030320-09397
from part-time eligible to part-time non-eligible retroactive to October 1, 2009.
9. No County match is required however, it should be noted that the FY 2010 budget of this grant
includes two (2) positions (#1070403-07834 and #1070410-09396) partially General
Fund/General Purpose funded in Community Corrections.
10. In addition to the grant and independent of the grant award, the FY 2010 Adopted Budget
includes a General Fund/General Purpose appropriation of $4,589,240 for Community
Corrections.
11. The FY 2010 Adopted Special Revenue Budget already includes positions at the reduced rate
and therefore, no budget amendment is recommended.
12. The FY 2010 Adopted Special Revenue (SR) budget is amended as detailed in the attached
Schedule A to reflect the new grant award of $1,682,695, which is $342,416 less than the
Adopted Budget of $2,025,111.
FINANCE COMMITTEE
*REPORT (MISC. #10008)
BY: Human Resources Committee, Sue Ann Douglas, Chairperson
IN RE: SHERIFF’S OFFICE – CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES
IN THE CHARTER TOWNSHIP OF HIGHLAND, 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The Human Resources Committee having reviewed the above referenced resolution on January 13, 2010
reports with the recommendation the resolution be adopted.
Chairperson, on behalf of the Human Resources Committee, I move the acceptance of the foregoing
report.
HUMAN RESOURCES COMMITTEE
MISCELLANEOUS RESOLUTION #10008
BY: Public Services Committee, Jeff Potter, Chairperson
IN RE: SHERIFF'S OFFICE - CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES IN
THE CHARTER TOWNSHIP OF HIGHLAND - 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Charter Township of Highland has contracted with the Oakland County Sheriff's Office to
provide law enforcement services for the Township (M.R. #09302); and
WHEREAS paragraph 20 of this Contract provided that an amendment to this Contract must be approved
by concurrent resolutions of both the Oakland County Board of Commissioners and the Highland
Township Board; and
WHEREAS the Charter Township of Highland has approved a proposed amendment to the contract
(Schedule A Deputies Contracted) which would add (1) Patrol Investigator bringing the number of Patrol
Investigators to three (3) and bringing the total number of contracts to nineteen (19); and
WHEREAS the Sheriff has agreed to add one (1) Patrol Investigator for the Charter Township of Highland
under the terms of this contract.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves an
amendment to the original Schedule A (Sheriff Deputies Contracted) of the Oakland County Sheriff's
Office 2010 Law Enforcement Services Agreement with the Charter Township of Highland to add one (1)
Patrol Investigator.
BE IT FURTHER RESOLVED that one Deputy II position be created in the Highland/Contracted Patrol-
Other Municipalities/Patrol Services Division of the Sheriff’s Office.
BE IT FURTHER RESOLVED that one semi-marked vehicle with radio and MDC be added to the county
fleet.
BE IT FURTHER RESOLVED that this amendment will take effect January 1, 2010.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
Commissioners Minutes Continued. January 20, 2010
25
Copy of Sheriff’s Deputies Contracted for and to be Assigned to Municipality on file in County Clerk’s
office.
OAKLAND COUNTY SHERIFF'S OFFICE 2010 LAW ENFORCEMENT SERVICES AGREEMENT WITH
CHARTER TOWNSHIP OF HIGHLAND
Amendment 1
Pursuant to paragraph 24 of the 2010 Law Enforcement Services Agreement between the COUNTY and
the CHARTER TOWNSHIP OF HIGHLAND, the parties hereby agree to amend said contract in
accordance with the attached Schedule A.
All other contractual provisions, of the 2010 Law Enforcement Services Agreement not otherwise affected
by the attached Schedule A, remain in full force and effect.
FOR AND IN CONSIDERATION of the mutual assurances, promises, acknowledgments, set forth in this
Amendment 1 to the 2010 Law Enforcement Services Agreement, ("Amendment") and for other good and
valuable consideration, the receipt and adequacy of which is hereby acknowledged, the undersigned
hereby execute this Amendment on behalf of the Parties, and by doing so legally obligate and bind the
Parties to the terms and conditions of this Contract.
IN WITNESS WHEREOF, Patricia M. Pilchowski, Supervisor of the Charter Township of Highland, hereby
acknowledges that she has been authorized by a resolution of the Township Board, to execute this
Amendment on behalf of the Municipality and hereby accepts and binds the Municipality to the terms and
conditions of this Amendment.
EXECUTED: __________________________ DATE: _______________
Patricia M. Pilchowski, Supervisor
WITNESSED: __________________________, Clerk DATE: _______________
Charter Township of Highland
IN WITNESS WHEREOF, Bill Bullard, Jr., Chairperson, Oakland County Board of Commissioners hereby
acknowledges that he has been authorized by a resolution of the Oakland County Board of
Commissioners, to execute this Amendment on behalf of Oakland County, and hereby accepts and binds
Oakland County to the terms and conditions of this Amendment.
EXECUTED: __________________________ DATE: _______________
Bill Bullard, Jr., Chairperson
Oakland County Board of Commissioners
WITNESSED: __________________________ DATE: _______________
Ruth Johnson, Clerk
County of Oakland
FISCAL NOTE (MISC. #10008)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: SHERIFF’S OFFICE - CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES IN
THE CHARTER TOWNSHIP OF HIGHLAND - 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The Charter Township of Highland has contracted with the Oakland County Sheriff’s Office to
provide law enforcement services for the Township (M.R. #09302).
2. Amendment #1 to the contract agreement for the calendar year period of January 1, 2010 through
December 31, 2010 adds one (1) Patrol Investigator bringing the number of Patrol Investigators
to three (3) and raises the total number of contracted positions at this community from 18 to 19.
3. Resolution also specifies the addition of one (1) semi-marked patrol vehicle (with MDC, mobile
and prep radio) to the county fleet.
4. A budget amendment is recommended as follows:
GENERAL FUND (#10100) – OPERATING UNIT #40060
Revenues FY 2010 FY 2011 FY 2012
4030601-116180-632093 Sher. Spec. Deputy $122,020 $122,020 $122,020
Total Revenues $122,020 $122,020 $122,020
Expenditures
Commissioners Minutes Continued. January 20, 2010
26
4030601-116180-702010 Salaries $ 65,803 $ 65,803 $ 65,803
4030601-116180-712020 Overtime 5,134 5,134 5,134
4030601-116180-722790 Social Sec. 5,034 5,034 5,034
4030601-116180-722770 Retirement 20,682 20,682 20,682
4030601-116180-722780 Hospitalization 10,704 10,704 10,704
4030601-116180-722760 Group Life 197 197 197
4030601-116180-722750 Workers Comp 1,715 1,715 1,715
4030601-116180-722810 Disability 230 230 230
4030601-116180-722820 Unemployment 132 132 132
4030601-116180-722800 Dental 698 698 698
4030601-116180-722850 Optical 54 54 54
4030601-116180-776661 Motor Pool 9,840 9,840 9,840
4030601-116180-750070 Deputy Supplies 393 393 393
4030601-116180-750581 Uniforms 466 466 466
4030601-116180-730653 Equip Rental 180 180 180
4030601-116180-774677 Insurance Fund 595 595 595
4030601-116180-773535 CLEMIS 163 163 163
Total Expenditures $122,020 $122,020 $122,020
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*REPORT (MISC. #10009)
BY: Human Resources Committee, Sue Ann Douglas, Chairperson
IN RE: SHERIFF’S OFFICE – CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES
IN THE CHARTER TOWNSHIP OF INDEPENDENCE – 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The Human Resources Committee having reviewed the above referenced resolution on January 13, 2010
reports with the recommendation the resolution be adopted.
Chairperson, on behalf of the Human Resources Committee, I move the acceptance of the foregoing
report.
HUMAN RESOURCES COMMITTEE
MISCELLANEOUS RESOLUTION #10009
BY: Public Services Committee, Jeff Potter, Chairperson
IN RE: SHERIFF'S OFFICE – CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES
IN THE CHARTER TOWNSHIP OF INDEPENDENCE – 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Charter Township of Independence has contracted with the Oakland County Sheriff's
Office to provide law enforcement services for the Township (M.R. #09305); and
WHEREAS paragraph 20 of this Contract provided that an amendment to this Contract must be approved
by concurrent resolutions of both the Oakland County Board of Commissioners and the Independence
Township Board; and
WHEREAS the Charter Township of Independence has approved a proposed amendment to the contract
(Schedule A Deputies Contracted) which would add (2) Patrol Investigators bringing the number of Patrol
Investigators to seven (7) and bringing the total number of contracts to twenty-eight (28); and
WHEREAS the Sheriff has agreed to add two (2) Patrol Investigators for the Charter Township of
Independence under the terms of this contract.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves an
amendment to the original Schedule A (Sheriff Deputies Contracted) of the Oakland County Sheriff's
Office 2010 Law Enforcement Services Agreement with the Charter Township of Independence to add
two (2) Patrol Investigators.
BE IT FURTHER RESOLVED that two (2) Deputy II positions be created in the Independence/
Contracted Patrol-Other Municipalities/Patrol Services Division of the Sheriff’s Office.
Commissioners Minutes Continued. January 20, 2010
27
BE IT FURTHER RESOLVED that two semi-marked vehicles with radio and MDC be added to the county
fleet.
BE IT FURTHER RESOLVED that this amendment will take effect January 1, 2010.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
Copy of Schedule A Sheriff’s Deputies Contracted for and to be Assigned to Municipality on file in County
Clerk’s office.
OAKLAND COUNTY SHERIFF'S OFFICE 2010 LAW ENFORCEMENT SERVICES AGREEMENT WITH
CHARTER TOWNSHIP OF INDEPENDENCE
Amendment 1
Pursuant to paragraph 20 of the 2010 Law Enforcement Services Agreement between the COUNTY and
the CHARTER TOWNSHIP OF INDEPENDENCE, the parties hereby agree to amend said contract in
accordance with the attached Schedule A.
All other contractual provisions, of the 2010 Law Enforcement Services Agreement not otherwise affected
by the attached Schedule A, remain in full force and effect.
FOR AND IN CONSIDERATION of the mutual assurances, promises, acknowledgments, set forth in this
Amendment 1 to the 2010 Law Enforcement Services Agreement, ("Amendment") and for other good and
valuable consideration, the receipt and adequacy of which is hereby acknowledged, the undersigned
hereby execute this Amendment on behalf of the Parties, and by doing so legally obligate and bind the
Parties to the terms and conditions of this Contract.
IN WITNESS WHEREOF, David Wagner, Supervisor of the Charter Township of Independence, hereby
acknowledges that he has been authorized by a resolution of the Township Board, to execute this
Amendment on behalf of the Municipality and hereby accepts and binds the Municipality to the terms and
conditions of this Amendment.
EXECUTED: __________________________ DATE: _______________
David Wagner, Supervisor
WITNESSED: __________________________, Clerk DATE: _______________
Charter Township of Independence
IN WITNESS WHEREOF, Bill Bullard, Jr., Chairperson, Oakland County Board of Commissioners, hereby
acknowledges that he has been authorized by a resolution of the Oakland County Board of
Commissioners, to execute this Amendment on behalf of Oakland County, and hereby accepts and binds
Oakland County to the terms and conditions of this Amendment.
EXECUTED: __________________________ DATE: _______________
Bill Bullard, Jr., Chairperson
Oakland County Board of Commissioners
WITNESSED: __________________________ DATE: _______________
Ruth Johnson, Clerk
County of Oakland
FISCAL NOTE (MISC. #10009)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: SHERIFF’S OFFICE – CONTRACT AMENDMENT #1 FOR LAW ENFORCEMENT SERVICES
IN THE CHARTER TOWNSHIP OF INDEPENDENCE – 2010
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The Charter Township of Independence has contracted with the Oakland County Sheriff’s Office
to provide law enforcement services for the Township (M.R. #09305).
2. Amendment #1 to the contract agreement for the calendar year period of January 1, 2010 through
December 31, 2010 adds (2) Patrol Investigators bringing the number of Patrol Investigators to
seven (7) and raises the total number of contracted positions at this community from 26 to 28.
3. Resolution also specifies the addition of two (2) semi-marked patrol vehicles (with MDC, mobile
and prep radios) to the county fleet.
Commissioners Minutes Continued. January 20, 2010
28
4. A budget amendment is recommended as follows:
GENERAL FUND (#10100) – OPERATING UNIT #40080
Revenues FY 2010 FY 2011 FY 2012
4030601-116180-632093 Sher. Spec. Deputy $244,040 $244,040 $244,040
Total Revenues $244,040 $244,040 $244,040
Expenditures
4030601-116180-702010 Salaries $131,606 $131,606 $131,606
4030601-116180-712020 Overtime 10,268 10,268 10,268
4030601-116180-722790 Social Sec. 10,068 10,068 10,068
4030601-116180-722770 Retirement 41,364 41,364 41,364
4030601-116180-722780 Hospitalization 21,408 21,408 21,408
4030601-116180-722760 Group Life 394 394 394
4030601-116180-722750 Workers Comp 3,430 3,430 3,430
4030601-116180-722810 Disability 460 460 460
4030601-116180-722820 Unemployment 264 264 264
4030601-116180-722800 Dental 1,396 1,396 1,396
4030601-116180-722850 Optical 108 108 108
4030601-116180-776661 Motor Pool 19,680 19,680 19,680
4030601-116180-750070 Deputy Supplies 786 786 786
4030601-116180-750581 Uniforms 932 932 932
4030601-116180-730653 Equip Rental 360 360 360
4030601-116180-774677 Insurance Fund 1,190 1,190 1,190
4030601-116180-773535 CLEMIS 326 326 326
Total Expenditures $244,040 $244,040 $244,040
FINANCE COMMITTEE
(The vote for this motion appears on page 29.)
*MISCELLANEOUS RESOLUTION #10010
BY: Public Services Committee, Jeff Potter, Chairperson
IN RE: SHERIFF’S OFFICE – 2010 OFF-ROAD VEHICLE (ORV) SAFETY EDUCATION PROGRAM
GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the State of Michigan, Department of Natural Resources (DNR), has awarded the Sheriff’s
Office Marine Safety Unit $9,525 for the Off-Road Vehicle Safety Education Program; and
WHEREAS no county match or additional positions are required; and
WHEREAS the acceptance of this grant does not obligate the County to any future commitment; and
WHEREAS the continuation of the program is contingent upon future levels of reimbursement program
funding.
NOW THEREFORE BE IT RESOLVED that the Board of Commissioners approves the Department of
Natural Resources 2009-2010 ORV Safety Education Program Grant Acceptance Agreement and that the
Board Chairperson, on behalf of the County of Oakland, is authorized to execute said agreement, as
attached.
BE IT FURTHER RESOLVED that no grant match is required.
Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
Copy of Grant Review Sign Off – Sheriff’s Office on file in County Clerk’s office.
Copy of FY 2010 Off-Road Vehicle (ORV) Safety Education Grant Agreement on pages 528-530.
Commissioners Minutes Continued. January 20, 2010
29
FISCAL NOTE (MISC. #10010)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: SHERIFF’S OFFICE – 2010 OFF-ROAD VEHICLE (ORV) SAFETY EDUCATION PROGRAM
GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The State of Michigan, Department of Natural Resources (DNR), has awarded the Sheriff’s Office
Marine Safety Unit $9,525 for an Off-Road Vehicle Safety Education Program.
2. The grant period is from October 1, 2009 through September 30, 2010.
3. No County match or additional positions are required.
4. A budget amendment to the Fiscal Year 2010 Sheriff’s Office Marine Safety budget is
recommended as follows:
GENERAL FUND #10100 FY 2010
Revenue
10100-4030601-116200-615571 Grants State $ 9,525
Total General Fund Revenue $ 9,525
Expenditures
10100-4030601-116200-702140 Other Misc. Salaries $ 9,525
Total General Fund Expenditures $ 9,525
$ -0-
FINANCE COMMITTEE
Vote on Consent Agenda:
AYES: Burns, Capello, Coleman, Coulter, Douglas, Gershenson, Gingell, Gosselin, Greimel,
Hatchett, Jackson, Jacobsen, Long, McGillivray, Middleton, Nash, Potter, Potts, Runestad,
Schwartz, Scott, Taub, Woodward, Zack, Bullard. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended
Consent Agenda were adopted (with accompanying reports being accepted).
Commissioner Middleton stated there were no items to report on the Regular Agenda for the Finance
Committee.
REPORT (MISC. #09260)
BY: General Government Committee, Christine Long, Chairperson
IN RE: BOARD OF COMMISSIONERS – SUPPORT FOR HR 3745 – THE COMMUNITY ACCESS
PRESERVATION ACT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The General Government Committee, having considered the above titled resolution on January 11, 2010,
hereby recommends that the resolution be amended as follows:
1. Strike the first WHEREAS.
2. Strike all references to “CMN” and instead insert “Local Public Access Cable Channels”.
3. Amend the 9th WHEREAS:
WHEREAS HR 3745 addresses critical and immediate threats to PEG channels by: (1)
allowing federal funds that are currently provided to PEG channels additional monies
beyond base franchise fees to be used for operating expenses, and not just for facilities
and equipment; (2) ensuring that cable operators treat PEG channels the same as all
other channels and do not discriminate against them in regard to quality, accessibility,
functionality, placement, and price; and (3) allowing decisions regarding PEG channels to
continue to be made at the local level.
Commissioners Minutes Continued. January 20, 2010
30
Chairperson, on behalf of the General Government Committee, I move the acceptance of the foregoing
report.
GENERAL GOVERNMENT COMMITTEE
MISCELLANEOUS RESOLUTION #09260
BY: Commissioners Tim Greimel, District #11; Tim Burns, District #19
IN RE: BOARD OF COMMISSIONERS - SUPPORT FOR HR 3745 - THE COMMUNITY ACCESS
PRESERVATION ACT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS Community Media Network (CMN), a Public Access cable channel operating in Oakland
County, plays a significant role in Oakland County; and
WHEREAS CMN is a unique and valuable resource for enrichment, entertainment, local public safety and
emergency information, and discourse for the residents of Oakland County; and
WHEREAS CMN televises programs about local government topics and other community issues, so that
citizens are informed and involved in their community; and
WHEREAS CMN contributes to the democratic process by providing opportunities for elected officials and
candidates for office to discuss local issues; and
WHEREAS CMN provides a window through which residents can view the diversity of cultures, participate
in recreational and enrichment activities, learn about health, wellness, faith, and legal topics, and enjoy
the artistic endeavors in our community; and
WHEREAS CMN reflects the unique identity of Oakland County; and
WHEREAS it is important to preserve all public, educational and governmental access (PEG) channels
and their funding, and to ensure that the channels continue to be available to everyone in the
communities they serve; and
WHEREAS HR 3745, the Community Access Preservation Act, has been introduced in the United States
Congress; and
WHEREAS HR 3745 addresses critical and immediate threats to PEG channels by: (1) allowing federal
funds that are currently provided to PEG channels to be used for operating expenses, and not just for
facilities and equipment; (2) ensuring that cable operators treat PEG channels the same as all other
channels and do not discriminate against them in regard to quality, accessibility, functionality, placement,
and price; and (3) allowing decisions regarding PEG channels to continue to be made at the local level.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners supports
immediate passage of HR 3745 by the United States Congress.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners calls on our
Congressional delegation to take all possible actions in support of the passage of HR 3745, including but
not limited to endorsing, co-sponsoring, and voting for HR 3745, and to work for its rapid passage.
BE IT FURTHER RESOLVED that the Oakland County Clerk is requested to forward copies of this
adopted resolution to: Michigan’s United States Senators, those members of the United States House of
Representatives who represent Oakland County, the Michigan Association of Counties, the National
Association of Counties, and Oakland County’s legislative lobbyists.
Chairperson, we move the adoption of the foregoing resolution.
TIM GREIMEL, GARY McGILLIVRAY, TIM
BURNS, DAVID COULTER, MATTIE
HATCHETT, HELAINE ZACK, MARCIA
GERSHENSON, DAVID WOODWARD, JANET
JACKSON, STEVEN SCHWARTZ
Copy of H.R. 3745 on file in County Clerk’s office.
Moved by Long supported by Greimel the resolution be adopted.
Moved by Long supported by Greimel the General Government Committee Report be accepted.
A sufficient majority having voted in favor, the report was accepted.
Commissioners Minutes Continued. January 20, 2010
31
Moved by Long supported by Greimel the resolution be amended to coincide with the recommendation in
the General Government Committee Report.
A sufficient majority having voted in favor, the amendment carried.
Discussion followed.
Vote on resolution, as amended:
AYES: Capello, Coleman, Coulter, Douglas, Gershenson, Gingell, Gosselin, Greimel, Hatchett,
Jacobsen, Long, McGillivray, Middleton, Nash, Potter, Potts, Runestad, Schwartz, Scott, Taub,
Woodward, Zack, Bullard, Burns. (24)
NAYS: None. (0)
ABSTAIN: Jackson. (1)
A sufficient majority having voted in favor, the resolution, as amended, was adopted.
REPORT (MISC. #09326)
BY: General Government Committee, Christine Long, Chairperson
IN RE: BOARD OF COMMISSIONERS – OAKLAND COUNTY CITIZEN ACADEMY STUDY GROUP
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The General Government Committee, having considered the above titled resolution on January 11, 2010,
hereby recommends that the resolution be amended as follows.
1. Amend the 2nd WHEREAS:
BE IT FURTHER RESOLVED that at least two (2) Oakland County Commissioners shall
be appointed by the Board Chair to serve on the Citizen Academy Study Group, with a
minimum of one (1) Commissioner from the majority party and one (1) Commissioner
from the minority party to be recommended by the General Government Committee to
the full Board of Commissioners.
Chairperson, on behalf of the General Government Committee, I move the acceptance of the foregoing
report.
GENERAL GOVERNMENT COMMITTEE
MISCELLANEOUS RESOLUTION #09326
BY: Eric Coleman, District #23
IN RE: BOARD OF COMMISSIONERS – OAKLAND COUNTY CITIZEN ACADEMY STUDY GROUP
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS across our nation, counties have recognized the benefit of establishing a “Citizens Academy”
to support the community as a whole by enabling interested residents to become more involved in local
government by educating them about county government policies and procedures; and
WHEREAS by establishing a Citizens Academy, county governments develop a partnership with citizens;
encourage citizens to take a more active role in government; meet and interact with other community-
minded citizens; and foster an atmosphere for discussion and questions; and
WHEREAS many county-sponsored Citizens Academies offer a curriculum that involves seminars and
workshops featuring topics, such as: elections, growth management, community service, public
protection, emergency services, the correctional system, property assessments, budgets, information
technology, parks, personnel and courtroom watching; and
WHEREAS an Oakland County Citizen Academy would provide a unique opportunity for citizens to
develop a better understanding about Oakland County government and create an appreciative learning
experience and understanding that participants can take back to their communities.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
supports the concept of establishing an Oakland County Citizens Academy program designed to engage
community members in participation, communication, mutual learning and understanding of the
operations of Oakland County government.
Commissioners Minutes Continued. January 20, 2010
32
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners establishes a Citizens
Academy Study Group, with membership comprised of representatives from the offices of the County
Executive, County Clerk/Register of Deeds, County Sheriff, County Prosecuting Attorney, County
Treasurer, Circuit Court Judges, Parks and Recreation Commission, Road Commission for Oakland
County, and any county department or division that is interested in participating.
BE IT FURTHER RESOLVED that at least two (2) Oakland County Commissioners shall be appointed to
serve on the Citizen Academy Study Group, with a minimum of one (1) Commissioner from the majority
party and one (1) Commissioner from the minority party to be recommended by the General Government
Committee to the full Board of Commissioners.
BE IT FURTHER RESOLVED that the Citizen Academy Study Group shall submit its recommendations to
the Board of Commissioners through its appropriate committees no later than March 30, 2010.
BE IT FURTHER RESOLVED that the Oakland County Clerk is requested to forward copies of this
adopted resolution to Oakland County’s Executive, Clerk/Register of Deeds, Sheriff, Prosecutor Attorney,
Treasurer, Circuit Court Judges, Parks and Recreation Commission, Water Resources Commissioner,
and Road Commission for Oakland County.
Chairperson, we move the adoption of the foregoing resolution.
ERIC COLEMAN, JANET JACKSON, TIM
GREIMEL, DAVID COULTER, GARY
McGILLIVRAY, JIM NASH, MARCIA
GERSHENSON, HELAINE ZACK, MATTIE
HATCHETT, STEVEN SCHWARTZ, TIM
BURNS, KIM CAPELLO, DAVID POTTS
Moved by Long supported by Coleman the resolution be adopted.
Moved by Long supported by Coleman the General Government Committee Report be accepted.
A sufficient majority having voted in favor, the report was accepted.
Moved by Long supported by Coleman the resolution be amended to coincide with the recommendation
in the General Government Committee Report.
A sufficient majority having voted in favor, the amendment carried.
Discussion followed.
Vote on resolution, as amended:
AYES: Coleman, Coulter, Douglas, Gershenson, Gingell, Gosselin, Greimel, Hatchett, Jackson,
Jacobsen, Long, McGillivray, Middleton, Nash, Potter, Potts, Runestad, Schwartz, Scott, Taub,
Woodward, Zack, Bullard, Burns, Capello. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolution, as amended, was adopted.
REPORT (MISC. #09327)
BY: General Government Committee, Christine Long, Chairperson
IN RE: BOARD OF COMMISSIONERS – SMART TRANSPORTATION
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The General Government Committee, having considered the above titled resolution on January 11, 2010,
hereby recommends that the resolution be amended as follows:
1. Amend the NOW THEREFORE BE IT RESOLVED:
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners hereby requests the Executive Director and/or Board of Directors of
SMART to provide the Oakland County Public Transportation Authority and the
Commissioners Minutes Continued. January 20, 2010
33
Oakland County Board of Commissioners, through the General Government Committee,
with the following information:
Chairperson, on behalf of the General Government Committee, I move the acceptance of the foregoing
report.
GENERAL GOVERNMENT COMMITTEE
MISCELLANEOUS RESOLUTION #09327
BY: Eric Coleman, District #23
IN RE: BOARD OF COMMISSIONERS – SMART TRANSPORTATION
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS Michigan Public Act 204 of 1967, created SEMTA (Southeastern Michigan Transportation
Authority) which was responsible for public transportation services and facilities for the Southeastern
Michigan region; and
WHEREAS In 1989, Public Act 204 was amended and SEMTA was renamed SMART (Suburban Mobility
Authority for Regional Transportation); and
WHEREAS regular and timely information is not being received from SMART relative to budgetary
projections or anticipated changes in transportation service; and
WHEREAS transparency is government is encouraged because it promotes accountability and provides
information for citizens and decision-makers; and
WHEREAS government and public agencies should be participatory and collaborative. Public
engagement enhances the effectiveness and improves the quality decisions. Knowledge is widely
dispersed in society, and public officials benefit from having access to that knowledge; and
WHEREAS the Oakland County Board of Commissioners, as the duly elected representatives of the
citizens of Oakland County, should have current access to information relative to regional transportation
that is supported by our local taxpayers.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
requests the Executive Director and/or Board of Directors of SMART to provide the Oakland County
Board of Commissioners, through the General Government Committee, with the following information:
By-laws and Rules and Procedures (and any subsequent updates)
Annual Financial Report
The Annual Report
Minutes from Board of Director’s Meetings
Minutes from all Committee Meetings
Updates of any budgetary changes
Updates of any changes in service
Updates of any changes in fares
Updates of any deficit reduction plans
Copies of Press Releases
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners respectfully requests
that at least once a year, that the Executive Director of SMART make a formal presentation on the status
of transportation service in Oakland County and the region.
BE IT FURTHER RESOLVED that the Oakland County Clerk is requested to forward copies of this
adopted resolution to the Executive Director and each member of the Board of Directors of SMART.
Chairperson, we move the adoption of the foregoing resolution.
ERIC COLEMAN, JANET JACKSON, TIM
GREIMEL, DAVID COULTER, GARY
McGILLIVRAY, MARCIA GERSHENSON, JIM
NASH, HELAINE ZACK, TIM BURNS, STEVEN
SCHWARTZ, MATTIE HATCHETT, KIM
CAPELLO
Moved by Long supported by Coleman the resolution be adopted.
Moved by Long supported by Coleman the General Government Committee Report be accepted.
Commissioners Minutes Continued. January 20, 2010
34
A sufficient majority having voted in favor, the report was accepted.
Moved by Long supported by Coleman the resolution be amended to coincide with the recommendation
in the General Government Committee Report.
A sufficient majority having voted in favor, the amendment carried.
Discussion followed.
Vote on resolution, as amended:
AYES: Coulter, Douglas, Gershenson, Gingell, Gosselin, Greimel, Hatchett, Jackson, Jacobsen,
Long, McGillivray, Middleton, Nash, Potter, Potts, Runestad, Schwartz, Scott, Taub, Woodward,
Zack, Bullard, Burns, Capello, Coleman. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolution, as amended, was adopted.
REPORT
BY: General Government Committee, Christine Long, Chairperson
IN RE: BOARD OF COMMISSIONERS - APPOINTMENTS TO COORDINATING ZONING
COMMITTEE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The General Government Committee, having received a recommendation from the Planning and Building
Committee for appointments to the Coordinating Zoning Committee pursuant to Board Rule XI.D.(4) and
MCL 125.3307, hereby recommends that the following commissioners be appointed to serve for a one-
year term:
COORDINATING ZONING COMMITTEE (One-year term ending 12/31/2010)
Robert Gosselin, Kim Capello, Steve Schwartz
Chairperson, on behalf of the General Government Committee, I move the acceptance of the foregoing
report.
GENERAL GOVERNMENT COMMITTEE
Copy of Letter from John Scott, Chairperson, Planning and Building Committee on file in County Clerk’s
office.
Moved by Long supported by Gingell the General Government Committee Report be accepted.
A sufficient majority having voted in favor, the report was accepted.
Moved by Long supported by Gingell the appointments of Robert Gosselin, Kim Capello and Steve
Schwartz to the Coordinating Zoning Committee for a one-year term ending December 31, 2010 be
confirmed.
Vote on appointment:
AYES: Douglas, Gershenson, Gingell, Gosselin, Greimel, Hatchett, Jackson, Jacobsen, Long,
McGillivray, Middleton, Nash, Potter, Potts, Runestad, Schwartz, Scott, Taub, Woodward, Zack,
Bullard, Burns, Capello, Coleman, Coulter. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the appointments of Robert Gosselin, Kim Capello, and Steve
Schwartz to the Coordinating Zoning Committee for a one-year term ending December 31, 2010 were
confirmed.
Commissioners Minutes Continued. January 20, 2010
35
Commissioner Douglas stated there were no items to report on the Regular Agenda for the Human
Resources Committee.
MISCELLANEOUS RESOLUTION #10011
BY: Planning and Building Committee, John A. Scott, Chairperson
IN RE: FACILITIES MANAGEMENT – DEPARTMENT OF ENERGY EECBG GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Department of Energy has awarded the Department of Facilities Management grant
funding in the amount of $4,879,700 for a period of three years; and
WHEREAS this is the first year of grant acceptance for this program; and
WHEREAS this is direct funding without the need for matching funds; and
WHEREAS this grant is to be used to improve the energy efficiency of County facilities and buildings; and
WHEREAS no new staff positions will be required to implement or administer this grant; and
WHEREAS Facilities Management will issue RFPs for Energy Audit Services upon grant acceptance; and
WHEREAS the grant agreement has been processed through the County Executive Contract Review
Process and the Board of Commissioners’ Grant Acceptance Procedures.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts grant
funding from the Department of Energy in the amount of $4,879,700, county match of $0, for a period of
three years effective immediately.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to
execute the grant agreement and to approve any grant extensions or changes, within fifteen percent
(15%) of the original award, which are consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the County to any future
commitment and that no special revenue positions are required for acceptance.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Grant Review Sign Off – Facilities Management, Federal Assistance Reporting Checklist and
Instructions, Attachment #3 Budget Information – Non Construction Programs, and Special Terms and
Conditions on file in County Clerk’s office.
Copy of Department of Energy EECBG Grant Acceptance on pages 531-540.
FISCAL NOTE (MISC. #10011)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: FACILITIES MANAGEMENT – DEPARTMENT OF ENERGY EECBG GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The resolution accepts 2009 Recovery Act – Energy Efficiency and Conservation Block Grant
(EECBG) Federal funding from the U.S. Department of Energy in the amount of $4,879,700
(Contract #DE-EE0000750/000).
2. The purpose of the EECBG Grant is to assist eligible entities in creating and implementing
strategies to: (1) reduce fossil fuel emissions in a manner that is environmentally sustainable and,
to the maximum extent practicable, maximizes benefits for local and regional communities; (2)
reduce the total energy use of the eligible entities; and (3) improve energy efficiency in the
building sector, the transportation sector, and other appropriate sectors.
3. Projects totaling $4,879,700 in the award include: (1) Building and Facilities Energy Audits
$195,500; (2) Facilities Management Energy Program $3,661,300; (3) Airport Site Lighting LED
Replacements $224,300; (4) New Airport Terminal Building – Renewable Energy Enhancements
$271,300; (5) New Airport Terminal Building – Energy Saving and Avoidance Construction
Enhancements $400,800; and (6) New Airport Terminal Building – Transportation Alternatives
$126,500.
Commissioners Minutes Continued. January 20, 2010
36
4. The grant award is in the same amount as the application.
5. The grant funding period is from November 17, 2009 through November 16, 2012.
6. No County match is required for the EECBG grant.
7. Amendments for the 2009 Recovery Act – Energy Efficiency and Conservation Block Grant
Acceptance are as follows:
ENERGY EFFICIENCY & CONSERVATION BLOCK GRANT - FUND #29580 (GR0000000481)
FY 2010
Revenue
1040701-140010-610313 Facilities - Federal Operating $2,781,800
1030701-154000-610313 Airport - Federal Operating 1,022,900
6010101-149090-610313 Water Resources – Fed. Oper. 750,000
5060101-160000-610313 Parks - Federal Operating 325,000
$4,879,700
Expenditure
1040701-140010-730373 Facilities - Contracted Svcs $2,781,800
1030701-154000-730373 Airport - Contracted Svcs 1,022,900
6010101-149090-730373 Water Resources – Cont. Svcs 750,000
5060101-160000-730373 Parks - Contracted Svcs 325,000
$4,879,700
FINANCE COMMITTEE
Moved by Scott supported by Nash the resolution (with fiscal note attached) be adopted.
Discussion followed.
AYES: Gershenson, Gingell, Gosselin, Greimel, Hatchett, Jackson, Jacobsen, Long, McGillivray,
Middleton, Nash, Potter, Runestad, Schwartz, Scott, Taub, Woodward, Zack, Bullard, Burns,
Capello, Coleman, Coulter, Douglas. (25)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolution (with fiscal note attached) was adopted.
MISCELLANEOUS RESOLUTION #10012
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: DEPARTMENTS OF FACILITIES MANAGEMENT AND HEALTH AND HUMAN SERVICES –
HOMELAND SECURITY DIVISION – APPROVAL AND ACCEPTANCE OF LEASE AGREEMENT FOR
URBAN SEARCH AND RESCUE STORAGE FACILITY, 6226 “G” ROW NORTH SERVICE ROAD,
WATERFORD, MICHIGAN
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS Oakland County has purchased, on behalf of the Southeast Michigan Homeland Security
Board, various pieces of specialized search and rescue equipment and vehicles; and
WHEREAS at the present time no adequate County owned facility exists on or off the Oakland County
Service Center, which would accommodate storage and provide for routine maintenance of said
equipment; and
WHEREAS the County Administration has negotiated the terms of the attached two-year lease
agreement at a rental rate of $7,200 per month for use of an airport hangar located at 6226 “G” Row
North Service Road, Waterford, MI with Aviation Station North LLC, as Landlord; and
WHEREAS the rent for the leased premises will be paid for from monies from the FY 07 and FY 08 Urban
Area Security Initiative Grant; and
WHEREAS it is the recommendation that the Oakland County Board of Commissioners accept and
approve the terms and conditions of the attached Lease Agreement; and
WHEREAS the County Administration and Facilities Management have reviewed and/or prepared all
necessary documents related to the attached lease agreement; and
WHEREAS the Departments of Corporation Counsel and Risk Management have reviewed and signed
off on the Lease Agreement.
Commissioners Minutes Continued. January 20, 2010
37
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Lease Agreement for use of 6226 “G” Row North Service Road between the
County of Oakland and Aviation Station North, LLC.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Lease Agreement and all other related documents
between the County of Oakland and Aviation Station North, LLC, which may be required.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Lease on file in County Clerk’s office.
FISCAL NOTE (MISC. #10012)
BY: Finance Committee, Tom Middleton, Chairperson
IN RE: DEPARTMENTS OF FACILITIES MANAGEMENT AND HEALTH AND HUMAN SERVICES –
HOMELAND SECURITY DIVISION - APPROVAL AND ACCEPTANCE FOR URBAN SEARCH AND
RESCUE STORAGE FACILITY, 6226 “G” ROW NORTH SERVICE ROAD, WATERFORD, MICHIGAN
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced
resolution and finds:
1. The resolution approves and authorizes a Lease Agreement between the County of Oakland and
Aviation Station North, LLC (landlord) for the lease of a 14,400 square foot hangar located at
6226 “G” Row North Service Road, Waterford, Michigan.
2. Currently no adequate County owned facility exists on or off campus which would accommodate
storage and provide routine maintenance of specialized search and rescue equipment and
vehicles.
3. The lease agreement begins upon execution of the lease and will end on December 31, 2012.
The cost of the lease is $7,200 per month and includes all structural maintenance, site
maintenance, snow removal, lawn maintenance, trash removal, taxes, and utilities.
4. The County of Oakland has the right to cancel this Lease for any reason upon thirty (30) days
written notice to Aviation Station North, LLC (landlord) with no penalty.
5. Funding for the lease premises will be paid from unspent 2007 and 2008 grant money to cover
the lease. Funding is estimated at $14,400, through March 31, 2010 from the Grant Year 2007
Urban Area Security Initiative Grant (UASI). The remainder of funding for the lease agreement is
available in the Grant Year 2008 Urban Area Security Initiative Grant (UASI) which is
approximately $100,800.
6. Grant monies are projected to extend thru May 31, 2011. There is no secured funding beyond
May 31, 2011, to complete the lease agreement. Homeland Security will look for additional
sources.
7. The FY 2010, FY 2011 budget is amended as follows:
FY 2010 FY 2011
GRANT YEAR 2007 (UASI)
Fund 29340 Grant #0000000399
Expense:
1060601-115127-731626 Rent $14,400
1060601-115127-750154 Exp. Equip. (14,400)
$ -0-
GRANT YEAR 2008 (UASI)
Fund 29340 Grant #0000000453
Expense:
1060601-115127-731626 Rent $43,200 $57,600
1060601-115127-750154 Exp. Equip. (43,200) (57,600)
$ -0- $ -0-
FINANCE COMMITTEE
Moved by Scott supported by Runestad the resolution (with fiscal note attached) be adopted.
Commissioners Minutes Continued. January 20, 2010
38
AYES: Gingell, Gosselin, Greimel, Hatchett, Jackson, Jacobsen, Long, McGillivray, Middleton,
Nash, Potter, Runestad, Schwartz, Scott, Taub, Woodward, Zack, Bullard, Burns, Capello,
Coleman, Coulter, Douglas, Gershenson. (24)
NAYS: Potts. (1)
A sufficient majority having voted in favor, the resolution (with fiscal note attached) was adopted.
MISCELLANEOUS RESOLUTION #10013
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: PARKS AND RECREATION COMMISSION – DEPARTMENT OF FACILITIES MANAGEMENT
– APPROVAL AND ACCEPTANCE OF PURCHASE AGREEMENT FOR THE ACQUISITION OF 186-
ACRES FOR EXPANSION OF INDEPENDENCE OAKS COUNTY PARK
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS pursuant to Miscellaneous Resolution #08009 dated January 17, 2008 the County of Oakland
entered into a Michigan Department of Natural Resources Trust Fund Land Acquisition Project
Agreement to receive a grant to reimburse Oakland County forty-two percent of the acquisition cost of
property known as the Upper Bushman Lake property for expansion of Independence Oaks County Park;
and
WHEREAS pursuant to the authorization of the Oakland County Planning and Building Committee the
Oakland County Parks and Recreation Commission and the Department of Facilities Management with the
assistance of Oakland County Corporation Counsel have negotiated the terms and conditions of the
attached Purchase Agreement with Craig Arnold and Maria Arnold, husband and wife, for the purchase of
approximately 186-acres of land in Independence Township known as parcel numbers 08-03-201-006 and
08-03-201-007; and
WHEREAS said Purchase Agreement was recommended for approval by the Oakland County Parks and
Recreation Commission on December 2, 2009; and
WHEREAS the Oakland County Parks and Recreation Commission has budgeted sufficient funds from its
land acquisition fund to complete the purchase of said property; and
WHEREAS pursuant to the terms and conditions of said Purchase Agreement and in accordance with
Michigan Natural Resources Trust Fund Agreement No. TF06-199 the County of Oakland shall pay Craig
Arnold and Maria Arnold the sum of $2,836,000 via a cash sale for the purchase of said property subject
to the County performing its required due diligence investigation of the subject property; and
WHEREAS the Departments of Facilities Management and Corporation Counsel have reviewed and/or
prepared all necessary documents related to the attached Purchase Agreement and recommend its
approval.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and accepts the terms and conditions of the attached Purchase Agreement between the County of Oakland,
as purchaser, and Craig Arnold and Maria Arnold, sellers, for a cash sale purchase.
BE IT FURTHER RESOLVED that the County of Oakland Board of Commissioners hereby directs its
Chairperson or his designee to execute the attached Purchase Agreement and all other related documents
between the County of Oakland and Craig Arnold and Maria Arnold, which may be required to complete the
purchase of said property.
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
Copy of Purchase Agreement, Exhibit A Legal Descriptions of Upper Bushman Lake Parcels, Exhibit B
Description of the Residential Dwellings, Structures and Personal Property, Exhibit C Legal Descriptions of
Upper Bushman Lake Parcels on file in County Clerk’s office.
The Chairperson referred the resolution to the Finance Committee. There were no objections.
Commissioners Minutes Continued. January 20, 2010
39
MISCELLANEOUS RESOLUTION #10014
BY: Planning and Building Committee, John Scott, Chairperson
IN RE: OAKLAND COUNTY PARKS AND RECREATION MILLAGE, 2012 - 2021
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the one-quarter voted millage for the Oakland County Parks and Recreation areas in Oakland
County will expire December 31, 2011; and
WHEREAS the mission of the Oakland County Parks and Recreation Commission is to “deliver quality
parks, recreation, facilities, programs, services and maintenance through a dedicated professional Park
Commission and staff that listen to the needs of citizens, create innovative parks, recreation facilities and
programs and increase the quality of life for the residents of Oakland County”; and
WHEREAS in a 2008 county-wide survey, the citizens were very supportive of the actions of the Oakland
County Parks and Recreation Commission, including: the repair of older park buildings, shelters, and
playgrounds, the purchase of land to preserve open space and protect the environment, and purchase of
land to develop walking and biking trails; and
WHEREAS in the same county-wide survey, the majority of respondents indicated they would vote in
favor of renewing the dedicated millage; and
WHEREAS continued millage funding will be necessary in order to meet the mission of the Oakland
County Parks and Recreation Commission and the needs and requests of the citizens of Oakland County;
and
WHEREAS Oakland County Corporation Counsel has reviewed and approved the proposed ballot
language.
NOW THEREFORE BE IT RESOLVED the Oakland County Parks and Recreation Commission hereby
recommends the Oakland County Board of Commissioners approve the following ballot question be
placed on the ballot at the August 3, 2010 Primary Election for the continuation of the millage at the
current rate of 0.2415 mills for an additional ten (10) years for the purpose of operating, maintaining,
improving and acquiring parks and recreation areas and facilities in Oakland County:
“The Oakland County Parks and Recreation Commission was created in 1966 pursuant to
Public Act 261 of 1965. Since 1967, there has been a separately dedicated parks and
recreation millage. The current millage will expire on December 31, 2011.
Accordingly, shall the current millage of .2415 mills, for the purpose of operating, maintaining,
improving and acquiring parks and recreation areas and facilities in Oakland County, Michigan,
be renewed for a period of ten (10) years from 2012 to 2021? The .2415 mills is equal to
$0.2415 per $1,000.00 of taxable value. The millage, if renewed, will generate approximately
$10,900,000 in 2012. Revenue from this millage will be disbursed only to the County of
Oakland to be used solely for the purpose of funding the Oakland County Parks and Recreation
Commission.
This renewal is a continuation of the previous increase of the constitutional tax limitation on the
total amount of general ad valorem taxes which may be imposed each year for all purposes
upon taxable property in Oakland County, Michigan as set forth in Section 6, Article 9 of the
Michigan Constitution.”
Chairperson, on behalf of the Planning and Building Committee, I move the adoption of the foregoing
resolution.
PLANNING AND BUILDING COMMITTEE
The Chairperson referred the resolution to the Finance Committee. There were no objections.
MISCELLANEOUS RESOLUTION #10015
BY: Public Services Committee, Jeff Potter, Chairperson
IN RE: PUBLIC SERVICES/MEDICAL EXAMINER - CONTRACT TO PROVIDE TOXICOLOGY
SERVICES TO BAY COUNTY AND TUSCOLA COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Michigan County of Bay and Tuscola have requested that the County of Oakland provide
toxicology services of the Oakland County Medical Examiner; and
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WHEREAS Pursuant to the Urban Cooperation Act of 1967, 1967 PA 7, MCL 124.501 et seq., the
aforementioned Counties may enter into this agreement for the purposes of providing toxicology services
only of the Oakland County Medical Examiner’s Office; and
WHEREAS the contracts provides that mutual agreement and amendment shall not become effective
prior to the approval by concurrent resolutions of both the Oakland County Board of Commissioners and
Bay and Tuscola County Board of Commissioners; and
WHEREAS the Bay and Tuscola County Board of Commissioners have approved the request for
toxicology services; and
WHEREAS through their purchasing policies, the aforementioned county has agreed to enter into
contract to use toxicology services of the Oakland County Medical Examiner; and
WHEREAS Corporation Counsel has reviewed and approves the contract language which include to
Scope of Services, Fee Schedule, Compensation to Oakland County for services performed and
guaranteed compliance by the Oakland County Medical Examiner with all applicable Federal, State and
local laws, ordinances, rules and regulation; and
WHEREAS the Oakland County Medical Examiner and Corporation Counsel has reviewed and/or
prepared all necessary documents related to the attached contracts between the counties of Bay and
Tuscola and the County of Oakland; and
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby approves
and authorizes the attached Interlocal agreement between the County of Bay and Tuscola and the County
of Oakland.
Chairperson, on behalf of the Public Services Committee, I move adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
Copy of 2009 Interlocal Agreement for Medical Examiner (Toxicology Only) Services Between Oakland
County and Bay County and 2009 Interlocal Agreement for Medical Examiner (Toxicology Only) Services
Between Oakland County and Tuscola County on file in County Clerk’s office.
The Chairperson referred the resolution to the Finance Committee. There were no objections.
Commissioner Dave Coulter withdrew his motion to discharge MR #09129 – Board of Commissioners –
Authorizing Inter-Governmental Transfer to Expand Access to Health Care for Oakland County
Residents, and Contracting Administration of County’s Indigent Hospitalization Program with Oakland
Health Plan, Inc. from the General Government and Finance Committees, and gave notice that he plans
to discharge the resolution at the next regular Board Meeting on February 2, 2010.
MISCELLANEOUS RESOLUTION #10016
BY: Shelley G. Taub and Eric Coleman
IN RE: BOARD OF COMMISSIONERS – RECOGNITION OF THE NATIONAL ASSOCIATION OF
COUNTIES’ (NACO) 75TH ANNIVERSARY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the National Organization of Counties (NACo) was established in 1935, when it was first
called the National County Officers Association; and
WHEREAS the National Association of Counties (NACo) was formed to stimulate the continuing
improvement of county government; to speak nationally for county government; to contribute to the
knowledge and awareness of the heritage and future of county government; to serve as a liaison between
the nation's counties and other levels of government; and to achieve public understanding of the role of
counties in the federal system; and
WHEREAS NACo provides essential services to the nation’s 3,066 counties across the United States.
This represents 3/4 of all counties and over 85% of the nation's population; and
WHEREAS NACo provides a mechanism for counties to exchange information and advice and improve
services rendered to the public by county government; and
WHEREAS NACo advances issues with a unified voice before the federal government, improves the
public's understanding of county government, assists counties in finding and sharing innovative solutions
through education and research, and provides value-added services to save counties and taxpayers
money; and
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WHEREAS counties save tax dollars and staff time with NACo through cooperative purchasing programs,
research information, technical assistance, and careful review of legislation and regulations; and
WHEREAS NACo offers a free program that allows Oakland County to provide its residents with a free
Prescription Drug Discount Card Program that assists residents with prescription costs. Since this
national program began in 2004, it has provided an average savings of more than 23 percent per
prescription, and nearly 1,100 participating counties have saved their residents more than $170 million;
and
WHEREAS NACo, as “The Voice of America’s Counties”, works alongside its members to vigorously
lobby the Administration and Congress on all issues affecting counties and their residents; and
WHEREAS in 2010, the National Association of Counties is engaging in a year-long celebration of its 75th
Anniversary.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby extends
its congratulations to the board, members, staff, and affiliates of the National Association of Counties on
the occasion of its 75th Anniversary.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners commends the National
Association of Counties as a highly respected partner and leader in supporting and strengthening our
nation’s counties.
BE IT FURTHER RESOLVED that the Oakland County Clerk is requested to forward copies of this
adopted resolution to the National Association of Counties and the Michigan Association of Counties.
Chairperson, we move the adoption of the foregoing resolution.
SHELLEY TAUB, ERIC COLEMAN, SUE ANN
DOUGLAS, MATTIE HATCHETT, CHRISTINE
LONG, STEVEN SCHWARTZ, BRADFORD
JACOBSEN, HELAINE ZACK, JEFF POTTER,
DAVID WOODWARD, JIM RUNESTAD, JIM
NASH, DAVID POTTS, DAVID COULTER, BILL
BULLARD, GARY McGILLIVRAY, KIM
CAPELLO, TIM GREIMEL, MARCIA
GERSHENSON, TIM BURNS, JANET
JACKSON, MICHAEL GINGELL
The Chairperson referred the resolution to the General Government Committee. There were no
objections.
MISCELLANEOUS RESOLUTION #10017
BY: Shelley G. Taub and Jim Nash
IN RE: BOARD OF COMMISSIONERS – DESIGNATING APRIL 1, 2010 AS CENSUS DAY IN
OAKLAND COUNTY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen
WHEREAS in March, census forms will be mailed to residences in Oakland County; and
WHEREAS an accurate census count is vital to Oakland County and its residents’ well-being by helping
planners determine where to locate schools, day-care centers, roads and public transportation, hospitals
and other facilities, and is used to make decisions concerning business growth and housing needs; and
WHEREAS more than $300 billion per year in federal and state funding is allocated to states and
communities based on census data; and
WHEREAS for every 100 people not counted, Oakland County’s communities risk losing an estimated
$1.2 million over the next decade for federally funded programs alone; including such programs as
Medicaid, public housing assistance, community development block grants, mental health, senior care
and Title I funding; and
WHEREAS census data ensures fair Congressional representation by determining how many seats each
state will have in the U.S. House of Representatives as well as the redistricting of state legislatures,
county and city councils, and voting districts; and
WHEREAS the 2010 Census creates jobs that stimulate economic growth and increase employment
opportunities in our community; and
Commissioners Minutes Continued. January 20, 2010
42
WHEREAS the 2010 Census has ten (10) questions, which will only take ten minutes to complete and
mail back; and
WHEREAS for those households that complete and mail in the forms before the deadline, no further
action is required. Census workers, however, are required to visit each household that has not provided
the required census information by mailing in the forms; and
WHEREAS the information collected by the census is protected by law and remains confidential for 72
years; and
WHEREAS as a 2010 Census partner, Oakland County will support the goals and ideals for the 2010
Census and will disseminate 2010 Census information to encourage community participation: encourage
people in Oakland County to place an emphasis on the 2010 Census and to participate in events that will
raise overall awareness of the 2010 Census to ensure a full and accurate count; support census workers
as they help our community complete an accurate count.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
designates April 1, 2010 as Census Day in Oakland and joins the rest of the nation as a 2010 Census
Partner.
Chairperson, we move the adoption of the foregoing resolution.
SHELLEY TAUB, JIM NASH, TIM GREIMEL,
BILL BULLARD, SUE ANN DOUGLAS, KIM
CAPELLO, CHRISTINE LONG, DAVID
COULTER, THOMAS MIDDLETON, GARY
McGILLIVRAY, BRADFORD JACOBSEN, TIM
BURNS, JOHN SCOTT, JANET JACKSON,
JEFF POTTER, ERIC COLEMAN, JIM
RUNESTAD, MATTIE HATCHETT, DAVID
POTTS, STEVEN SCHWARTZ, HELAINE
ZACK, DAVID WOODWARD, MARCIA
GERSHENSON, MICHAEL GINGELL
The Chairperson referred the resolution to the General Government Committee. There were no
objections.
The Board adjourned at 8:00 p.m. to the call of the Chair or February 2, 2010, at 7:00 p.m.
RUTH JOHNSON BILL BULLARD, JR.
Clerk Chairperson
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DCH-0665 FY2010 1/09 (W) Page 1 of 16
Contract Manager and
Location/Building: Mark Steinberg
Lewis Cass Bldg, 5th fl.
Contract #:2010-
Grant Agreement Between
Michigan Department of Community Health
hereinafter referred to as the “Department”
and
Oakland County Health Division/Office of Substance Abuse Services
1200 N. Telegraph
Pontiac, MI 48341
Federal I.D.#:38-6004876
hereinafter referred to as the “Contractor”
for
Substance Use Disorder Services
Part I
1. Period of Agreement: This agreement shall commence on October 1, 2009 and
continue through September 30, 2010. This agreement is in full force and effect for the
period specified.
2. Program Budget and Agreement Amount
A. Agreement Amount
The total agreement amount is $4,634,746.00 and the Department’s agreement amount
is 1,253661.20, as shown in the attached budget (Attachment B). The federal funding
provided by the Department is $3,381,084.80, as follows:
Federal
Program
Title
Catalog of Federal
Domestic
Assistance (CFDA)
Title
CFDA
#
Federal Agency
Name
Federal
Grant
Award
Number
Award
Phase
Amount
SAPT Block
Grant
Block Grant for
Prevention and
Treatment of
Substance Abuse
93.959 Department of
Health and Human
Services/SAMHSA
10 B1 MI
SAPT
2010 $3,381,084.80
Infrastructure
Program for
Substance
Abuse
Prevention
Strategic Prevention
Framework State
Incentive Grants
93.243 Department of
Health and Human
Services/SAMHSA
5 U79
SP11196-01
2010 $0
Community
Mental
Health
Services
Block Grant
Block Grants for
Community Mental
Health Services
93.958 Department of
Health and Human
Services/SAMHSA
10B1MICMH
S
2010 $0
Total FY 2010 Federal Funding $3,381,084.80
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DCH-0665 FY2010 1/09 (W) Page 2 of 16
The grant agreement is designated as a:
Subrecipient relationship; or
Vendor relationship.
The grant agreement is designated as:
Research and development project; or
Not a research and development project.
B. Equipment Purchases and Title
Any contractor equipment purchases supported in whole or in part through this
agreement must be listed in the supporting Equipment Inventory Schedule.
Equipment means tangible, non-expendable, personal property having useful life
of more than one (1) year and an acquisition cost of $5,000 or more per unit.
Title to items having a unit acquisition cost of less than $5,000 shall vest with the
Contractor upon acquisition. The Department reserves the right to retain or
transfer the title to all items of equipment having a unit acquisition cost of $5,000
or more, to the extent that the Department’s proportionate interest in such
equipment supports such retention or transfer of title.
C. Deviation Allowance
A deviation allowance modifying an established budget category by $10,000 or
15%, whichever is greater, is permissible without prior written approval of the
Department. Any modification or deviations in excess of this provision, including
any adjustment to the total amount of this agreement, must be made in writing
and executed by all parties to this agreement before the modifications can be
implemented. This deviation allowance does not authorize new categories,
subcontracts, equipment items or positions not shown in the attached Program
Budget Summary and supporting detail schedules.
3. Purpose: The focus of the program is to provide for the administration and coordination
of substance abuse services within the designated coordinating agency region,
consisting of Oakland County (ies).
4. Statement of Work: The Contractor agrees to undertake, perform and complete the
services described in Attachment A, which is part of this agreement through reference.
5. Financial Requirements: The financial requirements shall be followed as described in
Part II of this agreement and Attachments B and D which are part of this agreement
through reference. The agency’s fiscal year allocation letter is incorporated by
reference into this agreement.
6. Performance/Progress Report Requirements: The progress reporting methods, as
applicable, shall be followed as described in Attachment C, which is part of this
agreement through reference.
7. General Provisions: The Contractor agrees to comply with the General Provisions
outlined in Part II, which is part of this agreement through reference. The Contractor
also agrees to comply with the requirements described in Attachment E: Other
Requirements, which is part of this agreement through reference. The Parties agree
that the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 09/10
AGREEMENT ADDENDUM A (pages 17 through 19, herein) is incorporated and
made part of this Agreement.
Item 2.B
is not
applicable.
Item 2.C
is not
applicable.
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8. Administration of the Agreement:
The person acting for the Department in administering this agreement (hereinafter
referred to as the Contract Manager) is:
Mark Steinberg, Administrator
Division of Grants and Contract Management, ODCP
Lewis Cass Building, 5th floor, Lansing, MI
(517) 335-0180
SteinbergM@michigan.gov
Name, Location/Building Title Telephone No. Email Address
9. Contractor’s Financial Contact for the Agreement:
The person acting for the Contractor on the financial reporting for this agreement is:
Name Title
E-Mail Address Telephone No.
10. Special Conditions:
A. This agreement is valid upon approval by the State Administrative Board as
appropriate and approval and execution by the Department.
B. This agreement is conditionally approved subject to and contingent upon the
availability of funds.
C. The Department will not assume any responsibility or liability for costs incurred
by the Contractor prior to the signing of this agreement.
D. The Contractor is required by PA 533 of 2004 to receive payments by electronic
funds transfer.
11. Special Certification:
The individual or officer signing this agreement certifies by his or her signature that he or
she is authorized to sign this agreement on behalf of the responsible governing board,
official or Contractor.
12. Signature Section:
For the CONTRACTOR
Name (Please print) Title
Signature Date
For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Mary Jane Russell, Interim Deputy Director, Operations Administration Date
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Part II
General Provisions
I. Responsibilities - Contractor
The Contractor in accordance with the general purposes and objectives of this
agreement will:
A. Publication Rights
1. Where activities supported by this agreement produce books, films, or
other such copyrightable materials issued by the Contractor, the
Contractor may copyright such but shall acknowledge that the
Department reserves a royalty-free, non-exclusive and irrevocable license
to reproduce, publish and use such materials and to authorize others to
reproduce and use such materials. This cannot include service recipient
information or personal identification data.
2. Any copyrighted materials or modifications bearing acknowledgment of
the Department’s name must be approved by the Department prior to
reproduction and use of such materials.
3. The Contractor shall give recognition to the Department in any and all
publications papers and presentations arising from the program and
service contract herein; the Department will do likewise.
B. Fees
Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and
report these as outlined by the Department’s fiscal procedures. Any
underrecoveries of otherwise available fees resulting from failure to bill for
eligible services will be excluded from reimbursable expenditures.
C. Program Operation
Provide the necessary administrative, professional, and technical staff for
operation of the program.
D. Reporting
Utilize all report forms and reporting formats required by the Department at the
effective date of this agreement, and provide the Department with timely review
and commentary on any new report forms and reporting formats proposed for
issuance thereafter.
E. Record Maintenance/Retention
Maintain adequate program and fiscal records and files, including source
documentation to support program activities and all expenditures made under the
terms of this agreement, as required. Assure that all terms of the agreement will
be appropriately adhered to and that records and detailed documentation for the
project or program identified in this agreement will be maintained for a period of
not less than three (3) years from the date of termination, the date of submission
of the final expenditure report or until litigation and audit findings have been
resolved.
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F. Authorized Access
Permit upon reasonable notification and at reasonable times, access by
authorized representatives of the Department, Federal Grantor Agency,
Comptroller General of the United States and State Auditor General, or any of
their duly authorized representatives, to records, files and documentation related
to this agreement, to the extent authorized by applicable state or federal law, rule
or regulation.
G. Audits
This section only applies to Contractors designated as subrecipients.
Contractors designated as vendors are exempt from the provisions of this
section.
1. Required Audit or Notification Letter
Contractors must submit to the Department either a Single Audit,
Financial Statement Audit, or Audit Status Notification Letter as described
below. If submitting a Single Audit or Financial Statement Audit,
Contractors must also submit a Corrective Action Plan for any audit
findings that impact MDCH-funded programs, and management letter (if
issued) with a response.
a. Single Audit
Contractors that expend $500,000 or more in federal awards
during the Contractor’s fiscal year must submit to the Department
a Single Audit prepared consistent with the Single Audit Act
Amendments of 1996, and Office of Management and Budget
(OMB) Circular A-133, “Audits of States, Local Governments, and
Non-Profit Organizations,” as revised.
The Contractor must comply with all requirements in the MDCH
Substance Abuse Prevention and Treatment Audit Guidelines,
current edition, as issued by the MDCH Office of Audit.
b. Financial Statement Audit
Contractors exempt from the Single Audit requirements that
receive $500,000 or more in total funding from the Department in
State and Federal grant funding must submit to the Department a
Financial Statement Audit prepared in accordance with generally
accepted auditing standards (GAAS). Contractors exempt from
the Single Audit requirements that receive less than $500,000 of
total Department grant funding must submit to the Department a
Financial Statement Audit prepared in accordance with GAAS if
the audit includes disclosures that may negatively impact MDCH-
funded programs including, but not limited to fraud, going concern
uncertainties, financial statement misstatements, and violations of
contract and grant provisions.
c. Audit Status Notification Letter
Contractors exempt from both the Single Audit and Financial
Statement Audit requirements (a. and b. above) must submit an
Audit Status Notification Letter that certifies these exemptions.
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The template Audit Status Notification Letter and further
instructions are available at http://www.michigan.gov/mdch by
selecting Inside Community Health – MDCH Audit.
2. Due Date and Where to Send
The required audit and any other required submissions (i.e. Corrective
Action Plan and management letter with a response), or audit Status
Notification Letter must be submitted to the Department within nine
months after the end of the Contractor’s fiscal year to:
Michigan Department of Community Health
Office of Audit
Quality Assurance and Review Section
P.O. Box 30479*
Lansing, Michigan 48910-7979
*For Express Delivery:
Capital Commons Center
400 S. Pine Street
Lansing, Michigan 48933
Alternatives to paper filing may be viewed at
http://www.michigan.gov/mdch by selecting Inside Community Health –
MDCH Audit.
3. Penalty
a. Delinquent Single Audit or Financial Statement Audit
If the Contractor does not submit the required Single Audit
reporting package, management letter (if issued) with a response,
and Corrective Action Plan; or the Financial Statement Audit and
management letter (if issued) with a response within nine months
after the end of the Contractor’s fiscal year and an extension has
not been approved by the cognizant or oversight agency for audit,
the Department may withhold from the current funding an amount
equal to five percent of the audit year’s grant funding (not to
exceed $200,000) until the required filing is received by the
Department. The Department may retain the amount withheld if
the Contractor is more than 120 days delinquent in meeting the
filing requirements and an extension has not been approved by
the cognizant or oversight agency for audit. The Department may
terminate the current grant if the Contractor is more than 180 days
delinquent in meeting the filing requirements and an extension has
not been approved by the cognizant or oversight agency for audit.
b. Delinquent Audit Status Notification Letter
Failure to submit the Audit Status Notification Letter, when
required, may result in withholding from the current funding an
amount equal to one percent of the audit year’s grant funding until
the Audit Status Notification Letter is received.
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4. Other Audits
The Department or federal agencies may also conduct or arrange for
“agreed upon procedures” or additional audits to meet their needs.
H. Subrecipient/Vendor Monitoring
The Contractor must ensure that each of its subrecipients comply with the
Single Audit Act requirements. The Contractor must issue management
decisions on audit findings of their subrecipients as required by OMB Circular A-
133.
The Contractor must also develop a subrecipient monitoring plan that addresses
“during the award monitoring” of subrecipients to provide reasonable assurance
that the subrecipient administers Federal awards in compliance with laws,
regulations, and the provisions of contracts, and that performance goals are
achieved. The subrecipient monitoring plan should include a risk-based
assessment to determine the level of oversight, and monitoring activities such as
reviewing financial and performance reports, performing site visits, and
maintaining regular contact with subrecipients.
The Contractor must establish requirements to ensure compliance for for–profit
subrecipients as required by OMB Circular A-133, Section .210(e)
The Contractor must ensure that transactions with vendors comply with laws,
regulations, and provisions of contracts or grant agreements in compliance with
OMB Circular A-133, Section .210(f).
I. Notification of Modifications
Provide timely notification to the Department, in writing, of any action by its
governing board or any other funding source that would require or result in
significant modification in the provision of services, funding or compliance with
operational procedures.
J. Software Compliance
The Contractor must ensure software compliance and compatibility with the
Department’s data systems for services provided under this agreement including,
but not limited to: stored data, databases, and interfaces for the production of
work products and reports. All required data under this agreement shall be
provided in an accurate and timely manner without interruption, failure or errors
due to the inaccuracy of the Contractor’s business operations for processing
date/time data.
K. Human Subjects
The Contractor will comply with Protection of Human Subjects Act, 45 CFR, Part
46. The Contractor agrees that prior to the initiation of the research, the
Contractor will submit institutional Review Board (IRB) application material for all
research involving human subjects, which is conducted in programs sponsored
by the Department or in programs which receive funding from or through the
State of Michigan, to the Department’s IRB for review and approval, or the IRB
application and approval materials for acceptance of the review of another IRB.
All such research must be approved by a federally assured IRB, but the
Department’s IRB can only accept the review and approval of another
institution’s IRB under a formally-approved interdepartmental agreement. The
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manner of the review will be agreed upon between the Department’s IRB
Chairperson and the Contractor’s IRB Chairperson or Executive Officer(s).
II. Responsibilities - Department
The Department in accordance with the general purposes and objectives of this
agreement will:
A. Reimbursement
Provide reimbursement in accordance with the terms and conditions of this
agreement based upon appropriate reports, records, and documentation
maintained by the Contractor.
B. Report Forms
Provide any report forms and reporting formats required by the Department at the
effective date of this agreement, and provide to the Contractor any new report
forms and reporting formats proposed for issuance thereafter at least ninety (90)
days prior to their required usage in order to afford the Contractor an opportunity
to review and offer comment.
III. Assurances
The following assurances are hereby given to the Department:
A. Compliance with Applicable Laws
The Contractor will comply with applicable federal and state laws, guidelines,
rules and regulations in carrying out the terms of this agreement. The Contractor
will also comply with all applicable general administrative requirements such as
OMB Circulars covering cost principles, grant/agreement principles, and audits in
carrying out the terms of this agreement. For purposes of this Agreement, OMB
Circular A-87 is applicable to Contractors that are local government entities, and
OMB Circular A-122 is applicable to Contractors that are non-profit entities.
B. Anti-Lobbying Act
The Contractor will comply with the Anti-Lobbying Act, 31 USC 1352 as revised
by the Lobbying Disclosure Act of 1995, 2 USC 1601 et seq, and Section 503 of
the Departments of Labor, Health and Human Services, and Education, and
Related Agencies section of the FY 1997 Omnibus Consolidated Appropriations
Act (Public Law 104-209). Further, the Contractor shall require that the language
of this assurance be included in the award documents of all subawards at all tiers
(including subcontracts, subgrants, and contracts under grants, loans and
cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
C. Non-Discrimination
1. In the performance of any contract or purchase order resulting herefrom,
the Contractor agrees not to discriminate against any employee or
applicant for employment or service delivery and access, with respect to
their hire, tenure, terms, conditions or privileges of employment, programs
and services provided or any matter directly or indirectly related to
employment, because of race, color, religion, national origin, ancestry,
age, sex, height, weight, marital status, physical or mental disability
unrelated to the individual’s ability to perform the duties of the particular
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job or position or to receive services. The Contractor further agrees that
every subcontract entered into for the performance of any contract or
purchase order resulting herefrom will contain a provision requiring non-
discrimination in employment, service delivery and access, as herein
specified binding upon each subcontractor. This covenant is required
pursuant to the Elliot-Larsen Civil Rights Act, 1976 PA 453, as amended,
MCL 37.2201 et seq., and the Persons with Disabilities Civil Rights Act,
1976 PA 220, as amended, MCL 37.1101 et seq., and any breach thereof
may be regarded as a material breach of the contract or purchase order.
2. The Contractor will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
a. Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin;
b. Title IX of the Education Amendments of 1972, as amended (20
U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination
on the basis of sex;
c. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination on the basis of handicaps;
d. the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-
6107), which prohibits discrimination on the basis of age;
e. the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as
amended, relating to nondiscrimination on the basis of drug abuse;
f. the Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (P.L. 91-616) as amended,
relating to nondiscrimination on the basis of alcohol abuse or
alcoholism;
g. §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.
§§290 dd-3 and 290 ee 3), as amended, relating to confidentiality of
alcohol and drug abuse patient records
h. any other nondiscrimination provisions in the specific statute(s) under
which application for Federal assistance is being made; and,
i. the requirements of any other nondiscrimination statute(s) which may
apply to the application.
3. Additionally, assurance is given to the Department that proactive efforts
will be made to identify and encourage the participation of minority owned
and women owned businesses, and businesses owned by persons with
disabilities in contract solicitations. The Contractor shall incorporate
language in all contracts awarded: (1) prohibiting discrimination against
minority owned and women owned businesses and businesses owned by
persons with disabilities in subcontracting; and (2) making discrimination
a material breach of contract.
D. Debarment and Suspension
Assurance is hereby given to the Department that the Contractor will comply with
Federal Regulation, 2 CFR part 180 and certifies to the best of its knowledge and
belief that it, its employees and its subcontractors:
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1. Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any federal department or contractor;
2. Have not within a three-year period preceding this agreement been
convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (federal, state, or local)
transaction or contract under a public transaction; violation of federal or
state antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or
receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a
government entity (federal, state or local) with commission of any of the
offenses enumerated in section 2, and;
4. Have not within a three-year period preceding this agreement had one or
more public transactions (federal, state or local) terminated for cause or default.
E. Federal Requirement: Pro-Children Act
1. Assurance is hereby given to the Department that the Contractor will
comply with Public Law 103-227, also known as the Pro-Children Act of
1994, 20 USC 6091 et seq, which requires that smoking not be permitted
in any portion of any indoor facility owned or leased or contracted by and
used routinely or regularly for the provision of health, day care, early
childhood development services, education or library services to children
under the age of 18, if the services are funded by federal programs either
directly or through state or local governments, by federal grant, contract,
loan or loan guarantee. The law also applies to children’s services that
are provided in indoor facilities that are constructed, operated, or
maintained with such federal funds. The law does not apply to children’s
services provided in private residences; portions of facilities used for
inpatient drug or alcohol treatment; service providers whose sole source
of applicable federal funds is Medicare or Medicaid; or facilities where
Women, Infants, and Children (WIC) coupons are redeemed. Failure to
comply with the provisions of the law may result in the imposition of a civil
monetary penalty of up to $1,000 for each violation and/or the imposition
of an administrative compliance order on the responsible entity. The
Contractor also assures that this language will be included in any
subawards which contain provisions for children’s services.
2. The Contractor also assures, in addition to compliance with Public Law
103-227, any service or activity funded in whole or in part through this
agreement will be delivered in a smoke-free facility or environment.
Smoking shall not be permitted anywhere in the facility, or those parts of
the facility under the control of the Contractor. If activities or services are
delivered in facilities or areas that are not under the control of the
Contractor (e.g., a mall, restaurant or private work site), the activities or
services shall be smoke-free.
F. Hatch Political Activity Act and Intergovernmental Personnel Act
The Contractor will comply with the Hatch Political Activity Act, 5 USC 1501-1509
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and 7324-7328, and the Intergovernmental Personnel Act of 1970, as amended by
Title VI of the Civil Service Reform Act, Public Law 95-454, 42 USC 4728 - 4763.
Federal funds cannot be used for partisan political purposes of any kind by any
person or organization involved in the administration of federally-assisted
programs.
G. Subcontracts
Assure for any subcontracted service, activity or product:
1. That a written subcontract is executed by all affected parties prior to the
initiation of any new subcontract activity. Exceptions to this policy may be
granted by the Department upon written request within 30 days of
execution of the agreement.
2. That any executed subcontract to this agreement shall require the
subcontractor to comply with all applicable terms and conditions of this
agreement. In the event of a conflict between this agreement and the
provisions of the subcontract, the provisions of this agreement shall
prevail.
A conflict between this agreement and a subcontract, however, shall not
be deemed to exist where the subcontract:
a. Contains additional non-conflicting provisions not set forth in this
agreement;
b. Restates provisions of this agreement to afford the Contractor the
same or substantially the same rights and privileges as the
Department; or
c. Requires the subcontractor to perform duties and/or services in
less time than that afforded the Contractor in this agreement.
3. That the subcontract does not affect the Contractor’s accountability to the
Department for the subcontracted activity.
4. That any billing or request for reimbursement for subcontract costs is
supported by a valid subcontract and adequate source documentation on
costs and services.
5. That the Contractor will submit a copy of the executed subcontract if
requested by the Department.
H. Procurement
Assure that all purchase transactions, whether negotiated or advertised, shall be
conducted openly and competitively in accordance with the principles and
requirements of OMB Circular A-102 as revised, implemented through applicable
portions of the associated “Common Rule” as promulgated by responsible federal
contractor(s), or 2 CFR, Part 215 (OMB Circular A-110) as amended, as
applicable, and that records sufficient to document the significant history of all
purchases are maintained for a minimum of three years after the end of the
agreement period.
I. Health Insurance Portability and Accountability Act
To the extent that this act is pertinent to the services that the Agency provides to
the Department under this agreement, the Agency assures that it is in
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compliance with the Health Insurance Portability and Accountability Act (HIPAA)
requirements including the following:
1. The Agency must not share any protected health data and information
provided by the Department that falls within HIPAA requirements except
as permitted or required by applicable law; or to a subcontractor as
appropriate under this agreement.
2. The Agency will ensure that any subcontractor will have the same
obligations as the Agency not to share any protected health data and
information from the Department that falls under HIPAA requirements in
the terms and conditions of the subcontract.
3. The Agency must only use the protected health data and information for
the purposes of this agreement.
4. The Agency must have written policies and procedures addressing the
use of protected health data and information that falls under the HIPAA
requirements. The policies and procedures must meet all applicable
federal and state requirements including the HIPAA regulations. These
policies and procedures must include restricting access to the protected
health data and information by the Agency’s employees.
5. The Agency must have a policy and procedure to immediately report to
the Department any suspected or confirmed unauthorized use or
disclosure of protected health data and information that falls under the
HIPAA requirements of which the Agency becomes aware. The Agency
will work with the Department to mitigate the breach, and will provide
assurances to the Department of corrective actions to prevent further
unauthorized uses or disclosures.
6. Failure to comply with any of these contractual requirements may result in
the termination of this agreement in accordance with Attachment A,
Section III. Agreement Termination.
7. In accordance with HIPAA requirements, the Agency is liable for any
claim, loss or damage relating to unauthorized use or disclosure of
protected health data and information by the Agency received from the
Department or any other source.
8. The agency will enter into a business associate agreement should the
Department determine such an agreement is required under HIPAA.
IV. Financial Requirements
A. Operating Advance
The Department will not issue an operating advance under this agreement.
B. Reimbursement Method
The Department will make prepayments equal to the Contractor’s prepayment
schedule that has been approved by the Department and the Contractor. The
prepayments will be monthly, paid up to the total Department allocation as
agreed to in the approved budget. Prepayments may be adjusted quarterly based
upon expenditure reports.
C. Revenues and Expenditures Report Submission—Initial and Final
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Revenues and Expenditures Reports (RERs) shall be prepared as indicated in
Attachment B, and submitted via the Electronic Grants Administration and
Management System (EGrAMS).
RERs shall be submitted twice per agreement year. One will be submitted with
the agency’s initial fiscal year EGrAMS application and one will be submitted as
the final RER for the fiscal year. The initial RER will be an Attachment report in
EGrAMS. The final RER will also be an Attachment report and due January 31
following the end of the fiscal year.
The final RER must reflect total actual program expenditures, regardless of the
source of funds.
To access EGrAMS, log in at:
https://egrams-mi.com/dch/user/home.aspx
Failure to meet financial reporting responsibilities as identified in this agreement
may result in withholding future payments.
D. Financial Status Report Submission-Quarterly
Financial Status Reports (FSRs) shall be ‘Expenditure’ reports. FSRs will be
prepared as indicated in Attachment D and submitted via EGrAMS. The first,
second, and third quarter FSRs must be submitted on a quarterly basis, no later
than the last day of the month following the end of each fiscal quarter.
FSRs must reflect total actual program expenditures. Expenditures are reported
only for State Agreement funds
E. Reimbursement Mechanism
All contractors must sign up through the on-line vendor registration process to
receive all State of Michigan payments as Electronic Funds Transfers
(EFT)/Direct Deposits, as mandated by PA 533 of 2004. Vendor registration
information is available through the Department of Management and Budget’s
web site:
http://michigan.gov/cpexpress
F. Final Obligations and Financial Status Report Requirements
1. Preliminary Close-out Report/Obligation Report
A Preliminary Close-out Report/Obligation Report, based on annual
guidelines, must be submitted via EGrAMS and by the due date provided
by the Department’s Accounting Division. The Contractor must provide
an estimate of total expenditures for the entire agreement period. The
information on the report will be used to record the Department’s year-
end accounts payables and receivables for this agreement.
2. Final RER
The final RER is due as stated in Attachment C to this agreement and
must be submitted via EGrAMS as an Attachment Report. The final RER
must be clearly marked “Final”. Final RERs not received by the due date
may result in the loss of funding requested on the Preliminary Close-out
Report/Obligation Report and may result in the potential reduction in the
subsequent year’s agreement amount.
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3. 4th Quarter FSR
The 4th quarter FSR will be the final FSR for the agreement period and
must be submitted via EGrAMS no later than 60 days following the end of
the fiscal year.
G. Unobligated Funds
Any unobligated balance of funds held by the Contractor at the end of the
agreement period will be returned to the Department or treated in accordance
with instructions provided by the Department.
V. Agreement Termination
The Department may cancel this agreement without further liability or penalty to the
Department for any of the following reasons:
A. This agreement may be terminated by either party by giving thirty (30) days
written notice to the other party stating the reasons for termination and the
effective date.
B. This agreement may be terminated on thirty (30) days prior written notice upon
the failure of either party to carry out the terms and conditions of this agreement,
provided the alleged defaulting party is given notice of the alleged breach and
fails to cure the default within the thirty (30) day period.
C. This agreement may be terminated immediately if the Contractor or an official of
the Contractor or an owner is convicted of any activity referenced in Section III.D.
of this agreement during the term of this agreement or any extension thereof.
VI. Final Reporting Upon Termination
Should this agreement be terminated by either party, within thirty (30) days after the
termination, the Contractor shall provide the Department with all financial, performance
and other reports required as a condition of this agreement. The Department will make
payments to the Contractor for allowable reimbursable costs not covered by previous
payments or other state or federal programs. The Contractor shall immediately refund to
the Department any funds not authorized for use and any payments or funds advanced
to the Contractor in excess of allowable reimbursable expenditures. Any dispute arising
as a result of this agreement shall be resolved in the State of Michigan.
VII. Severability
If any provision of this agreement or any provision of any document attached to or
incorporated by reference is waived or held to be invalid, such waiver or invalidity shall
not affect other provisions of this agreement.
VIII. Amendments
Any changes to this agreement will be valid only if made in writing and accepted by all
parties to this agreement. Any change proposed by the Contractor which would affect
the Department funding of any project, in whole or in part in Part I, Section 2.C. of the
agreement, must be submitted in writing to the Department for approval immediately
upon determining the need for such change.
IX. Liability
A. All liability to third parties, loss, or damage as a result of claims, demands, costs,
or judgments arising out of activities, such as direct service delivery, to be carried
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out by the Contractor in the performance of this agreement shall be the
responsibility of the Contractor, and not the responsibility of the Department, if
the liability, loss, or damage is caused by, or arises out of, the actions or failure
to act on the part of the Contractor, any subcontractor, anyone directly or
indirectly employed by the Contractor, provided that nothing herein shall be
construed as a waiver of any governmental immunity that has been provided to
the Contractor or its employees by statute or court decisions.
B. All liability to third parties, loss, or damage as a result of claims, demands, costs,
or judgments arising out of activities, such as the provision of policy and
procedural direction, to be carried out by the Department in the performance of
this agreement shall be the responsibility of the Department, and not the
responsibility of the Contractor, if the liability, loss, or damage is caused by, or
arises out of, the action or failure to act on the part of any Department employee
or agent, provided that nothing herein shall be construed as a waiver of any
governmental immunity by the State, its agencies (the Department) or employees
as provided by statute or court decisions.
C. In the event that liability to third parties, loss, or damage arises as a result of
activities conducted jointly by the Contractor and the Department in fulfillment of
their responsibilities under this agreement, such liability, loss, or damage shall be
borne by the Contractor and the Department in relation to each party's
responsibilities under these joint activities, provided that nothing herein shall be
construed as a waiver of any governmental immunity by the Contractor, the
State, its agencies (the Department) or their employees, respectively, as
provided by statute or court decisions.
X. Conflict of Interest
The Contractor and the Department are subject to the provisions of 1968 PA 317, as
amended, MCL 15.321 et seq, MSA 4.1700(51) et seq, and 1973 PA 196, as amended,
MCL 15.341 et seq, MSA 4.1700 (71) et seq.
XI. State of Michigan Agreement
This is a State of Michigan Agreement and is governed by the laws of Michigan. Any
dispute arising as a result of this agreement shall be resolved in the State of Michigan.
XII. Confidentiality
Both the Department and the Contractor shall assure that medical services to and
information contained in medical records of persons served under this agreement, or
other such recorded information required to be held confidential by federal or state law,
rule or regulation, in connection with the provision of services or other activity under this
agreement shall be privileged communication, shall be held confidential, and shall not be
divulged without the written consent of either the patient or a person responsible for the
patient, except as may be otherwise permitted or required by applicable state or federal
law or regulation. Such information may be disclosed in summary, statistical, or other
form, which does not directly or indirectly identify particular individuals.
XIII. Special Certification:
The individual or officer signing this agreement certifies by his or her signature that he or
she is authorized to sign this agreement on behalf of the responsible governing board,
official or Contractor.
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XIV. Signature Section:
FOR THE CONTRACTOR
Bill Bullard. Chairperson
Oakland County Board of Commissioners
Signature Date
FOR THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Mary Jane Russell, Interim Deputy Director
Operations Administration
Signature Date
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MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
FY 09/10 AGREEMENT ADDENDUM A
1. This addendum adds the following section to Part I and Renumbers existing 11
Special Certification to 12 and existing 12 Signature Section to 13:
Part I
11. Agreement Exceptions and Limitations
Notwithstanding any other term or condition in this Agreement including, but
not limited to, any provisions related to any services as described in the
Annual Action Plan, any Contractor (Oakland County) services provided
pursuant to this Agreement, or any limitations upon any Department funding
obligations herein, the Parties specifically intend and agree that the
Contractor may discontinue, without any penalty or liability whatsoever, any
Contractor services or performance obligations under this Agreement when
and if it becomes apparent that State or Department funds for any such
services will be no longer available. Notwithstanding any other term or
condition in this Agreement, the Parties specifically understand and agree
that no provision in this Agreement shall operate as a waiver, bar or limitation
of any kind, on any legal claim or right the Contractor may have at any time
under any Michigan constitutional provision or other legal basis (e.g., any
Headlee Amendment limitations) to challenge any State or Department
program funding obligations; and, the parties further agree that no term or
condition in this Agreement is intended and no such provision shall be
argued to state or imply that the Contractor voluntarily assumed or undertook
to provide any services as described in the Annual Action Plan, and thereby,
waived any rights the Contractor may have had under any legal theory, in law
or equity, without regard to whether or not the Contractor continued to
perform any services herein after any State or Department funding ends.
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2. This addendum modifies the following sections of Part II, General Provisions:
Part II
I. Responsibilities-Contractor
J. Software Compliance. This section will be deleted in its entirety and
replaced with the following language:
The Michigan Department of Community Health and the County of
Oakland will work together to identify and overcome potential data
incompatibility problems.
III. Assurances
A. Compliance with Applicable Laws. This first sentence of this
paragraph will be stricken in its entirety and replace with the following
language:
The Contractor will comply with applicable Federal and State laws,
and lawfully enacted administrative rules or regulations, in carrying out
the terms of this agreement.
I. Health Insurance Portability and Accountability Act. The
provisions in this section shall be deleted in their entirety and replaced
with the following language:
Contractor agrees that it will comply with the Health Insurance
Portability and Accountability Act of 1996, and the lawfully enacted
and applicable Regulations promulgated there under.
IX. Liability. Paragraph A. will be deleted in its entirety and replaced with the
following language.
A. Except as otherwise provided for in this Contract, all liability, loss, or
damage as a result of claims, demands, costs, or judgments arising
out of activities to be carried out pursuant to the obligations of the
Contractor under this Contract shall be the responsibility of the
Contractor and not the responsibility of the Department, if the liability,
loss, or damage is caused by, or arises out of the actions or failure to
act on the part of the Contractor, its employees, officers or agents.
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Nothing therein shall be construed as a waiver of any governmental
immunity for the Contractor, its agencies, employees, or Oakland
County, as provided by statute or modified by court decisions.
3. Special Certification:
The individual or officer signing this agreement certifies by his or her signature that
he or she is authorized to sign this agreement on behalf of the responsible
governing board, official or Contractor.
4. Signature Section:
For the COUNTY OF OAKLAND
Name and Title
Signature Date
For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Mary Jane Russell, Interim Deputy Director Date
Operations Administration
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ATTACHMENT A
Att A_Statement of Work Sub Abuse FY2010 Initial.doc Page 1 of 36
STATEMENT OF WORK
Please note: Items in this Statement of Work have been placed into one of three
categories: General; Administrative and Financial; and Services. This categorization is
for convenience of reference only. It is not intended, and should not be interpreted, as
limiting the applicability or scope of any item or items.
General
1. General Statement of Work
The general responsibilities of the coordinating agency (CA) under this
Agreement, based on P.A. 368 of 1978, as amended, are to:
a. Develop comprehensive plans for substance abuse treatment and
rehabilitation services and prevention services consistent with guidelines
established by the Department.
b. Review and comment to the Department on applications for licenses
submitted by local treatment, rehabilitation, and prevention organizations.
c. Provide technical assistance for local substance abuse service
organizations.
d. Collect and transfer data and financial information from local organizations
to the Department.
e. Submit an annual budget request to the Department for use of state
administered funds for its city, county, or region for substance abuse
treatments and rehabilitation services and prevention services in
accordance with guidelines established by the Department.
f. Make contracts necessary and incidental to the performance of the
Agency functions. The contracts may be made with public or private
agencies, organizations, associations, and individuals to provide for
substance abuse treatment and rehabilitation services and prevention
services.
g. Annually evaluate and assess substance abuse services in the city,
county, or region in accordance with guidelines established by the
Department and federal goals.
2. Action Plan
The CA will carry out its responsibilities under this Agreement consistent with the
CA’s most recent Action Plan as approved by the Department.
3. Substance Abuse Prevention and Treatment (SAPT) Block Grant
Requirements and Applicability to State Funds
Federal requirements deriving from Public Law 102-321, as amended by Public
Law 106-310, and federal regulations in 45 CFR Part 96 are pass-through
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Att A_Statement of Work Sub Abuse FY2010 Initial.doc Page 2 of 36
requirements. Federal Substance Abuse Prevention and Treatment (SAPT)
Block Grant requirements that are applicable to states are passed on to CAs
unless otherwise specified.
42 CFR Parts 54 and 54a, and 45 CFR Parts 96, 260, and 1050, pertaining to the
final rules for the Charitable Choice Provisions and Regulations, are applicable to
CAs as stated elsewhere in this Agreement.
Sections from PL 102-321, as amended, that apply to CAs and contractors
include but are not limited to: 1921(b); 1922 (a)(1)(2); 1922(b)(1)(2); 1923;
1923(a)(1) and (2), and 1923(b); 1924(a)(1)(A) and (B); 1924(c)(2)(A) and (B);
1927(a)(1) and (2), and 1927(b)(1); 1927(b)(2); 1928(b) and (c); 1929;
1931(a)(1)(A), (B), (C), (D), (E) and (F); 1932(b)(1); 1941; 1942(a); 1943(b);
1947(a)(1) and (2).
Selected specific requirements applicable to CAs are as follows:
a. Block Grant funds shall not be used to pay for inpatient hospital services
except under condition specified in federal law.
b. Funds shall not be used to make cash payments to intended recipients of
services.
c. Funds shall not be used to purchase or improve land, purchase, construct,
or permanently improve (other than minor remodeling) any building or any
other facility, or purchase major medical equipment.
d. Funds shall not be used to satisfy any requirement for the expenditure of
non-Federal funds as a condition for the receipt of Federal funding.
1. Funds shall not be used to provide individuals with hypodermic
needles or syringes so that such individuals may use illegal drugs.
e. Funds shall not be used to enforce state laws regarding the sale of
tobacco products to individuals under the age of 18.
f. Funds shall not be used to pay the salary of an individual at a rate in
excess of Level I of the Federal Executive Schedule, or approximately
$186,600.
SAPT Block Grant requirements also apply to the Michigan Department of
Community Health (MDCH) administered state funds, unless a written exception
is obtained from MDCH.
4. Licensure of Subcontractors
The CA shall enter into agreements for prevention, treatment, and recovery
services only with providers appropriately licensed for the service provided as
required by Section 6231 of P.A. 368 of 1978, as amended.
The CA must ensure that network providers residing and providing services in
bordering states meet all applicable licensing and certification requirements
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ATTACHMENT A
Att A_Statement of Work Sub Abuse FY2010 Initial.doc Page 3 of 36
within their states, that such providers are accredited per the requirements of this
Agreement, and that provider staff are credentialed per the requirements of this
Agreement.
5. Accreditation of Subcontractors
The CA shall enter into agreements for treatment services provided through
outpatient, early intervention, Methadone, sub-acute detoxification and residential
providers only with providers accredited by one of the following accrediting
bodies: Joint Commission on Accreditation of Health Care Organizations
(JCAHO); Commission on Accreditation of Rehabilitation Facilities (CARF); the
American Osteopathic Association (AOA); Council on Accreditation of Services
for Families and Children (COA); or National Committee on Quality Assurance
(NCQA). The CA must determine compliance through review of original
correspondence from accreditation bodies to providers.
Accreditation is not needed in order to provide access management system
(AMS) services, whether these services are operated by a CA or through an
agreement with a CA or for the provision of broker/generalist case management
services. Accreditation is required for AMS providers that also provide treatment
services and for case management providers that either also provide treatment
services or provide therapeutic case management. Accreditation is not required
for peer recovery or recovery support services when these are provided through
a prevention license.
If the CA plans to purchase case management services or recovery support
services, and only these services, from an agency that is not accredited per this
agreement, the CA may request a waiver of the accreditation requirement.
6. SAMHSA/DHHS License
The federal awarding agency, Substance Abuse and Mental Health Services
Administration, Department of Health and Human Services (SAMHSA/DHHS),
reserves a royalty-free, nonexclusive and irrevocable license to reproduce,
publish or otherwise use, and to authorize others to use, for federal government
purposes: (a) The copyright in any work developed under a grant, sub-grant, or
contract under a grant or sub-grant; and (b) Any rights of copyright to which a
grantee, sub-grantee or a contractor purchases ownership with grant support.
7. Cooperation with External Medicaid Evaluation
The CA is expected to cooperate with Department efforts in external evaluation
of Medicaid services, if the CA administers Medicaid services. The CA is
expected to ensure that CA-funded providers will provide necessary data and will
facilitate access to individuals’ files and other records as required.
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8. Monitoring of Subcontractors
The CA is required to assure that subcontractors comply with all applicable
requirements contained in this agreement. To this end, the CA must adopt
written policy and must implement procedures regarding monitoring of
subcontractors. The monitoring policy and procedures must be consistent with
requirements in this agreement, with the current MDCH substance use disorder
audit guidelines, and with applicable federal Office of Management and Budget
(OMB) circulars. The CA must prepare a report of monitoring findings, and must
make this report available to the public at least once every two years.
Part II of the agreement, section I.H on Sub-recipient/Vendor Monitoring, requires
that contractors conduct monitoring and risk-based assessments of sub-
recipients during the period of the agreement. The CA must conduct monitoring
and risk-based assessments of all subcontractors, during the period of the
agreement, including subcontractors that are vendors.
Administrative and Financial
1. Match Rules
Pursuant to Section 6213 of Public Act No. 368 of 1978, as amended, Michigan
has promulgated match requirement rules. Rules 325.4151 through 325.4153
appear in the 1981 Annual Administrative Code Supplement. In brief, the rule
defines allowable matching fund sources and states that the allowable match
must equal at least ten percent of each comprehensive CA budget (see
Attachment B to the Agreement) - less direct federal and other state funds.
Per PA 368, Administrative Rules, and contract, direct state/federal funds are
funds that come to the CA directly from a federal agency or another state source.
Funds that flow to the CA from the Department are not in this category, such as,
SPF/SIG, SDA and Communicable Diseases funding, and, therefore, are subject
to the local match requirement.
Match requirements apply both to budgeted funds during the agreement period
and to actual expenditures at year-end.
“Fees and collections” as defined in the Rule include only those fees and
collections that are associated with services paid for by the CA.
If the CA is found not to be in compliance with Match requirements, or cannot
provide reasonable evidence of compliance, the Department may withhold
payment or recover payment in an amount equal to the amount of the Match
shortfall.
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2. Reporting Fees and Collections Revenues
On the initial Revenues and Expenditures Report (RER), the CA is required to
report all estimated fees and collections revenue to be received by the CA and all
estimated fees and collections revenue to be received and reported by its
contracted services providers (see Attachment B to this Agreement).
On the final RER, the CA is required to report all actual fees and collections
revenue received by the CA and all actual fees and collections revenue received
and reported by its contracted services providers (see Attachment B to this
Agreement).
“Fees and collections” are as defined in the Annual Administrative Code
Supplement, Rule 325.4151 and in the Match Rule section of this Attachment.
3. Management of Department-Administered Funds
The CA shall manage all Department-administered funds under its control in
such a way as to assure reasonable balance among the separate requirements
for each funds source.
4. Sliding Fee Scale
The CA shall implement a sliding fee scale. All treatment providers shall utilize
the scale. The CA must adopt written policies and implement procedures for
determining when an individual has no ability to pay for services and for
determining when payment liability is to be waived.
Financial information needed to determine ability to pay (financial responsibility)
must be reviewed annually or at a change in an individual’s financial status,
whichever occurs sooner.
The CA sliding fee scale must be applied to all persons (except Medicaid,
MIChild, and ABW recipients) seeking substance use disorders services funded
in whole or in part by the CA. The CA has the option to charge fees for AMS
services, or not to charge. If the CA charges for AMS services, the same sliding
fee scale as applied to treatment services must be used.
The CA must assure that all available sources of payments are identified and
applied prior to the use of Department-administered funds. The CA must have
written policies and procedures to be used by network providers in determining
an individual’s ability to pay, and in identifying all other liable third parties. The
CA must also have policies and procedures for monitoring providers and for
sanctioning noncompliance.
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5. Inability to Pay
Services may not be denied because of inability to pay. If a person’s income falls
within the CA’s regional sliding fee scale, clinical need must be determined
through the standard assessment and patient placement process. If a financially
and clinically eligible person has third party insurance, that insurance must be
utilized to its full extent. Then, if benefits are exhausted, or if the person needs a
service not fully covered by that third party insurance, or if the co-pay or
deductible amount is greater than the person’s ability to pay, Community Grant
funds may be applied. Community Grant funds may not be denied solely on the
basis of a person having third party insurance.
6. Subcontracts with Hospitals
Funds made available through the Department shall not be made available to
public or private hospitals which refuse, solely on the basis of an individual’s
substance use disorder, admission or treatment for emergency medical
conditions.
7. Residency in CA Region
The CA may not limit access to the programs and services funded by this
Agreement only to the residents of the CA’s region, because the funds provided
by the Department under this Agreement come from federal and statewide
resources. Members of federal and state-identified priority populations must be
given access to screening and to assessment and treatment services, consistent
with the requirements of this Agreement, regardless of their residency. However,
for non-priority populations, the CA may give its residents priority in obtaining
services funded under this Agreement when the actual demand for services by
residents eligible for services under this Agreement exceeds the capacity of the
agencies funded under this Agreement.
8. Out-of- Network and Out-of-Region Services
The CA must have written policies and procedures for authorizing and
purchasing treatment services from out-of-network and out-of-region providers
for residents of the CA region who need care from such providers.
9. Reimbursement Rates for Community Grant, Medicaid and Other Services
The CA must pay the same rate when purchasing the same service from the
same provider, regardless of whether the services are paid for by Community
Grant funds, Medicaid funds, or other Department administered funds, including
Adult Benefit Waiver (ABW) and MIChild funds.
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10. Reimbursement for Primary Health Care with Communicable Diseases (CD)
Funds
CD funds shall not be used to purchase primary health care unless the
Department approves such use in writing.
11. Minimum Criteria for Reimbursing for Services to Persons with Co-
Occurring Disorders
Department funds made available to the CA through this Agreement, and which
are allowable for treatment services, may be used to reimburse providers for
integrated mental health and substance use disorder treatment services to
persons with co-occurring substance use and mental health disorders.
The CA may reimburse a Community Mental Health Services Program (CMHSP)
or Pre-paid Inpatient Health Plan (PIHP) for substance use disorders treatment
services for such persons who are receiving mental health treatment services
through the CMHSP or PIHP. The CA may also reimburse a provider, other than
a CMHSP or PIHP, for substance use disorders treatment provided to persons
with co-occurring substance use and mental health disorders. As always, when
reimbursing for substance use disorders treatment, the CA must have an
agreement with the CMHSP (or other provider); and the CMHSP (or other
provider) must meet all minimum qualifications, including licensure, accreditation
and data reporting.
12. Media Campaigns
A media campaign, very broadly, is a message or series of messages conveyed
through mass media channels including print, broadcast, and electronic media.
Messages regarding the availability of services in the CA region are not
considered to be media campaigns. Media campaigns must be compatible with
MDCH values, be coordinated with MDCH campaigns whenever feasible and
costs must be proportionate to likely outcomes. The CA shall not finance any
media campaign using Department-administered funding without prior written
approval by the Department.
13. Notice of Funding Excess or Insufficiency
The CA must advise the Department in writing and uploaded to the Electronic
Grants Administration and Management System (EGrAMS) by June 1 if the
amount of Department funding may not be used in its entirety or appears to be
insufficient.
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14. Subcontractor Information to be Retained at the CA
a. Budgeting Information for Each Service.
b. Documentation of How Fixed Unit Rates Were Established:
The CA shall maintain documentation regarding how each of the unit rates
used in its agreements was established. The process of establishing and
adopting rates must be consistent with criteria in OMB Circular A-87 or A-
122, whichever is applicable, and with the requirements of individual fund
sources.
c. Indirect Cost Documentation:
The CA shall review subcontractor indirect cost documentation in
accordance with OMB Circular A-87 or A-122, as applicable.
d. Equipment Inventories:
The CA must apply the following to all subcontractors that have budgeted
equipment purchases in their contracts with the CA:
Any contractor equipment purchases supported in whole or in part through
this agreement must be listed in the supporting Equipment Inventory
Schedule. Equipment means tangible, non-expendable, personal property
having useful life of more than one (1) year and an acquisition cost of
$5,000 or more per unit. Title to items having a unit acquisition cost of
less than $5,000 shall vest with the Contractor upon acquisition. The
Department reserves the right to retain or transfer the title to all items of
equipment having a unit acquisition cost of $5,000 or more, to the extent
that the Department’s proportionate interest in such equipment supports
such retention or transfer of title.
e. Fidelity Bonding Documentation:
The CA shall maintain fidelity bonding documentation.
15. Reporting Requirements
a. General Requirements
Requirements concerning specific reports are contained elsewhere in the
Agreement, including in Attachment C. The following requirements
generally pertain:
1. Each report must be submitted by the specified due date. Reports
successfully e-mailed or uploaded to the EGrAMS by the due date
are considered timely.
2. Reports must be sent to the addressee and via the submission
route (e.g., uploaded, e-mailed, etc.) specified in this Agreement.
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Reports that are not sent to the specified addressee are subject to
being determined not timely or not received.
3. Reports must be submitted on the form and in the format specified
in this Agreement (if form and format are specified).
b. Legislative Reports (LRs) and Final Financial Reports
If the contractor does not submit the LR, or the final RER (which includes
the ABW/MIChild Year-end Balance Worksheet) within fifteen (15)
calendar days of the due date, the Department may withhold from the
current year funding an amount equal to five (5) percent of that funding
(not to exceed $100,000) until the Department receives the required
report. The Department may retain the amount withheld if the contractor
is more than forty-five (45) calendar days delinquent in meeting the filing
requirements.
The CA must assure that the financial data in these reports are consistent
and reconcile between the reports; otherwise, the reports will be
considered as not submitted and will be subject to financial penalty, as
mentioned above.
c. Data Reporting Timeliness and Completeness Standards
MDCH monitors the timeliness of submission for all required reports.
Reports that arrive after the established due date are recorded as late. If
the submission arrives more than five (5) calendar days past due, a letter
will be sent to the CA Director to notify the CA of the lack of compliance
with the published due date. Sanctions for noncompliance (depending on
the severity and frequency) may include a requirement for a corrective
action plan or may include an adjustment in prepayments.
For data transactions that are submitted via the Date Exchange Gateway
(DEG), including admission, discharge, and encounter batches, the
processing system logs the dates and times the batches were transferred
and processed. When the system is in production, monthly submissions
by the CAs are required. Data submissions are monitored daily by MDCH
staff.
d. Data Completeness
The CA is responsible for submitting 100% of required records. Initial
submissions combined with error corrections and resubmissions must
result in an accuracy rate of 100%.
On the second business day of every calendar month, the Department will
send to the CA an error rate or acceptance rate notification based on the
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number of errors in its error master file. This notification will serve as an
advisory for both MDCH and the CA.
On or before April 30, the CA is required to submit a live count (e-mail
transaction) from its information system noting the first six-month total
counts of admissions, discharges, and encounters (by code). This is
required for consultation purposes to identify whether the CA’s
submissions to MDCH show shortages compared to its local counts. The
Department will notify the CA of its acceptance rate. If the CA’s
acceptance rates are less than 98% for admission/discharge data and less
than 95% for encounters, the Department will notify the CA that
improvement is needed.
On or before November 30, the CA is required to submit the full 12-month
FY total counts of admissions, discharges, and encounters (by code).
This will also be submitted via e-mail. MDCH will calculate and
acceptance rate for all three, and generate a report back to the CA. Once
the acceptance rates are returned, if the 98% (admissions and
discharges) or 95% (encounters) acceptance thresholds are not met, out
of compliance CAs will have until December 31 to meet the acceptance
threshold.
The FY data sets will be finalized the first week of January, and shortages
in admissions, discharges, and/or encounters will be reflected in all of
MDCH’s reports both to the public and to the legislature.
e. National Outcome Measures (NOMS)
The emergence of the NOMS increases the importance of the
completeness, accuracy and timeliness of all treatment and prevention
data that are necessary for the Department to meet federal reporting
requirements. Concerning the Treatment NOMS, it is the responsibility of
the CA to ensure that the client information reported on these records
accurately reflects client status at admission and on the last day of
service.
f. Substance Use Disorder Prevention Data Set (SUDPDS)
CAs are required to collect and report the state-required prevention data
elements throughout the prevention provider network either through
participation in the SUDPDS or through an upload of the state-required
prevention data records to SUDPDS on a monthly basis.
CAs must assure that all records submitted to the state system are
consistent with the SUDPDS Reference Manual. (See Attachment E.)
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It is the responsibility of the CAs to ensure that the services reported to
the system accurately reflects staff service provision and participant
information for all CA-administered fund sources.
It is the responsibility of the CAs to monitor provider completeness,
timeliness and accuracy of provider data maintained in the system in a
manner which will ensure a minimum of 90 percent accuracy.
16. Critical Incidents and Sentinel Events
The CA must require all of its residential treatment providers to prepare and file
critical incident reports and sentinel event reports that include the following
components:
1. Provider determination whether critical incidents are sentinel events.
2. Following identification as a sentinel event, the provider must ensure that
a root cause analysis or investigation takes place.
3. Based on the outcome of the analysis or investigation, the provider must
ensure that a plan of action is developed and implemented to prevent
further occurrence of the sentinel event. The plan must identify who is
responsible for implementing the plan, and how implementation will be
monitored. Alternatively, the provider may prepare a rationale for not
pursuing a preventive plan.
The CA is responsible for oversight of the above processes.
Requirements for reporting data on Sentinel Events are contained in Attachment
E. These reporting requirements are narrower in scope than the responsibility to
identify and follow up on critical incidents and sentinel events.
A Critical Incident is any of the following that should be reviewed to determine
whether it meets the criteria for a sentinel event below:
1. Death of a recipient.
2. Serious illness requiring admission to hospital.
3. Alleged cause of abuse or neglect.
4. Accident resulting in injury to recipient requiring emergency room visit or
hospital admission.
5. Behavioral episode.
6. Arrest and/or conviction.
7. Medication error.
A Sentinel Event is an "unexpected occurrence involving death or serious
physical or psychological injury”, or the risk thereof. Serious injury specifically
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includes loss of limb or function. The phrase, “or risk thereof” includes any
process variation for which a recurrence would carry a significant chance of a
serious adverse outcome.” (JCAHO, 1998)
17. Claims Management System
The CA shall make timely payments to all providers for clean claims. This
includes payment at 90% or higher of clean claims from network providers within
60 days of receipt, and 99% or higher of all clean claims within 90 days of
receipt.
A clean claim is a valid claim completed in the format and time frames specified
by the CA and that can be processed without obtaining additional information
from the provider. It does not include a claim from a provider who is under
investigation for fraud or abuse, or a claim under review for medical necessity. A
valid claim is a claim for services that the CA is responsible for under this
Agreement. It includes services authorized by the CA.
The CA must have a provider appeal process to promptly and fairly resolve
provider-billing disputes.
18. Care Management
The CA may pay for care management as a service designed to support CA
resource allocation as well as service utilization. Care management is in
recognition that some clients represent such service or financial risk that closer
monitoring of individual cases is warranted. Care management must be
purchased and reported consistent with the instructions for the Administrative
Expenditures Report in Attachment B to this agreement.
19. Paying for Drug Screens
This item does not apply to medication-assisted services.
Department administered treatment funds can be used to pay for drug screens, if
all of the following criteria are met:
1. No other responsible payment source will pay for the screens. This
includes self pay, Medicaid, and private insurance. Documentation must
be placed in the client file;
2. The screens are justified by specific medical necessity criteria as having
clinical or therapeutic benefit; and
3. Screens performed by professional laboratories can be paid for one time
per admission to residential or detoxification services, if specifically
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justified. Other than these one-time purchases, Department funds may
only be used for in house "dip stick" screens.
The code(s) to use when entering the encounter data into CareNet is as follows:
H0003 is a lab test (sent out for analysis); or
H80100 is for in house screens (dip stick tests).
Services
1. General Services
a. 12-Month Availability of Services
The CA shall assure that, for any subcontracted treatment or prevention
service, each subcontractor maintains service availability throughout the
fiscal year for persons who do not have the ability to pay.
The CA is required to manage its authorizations for services and its
expenditures in light of known available resources in such a manner as to
avoid the need for imposing arbitrary caps on authorizations or spending.
“Arbitrary caps” are those that are not adjusted according to individualized
determinations of the needs of clients. This requirement is consistent with
Medical Necessity Criterion 1.4.3, which may be found elsewhere in
Attachment A.
b. Persons Associated with the Corrections System
When the CA or its AMS services receives referrals from the Michigan
Department of Corrections (MDOC), the CA shall handle such referrals as
per all applicable requirements in this agreement. This would include
determining financial and clinical eligibility, authorizing care as
appropriate, applying admissions preferences, and other steps. MDOC
referrals may come from probation or parole agents, or from MDOC
Central Office staff.
When persons who are on parole or probation seek treatment on a
voluntary basis from the CA’s AMS services or from a panel provider,
these self-referrals must be handled like any other self-referral to the
MDCH-funded network. AMS or provider staff may seek to obtain
releases to communicate with a person’s probation or parole agent but in
no instance may this be demanded as a condition for admission or
continued stay.
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The CA may collaborate with MDOC, and with the Office of Community
Corrections (OCC) within MDOC, on the purchase of substance use
disorders services and supports. This may include collaborative
purchasing from the same providers, and for the same clients. In such
situations, the CA must assure that:
1. All collaborative purchasing is supported by written agreements
among the participants.
2. Rates paid to providers, whether by a single purchaser or two or
more purchasers, do not exceed provider costs.
3. Rates paid to providers are documented and are developed
consistent with applicable OMB Circular(s).
4. No duplication of payment occurs.
c. State Disability Assistance (SDA)
MDCH continues to allocate SDA funding and to delegate management of
this funding to the CA. The SDA funding is identified in the CA’s allocation
letter. The CA is responsible for allocating these funds to qualified
providers. Minimum provider qualifications are MDCH licensure as a
residential treatment provider and accreditation by one of the five
approved accreditation bodies (identified elsewhere in this Agreement). A
provider may be located within the CA’s region or outside of the region.
SDA funds shall not be used to pay for room and board in conjunction with
sub-acute detoxification services.
When a client is determined to be eligible for SDA funding, the CA must
arrange for assessment and authorization for SDA room and board
funding and must reimburse for SDA expenditures based on billings from
providers, consistent with CA/provider agreements. In addition, the CA
may authorize such services for its own residents at providers within or
outside its region.
The CA shall not refuse to authorize SDA funds for support of an
individual’s treatment solely on the basis of the individual’s current or past
involvement with the criminal justice system.
Qualified providers may be reimbursed up to twenty-seven ($27) per day
for room and board costs for SDA-eligible persons during their stays in
Residential treatment.
To be eligible for MDCH-administered SDA funding for room and board
services in a substance use disorders treatment program, a person must
be determined to meet Michigan Department of Human Services’ (MDHS)
eligibility criteria; determined by the CA or its designee to be in need of
residential treatment services; authorized by the CA for residential
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treatment when the CA expects to reimburse the provider for the
treatment; at least 18 years of age or an emancipated minor, and in
residence in a residential treatment program each day that SDA payments
are made.
The CA may employ either of two methods for determining whether an
individual meets MDHS eligibility criteria:
1. The CA may refer the individual to the local MDHS office. This
method must be employed when there is a desire to qualify the
individual for an incidental allowance under the SDA program.
Or,
2. The CA may make its own determination of eligibility by applying
the essential MDHS eligibility criteria. See this DHS link for details:
http://www.michigan.gov/dhs/0,1607,7-124-5453_5526---,00.html
For present purposes only, these criteria are:
• Residency in substance use disorders residential treatment.
• Michigan residency and not receiving cash assistance from
another state.
• U.S. citizenship or have an acceptable alien status.
• Asset limit of $3,000 (cash assets only are counted).
Regardless of the method used, the CA must retain documentation
sufficient to justify determinations of eligibility.
The CA must have a written agreement with a provider in order to provide
SDA funds.
d. Persons Involved With the Michigan Department of Human Services
(MDHS)
The CA must work with the MDHS office(s) in its region to facilitate access
to prevention, assessment and treatment services for persons involved
with MDHS, including families in the child welfare system and public
assistance recipients. The CA must develop written agreements with
MDHS offices that specify payment and eligibility for services, access-to-
services priority, information sharing (including confidentiality
considerations), and other factors as may be of local importance.
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e. Primary Care Coordination
The CA must take all appropriate steps to assure that substance use
disorders treatment services are coordinated with primary health care. In
the case of CAs that are under contract with PIHPs for the Medicaid
substance abuse program, CAs are reminded that coordination efforts
must be consistent with these contracts.
Treatment case files must include, at minimum, the primary care
physician’s name and address, a signed waiver release of information for
purposes of coordination, or a statement that the client has refused to sign
this waiver.
Care coordination agreements or joint referral agreements, by themselves,
are not sufficient to show that the CA has taken all appropriate steps
related to coordination of care. Client case file documentation is also
necessary.
f. Cultural Competence
CA must have a written cultural competency plan implemented in practice
at their agency and at all provider agencies. The plan must include:
1. The CA’s identification and assessment of the cultural needs of
potential and active clients based on population served.
2. The CA’s identification standards for the recruitment and hiring of
culturally competent staff members.
3. The CA’s identification of how ongoing staff training needs in
cultural competency will be assessed and met and the evidence
that staff members receive training.
4. The CA’s process for ensuring that panel providers comply with all
applicable requirements concerning the provision of culturally
competent services.
5. The CA’s process for annually assessing its compliance with the
CA’s cultural competence plan.
g. Charitable Choice
The September 30, 2003 Federal Register (45 CFR part 96) contains
federal Charitable Choice SAPT block grant regulations, which apply to
both prevention and treatment providers/programs. In summary, the
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regulations require: 1) that the designation of religious (or faith-based)
organizations as such be based on the organization’s self-identification as
religious (or faith based), 2) that these organizations are eligible to
participate as providers—e.g. a “level playing field” with regard to
participating in the CA provider panel, 3) that a program beneficiary
receiving services from such an organization who objects to the religious
character of a program has a right to notice, referral, and alternative
services which meet standards of timeliness, capacity, accessibility and
equivalency—and ensuring contact to this alternative provider, and 4)
other requirements, including-exclusion of inherently religious activities
and non-discrimination.
The CA is required to comply with all applicable requirements of the
Charitable Choice regulations. The CA must ensure that treatment clients
and prevention service recipients are notified of their right to request
alternative services. Notice may be provided by the AMS or by providers
that are faith-based. The CA must assign responsibility for providing the
notice to the AMS, to providers, or both. Notification must be in the form of
the model notice contained in the final regulations, or the CA may request
written approval from MDCH of an equivalent notice.
The CA must also ensure that its AMS administer the processing of
requests for alternative services.
The model notice contained in the federal regulations is:
No provider of substance abuse services receiving Federal funds
from the U.S. Substance Abuse and Mental Health Services
Administration, including this organization, may discriminate against
you on the basis of religion, a religious belief, a refusal to hold a
religious belief, or a refusal to actively participate in a religious
practice.
If you object to the religious character of this organization, Federal
law gives you the right to a referral to another provider of substance
abuse services. The referral, and your receipt of alternative
services, must occur within a reasonable period of time after you
request them. The alternative provider must be accessible to you
and have the capacity to provide substance abuse services. The
services provided to you by the alternative provider must be of a
value not less than the value of the services you would have
received from this organization.
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h. Americans with Disabilities Act
The CA and its contractors must comply with applicable provisions of the
Americans with Disabilities Act (the ADA). Further information may be
found at:
Nondiscrimination on the Basis of Disability in State and Local
Government Services: United States Code of Federal Regulations, Title
28, Part 35, Washington, D.C. (1991).
i. Limited English Proficiency
The CAs must insure a current Limited English Proficiency
(LEP) policy is in place and in practice. The CA must also have
documentation that all providers have implemented the required LEP
policy and procedures and are in compliance with related Federal and
State requirements. The LEP policies and procedures must include the
following, as required by the Office of Civil Rights.
1. Procedures for identifying and assessing the language needs of the
CA, individual provider and the geographic area served. Needs
must be based on current local and regional census data, as well
as other state and regional data.
2. Identified range of oral language assistance options appropriate to
the CAs circumstances.
3. How the CA provides notice to LEP persons, in their primary
language, of the right to free language assistance.
4. What staff training and program monitoring is performed related to
LEP policies and procedures.
5. Provisions for written materials in language other than English
where a significant number or percentage of the affected population
needs services or information in a language other than English, to
communicate effectively.
6. Provisions for language interpreters who are trained and
competent.
7. Statements explaining timely assistance.
8. Statements explaining there will be no charge to the LEP recipient
for these services.
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9. Provisions regarding use of family member and/or friend as a
language interpreter must not be required. Should the consumer
choose to use family or friend as an interpreter, both the offering of
other resources, and the consumer’s choice, must be documented
in writing. Availability of consumer family and friends as
translator/interpreter will not waive other LEP requirements herein
described.
2. Treatment Services
a. Medical Necessity Criteria For Substance Use Disorders Supports
And Services
The CA must assure that treatment service authorization and
reauthorization decisions are consistent with the following Medical
Necessity Criteria. These criteria are substantively the same as the
applicable criteria for substance use disorders Medicaid services.
1.0 Medical Necessity Criteria
1.1 “Medically necessary” substance abuse services are
supports, services, and treatment:
1.1.1 Necessary for screening and assessing the presence
of substance use disorder; and/or
1.1.2 Required to identify and evaluate a substance use
disorder; and/or
1.1.3 Intended to treat, ameliorate, diminish or stabilize the
symptoms of a substance use disorder; and/or
1.1.4 Expected to arrest or delay the progression of a
substance use disorder; and/or
1.1.5 Designed to assist the individual to attain or maintain
a sufficient level of functioning in order to achieve
his/her goals of community inclusion and participation,
independence, recovery or productivity.
1.2 The determination of a medically necessary support, service
or treatment must be:
1.2.1 Based on information provided by the individual,
individual’s family, and/or other individuals (e.g.,
friends, personal assistants/aide) who know the
individual; and
1.2.2 Based on clinical information from the individual’s
primary care physician or clinicians with relevant
qualifications who have evaluated the individual; and
1.2.3 Based on individualized treatment planning; and
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1.2.4 Made by appropriately trained substance abuse
professionals with sufficient clinical experience; and
1.2.5 Made within federal and state standards for
timeliness; and
1.2.6 Sufficient in amount, scope and duration of the
service(s) to reasonably achieve its/their purpose.
1.3 Supports, services and treatment authorized by the CA must
be:
1.3.1 Delivered in accordance with federal and state
standards for timeliness in a location that is
accessible to the individual; and
1.3.2 Responsive to particular needs of multi-cultural
populations and furnished in a culturally relevant
manner; and
1.3.3 Provided in the least restrictive, most integrated
setting. Residential or other segregated settings shall
be used only when less restrictive levels of treatment,
service or support have been, for that beneficiary,
unsuccessful or cannot be safely provided; and
1.3.4 Delivered consistent with, where they exist, available
research findings, health care practice guidelines and
standards of practice issued by professionally
recognized organizations or government agencies.
1.4 Using criteria for medical necessity, a CA may:
1.4.1 Deny services a) that are deemed ineffective for a
given condition based upon professionally and
scientifically recognized and accepted standards of
care; b) that are experimental or investigational in
nature; or c) for which there exists another
appropriate, efficacious, less-restrictive and cost-
effective service, setting or support, that otherwise
satisfies the standards for medically-necessary
services; and/or
1.4.2 Employ various methods to determine amount, scope
and duration of services, including prior authorization
for certain services, concurrent utilization reviews,
centralized assessment and referral, gate-keeping
arrangements, protocols, and guidelines.
1.4.3 A CA may not deny services solely based on
PRESET limits of the cost, amount, scope, and
duration of services; but instead determination of the
need for services shall be conducted on an
individualized basis. This does not preclude the
establishment of quantitative benefit limits that are
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based on industry standards and consistent with 1.3.4
above, and that are provisional and subject to
modification based on individual clinical needs and
clinical progress.
b. Clinical Eligibility: DSM IV-TR Diagnosis
In order to be eligible for treatment services purchased in whole or part by
state-administered funds under the agreement, an individual must be
found to meet the criteria for one or more selected substance use
disorders found in the Diagnostic and Statistical Manual of Mental
Disorders (DSM IV-TR). These disorders are listed below. This
requirement is not intended to prohibit use of these funds for family
therapy. It is recognized that persons receiving family therapy do not
necessarily have substance use disorders.
303.90 Alcohol Dependence
305.00 Alcohol Abuse
303.00 Alcohol Intoxication
291.80 Alcohol Withdrawal
291.90 Alcohol-Related Disorder, Not Otherwise Specified
304.40 Amphetamine Dependence
305.70 Amphetamine Abuse
292.89 Amphetamine Intoxication
292.00 Amphetamine Withdrawal
292.90 Amphetamine-Related Disorder, Not Otherwise
Specified
304.30 Cannabis Dependence
305.20 Cannabis Abuse
292.89 Cannabis Intoxication
292.90 Cannabis-Related Disorder, Not Otherwise Specified
304.20 Cocaine Dependence
305.60 Cocaine Abuse
292.89 Cocaine Intoxication
292.00 Cocaine Withdrawal
292.90 Cocaine-Related Disorder, Not Otherwise Specified
304.50 Hallucinogen Dependence
305.30 Hallucinogen Abuse
292.89 Hallucinogen Intoxication
292.90 Hallucinogen-Related Disorder, Not Otherwise Specified
304.60 Inhalant Dependence
305.90 Inhalant Abuse
292.89 Inhalant Intoxication
292.90 Inhalant-Related Disorder, Not Otherwise Specified
304.00 Opioid Dependence
305.50 Opioid Abuse
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292.89 Opioid Intoxication
292.00 Opioid Withdrawal
292.90 Opioid-Related Disorder, Not Otherwise Specified
304.60 Phencyclidine Dependence
305.90 Phencyclidine Abuse
292.89 Phencyclidine Intoxication
292.90 Phencyclidine-Related Disorder, Not Otherwise
Specified
304.80 Polysubstance Dependence
304.10 Sedative, Hypnotic, or Anxiolytic Dependence
305.40 Sedative, Hypnotic, or Anxiolytic Abuse
292.89 Sedative, Hypnotic, or Anxiolytic Intoxication
292.00 Sedative, Hypnotic, or Anxiolytic Withdrawal
292.90 Sedative, Hypnotic, or Anxiolytic-Related Disorder, Not
Otherwise Specified
304.90 Other (or Unknown) Substance Dependence
305.90 Other (or Unknown) Substance Abuse
292.89 Other (or Unknown) Substance Intoxication
292.00 Other (or Unknown) Substance Withdrawal
c. Satisfaction Surveys
The CA shall assure that all network subcontractors providing treatment
conduct satisfaction surveys of persons receiving treatment at least once
a year. Surveys may be conducted by individual providers or may be
conducted centrally by the CA. Clients may be active clients or clients
discharged up to 12 months prior to their participation in the survey.
Surveys may be conducted by mail, telephone, or face-to-face. The CA
must compile findings and results of client satisfaction surveys for all
providers, and must make findings and results, by provider, available to
the public.
d. MIChild
MIChild Covered Services
The CA must assure use of a standardized assessment process, including
the American Society of Addiction Medicine (ASAM) Patient Placement
Criteria, to determine clinical eligibility for services based on medical
necessity.
Substance use disorders services are covered when medically necessary
as determined by the CA. This benefit should be construed the same as
are medical benefits in a managed care program. Inpatient (hospital-
based) services are covered, but the CA is permitted to substitute less
costly services outside the hospital if they meet the medical needs of the
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patient. In the same way, the CA may substitute services for inpatient or
residential services if they meet the child’s needs and they are more cost
effective.
Covered services are as follows:
1. Outpatient Treatment
2. Residential Treatment
3. Inpatient Treatment
4. Laboratory and Pharmacy
These benefits apply only when a CA’s employed or contracted physician
writes a prescription for pharmacy items or lab.
Eligibility
Eligible persons are persons of age 18 or less who are determined eligible
for the MIChild program by the MDCH and enrolled by the Department’s
administrative vendor and live in the region covered by the CA. The CA is
responsible for determining eligibility and for charging all authorized and
allowable services to the MIChild program up to the CA’s annual MIChild
revenues.
Per Enrolled Child Per Month
Monthly, MDCH will provide the CA with the federal share of MIChild funds
as a per capita payment based upon a Per Enrolled Child Per Month
(PECPM) methodology for MIChild covered services. Included with these
funds will be an electronic copy of the names of the MIChild enrollees
forming the basis of these calculations. In consideration for accepting the
federal funding pushed to the CA, the CA agrees to redirect existing state
general fund dollars to match the MIChild federal FMAP funds (Title XXI
State Children’s Health Insurance Program) and carry out the associated
substance use disorders program requirements.
The PEPCM rate and the federal fund source are updated, as needed, by
the Department on an annual basis or as rates change.
The PECPM funding is a per capita payment for medically necessary
MIChild-covered services including outpatient, residential and inpatient
services as authorized by the CA. If the MIChild capitation is not sufficient
to serve the MIChild enrollees, use of state-allocated Community Grant
funds is allowed. Federal SAPT Block Grant funds may not be used for
inpatient care.
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Data Collection and Reporting
The CA must account separately for expenses related to MIChild
enrollees. Reporting of MIChild revenues and expenditures will be
through the RER as indicated in Attachment B to this Agreement and via
the Financial Status Report (FSR) as indicated in Attachment D to this
Agreement.
In the event that program costs are less than PECPM revenues and the
state match amounts, the CA may retain the balances as Local funds. In
the event that program costs are greater than the federal PECPM and
state match amounts, the CA may use other State Agreement funds
budgeted for treatment in this Agreement
The MIChild balances, as reported on the ABW/MIChild Year-end Balance
Worksheet, are the Actual Revenues minus the Actual Expenditures. If
reporting year-end unspent fund balances on this Worksheet, the agency
must report BOTH the state match balance and the federal PECPM
balance.
The state match fund balance, along with the federal PECPM fund
balance, cannot be expended in the same fiscal year as earned. These
unexpended funds must be carried forward into the next fiscal year and
reported as Local funds. The funds become Local funds only after
Department acceptance of the final RER.
The funds must be expended consistent with requirements in this
Agreement, pertaining to State Agreement funds, to support the CA’s
substance abuse program.
Enrollees who receive substance use disorder services must be entered
into the Substance Abuse Disorder Statewide Client Data System
following the instructions in the data reporting specifications.
For the required reporting of encounters for MIChild eligible clients, the CA
will report these encounters via the 837 as follows:
2000B Subscriber Hierarchical Level
SBR Subscriber Information
SBR04 Insured Group Name: Use “MIChild” for the group name.
Access Timeliness
Access timeliness requirements are the same as those applicable to
Medicaid substance use disorders services, as specified in the agreement
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between MDCH and the PIHPs. Access must be expedited when
appropriate based on the presenting characteristics of individuals.
e. Adult Benefit Waiver
In consideration for accepting the federal funding pushed to the CA for the
State Medical Program (SMP) eligible under an approved Health
Insurance Flexibility and Accountability (HIFA) Adult Benefit Waiver
(ABW), the CA agrees to redirect existing state general fund dollars to
match the ABW federal FMAP funds (Title XXI State Children’s Health
Insurance Program) and carry out the associated substance use disorders
program requirements. Program requirements are contained in this
agreement and in the Department’s Medicaid Provider Manual’s chapter
on Adult Benefits Waiver I, which is available at the Department’s web
site, www.michigan.gov/mdch. The ABW program is contingent on
continued federal approval of the program.
The total ABW funding applied to program expenditures (federal plus
general fund match) shall not exceed $3.80 per enrolled eligible member
per month (PEPM). MDCH shall push the federal portion of the eligible
amount to the CA (PEPM X $3.80 X current federal percentage) based on
program enrollment. MDCH will issue the payment for each month not
later than the second Wednesday of that month. The amount of general
fund dollars applied by the CA to program costs shall equal the current
state percentage of the total PEPM during the agreement period following
the date of program initiation.
The PEPM rate and the federal fund source are updated, as needed, by
the Department, on an annual basis or as rates change.
The CA must account separately for expenses related to ABW enrollees.
Reporting of ABW revenues and expenditures will be through the RER as
indicated in Attachment B to this Agreement and via the FSR as indicated
in Attachment D to this Agreement.
In the event that program costs are less than PEPM revenues and the
state match amounts, the CA may retain the balances as Local funds. In
the event that program costs are greater than the federal PEPM and state
match amounts, the CA may use other State Agreement funds budgeted
for treatment in this Agreement
The ABW balances, as reported on the ABW/MIChild Year-end Balance
Worksheet, are the Actual Revenues minus the Actual Expenditures. If
reporting year-end unspent fund balances on this Worksheet, the agency
must report BOTH the state match balance and the federal PEPM
balance.
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The state match fund balance, along with the federal PEPM fund balance,
cannot be expended in the same fiscal year as earned. These
unexpended funds must be carried forward into the next fiscal year and
reported as Local funds. The funds become Local funds only after
Department acceptance of the final RER.
The funds must be expended consistent with requirements in this
Agreement, pertaining to State Agreement funds, to support the CA’s
substance use disorder program.
ABW Covered and Discretionary Services
ABW covered and discretionary services, as contained in the Medicaid
Provider Manual, are listed below.
Covered Services:
1. Initial assessment, diagnostic evaluation, referral and patient
placement;
2. Outpatient Treatment;
3. Intensive Outpatient Treatment; and
4. Federal Food and Drug Administration (FDA) approved
pharmacological supports for Methadone.
ABW Discretionary Services:
• Other substance use disorders services may be provided, at the
discretion of the CA, to enhance outcomes.
The CA is required to pay for medically necessary and requested covered
services, within applicable benefit limitations, for the enrolled population in
excess of the combined federal and applicable match funds. The CA may
apply available SAPT Block Grant funds and state general funds to pay for
ABW covered services when ABW funds (federal and state shares
combined) have been exhausted.
The CA may also choose to pay for non-covered and discretionary
services for ABW beneficiaries with other available funds. Any use of
SAPT Block Grant and state general funds to pay for discretionary or non-
covered services must be consistent with provisions in this agreement that
are applicable to these funds.
ABW beneficiaries who receive ABW covered services shall be treated
according to all applicable requirements of the ABW program, regardless
of source of funds for these services. ABW beneficiaries who receive
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ABW discretionary services shall be treated according to applicable ABW
program requirements when the source of funds is ABW funds.
The CA may not charge fees or co-pays to ABW beneficiaries for covered
services or for discretionary services purchased with ABW funds.
ABW funds may not be used to purchase care for persons who are
residents in institutions for mental diseases (IMDs).
Access Timeliness
Access timeliness requirements are the same as those applicable to
Medicaid substance use disorders services, as specified in the agreement
between MDCH and the PIHPs. Access must be expedited when
appropriate based on the presenting characteristics of individuals.
Appeals by ABW Enrollees
ABW beneficiaries must be provided written notice of right to appeal
proposed denials, reductions, suspensions or terminations of covered
services through the administrative hearing process, as described in All
Provider Bulletin 03-10.
Encounter Data and Quality Improvement Data
Enrollees who receive substance use disorders services must be entered
into the Substance abuse Statewide Client Data System following the
coding instructions in the data reporting specifications.
For the required reporting of encounters for ABW Eligible clients, the CA
will report these encounters via the 837 as follows:
2000B Subscriber Hierarchical Level
SBR Subscriber Information
SBR04 Insured Group Name: Use “ABW” for Adult Benefits Waiver.
The combined federal share and the GF match share amounts should be
reported separately by using the Primary, Secondary, and Tertiary Payer
guidelines under the 2000B Loop (Subscriber Hierarchical Loop SBR01
Data Element – Payer Responsibility Sequence Number Code). These
codes were covered at the Health Insurance Portability and Accountability
Act (HIPAA) Readiness Seminars in 2003.
Benefit Limits
Utilization control procedures consistent with best practice standards and
the three criteria stated below must be used. The CA may provide or
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authorize ABW covered and discretionary services only when these
services:
1. Meet the medical necessity criteria contained in this Agreement;
2. Are based on individualized determination of need; and
3. Meet the AMS service requirements contained in this Agreement,
including a level of care determination based on an evaluation of
the six assessment dimensions of the current ASAM Patient
Placement Criteria.
The CA must assure that all persons admitted to treatment have an
individualized treatment plan that emphasizes appropriate treatment and
recovery.
The CA shall not discontinue or interrupt ABW services when ABW
beneficiaries have been admitted to treatment, have exhausted their ABW
benefit, and are financially and clinically eligible for continued treatment
under the Community Grant program.
f. Intensive Outpatient Treatment – Weekly Format
The CA may purchase Intensive outpatient treatment (IOP) only if the
treatment consists of regularly scheduled treatment, usually group
therapy, within a structured program, for at least three days and at least
nine hours per week.
g. Services for Pregnant Women, Women with Dependent Children,
Women Attempting to Regain Custody and Their Children
The CA must assure that providers screen and/or assess pregnant
women, women with dependent children, and women attempting to regain
custody of their children to determine whether these women need and
request the defined federal services that are listed below. All federally
mandated services must be made available within each CA region.
Financial Requirements on Initial and Final RERs
The CA has been assigned an expenditure target for Women’s Specialty
Services in the CA’s initial allocation letter. State general fund dollars and
the state share of Medicaid dollars, as well as SAPT Block Grant dollars,
can be counted toward the expenditure target. CAs must report on their
RERs, in the Women’s Specialty column, all allowable expenditures for
Women’s Specialty Services, and only allowable expenditures.
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Financial Requirements on Quarterly FSRs
On each quarterly FSR, the CA must report all allowable Women’s
Specialty Services expenditures that utilize State Agreement funds.
Those funds are Community Grant and/or State Disability Assistance.
Treatment Episode Data Set (TEDS) and Encounter Reporting
Requirements
For TEDS reporting purposes, the Agency must code ‘yes’ for all women
eligible for and receiving qualified women’s specialty services. At
admission, this can be coded based on eligibility. To qualify, the women
must be either pregnant, have custody of a minor child, or be seeking to
regain custody of a minor child. The provider must be certified by the
agency as gender competent.
For all services that qualify based on qualifying characteristics both of the
women and of the provider, the HD modifier must be used (See
Attachment E/Section I Data Requirements: Substance Abuse Encounter
Reporting HCPCS and Revenue Codes Chart).
Requirements Regarding Providers
Women’s Specialty Services may only be provided by providers that are
gender-competent and that meet standard panel eligibility requirements.
The provider may be designated by the Department as Women’s Specialty
providers, but such designation is not required. The CA must continue to
provide choice from a list of providers who offer gender competent
treatment and identify providers that provide the additional services
specified in the federal requirements.
Federal Requirements
Federal requirements are contained in 45 CRF (Part 96) section 96.124,
and may be summarized as:
Providers receiving funding from the state-administered funds set aside for
pregnant women and women with dependent children must provide or
arrange for the 5 types of services, as listed below. Use of state-
administered funds to purchase primary medical care and primary
pediatric care must be approved, in writing, in advance, by the Department
contract manager.
1. Primary medical care for women, including referral for prenatal care
if pregnant, and while the women are receiving such treatment,
child care;
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2. Primary pediatric care for their children, including immunizations;
3. Gender specific substance use disorders treatment and other
therapeutic interventions for women, which may address issues of
relationships, sexual and physical abuse, parenting, and childcare
while the women are receiving these services;
Therapeutic interventions for children in custody of women in
treatment, which may, among other things, address their
developmental needs, issues of sexual and physical abuse, and
neglect; and
5. Sufficient case management and transportation to ensure that
women and their dependent children have access to the above
mentioned services. Women with dependent children are defined
to include women in treatment who are attempting to regain
custody of their children.
The above five types of services may be provided through the MDCH/CA
agreement only when no other source of support is available and when no
other source is financially responsible.
h. Admission Preference and Interim Services
The Code of Federal Regulations and the Michigan Public Health Code
define priority population clients. The priority populations are identified as
follows and in the order of importance:
1. Pregnant injecting drug user.
2. Pregnant.
3. Injecting drug user.
4. Parent at risk of losing their child(ren) due to substance use.
5. All others.
Access timeliness standards and interim services requirements for these
populations are provided in the next section.
i. Access Timeliness Standards
The following chart indicates the current admission priority standards for
each population along with the current interim service requirements.
Suggested additional interim services are in italics:
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Admission Priority Requirements
Population Admission Requirement Interim Service Requirement Authority
Pregnant
Injecting
Drug User
1) Screened and referred
within 24 hours
2) Detoxification,
Methadone or
Residential – Offer
Admission within 24
business hours
Other Levels or Care –
Offer Admission within 48
Business hours
Begin within 48 hours:
1. Counseling and education on:
a) HIV and TB
b) Risks of needle sharing
c) Risks of transmission to
sexual partners and infants
d) Effects of alcohol and drug
use on the fetus
2. Referral for pre-natal care
3. Early Intervention Clinical
Services
CFR 96.121;
CFR 96.131;
Treatment
Policy #04
Recommended
Pregnant
Substance
Use
Disorders
1) Screened and referred
within 24 hours
2) Detoxification,
Methadone or
Residential – Offer
admission within 24
business hours
Other Levels or Care –
Offer Admission within 48
Business hours
Begin within 48 hours
1. Counseling and education on:
a) HIV and TB
b) Risks of transmission to
sexual partners and infants
c) Effects of alcohol and drug
use on the fetus
2. Referral for pre-natal care
3. Early Intervention Clinical
Services
CFR 96.121;
CFR 96.131;
Recommended
Injecting
Drug User
Screened and referred
within 24 hours; Offer
Admission within 14 days
Begin within 48 hours –
maximum waiting time 120
days
1. Counseling and education on:
a) HIV and TB
b) Risks of needle sharing
c) Risks of transmission to
sexual partners and infants
2. Early Intervention Clinical
Services
CFR 96.121;
CFR 96.126
Recommended
Parent at
Risk of
Losing
Children
Screened and referred
within 24 hours. Offer
Admission within 14 days
Begin within 48 business hours
Early Intervention Clinical
Services
Michigan Public
Health Code
Section 6232
Recommended
All Others
Screened and referred
within seven calendar
days. Capacity to offer
Admission within 14 days
Not Required
CFR 96.131(a)
– sets the order
of priority;
MDCH and CA
contract
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j. Problem Gambling Integrated Treatment Project
(Applies Only To Agencies Who Have Allocations For This Program)
Implement the Problem Gambling Integrated Treatment Project, utilizing
funds made available through the Department to carry out the following
requirements:
• Perform gambling screening, using the NORC DSM Screen for
Gambling Problems (NODS), of substance abuse clients in the
gambling project service region. Those clients who score five or more
on the NODS must be referred for gambling treatment.
• Facilitate problem gambling therapist training.
• Provide problem gambling prevention and treatment services.
• Arrange for problem gambling media in northern and upper Michigan,
45 counties. (applies only to Northern Michigan Substance Abuse Services)
• Provide problem gambling outreach.
• Report project expenditures on the coordinating agency’s initial and
final RER, utilizing one of the “OTHER” columns of the RER.
• Report project expenditures on the coordinating agency’s quarterly
FSRs.
• Monthly demographic reporting will be by spreadsheet, expect to move
to using the TEDS system during FY2009.
• Monthly report the number of treatment clients receiving problem
gambling services, number of therapists trained, and describe
prevention, media, and outreach activities.
• Year-end report describing progress on project milestones and
deliverables.
k. Earmark-funded Special Projects: Reporting Requirements
This reporting requirement applies to only four CAs:
• Genesee County CMH, with respect to Flint Odyssey House
• Macomb County CMH, with respect to Sacred Heart Rehabilitation
Center
• network180, with respect to Hispanic Services
• Saginaw County Health Department, with respect to Saginaw Odyssey
House
These four CAs must submit an annual Earmark-funded Special Projects
Report by November 30, 2009 that contains the following information:
1. The name of the CA whose residents were served through the
earmarked funds during the year;
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2. The number of persons served by that CA, through those funds;
and
3. The total amount of earmarked funds paid to the provider for those
services.
See Attachment E-Other Requirements for this annual report form and
form instructions. This report will be submitted via EGrAMS, as an
‘Attachment’ Report.
l. Integrated Services for People with Co-occurring Mental Health and
Substance Use Disorders
(Applies Only To Agencies Who Have Allocations For This Program)
Each CA’s use of these funds is governed by terms and conditions of the
June 3, 2008, Request for Proposals for Integrated Services for People
with Co-occurring Mental Health and Substance Use Disorders, each
Department-approved CA Project Proposal, including any approved
updates and revisions for FY 2010, and all applicable requirements in the
MDCH/CA contract agreement. As stated in the RFP:
Neither the SAPT nor MHBG funds may be used to supplant
existing funds. Neither funding source may be used to fund
Medicaid approved services for Medicaid recipients. MDCH
contracts require that any service or activity funded in whole or in
part with this funding be delivered in a smoke-free facility or
environment.
In addition, the MHBG funds focus on the provision of services,
and, as a result, these funds may not be used to:
1. Purchase medication.
2. Purchase, lease, or insure vehicles.
3. Cover administrative (e.g., office space, utilities, Internet,
insurance) or indirect expenses.
No SAPT funds may be used to pay for assessments conducted by
a CA or an access management system agency that does not also
provide other substance use disorder treatment services. This is
consistent with existing Department policy.
Note: There are four ways in which MHBG and/or SAPT funds may
be used for project staffing so that no supplanting occurs:
1. If the position is a new hire, or
2. If the position is assuming additional hours (i.e., part-time to
full-time) and block grant funds are paying for the additional
hours only, or
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3. If an existing staff member is assuming the duties of the new
project and their previous duties are being reassigned, or
4. If the duties to be performed under this project were not
previously assigned/completed.
The following is a list of services that can be provided to satisfy the
requirements of both grant sources:
Therapy/counseling
Psychiatric time – evaluation and medication reviews
Peer support
Recovery support
Case management
New staff positions
Psychiatric medication and/or substance use treatment
medication (Only SAPT funds may be used.)
Mental health assessment (mental health funding only in
mental health system)
Developing collaborative arrangements with healthcare
providers to establish sustainability
Infrastructure development for establishing the delivery of
services
Financial reporting will be through quarterly and annual revenues
and expenditures reports (RERs) and financial status reports
(FSRs). A separate FSR for each fund source will be required.
Projects will be cost-settled at year-end.
3. Prevention Services
a. Prevention Requirements
Prevention funds may be used for needs assessment and related
activities. All prevention services must be based on a formal local needs
assessment.
The Department’s intent is to move toward a community-based,
consequence-driven model of prevention. In the meantime, based on
needs assessment, prevention activities must be targeted to high-risk
groups and must be directed to those at greatest risk of substance use
disorders and/or most in need of services within these high-risk groups.
CAs are not required to implement prevention programming for all high-
risk groups. The CA may also provide targeted prevention services to the
general population.
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ATTACHMENT A
Att A_Statement of Work Sub Abuse FY2010 Initial.doc Page 35 of 36
The high risk subgroups include but are not limited to: children of
substance abusers; pregnant women/teens; drop-outs; violent and
delinquent youth; persons with mental health problems; economically
disadvantaged citizens; persons who are disabled; victims of abuse;
persons already using substances; and homeless and/or runaway youth.
Additionally, children exposed prenatally to ATOD are identified as a high-
risk subgroup.
Prevention services must be provided through strategies identified by
CSAP. These strategies are: information dissemination; education;
alternatives; problem identification and referral; community based
processes; and environmental change.
Prevention-related funding limitations the CA must adhere to are: 1) A
maximum of 35% of prevention funding may be used for school based
activities as part of the usual school day, 2) CA expenditure requirements
for prevention, including Synar, as stipulated in the CA’s allocation letter,
3) 90% of prevention expenditures are expected to be directed to
programs which are implemented as a result of an evidence-based
decision making process, 4) Alternative strategy activities, if provided must
reflect evidence-based approaches and best practices such as multi-
generational and adult to youth mentoring, and 5) state-administered
funds used for information dissemination must be part of a multi-faceted
regional prevention strategy, rather than independent, stand-alone activity.
The CA must monitor and evaluate prevention programs at least annually
to determine if the program outcomes, milestones and other indicators are
achieved, as well as compliance with state and federal requirements.
Indicators may include integrity to prevention best practice models
including those related to planning prevention interventions such as
risk/protective factor assessment, community assets/resource
assessment, levels of community support, evaluation, etc. A written
monitoring procedure, which includes requirements for corrective action
plans to address issues of concern with a provider, is required.
b. Strategic Prevention Framework/State Incentive Grant (SPF/SIG)
Prevention Project
The CA’s use of SPF/SIG funds is governed by terms and conditions of
the SPF/SIG Notice of Award and all applicable requirements in the
MDCH/CA contract agreement.
Funds shall not be used to pay the salary of an individual at a rate in
excess of Level I of the Federal Executive Schedule, or approximately
$186,600 per year.
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ATTACHMENT A
Att A_Statement of Work Sub Abuse FY2010 Initial.doc Page 36 of 36
c. Fetal Alcohol Spectrum Disorders (FASD) Prevention Project/
Parent Child Assistance Program (PCAP)
(Applies Only To Agencies Who Have Allocations For This Program)
• The funds are to support allowable project expenditures during the
current fiscal year period;
• Expenditures must be reported in a separate column on the CA’s initial
and final RERs, utilizing one of the ‘Other’ columns. Title the column
“Fetal Alcohol Spectrum Disorders (FASD) Prevention Project;”
• Expenditures must be reported on the coordinating agency’s quarterly
FSRs.
• Funds may not be used to pay for anything other than those within the
budget detail;
• The CA must supply its own computer equipment; and
• Data must be entered into the web-based system provided by Northrop
Grumman as required by the PCAP model design.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 1 of 11
Michigan Department of Community Health
Financial Reporting Requirements
Fiscal Year (FY) 2010
The reporting of revenues and expenditures will be accomplished via two avenues. For
revenues and expenditures: an initial and a final Revenues and Expenditures Report
(RER). For expenditures only: quarterly and final Financial Status Reports (FSRs).
See Attachment D-FSR Instructions.
1. REPORTING REVENUES AND EXPENDITURES
Revenues and Expenditures Report
The main purposes and applications of the RER include the following:
• Display revenue sources and expected amounts, and how these are
budgeted at the start of a fiscal year;
• Enable management and monitoring of federal and state spending
requirements; and
• Enable reconciliation of prepayments and expenditures on an annual basis.
The initial RER and the final RER will be used to provide a standardized format
for reporting the financial status of individual programs. All actual expenditures
and revenues (including Medicaid, Adult Benefits Waiver [ABW], MI Child, Local,
Fees and Collections, and Other Contracts and Sources) for the particular
program are reported on the final RER.
The initial RER and final RER are ‘Attachment’ reports in EGrAMS. The agency
will be responsible for assuring that its budgets and expenditures, as reported on
the RER detail pages, correctly total to the RER Composite Page.
Reporting of revenues and expenditures must be consistent with Generally
Accepted Accounting Principles (GAAP).
All amounts entered on the RERs must be whole dollars.
2. ADMINISTRATIVE BUDGETS AND EXPENDITURES
Agency budgets and expenditures for Administration must be reasonable,
prudent, and commensurate with meeting the requirements of this agreement,
consistent with 2 CFR Part 225 (previously OMB Circular A-87) or 2 CFR Part
230 (previously OMB Circular A-122)., as applicable.
If the Administration budget contains a central cost allocation amount or rate, this
allocation must have been developed consistent with 2 CFR Part 225 (OMB
Circular A-87, Attachment C). Payments are subject to recovery, based on audit
findings.
When there is a central cost allocation, the agency must also submit via
EGrAMS, on agency letterhead, a Certificate of Cost Allocation Plan whenever a
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 2 of 11
central cost allocation is introduced or is revised, or every two years, whichever
is sooner. This Certificate of Cost Allocation Plan form is available electronically
(in WORD) from the MDCH contract manager or use the format shown below:
(Printed On Agency Letterhead)
Certificate of Cost Allocation Plan
This is to certify that I have reviewed the Cost Allocation Plan and to the best of my
knowledge and belief:
(1) All costs included in this proposal to establish cost allocations or billings for October
1, 2009 through September 30, 2010 are allowable in accordance with the
requirements of 2 CFR Part 225, “Cost Principles for State, Local, and Indian Tribal
Governments”, and the Federal award(s) to which they apply. Unallowable costs
have been adjusted for in allocating costs as indicated in the Cost Allocation Plan.
(2 CFR Part 225 can be found at
http://www.whitehouse.gov/omb/fedreg/2005/083105_a87.pdf
(2) All costs included in this proposal are properly allocable to Federal awards on the
basis of a beneficial or causal relationship between the expenses incurred and the
awards to which they are allocated in accordance with applicable requirements.
Further, the same costs that have been treated as indirect costs have not been
claimed as direct costs. Similar types of costs have been accounted for consistently.
I declare that the foregoing is true and correct.
Agency Name:
Signature:
Name of Official:
Title:
Date of Execution:
This Certificate of Cost Allocation Plan should be used for certification of the Agency’s
Cost Allocation Plan. This form must be signed by the Executive Director or Finance
Director of the agency.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 3 of 11
3. INITIAL ALLOCATION REVISION REQUEST
An allocation revision request is a request to move State Agreement funds
between allocated categories during the initial fiscal year agreement application
process. MDCH must approve or deny the request in EGrAMS before the
application process will continue.
The MDCH must allocate and manage state-administered funds in a way that
assures compliance with all federal and state requirements, including SAPT
Block Grant expenditure requirements. The initial allocations for each fiscal year
are in compliance with these requirements. Nonetheless, an agency may
propose to increase or reduce its allocations for Communicable Diseases or for
Prevention, within the limits of its total allocation. Though there is no separate
allocation for Treatment, this flexibility applies to Treatment as well. The MDCH
will be receptive to approving revisions in initial allocations when 1) the agency
can demonstrate that all applicable planning and agreement requirements can be
achieved, perhaps through the use of other available resources, for all affected
program and budget areas and 2) the MDCH can maintain compliance with
federal and state requirements. With regard to redirection of Treatment funds,
the agency must be able to demonstrate that treatment needs within the
catchment area are fully met and that there is adequate capacity to meet drug
court and offender re-entry initiatives as well.
4. BUDGET AMENDMENTS
A budget amendment is required when there is either an increase or decrease to
the agency’s State Agreement amount.
Requests for budget amendments must be submitted via EGrAMS. The due
date for final amendments is typically in late June annually. MDCH will notify the
agency of a specific date at least 30 days in advance of the due date.
The final amendment will be the last opportunity that an agency can transfer
funding from the Communicable Diseases expenditure category to another
expenditure category.
5. BUDGET REVISIONS
A budget revision involves moving state-administered funds between expenditure
budgets (Prevention, Treatment, Communicable Diseases, etc.) without changing
the total budgeted amount of state-administered funds.
Agency Discretionary Revisions
The agency is granted limited discretion to revise the budgeted amounts of state-
administered funds without prior approval by MDCH. This discretion is applicable
only to the budget categories of agency Administration, Treatment, Prevention,
and Communicable Diseases, and it is applicable only to Community Grant
funds. It is not applicable to the WSS’ Target.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 4 of 11
The agency may decrease or increase each of the above four budget categories
by up to $50,000 annually through the transfer of Community Grant funds among
these budget categories. Under this discretion, $50,000 is the annual, maximum
net change, up or down, that may be effected in any one of the four budget
categories.
On the final RER, Community Grant row, expenditures for Treatment, Women’s
Specialty Services (WSS), Adult Benefits Waiver (ABW) and MIChild are
fungible, once required targets and match requirements are met. Expenditures in
excess of the WSS target and ABW and MIChild match requirements can be
moved across these four (4) budget categories as needed and as is consistent
with this agreement without invoking the $50,000 Deviation Allowance.
Reducing the amount of budgeted Community Grant funds does not reduce or
amend any requirements stated elsewhere in this agreement, with respect to any
the four budget categories. For example, reducing the Communicable Disease
budget does not reduce the CA’s program or performance responsibilities
regarding Communicable Diseases.
The agency must inform its MDCH contract manager by e-mail of any
Discretionary Budget revisions. All discretionary revisions must be reported on
the final RER.
NOTE: With respect to Prevention only--if the agency has received approval to
reduce its Prevention budget by $50,000 or more, there is no agency option for
additional reductions on a discretionary basis. Any additional reductions must be
approved by the MDCH contract manager in writing in advance.
6. NOTICE OF FUNDING EXCESS OR INSUFFICIENCY—DUE JUNE 1
All agencies must advise the MDCH in writing and uploaded to EGrAMS by June
1 if the amount of State Agreement funding may not be used in its entirety or
appears to be insufficient. It is especially important that agencies notify the
MDCH if State Disability Assistance (SDA) funds will be lapsed or if the WSS
target cannot be met.
7. REVENUES
For State Agreement fund sources, Revenues are as listed in the agency’s
allocation letter.
For most other funds sources, Revenues are estimates. In some cases, the
agency may not be planning to expend all fiscal year Revenues.
On the final RER for the fiscal year, revenues and expenditures must be actual.
It is understood that, for non-State Agreement sources, total actual expenditures
may be less than total Revenues.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 5 of 11
8. INITIAL OR CURRENT ANNUAL BUDGET PLAN AND AGGREGATE
PLANNED (BUDGETED) EXPENDITURES
For State Agreement fund sources, planned (budgeted) expenditures, added
together, must equal the Initial Annual Budget Plan or the Current Annual Budget
Plan, as applicable, as entered on the RER-Composite.
For most other fund sources, planned (budgeted) expenditures are estimates. In
some cases, the agency may not be planning to expend all fiscal year revenues.
It is not necessary that aggregate planned (budgeted) expenditures equal the
Initial Annual Budget Plan or the Current Annual Budget Plan, as applicable, as
entered on the RER-Composite. That is, planned (budgeted) expenditures in
each row do not necessarily add to the total planned budget.
On the final RER for the fiscal year, revenues and expenditures must be actual.
It is understood that, for non-State Agreement sources, total actual expenditures
may be less than total planned (budgeted) expenditures. Exception: Local
Match.
9. REPORTING FEES AND COLLECTIONS
The MDCH/agency agreement requires agencies to report actual fees and
collections associated with services that the agency purchases. Expected
revenues from fees and collections must be reported on the initial annual RER.
The final RER for the fiscal year must report actual revenues.
Some agencies reimburse providers net of co-pay amounts, whether or not the
co-pays are actually collected by providers. Please do not report uncollected co-
pay revenues. Report only the revenues actually earned.
Food stamp revenue, in conjunction with residency, should be reported in Fees
and Collections—Section F on the initial and final RERs.
10. LOCAL MATCH—HOW TO BUDGET FEES/COLLECTIONS AND LOCAL
FUNDS
Amounts for Local Match are reported in the initial and final RERs. Please be
sure that the amounts entered meet Local Match criteria. The substance use
disorders agreement (Attachment A) clarifies which fees and collections may
count toward Local Match.
Some agencies may be using an incorrect formula to compute the minimum,
required Local Match. Please use the following worksheet to assist in computing
the agency’s Local Match percentage:
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 6 of 11
MATCH COMPUTATION - MUST BE AT LEAST 10%
a. GRAND TOTAL FUNDING $
(Last row of initial RER, page 2, Initial Annual Budget Plan Column 3, or
last row of final RER, page 2, Current Annual Budget Plan, Column 3)
b. LESS:
Section B. Medicaid subtotal $
Section C. ABW subtotal $
Section D. MIChild subtotal $ Section G. Other Contracts & Sources (incl. direct Federal) $
c. TOTAL (Subtotal of b.) ($ )
d. FUNDS SUBJECT TO MATCH (a minus c) $
e. MATCH FUNDS:
Section E. Local Subtotal $
Section F. Fees & Collections Subtotal $
f. TOTAL MATCH FUNDS (Subtotal of e.) $
g. MATCH PERCENTAGE (f/d * 100 = 00.00%) %
11. MICHILD AND ABW SAVINGS
MIChild and ABW savings become Local funds in the fiscal year following the
year in which the savings were earned. Savings should be entered in Section E.
Local, Row E-Other Local in the initial and final RER of the fiscal year following
the year in which the savings were earned.
The MIChild and ABW savings must be expended consistent with requirements
in this Agreement, pertaining to State Agreement funds, to support the agency’s
substance use disorders program.
12. POSTING MEDICAID REVENUES THAT ARE TRANSFERS FROM A PIHP
Some agencies receive increased Medicaid revenues in the form of transfers
from a PIHP, usually late in the fiscal year. Assuming these are current year
PEPM funds, these revenues and associated expenditures should be entered on
the final RER-Composite.
13. ADULT BENEFITS WAIVER
ABW Covered Services
For the Federal share of ABW PEPM revenue, please enter the amount on the
RER—Composite. Also enter the same amount on the initial and final RER,
ABW row, assuming your agency plans to spend the full amount during the fiscal
year. This will eliminate double-counting the General Fund match for ABW
revenue.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 7 of 11
Note that the check received by each agency each month for ABW is the Federal
share only.
For the State share of the ABW PEPM revenue, please enter the amount on the
initial and final RERs, Community Grant row, ABW column. Also enter the
amount on the EGrAMS initial agreement application.
To obtain the State share of the ABW PEPM, use the following formula:
Federal PEPM = Total x State % = State Match
Federal %
For those agencies that plan to spend Community Grant funds over and above
the combined Federal and State shares of the ABW PEPM revenue, also include
that additional amount (combined with the State share) on the initial and final
RER, Community Grant row, ABW column. Agencies must also enter the State
share amount in the EGrAMS initial agreement application.
ABW Discretionary Services
If an ABW beneficiary is ABW eligible and Community Grant eligible and is
provided ABW discretionary services paid for with Community Grant funds, enter
those expenditures on the final RER. ABW PEPM funds (federal and state)
must have been exhausted first.
The Federal and State ABW percentages for each fiscal year will be updated, as
needed, by MDCH on an annual basis or as rates change.
MDCH will issue the payment for each month not later than the second
Wednesday of that month.
For all other revenues and expenditures utilized for the ABW program, over and
above the combined Federal and State shares of the ABW PEPM revenue,
please enter those amounts on the final RER. Please note that Medicaid cannot
be utilized for the ABW program.
MDCH wants to capture the data that reports the total revenue (source and
amount) used to subsidize the ABW program.
14. MIChild
On a monthly basis, MDCH will provide the agency with the federal share of
MIChild funds as a per capita payment based upon a Per Enrolled Child Per
Month (PECPM) methodology for MIChild covered services. Included with these
funds will be an electronic copy of the names of the MIChild enrollees forming the
basis of these calculations. In consideration for accepting the federal funding
pushed to the agency, the agency agrees to redirect existing state general fund
dollars to match the MIChild federal FMAP funds (Title XXI State Children’s
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 8 of 11
Health Insurance Program) and carry out the associated substance abuse
program requirements. The PEPCM rate is $0.47 (47 cents) per month.
The Federal and State MIChild percentages for each fiscal year will be updated,
as needed, by MDCH on an annual basis or as rates change.
The PECPM funding is a per capita payment for medically necessary MIChild-
covered services including outpatient, residential and inpatient services as
authorized by the agency. If the MIChild capitation is not sufficient to serve the
MIChild enrollees, use of state-allocated Community Grant funds is allowed.
Federal SAPT Block Grant funds may not be used for inpatient care.
15. EARMARKED FUNDS
Special, earmarked funds will be identified in the agency’s initial fiscal year
allocation, as shown in EGrAMS. Earmarked funds may include Odyssey House,
Sacred Heart, Hispanic Services or other identified programs. The agency must
budget separately these special earmarked funds in the initial fiscal year
agreement application, the initial RER, and the final RER.
16. WOMEN’S SPECIALTY SERVICES—REQUIRED TARGET
Each agency’s Women’s Specialty Services (WSS) funds are combined with the
Community Grant allocation. For the purpose of assuring statewide compliance
with the SAPT Block Grant minimum expenditure requirement for Women’s
Specialty Services, each agency is given a minimum expenditure target for these
services, as stated in its initial allocation letter in EGrAMS. All program/services
objectives related to Women’s Specialty Services remain in place.
The expenditure target can be reached through the expenditure of a combination
of SAPT Block Grant and state funds for specialty treatment services for eligible
women. Eligible women are those who are pregnant, who have dependent
children, or who are seeking to regain custody of dependent children. State
funds include state funds allocated through this agreement, including SDA funds,
as well as the state share amount of Medicaid funds. Use of federal and state
funds must be consistent with applicable agreement requirements.
Attainment of the expenditure target and program/services objectives is a
contract performance requirement. The target can be amended by mutual
agreement. MDCH will not approve budget revisions or amendments that appear
to create risk of failing to meet the Women’s Specialty Maintenance of Effort.
If an agency reports Medicaid funds for WSS on the initial and final RERs, the
agency must post both Medicaid federal and state share for WSS—not just the
Medicaid state share.
The Federal and State Medicaid percentages for each fiscal year will be updated,
as needed, by MDCH on an annual basis or as rates change.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 9 of 11
As a check, when adding both Medicaid federal and state share for WSS
(budgets or expenditures), the total amount multiplied by the current-year state or
federal Medicaid Federal Medical Assistance Program (FMAP) percent must be
the amount posted in the agency’s budget.
EXAMPLE:
FY2009 BUDGET YTD/Final
B. Medicaid
1. Current Year PEPM (Federal & State)
2. Federal share only for Women’s
Specialty
$79,376 $63,225
3. State share only for Women’s Specialty $52,325 $41,678
4. Reinvestment Savings
B. Subtotal $131,701 $104,903
$131,701 x .3973 = $52,325 (state share for WSS)
17. PREVENTION ALLOCATION
There are no separate allocations for Tobacco Vendor Education or Non-Synar
Tobacco Retailers Inspections. Agencies are expected to use their Prevention
allocations to meet tobacco-related performance objectives and to accomplish
other Prevention plans developed through the Annual Plan Guidelines.
18. COMMUNICABLE DISEASES
The agency is required to assure that HIV/AIDS and other communicable
disease services as described in the MDCH/Agency agreement are provided.
Since Michigan is not a designated state, agencies may not use any Substance
Abuse Prevention and Treatment (SAPT) Block Grant funds for HIV early
intervention programs/services.
19. DISTRIBUTION
The initial and final RERs should be prepared and distributed as follows:
One Copy - An electronic or printed copy of each RER should be retained by
agency.
One Copy - Submitted electronically via EGrAMS at http://egrams-mi.com/dch.
Submission of the RERs shall be in accordance with the instructions in
Attachment C-Required Reports.
20. RETENTION
All RERs should be retained for a period complying with the retention policies
established in the agreement.
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Attachment B
Att_B Financial Rpting Req FY2010 Initial.doc Page 10 of 11
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Final Year-end Reporting
Revenues and Expenditures Report
The final RER is due by January 31 following the end of the fiscal year. The form must
be marked “FINAL” on the Face Page.
The final RER will be used for final cost settlement purposes.
Budgets on the final RER must be the same as those presented on the final amendment
for the year.
Final, year-end expenditures can be more than the corresponding budget, within the
$50,000 Deviation Allowance.
Within these final reports, financial information must be consistent and reconcile
between the reports:
1) ABW/MIChild Year-end Balance Worksheet
2) Administration Expenditures Report
3) Legislative Report/Provider Network List
4) Prevention Expenditures by Strategy Report
5) Revenues and Expenditures Report-Final
The agency is required to liquidate all accounts payable and encumbrances by
December 31 (see definitions below).
Exceptions may be granted for one-time obligations that cannot be liquidated within this
time period. However, should this be the case, an additional fifteen (15) days may be
provided if a written request for an extension, with the reason why additional time is
needed, is submitted by the due date of the final RER. Please submit such requests to
the agency’s contract manager.
Failure to meet these final reporting deadlines may result in the State’s inability to
reimburse the full amount of the State’s share of the gross expenditures.
In addition to submitting initial and final RERs, other financial information will be
requested to assist MDCH in properly closing the State’s fiscal year (September 30).
This information will help ensure sufficient funds have been reserved by the State to
make reimbursement for the agreement in the State’s upcoming fiscal year. The
additional financial information required will include an estimate of open commitments
and obligations incurred as of September 30, but not yet paid. The MDCH/Accounting
Division will provide detailed instructions for reporting additional financial information by
mid-August of each year.
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Att_B Financial Rpting Req FY2010 Initial.doc Page 11 of 11
DEFINITIONS:
• Accounts Payable - Obligations for goods or services received, which have not been
paid for as of the end of the agreement period.
• Encumbrances - Commitments at the end of the agreement period related to
unperformed (executory) contracts for goods and services.
Note: If an agreement does not end on September 30, it is still necessary to estimate
accounts payable as of September 30.
All inquiries regarding financial reporting issues should be directed to the Expenditure
Operations Section of the MDCH/Accounting Division.
References:
Michigan Department of Management and Budget
• Guide to State Government (1210.27).
• Year-End Closing Guide.
Federal OMB Circular A-102 (Revised & DHHS Common Rule).
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Attachment B
State
CERTIFICATION SECTION
Submission Type (check one)Contract No.
Total Expenditures YTD:
Balance:
$0
$0
City
Contact Person Telephone Number and E-mail Address
CERTIFICATION: I certify that I am authorized to sign on behalf of the local agency and that this is an accurate statement of
expenditures and collections for the report period. Appropriate documentation is available and will be maintained for the
required period to support costs and receipts reported.
If Yes is checked, I certify that I have submitted to MDCH the required Central Cost Allocation Plan Certification on our
agency’s letterhead; Or
If Yes is checked, I certify that I will submit, to the MDCH/ODCP Contract Manager, a completed/signed Central Cost
Allocation Plan Certification on our agency's letterhead within 30 days from the date listed below.
Authorized Signature Date Title
ZIP Code
Agreement Period
Michigan Department of Community Health
Contractor Name Federal ID No.
Page Number(s)
Face Page
CERTIFICATION: I certify that this agency uses a Central Cost Allocation Plan. (check one)
$0
Year-end Reconciliation
(For State Agreement Funds Only-Section A)
Mailing Address (Number and Street)
FROM: 10.01.09
Total Prepayments YTD:
TO: 09.30.10
Revenues and Expenditures Report
Date Prepared
1 of 7
2010-
Yes No
Initial Final
Att_B RER FY2010 Blank Initial .xls/Face Page Page 1 of 7
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Contractor Name:Contract #:Address: From: 10.01.09 To: 09.30.10ExpendituresInitial Annual Budget PlanCurrent Annual Budget PlanAgreement PeriodA. State Agreement 1. Community Grant$0$0$0$0$02. Prevention$0$0$0$0$03. Communicable Diseases$0$0$0$0$04. State Disability Assistance$0$0$0$0$05. SPF/SIG$0$0$0$0$06. FASD Award$0$0$0$0$07. Problem Gambling Prevention/Treatment$0$0$0$0$08. Integrated Tx-MH Block Grant (100%)$0$0$0$0$09. Integrated Tx-SAPT Block Grant(100%)$0$0$0$0$0A. Subtotal$0$0$0$0$0B. Medicaid1. Current Year PEPM (Federal & State)$0$0$0$0$02. Federal share only for Women's Specialty$0$0$0$0$03. State share only for Women's Specialty$0$0$0$0$04. Reinvestment Savings$0$0$0$0$0B. Subtotal$0$0$0$0$0C. ABW Current Year PEPM--Federal Share Only (Subtotal)$0$0$0$0$0D. MIChild Current Year PEPM (Subtotal)$0$0$0$0$0E. LOCAL1. Current Year PA2$0$0$0$0$02. PA2 Fund Balance$0$0$0$0$03. Other Local$0$0$0$0$0E. Subtotal$0$0$0$0$0F. Fees & Collections (Subtotal)$0$0$0$0$0G. Other Contracts & Sources (Subtotal)$0$0$0$0$0Grand Total of Subtotals A-G$0$0$0$0$0MDCH REVENUES AND EXPENDITURES REPORT - COMPOSITEFunds SourceBudget PlansBalanceRevenuesAgreement PeriodSubmission Type: Initial Final Att_B RER FY2010 Blank Initial .xls/CompositePage 2 of 7Commissioners Minutes Continued. January 20, 2010125
Contractor Name:Contract #:Address:From:10.01.09To:09.30.10EXPENDITURE DETAILFunds SourcePlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalA. State Agreement 1. Community Grant$0$0$0$0$0$02. Prevention$0$03. Communicable Diseases4. State Disability Assistance$0$0$0$05. SPF/SIG$0$06. FASD Award7. Problem Gambling Prevention/Treatment8. Integrated Tx-MH Block Grant (100%)9. Integrated Tx-SAPT Block Grant(100%)A. Subtotal$0 $0 $0 $0 $0 $0 $0 $0B. Medicaid1. Current Year PEPM (Federal & State)$0$0$0$02. Federal share only for Women's Specialty$0$03. State share only for Women's Specialty$0$04. Reinvestment Savings$0$0$0$0$0$0$0$0B. Subtotal$0$0$0$0$0$0$0$0C. ABW Current Year PEPM--Federal Share Only (Subtotal)$0$0D. MIChild Current Year PEPM (Subtotal)$0$0E. LOCAL1. Current Year PA2$0$0$0$0$0$02. PA2 Fund Balance$0$0$0$0$0$03. Other Local$0$0$0$0$0$0$0$0E. Subtotal$0$0$0$0$0$0$0$0F. Fees & Collections (Subtotal)$0$0$0$0$0$0$0$0G. Other Contracts & Sources (Subtotal)$0$0$0$0$0$0$0$0Grand Total of Subtotals A-G$0$0$0$0$0$0$0$0MDCH REVENUES AND EXPENDITURES REPORTAdministrationWomen's SpecialtyTreatmentAgreement PeriodSubmission Type:PreventionInitial Final Att_B RER FY2010 Blank Initial .xls/Expend_Adm,Tx,Prev,WSSPage 3 of 7Commissioners Minutes Continued. January 20, 2010126
Contractor Name:Contract #:Address:From:10.01.09To:09.30.10EXPENDITURE DETAILFunds SourcePlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalA. State Agreement 1. Community Grant$0$0$0$0$0$02. Prevention3. Communicable Diseases$0$04. State Disability Assistance5. SPF/SIG$0$06. FASD Award7. Problem Gambling Prevention/Treatment8. Integrated Tx-MH Block Grant (100%)9. Integrated Tx-SAPT Block Grant(100%)A. Subtotal$0 $0 $0 $0 $0 $0 $0 $0B. Medicaid1. Current Year PEPM (Federal & State)2. Federal share only for Women's Specialty3. State share only for Women's Specialty4. Reinvestment SavingsB. SubtotalC. ABW Current Year PEPM-Federal Share Only (Subtotal)$0$0D. MIChild Current Year PEPM (Subtotal)$0$0E. LOCAL1. Current Year PA2$0$0$0$0$0$0$0$02. PA2 Fund Balance$0$0$0$0$0$0$0$03. Other Local$0$0$0$0$0$0$0$0E. Subtotal$0$0$0$0$0$0$0$0F. Fees & Collections (Subtotal)$0$0$0$0$0$0$0$0G. Other Contracts & Sources (Subtotal)$0$0$0$0$0$0$0$0Grand Total of Subtotals A-G$0$0$0$0$0$0$0$0MDCH REVENUES AND EXPENDITURES REPORTSPF/SIGABWAgreement PeriodSubmission Type:Communicable DiseasesMIChildInitial FinalAtt_B RER FY2010 Blank Initial .xls/Expend_CD, ABW, MIChild,SPF_SIGPage 4 of 7Commissioners Minutes Continued. January 20, 2010127
Contractor Name:Contract #:Address:From:10.01.09To:09.30.10EXPENDITURE DETAILFunds SourcePlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalA. State Agreement 1. Community Grant2. Prevention3. Communicable Diseases4. State Disability Assistance5. SPF/SIG6. FASD Award$0$07. Problem Gambling Prevention/Treatment$0$08. Integrated Tx-MH Block Grant (100%)$0$09. Integrated Tx-SAPT Block Grant(100%)$0$0A. Subtotal$0$0$0$0$0$0$0$0B. Medicaid1. Current Year PEPM (Federal & State)2. Federal share only for Women's Specialty3. State share only for Women's Specialty4. Reinvestment Savings$0 $0 $0 $0B. Subtotal$0 $0 $0 $0C. ABW Current Year PEPM-Federal Share Only (Subtotal)D. MIChild Current Year PEPM (Subtotal)E. LOCAL1. Current Year PA2$0$0$0$0$0$0$0$02. PA2 Fund Balance$0$0$0$0$0$0$0$03. Other Local$0$0$0$0$0$0$0$0E. Subtotal$0$0$0$0$0$0$0$0F. Fees & Collections (Subtotal)$0$0$0$0$0$0$0$0G. Other Contracts & Sources (Subtotal)$0$0$0$0$0$0$0$0Grand Total of Subtotals A-G$0$0$0$0$0$0$0$0MDCH REVENUES AND EXPENDITURES REPORT Integrated Tx-SAPT Block Grant (100%)Problem Gambling Prevention/TreatmentAgreement PeriodSubmission Type:FASDIntegrated Tx-MH Block Grant (100%)Initial Final Att_B RER FY2010 Blank Initial .xls/Expend_OthersPage 5 of 7Commissioners Minutes Continued. January 20, 2010128
Contractor Name:Contract #:Address:From:10.01.09To:09.30.10EXPENDITURE DETAILFunds SourcePlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalPlannedYTD/FinalA. State Agreement 1. Community Grant$0$0$0$0$0$0$0$02. Prevention3. Communicable Diseases4. State Disability Assistance5. SPF/SIG6. FASD Award7. Problem Gambling Prevention/Treatment8. Integrated Tx-MH Block Grant (100%)9. Integrated Tx-SAPT Block Grant(100%)A. Subtotal$0 $0 $0 $0 $0 $0 $0 $0B. Medicaid1. Current Year PEPM (Federal & State)2. Federal share only for Women's Specialty3. State share only for Women's Specialty4. Reinvestment Savings$0$0$0$0$0$0$0$0B. Subtotal$0$0$0$0$0$0$0$0C. ABW Current Year PEPM-Federal Share Only (Subtotal)D. MIChild Current Year PEPM (Subtotal)E. LOCAL1. Current Year PA2$0 $0 $0 $0 $0 $0 $0 $02. PA2 Fund Balance$0 $0 $0 $0 $0 $0 $0 $03. Other Local$0 $0 $0 $0 $0 $0 $0 $0E. Subtotal$0 $0 $0 $0 $0 $0 $0 $0F. Fees & Collections (Subtotal)$0$0$0$0$0$0$0$0G. Other Contracts & Sources (Subtotal)$0$0$0$0$0$0$0$0Grand Total of Subtotals A-G$0$0$0$0$0$0$0$0MDCH REVENUES AND EXPENDITURES REPORTOthersOthersAgreement PeriodSubmission Type:Others OthersInitial Final Att_B RER FY2010 Blank Initial .xls/Expend_Others (2)Page 6 of 7Commissioners Minutes Continued. January 20, 2010129
Contractor Name:Agreement Period Contract #: 2010-Address:From:10.01.09 To: 09.30.10 Submission Type: Final$0$0$0$0 $0 $0$0$0$0$0$0$0$0$0$0MIChildMIChild Current Year PECPM-FederalMDCH REVENUES AND EXPENDITURES REPORTABW and MIChild Year-end Balance WorksheetFunds Source(Col. A)Actual Revenue(Col. B)Actual Expenditures(Col. C)Balance(Col. B - Col. C)When reporting year-end fund balances on this Worksheet, the agency must report BOTH the state match balance and the federal PEPM or PECPM balance. The state match fund balance, along with the federal PEPM or PECPM fund balance, cannot be expended in the same fiscal year as earned. These unexpended funds must be carried forward into the next fiscal year and reported as Local funds. The funds become Local funds only after MDCH acceptance of the final RER.The funds must be expended consistent with requirements in this Agreement, pertaining to State Agreement funds, to support the CA’s substance abuse program.ABW Current Year PEPM-Federal ABWState Share (Match)TotalThe CA is entitled to carry forward any ABW or MIChild year-end balances. These become Local funds in the next fiscal year and must be reported as "Other Local" on the initial and final RERs. State-share balances should not be included in any payable due to the State of Michigan.State Share (Match)Att_B RER FY2010 Blank Initial .xls/ABW_MIChild Balance WorksheetPage 7 of 7Commissioners Minutes Continued. January 20, 2010130
Att_B2 EquipInventoryForm FY2010 NOT APPLICABLE Initial.doc Page 1 of 1
ATTACHMENT B.2
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
CONTRACT MANAGEMENT SECTION
EQUIPMENT INVENTORY SCHEDULE
Please list equipment items that were purchased during the grant agreement period as
specified in the grant agreement budget’s cost detail schedule - Attachment B.2.
Provide as much information about each piece as possible, including quantity, item
name, item specifications: make, model, etc. Equipment is defined to be 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. Please complete and forward
to this form to the MDCH contract manager with the final progress report.
Contractor Name: Contract #: Date:
Quantity Item Name
Item Specification Tag Number Purchased
Amount
$
$
$
$
$
$
$
$
Total $ 0
Contractor’s Signature: Date:
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 1 of 8
Administration Expenditures Report
Introduction: The purpose of this technical requirement is to provide policy direction
with regard to CA Administration expenditures and specify annual supplemental
expenditure reporting requirements. The information will be used to determine
compliance with federal SAPT block grant administration and application requirements
as well as to develop a consistent framework for reporting and analysis of administrative
costs.
Application: Expenditures of the Coordinating Agency, regardless of revenue source,
that are not payments to the treatment or prevention service provider network for
treatment or prevention services.
CA administration excludes administrative costs of service providers regardless of
service or administrative function. Any provider’s indirect (if applicable), overhead and
management costs associated with delivering the service must be reported as program
expenditures.
Requirements: These requirements are consistent with the RER requirements
regarding administrative budgets and expenditures. The CA budget and expenditures
for Administration must be reasonable, prudent and commensurate with meeting the
contractual requirements between MDCH and the CA and must be consistent with OMB
Circular A-87 or A-122 as applicable. If the CA is a local government entity and
administration expenditures include a central cost allocation amount or rate, this
allocation must have been developed consistent with OMB Circular A-87, Attachment C.
Administration costs must be allocated to all funding sources in accordance with relative
benefits received in accordance with applicable OMB Circular cost principles. Further
detail regarding administrative cost distributions for Medicaid is provided on page 7 of
this document.
Special Note-Depreciation. Depreciation expenditures are only allowable as
permitted by GAAP and federal Circular A-87 or A-122 as applicable. Depreciation or a
use allowance is required by A-87 if approval to directly charge a capital asset has not
been granted.
DCH payments are subject to recovery, based on audit findings. Any CA that is a non-
profit entity cannot have a central cost allocation.
General: In keeping with changes made in FY05 to the RER reporting requirements
that eliminated CA reporting by object of expenditure and converted to program
reporting, the CA administration reporting is program and function based as well. It is
required that the CA accounting structure has the capability to both maintain object of
expenditures (e.g. travel, equipment, rent) but also to report these expenditures by
program function defined below as “final” CA Administration Cost Centers.
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Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 2 of 8
Final CA Administration Cost Centers: All CA administration expenditures must be
reported in one of the following program functions:
• General Administration
• Prevention Administration
• Treatment and Managed Care Administration (including AMS functions as
applicable)
• Recipient Rights
• Other Administrative Costs
The CA’s accounting system may incorporate both direct and distributed costs to these
final cost centers. All cost distributions must be consistent with applicable federal
regulations and state contract requirements.
If the CA’s accounting system does not directly charge (identify) each expenditure within
these five spending categories as final cost centers, the CA must have a system in
place by which to appropriately distribute expenditures to these categories. This could
be a combination of expenditure object codes and a cost distribution model that meets
OMB Circular requirements as applicable. It may include staff time studies.
Note that RER requirements incorporate the requirement that when there is a central
cost allocation, the CA Chief Executive Office or Chief Financial Officer must submit and
provide Certification as to the appropriateness of the cost allocation process. The CA
central cost allocation plan certification form must be submitted when introduced and
when revised or every two years, whichever is sooner.
General Administration. General administration includes the six expenditure
categories defined as administration by federal block grant requirements. These are
indirect costs, grants and contract management, CA audit, CA policy and procedure
development; personnel management and legislative liaison activities if applicable.
Additionally, general administration includes expenditures for those functions associated
with administering the substance abuse services delivery system that are not otherwise
included in the Prevention, Treatment, Managed Care, or Recipient Rights categories.
It includes executive leadership of the CA. The medical director of the CA should be
reflected in general administration if role of the medical director is to provide overall
leadership to functions such as the development of clinical policies/protocols, treatment
guidelines, level of care criteria, utilization management and utilization review. The
costs of the Medical director’s provision of clinical consultation or treatment services
must be reported as Treatment expenditures.
Examples of other expenditures to be included in general administration include CA
membership dues, advertising, insurances, board costs, Advisory Council costs and CA
budget development. Also, when not specific to treatment or prevention services,
examples include interpreter services, community forums and public hearings. Finally,
time spend by the executive leadership in interagency collaboration--which could, for
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133
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 3 of 8
example, include the development and operation of drug courts, integrated treatment
projects, participation in local work groups, collaborating bodies, etc can be included in
the general administration category.
Federal SAPT regulations limit total state-wide block grant general administration
expenditures to 5%. The department will aggregate expenditures and apply the 5% limit
on a statewide basis to this general administration category for the SAPT block grant.
However, it is understood that individual CA expenditures in this category may be above
or below the 5% level for this category depending on budget size, entity need and local
contributions. Accurate reporting of these administrative expenditures is critical to
meeting federal requirements of the federal block grant.
Prevention Administration CA prevention administration expenditures include costs
associated with the administration of prevention services. CA Synar-compliance
activities and other CA administrative expenditures directly attributable to the substance
abuse prevention program should be included in this category.
Additionally, prevention administration includes those CA administrative costs
associated with prevention program site visits, needs assessment, planning, program
development, research and evaluation, reviews conducted in accordance with section
6228(b) of the Public Health Code (PA 368 (1978) as amended), quality assurance and
post employment CA training including training paid by the CA for provider network
staff. Costs associated with proctoring exams or credentialing of prevention staff must
also be included in this expenditure category.
Communicable Diseases administrative costs may be reported under the category
which is appropriate to the internal organization of the CA and the management of the
Communicable Diseases program. For example, in some CAs, this program is
administered through the prevention administration and through the treatment
administration in other CAs. In the former, these CA administration expenditures would
be reported with prevention; in the latter, with the treatment/managed care
administration expenditures.
Treatment and Managed Care Administration (including AMS).
Both treatment and managed care administration expenditures are combined and
reported as treatment and managed care administration expenditures. It is not,
therefore, necessary to distinguish between treatment or managed care administration
activities such as treatment program site visit administration expenditures vs quality
management expenditures.
a) Treatment: CA treatment administration expenditures include costs associated with
administration of the treatment program including, if employed by the CA, the women’s
specialist, the treatment or clinical administrator, and other costs attributable to the
substance abuse treatment program. When performed by treatment administration
staff, costs associated with the development of drug court programs, integrated
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134
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 4 of 8
treatment projects, participation in local collaborating bodies, etc. should be included in
this category.
Additionally, treatment administration includes those CA administrative costs associated
with treatment program site visits, needs assessment, planning, program development,
research and evaluation, reviews conducted in accordance with section 6228(b) of the
Public Health Code (PA 368 (1978) as amended), quality assurance and post
employment CA training including training paid by the CA for provider network staff.
Costs associated with proctoring exams or credentialing of treatment staff must also be
included in this expenditure category.
Communicable Diseases administrative costs may be reported under the category
which is appropriate to the internal organization of the CA and the management of the
Communicable Diseases program. For example, in some CAs, this program is
administered through the prevention administration and through the treatment
administration in other CAs. In the former, these CA administration expenditures would
be reported with prevention; in the latter, with the treatment/managed care
administration expenditures.
b) Managed Care Administration (including AMS): This includes CA administrative
costs in the following six categories, regardless of source of revenue:
• Utilization Management (UM)-those administrative functions that pertain to the
assurance of appropriate clinical service delivery. UM is intended to assure that
only eligible clients receive services, and that clients are linked to other services
when necessary. UM components include:
1) access and eligibility determination;
2) level of care determination and service/support selection; service
authorization.
3) care management if it is limited to those clients that represent a service
or financial risk to the CA and is individual case (client) monitoring
carried out on behalf of the CA.
4) utilization review of individual clients records specific to provider
practices and system trends.
5) review and monitoring of the provider network to determine appropriate
application of service guidelines and criteria.
• Customer services that encompass activities directed at the entire population of
the CA. It is understood that providers throughout the CA network carry out
some customer services activities as part of the service process; these costs are
not included in this CA administrative function, but are to be reported within the
provider costs. This function includes four types of activities:
1) information services that include general information and orientation to the CA
system; development and dissemination of informational brochures, operation
of a telephone line(s) and websites to provide information about services
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135
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 5 of 8
provided and respond to general inquiries and outreach activities to identify
and establish communication with underserved groups. Any marketing or
public relations activities should also be included in this category.
Additionally, CAs frequently handle various DUI information/referral and
respond to general substance abuse services inquiries. If the costs of such
activities are separately identified, these should be categorized as customer
services.
2) Coordination of client participation in services. This includes costs associated
with enhancing or enabling client participation in advisory groups, task forces,
working committees, policy and program development and other activities
intended to engage clients including other stakeholders in decision oriented
activities throughout the provider network.
3) Client complaint, grievance and appeals processes except recipient rights.
This includes activities such as investigation and management of informal
complaints and formal grievances and appeals; administrative fair hearings,
and any informal means used by the CA to resolve complaints. This also
includes costs associated with the processes used by the CA to collect data
and perform related analyses.
4) Community Benefit. This includes costs associated with activities, other than
those conducted as prevention, which are directed at the population of the
entire service areas or service area sub-populations. Examples include
participation in community planning bodies, community emergency and group
trauma services, or administrative costs associated with partnership
arrangement with community organizations.
• Provider Network Management. These costs encompass activities directed at
ensuring that qualified providers of sufficient number and variety to provide
consumer choice and that the provider network is in compliance with regulatory
requirements and the performance expectations of the CA. Provider network
management includes network development, contract management, network
policy development and provider credentialing, privileging and verification.
Network development-is the process of identifying and analyzing client provider
needs; provider procurement, development of agreements with alternative payers
or related agencies with goal of coordinating funding. Additionally, this function
incorporates network provider training in relation to the CA performance
expectations for the provider. Contract management includes contract language,
contract negotiation and oversight including reviews for evidence of abuse and/or
fraud, compliance monitoring and sanctioning as well as the development of
standards for participation in the provider panel. Costs associated with
credentialing and privileging may be included in this cost area.
• Quality Management (QM): These costs encompass activities directed toward
ensuring that standards of staff, program and management performance exist;
that compliance is assessed and that ongoing improvements are introduced,
monitored and indicated improvements implemented. Since most service
provider organizations have quality management programs, CA quality
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136
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 6 of 8
management administration is limited to specific developmental and
improvement activities intended to improve the overall effectiveness of the CA
network’s clinical and administrative practices. These could, however, include
QM pilot projects initiated and supported by the CA and intended to improve the
overall network. QM includes standard setting including activities such as
research based practice guidelines, clinical pathway protocols and authorization
criteria; selection of standard tools for screening, assessment, etc. and
performance management; Also, conducting performance assessment,
development and implementation of compliance plans and action when non-
compliance is revealed; and costs associated with managing reviews conducted
by outside agencies such as accrediting bodies, etc. Finally, this component
includes research activities; continuous quality improvement processes including
facilitation of such activities in the provider network; provider education and
training in response to QM identified needs and development of quality
improvement plans.
• Financial Management: includes costs associated with financial management
that are 1) carried out as Medicaid financial management functions delegated by
the PIHP and 2) all other financial management expenditures of the CA carried
out under its authority as the regional substance abuse coordinating agency in its
contract with MDCH/ODCP. This should not included administrative
expenditures of the CA for Medicaid administration that is not delegated by the
PIHP. Financial management includes service unit and client centered cost
analysis and rate setting or the development of standards for rates; risk-related
analysis, modeling and underwriting as well as CA expenditures relative to
provider claims adjudication and payment. This category may also include
financial management expenditures for other CA local funds.
• Information Systems Management (ISM): ISM includes the costs processes
and systems designed to support management, administrative and clinical
decisions with the provision of data and information to support accountability and
information requirements to and of the CA as a managed care provider. Costs
include equipment, software, connectivity, management, and security. ISM
administrative costs do not include those attributable to the provision of
prevention or treatment services or on behalf of a service provider.
Recipient Rights: These are the costs of CA recipient rights related responsibilities as
required by Article 6 of the Public Health Code and Administrative Rule Part 3 Recipient
Rights. Note that this excludes grievance and appeal related costs that are described
under Managed Care Administration.
Other Administrative Costs: CA administrative costs not otherwise reported, must be
included in the Other Administrative Costs category. Occasionally, a CA may serve as
a fiduciary for other grants or community services. Administrative costs associated with
these activities should be reported as Other Administrative Costs.
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137
Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 7 of 8
Communicable Diseases administrative costs may be reported under the category that
is appropriate to the internal organization of the CA and the management of the
Communicable Diseases program. For example, in some CAs, this program is
administered through the prevention administration and through the treatment
administration in other CAs. In the former, these CA administration expenditures would
be reported with prevention; in the latter, with the treatment/managed care
administration expenditures.
Revenue Specific CA Administration Requirements:
Medicaid
With regard to Medicaid, only those CA administrative costs for functions delegated by
the PIHP to the CA may be considered Medicaid managed care administrative costs.
All other CA Medicaid administrative costs are considered program management
costs for Medicaid purposes.
Special Note: Medicaid CA administrative costs not attributable to those functions
delegated by the PIHP to the CA must be consistent with OMB circular requirements
and should not be reported to the PIHP as managed care administrative costs. Such
costs are allowable as program administration costs. Specific reporting requirements
for Medicaid are under the authority of the PIHP.
Federal Block Grant
Federal SAPT Administration. The federal administration definition includes CA
administration expenditures for:
• Indirect costs distributed to the CA program by the administering authority (such
as a county, a county health department or a community mental health authority)
if consistent with A-87 Circular requirements
• Grants and contract management (excludes provider network related
management functions or payments for prevention and treatment services)
• Audit of the CA
• Costs associated with CA policy, program and procedure development not
specific to prevention or treatment programs.
• Personnel management/HR operations
• Legislative Liaison if applicable and otherwise allowable
These federal block grant administrative expenditures are categorized as “general
administration”.
MI CHILD, ABW Waiver
Administration expenditures charged to MIChild and ABW must comply with OMB
Circular A-87 or A-122 as applicable and contract requirements.
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Attachment B.3
Att_B3 CA AdminExpRptInstructions FY2010 Initial.doc Page 8 of 8
PA 2
Informal opinion by the Attorney General is that CA Administrative costs may not be
charged to PA 2 funds.
Commissioners Minutes Continued. January 20, 2010
139
Attachment B.3A. State Agreement 1. Community Grant$02. Prevention3. Communicable Diseases$04. State Disability Assistance5. SPF/SIG$06. FASD Award7. Problem Gambling Prevention/Treatment8. Integrated Tx-MH Block Grant (100%)9. Integrated Tx-SAPT Block Grant(100%)A. Subtotal State Agreement$0 $0 $0 $0 $0 $0B. Medicaid1. Current Year PEPM (Federal & State)$02. Federal share only for Women's Specialty$03. State share only for Women's Specialty$04. Reinvestment Savings$0B. Subtotal Medicaid$0 $0 $0 $0 $0 $0C. ABW Current Year PEPM-Federal Share Only (Subtotal)$0D. MIChild Current Year PEPM (Subtotal)$0E. LOCAL1. Other Local$0E. Subtotal Local$0 $0 $0 $0 $0 $0F. Fees & Collections (Subtotal)$0G. Other Contracts & Sources (Subtotal)$0Grand Total of Subtotals A-G$0 $0 $0 $0 $0 $0 Contract Number (enter # below)OTHER ADMIN EXPENSES(Col. G)REVENUE SOURCE(Col. A)ADMINISTRATION EXPENDITURES REPORTTREATMENT AND MGED CARE ADMIN.(Col. E)Fiscal Year (enter # below)RECIPIENT RIGHTS(Col F.)TOTAL CA ADMIN EXPENSES(Col. B)(Total of Columns C-G)GENERAL(Col. C)PREVENTION(Col. D)Address:Contractor Name:Att_B3 CA AdminExpRpt FY2010 Initial.xlsPage 1 of 1Commissioners Minutes Continued. January 20, 2010140
Att_C Required Reports FY2010 Initial.doc Page 1 of 6
ATTACHMENT C
REQUIRED REPORTS – Fiscal Year (FY) 2010
All reports listed here, unless otherwise noted, must be submitted via the Electronic
Grants Administration and Management System (EGrAMS). There are three (3) types of
reports: Statistical, Expenditure, and Attachment. Statistical and Expenditure Reports
will be completed on-line. Attachment Reports will be uploaded to EGrAMS.
The following table lists reports that the Contractor is required to submit to the
Department under this Agreement. The table also indicates the time period covered by
each report, the due date of each report, where within the Department each report must
be submitted, and the source of instructions and specifications for completing each
report.
The contents of the table supersede any other communication of reporting
requirements. Revisions in the “Required Reports” table, which were made since prior
editions, are shown in strikeout or BOLD.
Contractors are responsible for submitting all reports on time and per reporting
instructions. Reports transmitted on or before the due date are considered timely.
Reports that require an original signature should be mailed to the appropriate
addressee(s) as listed at the end of Attachment C, with the transmission date
determined by postmark or commercial carrier receipt.
Commissioners Minutes Continued. January 20, 2010
142
Attachment C
Required Reports – Fiscal Year (FY) 2010
Att_C Required Reports FY2010 Initial.doc Page 2 of 6
Document Title/Data Submissions Period
Covered Due Date Where to Submit Instructions &
Specifications
Administration Expenditures Report Fiscal Year
2010
January 31, 2011 –
mandatory
submission
EGrAMS –
Attachment Report
Contract
Attachment B
Audit Report Fiscal Year
2010
9 months after close
of Contractor’s fiscal
year
Office of Audit
(See last page of
Attachment C)
Contract Part II
Communicable Disease Provider
Contact Information
Fiscal Year
2009
October 31, 2008
EGrAMS –
Attachment Report
Contract
Attachment E
Communicable Disease Provider
Information Plan/Report
(Applies Only To Agencies Who Have
Allocations For This Program)
Fiscal Year
2010
October 31, 2009 –
plan
April 30, 2010 –
first 6 months
January 31, 2011 –
second 6 months
EGrAMS –
Attachment Report
Contract
Attachment E
Fetal Alcohol Spectrum Disorders
(FASD) Prevention and Intervention
Project
(Applies Only To Agencies Who Have
Allocations For This Program)
As required
by Northrop
Grumman
Submit in real time –
FASD Prevention
Data
https://live.datstat.
com/NGPCAP-
PMC/default.aspx
Contract
Attachments A
and E
FASD Prevention and Intervention
Project: Revenues and Expenditures
Report
(Applies Only To Agencies Who Have
Allocations For This Program)
Monthly 15th day of the month
following the month
in which the activity
occurred
EGrAMS –
Attachment Report
Contract
Attachment B
FASD Prevention and Intervention
Project: Revenues and Expenditures
Report – FINAL
(Applies Only To Agencies Who Have
Allocations For This Program)
Fiscal Year
2010
January 31, 2011
EGrAMS –
Attachment Report
Contract
Attachment B
Financial Status Report – 1st thru 3rd
Quarters
Quarterly –
Oct-Dec;
Jan-March;
April-June
January 31, April 30,
and July 31
(Last day of the month,
following the end of
the quarter)
EGrAMS –
Expenditure
Report
Contract
Attachment D
Financial Status Report – 4th
Quarter/Final
Fiscal Year
2010
November 30, 2010
EGrAMS –
Expenditure
Report
Contract
Attachment D
Commissioners Minutes Continued. January 20, 2010
143
Attachment C
Required Reports – Fiscal Year (FY) 2010
Att_C Required Reports FY2010 Initial.doc Page 3 of 6
Document Title/Data Submissions Period
Covered Due Date Where to Submit Instructions &
Specifications
Health Insurance Portability &
Accountability Act (HIPAA) 837
Encounters
As services
are
provided,
complete
records.
Submit
monthly for
each
quarter.
Monthly (minimum 12
submissions per
year), 30 days post
adjudication of a
claim
Via DEG to MDCH
/MIS Operations
(See last page of
Attachment C)
Contract
Attachment E
Supplemental
Instructions to
SA CAs for 837
Encounter Data
Submission
HIV Data Report
CA assures HIV providers will utilize
MDCH/HAPIS data collection
methods, including Uniform Reporting
System (URS) CareWare for case
management and HIV Event System
(HES) for Counseling, Testing and
Referral (CTR) and other
prevention/risk reduction activity.
Monthly Submit in real time –
HIV Data
www.hapis.org Contract
Attachment E
Injecting Drug Users 90% Capacity
Treatment Report
Quarterly –
Oct-Dec;
Jan-March;
April-June;
July-Sept
January 31, April 30,
July 31, and
October 31
(Last day of the month,
following the end of
the quarter)
EGrAMS –
Attachment Report
Contract
Attachment E
Integrated Services for People with
Co-occurring Mental Health and
Substance Use Disorders – Narrative
Report
(Applies Only To Agencies Who Have
Allocations For This Program)
Quarterly –
Oct-Dec;
Jan-March;
April-June;
July-Sept
January 31, April 30,
July 31, and
October 31
(Last day of the month,
following the end of
the quarter)
EGrAMS –
Attachment Report
Contract
Attachment E
Legislative Report/Section 408
(formerly entitled Substance Abuse
Entity Inventory/ Legislative Report)
Fiscal Year
2010
January 31, 2011 –
for prior fiscal year
EGrAMS –
Attachment Report
Instructions will
be issued by
December 10
annually.
Notice of Excess or Insufficient Funds
Fiscal Year
2010
May June 1, 2009
EGrAMS –
Attachment Report
Contract
Attachment A
Performance Indicators
Quarterly –
Oct-Dec;
Jan-March;
April-June;
July-Sept
February 28, May 31,
August 31, and
November 30
(Two months following
the end of the quarter)
EGrAMS –
Statistical Report
Contract
Attachment E
Commissioners Minutes Continued. January 20, 2010
144
Attachment C
Required Reports – Fiscal Year (FY) 2010
Att_C Required Reports FY2010 Initial.doc Page 4 of 6
Document Title/Data Submissions Period
Covered Due Date Where to Submit Instructions &
Specifications
Preliminary Closeout Report Schedule
(Identified in EGrAMS as an
Obligations Report)
Fiscal Year
2010
September 2010
Determined by DMB,
in August, at year-
end closing.
EGrAMS –
Attachment
Statistical Report
(BFA/Accounting)
Contract Part II
Prevention Expenditures by Strategy
Report
Fiscal Year
2010
January 31, 2010
EGrAMS –
Attachment
Report
Contract
Attachment E
Prevention Report for SAPT/Block
Grant (REVISED)
Fiscal Year
2008
(Required,
if not
previously
submitted)
August 15, 2010
EGrAMS –
Attachment
Report
Contract
Attachment E
Priority Populations Waiting List
Deficiencies Report
Monthly End of the month
following the month
in which the
exception occurred
EGrAMS –
Statistical Report
Contract
Attachment E
Problem Gambling Integrated
Treatment Project Report –
Monthly
(Applies Only To Agencies Who Have
Allocations For This Program)
Monthly Last day of the
month following the
month in which the
activity occurred
EGrAMS –
Attachment Report
Contract
Attachments A
and E
Problem Gambling Integrated
Treatment Project Report –
Final Year-end
(Applies Only To Agencies Who Have
Allocations For This Program)
Fiscal Year
2010
October 31, 2010
EGrAMS –
Attachment Report
Contract
Attachments A
and E
Revenues and Expenditures Report
(RER) including ABW/MIChild Balance
Worksheet – Final
Fiscal Year
2010
January 31, 2011
EGrAMS –
Attachment
Report
Contract
Attachment B
Sentinel Events Data Report
(residential treatment only)
Semi-
Annual CA
Summary
April 30, 2010 and
October 31, 2010
(Last day of the month
following the end of
the 2nd & 4th quarters)
EGrAMS –
Attachment Report
Contract
Attachment E
Commissioners Minutes Continued. January 20, 2010
145
Attachment C
Required Reports – Fiscal Year (FY) 2010
Att_C Required Reports FY2010 Initial.doc Page 5 of 6
Document Title/Data Submissions Period
Covered Due Date Where to Submit Instructions &
Specifications
Special Projects, Earmark-funded:
Flint Odyssey House
Hispanic Services
Sacred Heart Rehab Center
Saginaw Odyssey House
(Applies Only To Agencies Who Have Earmarked Allocations For These Programs)
Fiscal Year
2010
November 30, 2010
EGrAMS –
Attachment Report
Contract
Attachments A
and E
State Prevention Framework, State
Incentive Grant (SPF/SIG)
Budget/Expenditure Report—
TO BE DETERMINED
1st 6 months
of Fiscal
Year 2010
April 30, 2010
EGrAMS –
Attachment Report
Contract
Attachments A
and B
SPF/SIG Budget/Expenditure Report –
Final Report—
TO BE DETERMINED
FY2010 November 30, 2010
EGrAMS –
Attachment Report
Contract
Attachments A
and B
Substance Use Disorder Prevention
Data Set (SUDPDS)
Monthly Last day of month
www.sudpds.com Contract
Attachment E
Tobacco/Formal Synar – Youth
Access to Tobacco (YTA) Compliance
Checks Report
July 1-31,
2010
August 15, 2010
EGrAMS –
Attachment Report
Instructions to be
e-mailed to
agencies in
June 2010
Tobacco Retailer Listing –
Improved
(REVISED)
Annual March 31, 2010
EGrAMS –
Attachment
Report
Contract
Attachment E
Treatment Episode Data Set (TEDS) Monthly Last day of each
month
Via DEG to MDCH
/MIS Operations
(See last page of
Attachment C)
Contract
Attachment E
Women’s Specialty Services Report
(REVISED)
Fiscal Year
2010
January 31, 2011
EGrAMS –
Attachment
Report
Contract
Attachment E
Youth Access to Tobacco Activity
Annual Report
Fiscal Year
2010
October 31, 2010
EGrAMS –
Attachment Report
Contract
Attachment E
Commissioners Minutes Continued. January 20, 2010
146
Attachment C
Required Reports – Fiscal Year (FY) 2010
Att_C Required Reports FY2010 Initial.doc Page 6 of 6
To submit via DEG to MDCH/MIS Operations:
Client Admission and Discharge Client records must be sent electronically to:
Michigan Department of Community Health
Michigan Department of Information Technology
Data Exchange Gateway (DEG)
For admissions: put c:\4823 4823@dchbull
For discharges: put c:\4824 4824@dchbull
To send to the Office of Audit:
Paper versions of reports should be via:
U.S. mail to:
Michigan Department of Community Health
Office of Audit
Quality Assurance and Review Section
P.O. Box 30479
Lansing, MI 48909-7979
Overnight services (UPS, FedEx) to:
Michigan Department of Community Health
Office of Audit
Quality Assurance and Review Section
Capitol Commons Center
400 S. Pine Street
Lansing, MI 48933
Alternatives to paper filing may be viewed at:
http://www.michigan.gov/mdch/0,1607,7-132-2946_43164_43171-150870--,00.html
Commissioners Minutes Continued. January 20, 2010
147
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 1 of 11
FINANCIAL STATUS REPORT
Form Preparation Instructions
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
I. INTRODUCTION:
The Financial Status Report (FSR) is used to provide a standardized format for reporting the
financial status of individual programs. All expenditures and revenues for the State Agreement
Amounts are reported on the FSR.
The FSR is prepared shortly after the end of each quarter and must be submitted to the Michigan
Department of Community Health, Bureau of Finance through MI E-Grants, no later than the last
day of the month following the end of each fiscal quarter. The fourth quarter FSR must be
marked as final and is due sixty (60) days after the end of the agreement. In addition, a final
Revenue and Expenditure Report (RER) is required and due as specified in the program
agreement and must reflect actual revenues and expenditures. See attachments A, B and C of the
agreement for provisions and reporting instructions specific to the Revenue and Expenditure
report.
The FSR is to be prepared reporting expenditures on a cash or accrued basis and revenue on an
accrued basis. See following definitions:
Cash Expenditures - Actual cash outlays for goods and services received.
Accrued Expenditures - Goods and services received, but not yet paid for.
Accrued Revenue - Total revenue earned, including amounts received and amounts earned and
not received. The amount of accrued revenue must be in compliance with available funding
sources per terms of the agreement.
II. DISTRIBUTION:
FSRs are submitted electronically through MI E-Grants in accordance with the following
instructions and will be reviewed by the Contract Manager and once approved, forwarded
electronically to:
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
BUREAU OF FINANCE
ACCOUNTING DIVISION
P.O. BOX 30720
LANSING MI 48909-8220
One Copy – An electronic or printed copy of the FSR should be retained by Local Agency
III. RETENTION:
This report should be retained for a period complying with the retention policies established in
the agreement.
Commissioners Minutes Continued. January 20, 2010
148
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 2 of 11
IV. Submitting the FSR in MI E-Grants
The FSR is submitted to the Contract Manager through MI E-Grants and is used to report
quarterly expenditures and document revenues spent for State Agreement funded activities. The
FSR in MI E-Grants can only be submitted by an individual assigned the Financial Officer
permission by the Grantee Agency’s Project Director. Other individuals assigned a different
permission (i.e., project director, report administrator and/or authorized official) can enter data
into the FSR, but only the person with the financial officer permission can submit the report for
approval.
To complete and submit the quarterly FSR, the user navigates to the Progress Reports screen.
1. User logs into MI E-Grants system by entering username and password.
2. User selects the FSR by choosing the following from the drop down menu and clicking the
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 3 of 11
c. Reports that appear in red are past due.
3. Enter selected FSR report by clicking on the report name.
FSR Overview
The FSR provides a standardized format for reporting the financial status of individual programs.
All expenditures and revenues for a particular program are reported on the FSR.
Worksheet Tabs:
The FSR contains two tabs. Each tab contains a worksheet that the user must complete in order
to submit the FSR.
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 4 of 11
Data Entry Procedure:
1. In the Expenditures tab, click the blue hyperlinks within each major activity category to open
the category detail screen.
Only categories that have
been budgeted will display
the blue hyperlinks.
2. On the category detail screen,
record current expenditure
amounts into the appropriate
fields that correspond with
each category activity.
Only the boxes in the
‘Current’ column are used.
The remaining fields
automatically calculate.
3. After the first quarter FSR
report is submitted,
corrections to a prior
reporting period can be made
by clicking on the
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 5 of 11
MI E-Grants populates the budget column to reflect the revenue amounts of the current executed
agreement/amendment. During each report submission, the user enters the amount of funds used
from each identified budget category into the Current column. MI E-Grants automatically
calculates the YTD and Balance columns to assure accuracy. MI E-Grants also provides the user
with the Total Expenditures from the Expenditure worksheet for quick reference.
Data Entry Procedure:
Entries on the Source of Funds tab are done directly on the page. The Source of Funds data form
is similar to the Expenditures data form, but the Source of Funds form collects only the total
amount for each category.
1. Click in the ‘Current’ column and enter in the state amount spent for each activity. Only the
boxes in the ‘Current’ column are used. The remaining boxes are automatically calculated.
2. When finished with the
form, click the
button at the bottom of the
screen.
Validation Process:
The user clicks the
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 6 of 11
Attachments:
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 7 of 11
V. UNDERSTANDING THE SYSTEM GENERATED FSR REPORT:
MI E-Grants generates a Financial Status Report in .PDF form which contains the following
fields and reflects the information indicated. Please see attached sample document.
A. FE ID Number – Federal ID Number. Field is populated by system from information
entered in the Grantee Agency screen.
B. Local Agency Name - Name of the local agency. Field is populated by system from
information entered in the Grantee Agency screen.
C. Street Address - Street address of the local agency. Field is populated by system from
information entered in the Grantee Agency screen.
D. City, State, ZIP Code - City, State, and ZIP Code of the local agency. Field is populated
by system from information entered in the Grantee Agency screen.
E. Contract Number - Department of Community Health Contract Number. Field is
populated by system.
F. Program - Title of the program. Field is populated by system.
G. Report Period - Enter the inclusive date of the quarterly report. Field is populated by
system. Check box if FINAL REPORT.
H. Agreement Period - Inclusive dates of the agreement. Field is populated by system.
I. Code – This field is no longer used.
J. Date Prepared - Enter Date on which the report is prepared. Field is populated by
system.
K. Operational Advance - This field is not applicable.
Expenditures:
L. Current Period - Enter the current period expenditures for the following items.
Expenditures must include only those authorized under the terms of the agreement, as
specified in the budget column. CA Discretionary Revisions must be reported on the
Final RER submission only. Report all expenditures related to the State Agreement
amount. (The current period must represent the report period.)
1. Community Grant - This category includes allowable expenditures related to the
performance of activities supported by Community Grant funds as identified by
the following subcategories: Administration, Treatment, State share of ABW and
MI-Child, Women’s Specialty targets and Special Earmarked Projects as defined
in Attachments A and B.
a. Administration – Enter expenditures associated with providing
administration services.
b. Treatment – Enter expenditures associated with providing treatment
services.
Commissioners Minutes Continued. January 20, 2010
154
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 8 of 11
c. Women’s Specialty – Enter state share of expenditures associated with the
Women’s Specialty target.
d. State share of ABW – Enter the state share of expenditures associated with
providing ABW services. For those agencies planning to spend
Community Grant funds over and above the Federal and State shares of
ABW PEPM revenue, include the additional amount in this subcategory.
e. State share of MI-Child - Enter the state share of expenditures associated
with providing MI-Child services.
f. Other (Special Earmarked Projects) – Special earmarked funds are
identified in the agency’s initial fiscal year allocation letter and may
include: Odyssey House, Sacred Heart, Hispanic Services or other
identified programs. Enter expenditures associated with the Special
Earmarked Project services.
2. Prevention - This category includes allowable expenditures related to the
performance of prevention activities as defined in Attachments A and B.
3. Communicable Disease - This category includes allowable expenditures related
to the performance of communicable disease activities as defined in Attachments
A and B.
4. State Disability Assistance - This category includes allowable expenditures
related to the performance of State Disability Assistance activities as defined in
Attachments A and B.
5. Strategic Planning Framework/State Incentive Grant (SPF/SIG) – This
category includes allowable expenditures related to the performance of SPF/SIG
activities as defined in Attachments A and B.
6. Fetal Alcohol Syndrome Disorder (FASD) Award – This category includes
allowable expenditures related to the performance of FASD activities as defined
in Attachments A and B.
7. Problem Gambling Prevention/Treatment – This category includes allowable
expenditures related to the performance of problem gambling
prevention/treatment activities as defined in Attachments A and B.
8. Integrated Treatment – MH Block Grant – This category includes allowable
expenditures related to the performance of MH Block Grant activities as defined
in Attachments A and B.
9. Integrated Treatment – SAPT Block Grant – This category includes allowable
expenditures related to the performance of SAPT Block Grant activities as
defined in Attachments A and B.
10. Total State Agreement – This line sums each of the columns and reflects
expenditures incurred against the State Agreement amount.
11. Total Expenditures – This line sums each of the columns and reflects total
expenditures reported for this report.
Commissioners Minutes Continued. January 20, 2010
155
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 9 of 11
M. Correction Period – Corrections column is enabled after the first reporting period and is
used to correct any over or understatement of expenditures from a prior period.
N. Expenditures Agreement YTD Column – System sums the "Current Period" amounts
from this period's report and the "Agreement YTD" amounts from the previously
submitted period reports for each item (lines 1-11) in the Agreement YTD Column.
Enter only amounts for the current agreement period in this column.
O. Agreement Budget Column – System displays the most current approved budget at the
time that reporting was initiated. If the FSR is in process at the time a budget amendment
is executed, the revised budget will be reflected in the next period’s FSR.
P. Agreement Balance Column - These balances are computed by subtracting the
"Agreement YTD" expenditure amount from the "Budget" amount for each item. Show
overages as negative amounts.
Q. Expend% - System calculates the percentage of funds expended by dividing the
“Agreement YTD” expenditure amount by the “Budget” amount for each item. Show
overages as amounts greater than 100%.
Source of Funds (Revenues):
R. State Amount - Enter the current period revenues for the following State Agreement
items. Revenues must equal expenditures. (The current period must represent the report
period.)
1. Community Grant
2. Prevention
3. Communicable Disease
4. State Disability Assistance
5. Strategic Planning Framework/State Incentive Grant (SPF/SIG)
6. Fetal Alcohol Syndrome Disorder (FASD) Award
7. Problem Gambling Prevention/Treatment
8. Integrated Treatment – MH Block Grant
9. Integrated Treatment – SAPT Block
10. Total State Agreement – This line sums each of the columns and reflects revenues
requested through this report.
11. Total Funding – This line sums each of the columns and reflects total revenues
reported through this report.
S. Total – System sums the total for each item.
Commissioners Minutes Continued. January 20, 2010
156
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 10 of 11
T. Correction - Correction column is enabled after the first reporting period and is used to
correct any over or understatement of expenditures from a prior period. If corrections are
entered for an item on the Expenditure tab, they must also be entered into the Source of
Funds tab.
U. Revenue Agreement YTD Column – System sums the "Current Period" amounts from
this period's report and the "Agreement YTD" amounts from the previously submitted
period reports for each item (lines 1-11) in the Agreement YTD Column.
V. Agreement Budget Column – System displays the most current approved budget at the
time that reporting was initiated. If the FSR is in process at the time a budget amendment
is executed, the revised budget will be reflected in the next period’s FSR.
W. Agreement Balance Column - These balances are computed by subtracting the
"Agreement YTD" expenditure amount from the "Budget" amount for each item. Show
overages as negative amounts.
X. Expend% - System calculates the percentage of funds expended by dividing the
“Agreement YTD” expenditure amount by the “Budget” amount for each item. Show
overages as amounts greater than 100%.
Y. Authorized Signature and Date Signed – The report may only be submitted by
individuals assigned the Financial Officer permission. The individual submitting the
report certifies that the documentation and records are available and easily accessible in
support of all the data contained on the report. The individual submitting the report on
behalf of the local agency certifies that he/she is authorized to submit the report on behalf
of the local agency. Any item found as a result of audits to be improper or undocumented
will be subject to an audit citation and generally will require a payment adjustment. Field
remains blank but system tracks name, permission, date and time of submission.
Z. FOR STATE USE ONLY - This section of the form is for State use only.
Commissioners Minutes Continued. January 20, 2010
157
Attachment D
Att D_FSR Instructions FY2010 Initial.doc Page 11 of 11
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
FINANCIAL STATUS REPORT
FINAL REPORTING
A final Financial Status Report is due within sixty days of the end of the agreement period and
must be marked “FINAL”. A final Revenue and Expenditure Report (RER) is due by January 31
following the end of the fiscal year. The agency is required to liquidate all accounts payable and
encumberances by December 31 (see definitions below).
Failure to meet these final reporting deadlines may result in the loss of funding requested on the
Preliminary Close-out Report/Obligation Report and may result in the potential reduction in the
subsequent year’s agreement amount.
In addition to submitting FSRs, other financial information will be requested to assist DCH in
properly closing the State’s fiscal year (September 30). This information will help ensure
sufficient funds have been reserved by the state to make reimbursement for the contract in the
State’s upcoming fiscal year. The additional financial information required will include an
estimate of open commitments and obligations incurred as of September 30, but not yet paid.
The DCH Accounting Division will provide detailed instructions for reporting additional
financial information mid-August of each year.
DEFINITIONS:
• Accounts Payable - Obligations for goods or services received, which have not been paid for
as of the end of the agreement period.
• Encumbrances - Commitments at the end of the agreement period related to unperformed
(executory) contracts for goods and services.
Note: If a contract does not end on September 30th it is still necessary to estimate accounts
payable as of September 30th. All inquiries regarding financial reporting issues should be
directed to the Expenditure Operations Section of the Accounting Division.
References:
Michigan Department of Management and Budget
• Guide to State Government (1210.27).
• Year-End Closing Guide.
Federal OMB Circular A-102 (Revised & DHHS Common Rule).
Commissioners Minutes Continued. January 20, 2010
158
Att E_Table of Contents FY2010 Initial.doc Page 1 of 3
ATTACHMENT E
OTHER REQUIREMENTS
I. DATA REQUIREMENTS
Data Collection/Recording and Reporting Requirements—Revised September
2007
Instructions for Data Submission for the Fetal Alcohol Spectrum Disorders
(FASD) Prevention and Intervention Project—Effective February 2, 2008;
Revised June 2009
(Applies Only To Agencies Who Have Allocations For This Program)
Instructions for Treatment Episode Data Set (TEDS) Submission for Substance
Abuse Services Coordinating Agencies; Revised September 2008
Performance Indicators for Substance Abuse Services: Electronic Submission
Forms; Revised August 2007
Sentinel Event Reporting Guidance; Revised August 2007
Substance Abuse Encounter Reporting: HCPCS and Revenue Codes--
August 2007; Revised August 2009
Substance Use Disorder Prevention Data Set System Reference Manual—
Effective October 1, 2007; Revised April 29, 2008
Supplemental Instructions to Substance Abuse Coordinating Agencies for 837
Encounter Data Submission; Revised August 2007
II. METHADONE REQUIREMENTS
Treatment Policy #03, Buprenorphine--Effective October 1, 2006
Treatment Policy #04, Off-site Dosing Requirements for Medication-Assisted
Treatment--Effective December 1, 2006
Treatment Policy #05, Enrollment Criteria for Methadone Maintenance and
Detoxification Program; Revised January 1, 2008
Commissioners Minutes Continued. January 20, 2010
159
Att E_Table of Contents FY2010 Initial.doc Page 2 of 3
III. PREVENTION REQUIREMENTS
Prevention Policy #01, Synar—Effective October 1, 2006
Prevention Policy #02, Addressing Communicable Disease Issues in the
Substance Abuse Network—Effective October 1, 2006
Tobacco Retailer Master List Updates Improvement And Clarification
Process Instructions--Effective October 1, 2007; Revised August 2009
IV. REPORTING REQUIREMENTS
Communicable Disease Provider Contact Information—August 2008
Communicable Disease Provider Information Plan/Report and Instructions;
Revised August 2008
HIV Data Reporting Requirements (HAPIS)—June 2009
Injecting Drug Users 90% Capacity Treatment Report/Instructions—August 2008
Integrated Services for People with Co-occurring Mental Health
And Substance Use Disorders Narrative Report—August 2008; Revised June
2009
Prevention Expenditures by Strategy Report/Instructions—August 2005
Prevention Report for SAPT Block Grant Report/Instructions—For FY2008;
Revised August 2009
Priority Populations Waiting List Deficiencies Report/Instructions—August 2005;
Revised January 1, 2006
Problem Gambling Integrated Treatment Project Report—Effective July 1,
2008; Revised August 2009
(Applies Only To Agencies Who Have Allocations For This Program)
Special Projects Report: Earmarked-Funded—Effective October 1, 2007; Revised
June 2009
(Applies Only To Agencies Who Have Allocations For ODCP-identified,
Statewide Programs)
Women’s Specialty Services Report/Instructions; Revised August 2009
Youth Access to Tobacco Activity Annual Report—August 2005; Revised June
2009
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160
Att E_Table of Contents FY2010 Initial.doc Page 3 of 3
V. CREDENTIALING AND STAFF QUALIFICATION REQUIREMENTS
Credentialing and Staff Qualification Requirements for the CA Provider
Network—Effective June 30, 2009; Revised August 2009
VI. TECHNICAL ADVISORIES
Contract Technical Advisory #01, Local Advisory Council Guidelines--Issued
August 9, 1990; Reissued September 18, 2006
Treatment Technical Advisory #01, Suboxone® Use in an Opioid Treatment
Program—Issued December 1, 2005
Treatment Technical Advisory #04, Fetal Alcohol Spectrum Disorders—Issued
January 1, 2007
Treatment Technical Advisory #05, Welcoming--Issued October 1, 2006
Treatment Technical Advisory #06, Counseling Requirements for Clients
Receiving Methadone Treatment—Issued August 10, 2007
Treatment Technical Advisory #07, Peer Recovery/Recovery Support—Issued
March 17, 2008
VII. TREATMENT REQUIREMENTS
Treatment Policy #02, Acupuncture—Effective May 1, 1994; Reissued March
2007
Treatment Policy #06, Individualized Treatment Planning—Effective October 1,
2006
Treatment Policy #07, Access Management System—Effective November 1,
2006
Treatment Policy #08, Substance Abuse Case Management Program
Requirements—Effective January 1, 2008
Treatment Policy #09, Outpatient Treatment Continuum of Services—Effective
June 20, 2008
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Att E_Data collect_record_rpt req FY2010 Initial.doc Page 1 of 6
MICHIGAN DEPARTMENT OF COMMMUNITY HEALTH
DATA COLLECTION/RECORDING AND REPORTING
REQUIREMENTS for COORDINATING AGENCIES (CAs)- Effective
10/1/2007
Overview of Reporting Requirements
The reporting of substance abuse services data by the Substance Abuse Coordinating
Agency (CA) as described in this material meets several purposes at MDCH including:
-Federal data reporting for the SAPT Block Grant application and progress report, as
well as for the treatment episode data set (TEDS) reported to the federal Office of
Applied Studies, SAMHSA.
-Managed Care Contract Management
-System Performance Improvement
-Statewide Planning
-CMS Reporting
-Actuarial activities
Special reports or development of additional reporting requirements beyond the initial
data and reports required by the Department may be requested within the established
parameters of the contract. The CA will likely maintain, for management and local
decision-making, additional information to that specified in the reporting requirements.
Standards for collecting and reporting data continue to evolve. Where standards and
data definitions exist, it is expected that each CA will meet those standards and use the
definitions in order to assure uniform reporting across the state. Likewise, it is
imperative that the CA employs quality control measures to check the integrity of the
data before it is submitted to MDCH. Error reports generated by MDCH will be available
to the submitting CA the day following a DEG submission. MDCH’s expectation is that
the records that receive error Ids will be corrected and resubmitted as soon as possible.
The records in the error file are cumulative and will remain errors until they have been
corrected.
Individual services recipient data received at MDCH are kept confidential and are
always reported out in aggregate. Only a limited number of MDCH staff can access the
data that contains any possible individual client identifiers. (Social Security number, date
of birth, diagnosis, etc.) All persons with such data access have signed assurances
with MDCH indicating that they are knowledgeable about substance abuse services
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confidentiality regulations and agree to adhere to these and other departmental
safeguards and protections for data.
Technical specifications-- including file formats, error descriptions, edit/error criteria, and
explanatory materials on record submission with associated record tagging
requirements at the CA level to assure data synchronization with MDCH data records,
are in the Instructions for Treatment Episode Data Set (TEDS) Submission for
Substance Abuse Coordinating Agencies.
Reporting covered by these specifications includes the following:
-TEDS Admission Records (due monthly)
-TEDS Discharge Records (due monthly)
-837 Encounter Records
A. Basis of Data Reporting
The basis for data reporting policies for Michigan substance abuse services
includes:
1. Federal funding awarded to Michigan through the Substance Abuse
Prevention and Treatment (SAPT) federal block grant to share in support
of substance abuse treatment and prevention requires submission of
proposed budgets and plans. Resources and plans must be reviewed and
considered by the State in light of statewide needs for substance abuse
services.
2. Public Act 368 of 1978, as amended, requires that the department
develop:
A comprehensive State plan through the use of federal, State, local, and
private resources of adequate services and facilities for the prevention and
control of substance abuse and diagnosis, treatment, and rehabilitation of
individuals who are substance abusers.
In addition, the department shall:
Establish a statewide information system for the collection of statistics,
management data, and other information required.
Collect, analyze and disseminate data concerning substance abuse
treatment and rehabilitation services and prevention services.
Conduct and provide grant-in-aid funds to conduct research on the
incidence, prevalence, causes, and treatment of substance abuse and
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disseminate this information to the public and to substance abuse services
professionals.
3. Comprehensive planning requires statewide needs assessments to
include identification of the extent and characteristics of both risks for
development and current substance abuse problems for the citizens of
Michigan.
B. Policies and Requirements Regarding Data
Treatment Data reporting will encompass Substance Abuse (SA) services
provided to clients supported in whole or in part with state administered funds
through funds for SA services to Medicaid recipients included in CA contracts.
Definitions:
State administered funds: Any state or federal funding provided by the
MDCH/DSAGS/SA contract. Funds provided include federal SAPT Block Grant, state
general funds, MIChild, ABW, and other categorical or special funds. Medicaid funds
that are covered under the MDCH/PIHP contract are considered state administered
funds.
Data: Client admission and discharge records (for treatment services), and client
institutional and professional encounter records, and backup required to produce this
information (e.g. billings from providers, services logs, etc.). Prevention services data
are not addressed herein.
Services: Substance abuse treatment (residential, residential detox, intensive
outpatient, outpatient, including pharmacological supports as part of above), substance
abuse assessment (screening, assessment, referral and follow-up) provided by
appropriately state licensed programs. Prevention services data are not addressed
herein.
Supported in whole or in part: Describes those services for which the CA pays,
inclusive of co-pays with other sources of funds (e.g. first party, third party insurance,
and/or other funding sources).
Policy:
Reporting is required for all clients whose services are paid in whole or in part with state
administered funds regardless of the type of co-pay or shared funding arrangement
made for the services. This includes both co-pay arrangements where public funds are
applied from the starting date of admission to a service, as well as those where public
funds are applied subsequent to the application of other funding or payments.
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For purposes of MDCH reporting, an admission is defined as the formal acceptance of a
client into substance abuse treatment. An admission has occurred if and only if the
client begins treatment.
A client is defined as a person who has been admitted for treatment of his/her own drug
problem. A co-dependent (a person with no alcohol or drug abuse problem who is
seeking services because of problems arising from his or her relationship with an
alcohol or drug user) who has been formally admitted to a treatment unit and who has
his/her own client record also should be reported with the record indicating his/her co-
dependency.
A client’s episode of treatment is tracked by service category and by license number.
The first event at a new provider or in a new service category is an admission and the
last event is a discharge.
Any change in service and/or provider during a treatment episode should be reported as
a discharge, with transfer given as the reason for discharge. For reporting purposes,
“completion of treatment” is defined as the completion of ALL planned treatment for the
current episode. Completion of treatment at one level of care or with one provider is not
“completion of treatment” if there is additional treatment planned or expected as part of
the current episode. The reason for discharge given in all instances where the
treatment has not been terminated should be 06 (Transfer-Continuing in Treatment).
The code of 06 will identify the fact that the client’s treatment episode did not terminate
on the date reported.
1. Data definitions, coding and instructions issued by MDCH apply as written.
Where a conflict or difference exists between MDCH definitions and information
developed by the CA or locally contracted data system consultants, the MDCH
definitions are to be used.
2. All data collected and recorded on admission and discharge forms shall be
reported using the proper Michigan Department of Consumer and Industry Services (MDCIS) substance abuse services site license number. MDCIS
license numbers are the primary basis for recording and reporting data to MDCH
at the program level, along with the National Provider Identifier (NPI).
3. Combined reporting of client data in data uploads from more than one license
site number is not acceptable or allowable, regardless of how a CA funds a
provider organization.
4. Failure to assure initial set up and maintenance of the proper site license number
and CA code will result in data that will be treated as errors by MDCH. Any data
submitted to MDCH with improper license numbers will be rejected in full. The
necessary corrections and data resubmissions will be the sole responsibility of
the CA in cooperation with the involved service providers.
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5. There must be a unique Substance Abuse client identifier assigned and reported. It can be up to 11 characters in length, all numeric. This same number is to be
used to report data for all admissions and encounters for the individual within the
CA. It is recommended that a method be established by the CA and funded
programs to ensure that each individual is assigned the same identification
number regardless of how many times he/she enters services in any program in
the region, and that the client number be assigned to only one individual.
6. Any changes or corrections made at the CA on forms or records submitted by the
program must be made on the corresponding forms and appropriate records maintained by the program. Failure to maintain corresponding data at the CA and
program levels will result in data audit exceptions on discovery of discrepancies
during an MDCH on-site data audit/review. Each CA and its programs shall
establish a process for making necessary edits and corrections to ensure identical records. The CA is responsible for making sure records at the state
level are also corrected via submission of change records in data uploads.
7. Providers of residential and/or detoxification services must maintain a daily client
census log that contains a listing of each individual client in treatment. This listing
can be made in client name or using the client identification number. Census
must be taken at approximately the same time each day, such as when residents
are expected to be in bed. MDCH or the CA will review the daily client census
logs in data auditing site visits.
8. Providers of pharmacological support services (either methadone or
buprenorphine) must maintain a log that contains a listing of each client in
treatment, and their daily dosages of these medications provided by the program.
MDCH or the CA will review these logs in data auditing site visits
9. Diagnosis coding on client data forms shall be consistent with the client's
substance abuse treatment plan. If there is more than one substance abuse
diagnosis determined, then the secondary diagnosis code should be reported
accordingly. Diagnosis codes on the data records must be consistent with those listed on other client documentation (such as billing forms, etc.). Codes should be
entered using only the proper DSM-IV definitions for substance abuse and other
related problems that are being treated.
10. The primary diagnosis should correspond to the primary substance of abuse
reported at admission. The secondary diagnosis may or may not be consistent
with the secondary substance of abuse if another diagnosis better reflects a more
serious secondary problem than the secondary substance.
11. CAs must make corrections to all records that are submitted but fail to pass the
error checking routine. All records that receive an error code are placed in an
error master file and are not included in the analytical database. Unless acted
upon, they remain in the error file and are not removed by MDCH.
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12. The CA is responsible for generating each month's data upload to MDCH consistent with established protocols and procedures. Monthly and quarterly data
uploads must be received by MDCH via the DEG no later than the last day of the
following month.
13. Treatment clients may be admitted to more than one program or one service
category at the same time. However, only the highest priority admission is
reported under TEDS. The priority ranking is as follows: 1) Detoxification
Services; 2) Long-term Residential; 3) Short-term residential; 4) Intensive
Outpatient Services; 5) Outpatient with methadone or buprenorphine as part of
services; 6) Outpatient; and 7) Case Management Services.
14. The CA must communicate data collection, recording and reporting requirements
to local providers as part of the contractual documentation. CAs may not add to
or modify any of the above to conflict with or substantively affect State policy and
expectations as contained herein.
15. Statements of MDCH policy, clarifications, modifications, or additional
requirements may be necessary and warranted. Documentation shall be
forwarded accordingly.
16. Treatment clients who have not had any treatment activity in a 45-day period
shall be considered inactive and their case discharged. A treatment discharge
record should be completed and submitted; the effective date of discharge will be the last date of actual contact with the program. The record should be completed
and submitted based on the client’s status as of the last date of service; records
with all data items marked as unknown or left blank are not acceptable.
Commissioners Minutes Continued. January 20, 2010
167
Michigan Department of Community Health Page 1 of 31 TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
MICHIGAN DEPARTMENT OF
COMMUNITY HEALTH
INSTRUCTIONS
For:
Treatment Episode Data Set
(TEDS)
DATA SUBMISSION
FOR
SUBSTANCE ABUSE
COORDINATING AGENCIES
FY 2010
Commissioners Minutes Continued. January 20, 2010
168
Michigan Department of Community Health Page 2 of 31
TEDS Data Reporting Submission for Substance Abuse Services Programs
(Rev. 09.16.08)
Substance Abuse Treatment Episode Data Set (TEDS) File
SA Admission File Format
SA Admission Header Format
Field Name Type Size Begin End Comments
Note: Any errors on the HDDR or TRLR record will cause the entire file to reject and be returned to the
appropriate submitter via the Data Exchange Gateway (DEG) via the 4823 file.
EDI TYPE Text 4 1 4 “HDDR”
EDI APP Text 2 5 6 “MA”
EDI USER
EDI USER - prefix Text 5 7 11 “DCH00” (DCH zero zero)
EDI USER - CA ID Text 2 12 13 Service Bureau ID
EDI USER - suffix Text 1 14 14 Blank
EDI CREATION DATE Text 8 15 22 YYYYMMDD
EDI TRANSFER DATE Text 8 23 30 YYYYMMDD
EDI TRANSFER TIME Text 4 31 34 HHMM
EDI FILE NAME Text 4 35 38 4823
EDI RUN TYPE Text 1 39 39 “P” for production or
“T” for test
EDI BATCH IDENTIFIER Text 3 40 42 Unique batch identifier assigned by CA
FILLER Text 146 43 188
SA Admission Input File Format
Field Name Type Size Begin End Comments
Note: An Admission Record is stored using the following key values: CA Payer ID, Social Security Number, CA
Client ID, Admission Date, Admission Time of Day, Admission Service Category.
Each Admission Record must have the following unique key values: CA Payer ID, License Number, Social
Security Number, CA Client ID, Admission Date, Admission Time of Day.
Record Type Text 1 1 1 A=Admission
T=Transfer
Y=Transition-in
Submission Type Text 1 2 2 A=Add
C=Change
D=Delete
E=Error
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169
Michigan Department of Community Health Page 3 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
CA Code CA Name
001182841 Salvation Army-Harbor Light
001183024 Riverhaven
001182930 Kalamazoo
001182903 Macomb
001182850 Washtenaw
001183123 Pathways
001182832 Genesee
001182878 Lakeshore
001183052 Mid-South
001183061 Network180
001183104 Northern
001182896 Oakland
001182869 Saginaw
001182976 SEMCA
na St. Clair Co. HD
001182994 Western Upper Peninsula
001183033 Detroit
001182887 Thumb Alliance
001183169 Venture
CA Payer ID Text 9 3 11
License Number Text 6 12 17 DCIS License Number
Social Security Number Text 9 18 26
CA Client Identifier Text 11 27 37
Medicaid Identifier Text 10 38 47 Must be blank if not applicable
Admission Type Text 1 48 48 1 = first admission
2 = readmission
Co-Dependent Text 1 49 49 1 = yes
2 = no
Date of Admission Text 8 50 57 CCYYMMDD
Code Description
11 Outpatient
21 Residential detoxification
22 Residential - short-term (no
more than 29 days)
24 Residential - long-term (30 day
or more)
31 Intensive outpatient
61 Case Mangement
Service Category Text 2 58 59
Number of Prior Treatments Text 2 60 61 Number as reported
Code Description
01 Outpatient
Referral Source Text 2 62 63
05 Residential detoxification
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170
Michigan Department of Community Health Page 4 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
06 Residential
09 Intensive outpatient
10 Hospital: SA program
13 CDR
14 Other SARF
18 Prevention
19 Student assistance program
20 Drug Court - Adult
21 Drug Court -Adolescent
22 Community Corrections
29 Other SA program
30 Self
31 Family Court
32 Court
33 Probation/Parole
34 Police
35 Secretary of State
36 Lawyer
37 Mental Health
38 Family Independence Agency
39 Family/friend/relative
40 Other human services
41 Employer
42 Union
43 Clergy
44 School
45 Physician
46 Hospital (non-substance abuse)
47 Substance abuse client
48 Alcoholics Anonymous
49 Corrections
90 Other
County of Residence Text 2 64 65 Reference Appendix SA County Codes for
a list of valid county codes.
Date of Birth Text 8 66 73 CCYYMMDD
Sex Text 1 74 74 1= Male
2 = Female
Code Description
1 Native American
2 Asian or Pacific Islander
3 African American/Black
4 White
5 Hispanic
6 Multi-racial
8 Arab American
Race Text 1 75 75
9 Refused to provide
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171
Michigan Department of Community Health Page 5 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
0 Unknown
Code Description
0 Not one of listed groups
1 Puerto Rican
2 Mexican
3 Cuban
4 Other Hispanic
5 Arab Chaldean
Ethnicity Text 1 76 76
Code Description
1 Never Married
2 Married/Cohabiting
3 Widowed
4 Divorced
5 Separated
Marital Status Text 1 77 77
Military Status Text 1 78 78 1 = yes
2 = no
Education Text 2 79 80 00 to 25 number of years of education (e.g.,
4 years of college = 16)
Currently in Training /
Education
Text 1 81 81 4 = in training/education program
6 = in special education
7 = is attending college
0 = not applicable
Code Description
1 Employed, full time
2 Employed, part time
3 Unemployed - laid off, fired,
seasonal, actively sought work
in last 30 days
4 Not in competitive labor force -
includes homemaker, student
age 18 and over, day program
participant, resident or inmate
of an institution (includes
nursing home)
8 Not applicable to the person
(e.g., child under age 18)
Employment Status Text 1 82 82
Code Description
00 None
10 Alcohol
20 Heroin
21 Methadone (illicit)
22 Other opiates or synthetics
30 Barbituates
Primary Substance Text 2 83 84
31 Other sedatives or hypnotics
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Michigan Department of Community Health Page 6 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
32 Other tranquilizers
33 Benzodiazepines
34 GHB, GBL
41 Cocaine
42 Crack Cocaine
43 Methamphetamines
44 Other amphetamines
45 Methcathinone
50 Hallucinogens
51 PCP
52 Marijuana/hashish
53 Ecstasy (MDMA, MDA)
54 Ketamine
60 Inhalants
61 Antidepressants
70 Over-the-counter
72 Steroids
81 Talwin and PBZ
91 Other
Code Description
0 Not applicable (drug code was “none”)
1 Oral
2 Smoking
3 Inhalation/intranasal
(“snorting”)
4 Injection
5 Other
Primary Route Text 1 85 85
Primary Age at First Use Text 2 86 87 2 character age
98 = not applicable (drug code was “none”)
Primary Frequency of Use Text 2 88 89 2 characters
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
Primary Initial Prescription Text 1 90 90 Initially a prescription
0 = not applicable (drug code was “none”)
1 = yes
2 = no
Secondary Substance Text 2 91 92 For list of values, reference Primary
Substance
Secondary Route Text 1 93 93 For list of values, reference Primary Route
Secondary Age at First Use Text 2 94 95 2 character age
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Michigan Department of Community Health Page 7 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
98 = not applicable (drug code was “none”)
Secondary Frequency of Use Text 2 96 97 2 characters
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
Secondary Initial Prescription Text 1 98 98 Initially a prescription
0 = not applicable (drug code was “none”)
1 = yes
2 = no
Tertiary Substance Text 2 99 100 For list of values, reference Primary
Substance
Tertiary Route Text 1 101 101 For list of values, reference Primary Route
Tertiary Age at First Use Text 2 102 103 2 character age
98 = not applicable (drug code was “none”)
Tertiary Frequency of Use Text 2 104 105 2 characters
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
Tertiary Initial Prescription Text 1 106 106 Initially a prescription
0 = not applicable (drug code was “none”)
1 = yes
2 = no
Total Annual Income Number 6 107 112 6 characters, rounded to the nearest whole
dollar; no decimal points or commas
Number of Dependants Text 2 113 114 Number of dependents claimed in
determining ability-to-pay
Code Description
00 No status with corrections
system
01 In prison
02 In jail
03 Paroled from prison
04 Probation from jail
05 Juvenile detention center
06 Court supervision
08 Awaiting trial
09 Awaiting sentencing
Correctional Status Text 2 115 116
10 Refused to provide information
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Michigan Department of Community Health Page 8 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
98 Unknown
Total Arrests – 30 days Number 2 117 118 00 if no arrests
Arrests - Possession/Sales --
30 days
Number 2 119 120 00 if no arrests
Arrests - DUI/DWI – 30 days Number 2 121 122 00 if no arrests
Total Arrests - 5 years Number 2 123 124 00 if no arrests
Arrests - Possession/Sales - 5
years
Number 2 125 126 00 if no arrests
Arrests - DUI/DWI - 5 years Number 2 127 128 00 if no arrests
Living Arrangement Text 1 129 129 1 = independent
2 = dependent
3 = homeless
Methadone Part of Treatment Text 1 130 130 1 = yes (methadone)
2 = no
3 = buprenorphine
Primary Diagnosis Text 6 131 136 Reference Appendix SA Diagnosis Codes
for a list of the valid values
Secondary Diagnosis Text 6 137 142 Secondary Diagnosis may not be the same
as Primary Diagnosis
Pregnant Text 1 143 143 1 = yes
2 = no
Code Description
0 None
2 Adult child
3 Significant other
4 Hearing impaired
5 Visually impaired
6 Head injury
7 Developmentally disabled
8 Mobility impaired
9 Gambling Addiction
Other Factor 1 Text 1 144 144
Other Factor 2 Text 1 145 145 For list of values, reference Other Factor 1
Other Factor 3 Text 1 146 146 For list of values, reference Other Factor 1
Time Waiting to Enter
Treatment
Number 3 147 149 3 digit number of days
Primary Language Spoken Alpha 3 150 152 For list of values, refer to
http://lcweb.loc.gov/standards/iso639-
2/langhome.html
Indication of MH Issues Number 1 153 153 1 = yes
2 = no
Drug Court Client Number 1 154 154 1 = yes
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Michigan Department of Community Health Page 9 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
2 = no
Admission Time of Day Number 4 155 158 24-hour HHMM
Detailed Not in Labor Number 2 159 160 Code Description
01 Homemaker
02 Student
03 Retired
04 Disabled
05 Inmate of Institution
06 Other
07 Not Actively Seeking Work
98 Not Applicable
Date of First Contact Number 8 161 168 CCYYMMDD
Women’s Specialty Program Text 1 169 169 1= yes
2= no
Child Welfare Involvement Text 1 170 170 1= yes
2= no
Days of Social Support Text 2 171 172 2 characters
00 = no days of support
02 = 1 or 2 days a month
06 = 1 or 2 days a week
18 = 3-6 days a week
30 = daily support
98 = not applicable
Error ID Number 8 173 180
Filler Text 8 181 188
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176
Michigan Department of Community Health Page 10 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs (Rev. 09.16.08)
SA Admission Trailer Format
Field Name Type Size Begin End Comments
Note: Any errors on the HDDR or TRLR record will cause the entire file to reject and be returned to the
appropriate submitter via the Data Exchange Gateway (DEG) via the 4823 file.
EDI TYPE Text 4 1 4 “TRLR”
EDI APP Text 2 5 6 “MA”
EDI USER
EDI USER - prefix Text 5 7 11 “DCH00” (DCH zero zero)
EDI USER - CA ID Text 2 12 13 Service Bureau ID
EDI USER - suffix Text 1 14 14 Blank
EDI CREATION DATE Text 8 15 22 YYYYMMDD
EDI TRANSFER DATE Text 8 23 30 YYYYMMDD
EDI TRANSFER TIME Text 4 31 34 HHMM
EDI FILE NAME Text 4 35 38 4823
EDI RUN TYPE Text 1 39 39 “P” for production or
“T” for test
EDI BATCH IDENTIFIER Text 3 40 42 Unique batch identifier assigned by CA
EDI RECORD COUNT Number 6 43 48 Number of records in a file including the
header and trailer
FILLER Text 140 49 188
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177
Michigan Department of Community Health Page 11 of 31
TEDS Data Reporting Submission for Substance Abuse Services Programs
(Rev. 09.16.08)
SA Discharge File Format
SA Discharge Header Format
Field Name Type Size Begin End Comments
Note: Any errors on the HDDR or TRLR record will cause the entire file to reject and be returned to the
appropriate submitter via the Data Exchange Gateway (DEG) via the 4824 file.
EDI TYPE Text 4 1 4 “HDDR”
EDI APP Text 2 5 6 “MA”
EDI USER
EDI USER - prefix Text 5 7 11 “DCH00” (DCH zero zero)
EDI USER - CA ID Text 2 12 13 Service Bureau ID
EDI USER - suffix Text 1 14 14 Blank
EDI CREATION DATE Text 8 15 22 YYYYMMDD
EDI TRANSFER DATE Text 8 23 30 YYYYMMDD
EDI TRANSFER TIME Text 4 31 34 HHMM
EDI FILE NAME Text 4 35 38 4824
EDI RUN TYPE Text 1 39 39 “P” for production or
“T” for test
EDI BATCH IDENTIFIER Text 3 40 42 Unique batch identifier assigned by CA
FILLER Text 81 43 123
SA Discharge Input File Format
Field Name Type Size Begin End Comments
Note: A Discharge Record is stored using the following key values: CA Payer ID, License Number, Social Security
Number, CA Client ID, Admission Date, Admission Time of Day, Discharge Service Category.
Each Discharge Record must have the following unique key values: CA Payer ID, License Number, Social
Security Number, CA Client ID, Admission Date, Admission Time of Day.
Record Type Text 1 1 1 D=Discharge
X=Transition-out
Submission Type Text 1 2 2 A=Add
C=Change
D=Delete
E=Error
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Michigan Department of Community Health Page 12 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
CA Code CA Name
174462881 Riverhaven
174459975 Kalamazoo
174456919 Macomb
174454709 Washtenaw
174458216 Pathways
174464053 Genesee
174455644 Lakeshore
174458190 Mid-South
174464080 CMHSA of West MI
174458207 Northern
174456937 Oakland
174454718 Saginaw
174458243 SE MCA
174456928 Thumb (St. Clair Co)
174463350 Western Upper Peninsula
174811650 Salvation Army Harbor Light
174456991 Detroit
174859458 Thumb Alliance P
174854890 Venture
CA Payer ID Text 9 3 11
License Number Text 6 12 17 DCIS License Number
Social Security Number Text 9 18 26
CA Client Identifier Text 11 27 37
Medicaid Identifier Text 10 38 47 Must be blank if not applicable
Date of Admission Text 8 48 55 CCYYMMDD
Code Description
11 Outpatient
21 Residential detoxification
22 Residential - short-term (no
more than 29 days)
24 Residential - long-term (30 day
or more)
31 Intensive outpatient
61 Case Management
Discharge Service Category Text 2 56 57
Code Description
1 Employed, full time
2 Employed, part time
Employment Status Text 1 58 58
3 Unemployed - laid off, fired,
seasonal, actively sought work
in last 30 days
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Michigan Department of Community Health Page 13 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
4 Not in competitive labor force -
includes homemaker, student age 18 and over, day program
participant, resident or inmate
of an institution (includes
nursing home)
8 Not applicable to the person
(e.g., child under age 18)
Code Description
00 None
10 Alcohol
20 Heroin
21 Methadone (illicit)
22 Other opiates or synthetics
30 Barbituates
31 Other sedatives or hypnotics
32 Other tranquilizers
33 Benzodiazepines
34 GHB, GBL
41 Cocaine
42 Crack Cocaine
43 Methamphetamines
44 Other amphetamines
45 Methcathinone
50 Hallucinogens
51 PCP
52 Marijuana/hashish
53 Ecstasy (MDMA, MDA)
54 Ketamine
60 Inhalants
61 Antidepressants
70 Over-the-counter
72 Steroids
81 Talwin and PBZ
91 Other
PSA Code
Primary Substance
Text 2 59 60
Code Description
0 Not applicable (drug code was “none”)
1 Oral
2 Smoking
3 Inhalation/intranasal
(“snorting”)
4 Injection
5 Other
PSA Route
Primary Route
Text 1 61 61
PSA Frequency of Use
Primary Frequency of Use
Text 2 62 63 Number of days drug used in last 30 days
2 characters
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180
Michigan Department of Community Health Page 14 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
SSA Code
Secondary Substance
Text 2 64 65 For list of values, reference Primary
Substance
SSA Route
Secondary Route
Text 1 66 66 For list of values, reference Primary Route
SSA Frequency of Use
Secondary Frequency of Use
Text 2 67 68 Number of days drug used in last 30 days
2 characters
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
TSA Code
Tertiary Substance
Text 2 69 70 For list of values, reference Primary
Substance
TSA Route
Tertiary Route
Text 1 71 71 For list of values, reference Primary Route
TSA Frequency of Use
Tertiary Frequency of Use
Text 2 72 73 Number of days drug used in last 30 days
2 characters
00 = not used
02 = 1 or 2 times a month
06 = 1 or 2 times a week
18 = 3-6 times a week
30 = daily use
98 = not applicable (drug code was “none”)
Code Description
00 No status with corrections
system
01 In prison
02 In jail
03 Paroled from prison
04 Probation from jail
05 Juvenile detention center
06 Court supervision
08 Awaiting trial
09 Awaiting sentencing
10 Refused to provide information
98 Unknown
Correctional Status Text 2 74 75
Total Arrests – 30 days Number 2 76 77 00 if no arrests
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181
Michigan Department of Community Health Page 15 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
Arrests - Possession/Sales --
30 days
Number 2 78 79 00 if no arrests
Arrests - DUI/DWI – 30 days Number 2 80 81 00 if no arrests
Living Arrangement Text 1 82 82 1 = independent
2 = dependent
3 = homeless
MH Issues Identified Text 1 83 83 1 = none
2 = mild/moderate
3 = severe
Date of Discharge Text 8 84 91 CCYYMMDD
Code Description
01 Completed treatment
02 Left against staff advice
03 In jail
04 Staff decision for rules
violations
05 Death
06 Continuing in treatment -
transfer
07 Mutual staff/client decision
08 Early jail release
09 Client relocated
10 Program closed/merged
11 Other
Discharge Reason Text 2 92 93
Admission Time of Day Number 4 94 97 24-hour HHMM
Discharge Time of Day Number 4 98 101 24-hour HHMM
Detailed Not in Labor Number 2 102 103 Code Description
01 Homemaker
02 Student
03 Retired
04 Disabled
05 Inmate of Institution
06 Other
07 Not Actively Seeking Work
98 Not Applicable
Women’s Specialty Program Text 1 104 104 1= yes
2= no
Child Welfare Involvement Text 1 105 105 1= yes
2= no
Commissioners Minutes Continued. January 20, 2010
182
Michigan Department of Community Health Page 16 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Field Name Type Size Begin End Comments
Days of Social Support Text 2 106 107 2 characters
00 = no days of support
02 = 1 or 2 days a month
06 = 1 or 2 days a week
18 = 3-6 days a week
30 = daily support
98 = not applicable
Error ID Number 8 108 115
Filler Text 8 116 123
SA Discharge Trailer Format
Field Name Type Size Begin End Comments
Note: Any errors on the HDDR or TRLR record will cause the entire file to reject and be returned to the
appropriate submitter via the Data Exchange Gateway (DEG) via the 4824 file.
EDI TYPE Text 4 1 4 “TRLR”
EDI APP Text 2 5 6 “MA”
EDI USER
EDI USER - prefix Text 5 7 11 “DCH00” (DCH zero zero)
EDI USER - CA ID Text 2 12 13 Service Bureau ID
EDI USER - suffix Text 1 14 14 Blank
EDI CREATION DATE Text 8 15 22 YYYYMMDD
EDI TRANSFER DATE Text 8 23 30 YYYYMMDD
EDI TRANSFER TIME Text 4 31 34 HHMM
EDI FILE NAME Text 4 35 38 4824
EDI RUN TYPE Text 1 39 39 “P” for production or
“T” for test
EDI BATCH IDENTIFIER Text 3 40 42 Unique batch identifier assigned by CA
EDI RECORD COUNT Number 6 43 48 Number of records in a file including the
header and trailer
FILLER Text 75 49 123
Commissioners Minutes Continued. January 20, 2010
183
Michigan Department of Community Health Page 17 of 31
TEDS Data Reporting Submission for Substance Abuse Services Programs
(Rev. 09.16.08)
SA Diagnosis Codes
DRUG
CODE DRUG DIAGNOSIS CODE DIAGNOSIS
00 None 000.00 N/A
10 Alcohol
305.00
291.10
303.90
291.30
291.40
303.00
291.00
291.20
291.80
Alcohol
abuse
amnestic disorder
dependence
hallucinosis
idiosyncratic intoxication
intoxication
withdrawal delirium
Dementia associated with alcoholism
Uncomplicated alcohol withdrawal
20
21
22
Heroin
Methadone (non-Rx)
Other opiates/synthetics
305.50
304.00
292.00
Opioid
abuse/intoxication
dependence
withdrawal
30
31
32
33
34
Barbiturates
Other sedatives/hypnotics
Other tranquilizers
Benzodiazepine
GHB, GBL
305.40
292.83
304.10
292.00
Sedative, hypnotic, or anxiolytic
abuse/intoxication
amnestic disorder
dependence
withdrawal delirium
41
42
Cocaine
Crack Cocaine
305.60
292.81
292.11
304.20
292.00
Cocaine
abuse/intoxication
delirium
delusional disorder
dependence
withdrawal
43
44
45
Methamphetamines
Other amphetamines
Methcathinone ("cat")
305.70
292.11
292.81
304.40
292.00
Amphetamine or similarly acting sympathomimetic
abuse/intoxication
delusional disorder
delirium
dependence
withdrawal
50 Hallucinogens
305.30
292.11
305.30
292.84
292.89
Hallucinogen
abuse/hallucinosis
delusional disorder
dependence
mood disorder
Posthallucinogen perception disorder
51 PCP
305.90
292.81
292.11
304.50
292.84
292.90
Phencyclidine (PCP) or similarly acting
arylcyclohexylamine:
abuse/intoxication
delirium
delusional disorder
dependence
mood disorder
organic mental disorder NOS
Commissioners Minutes Continued. January 20, 2010
184
Michigan Department of Community Health Page 18 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
DRUG CODE DRUG DIAGNOSIS CODE DIAGNOSIS
53
54
Ecstasy
Ketamine
305.90
292.81
292.11
304.50
292.84
292.90
abuse/intoxication
delirium
delusional disorder
dependence
mood disorder
organic mental disorder NOS
52 Marijuana/hashish
305.20
292.11
304.30
Cannabis
abuse/intoxication
delusional disorder
dependence
60 Inhalants
305.90
304.60
Inhalant
abuse/intoxication
dependence
61 Antidepressants
305.90
292.83
292.89
292.81
292.11
292.82
292.12
292.84
292.90
292.89
292.00
304.90
Other or unspecified psychoactive substance
abuse/intoxication
amnestic disorder
anxiety disorder
delirium
delusional disorder
dementia
hallucinosis
mood disorder
organic mental disorder NOS
personality disorder
withdrawal
Psychoactive substance dependence NOS
70
72
Over-the-Counter
Steroids
305.90
305.90
304.90
Caffeine intoxication
Other or unspecified psychoactive substance
abuse/intoxication
Psychoactive substance dependence NOS
81 Talwin and PBZ
305.50
304.00
292.00
Opioid
abuse/intoxication
dependence
withdrawal
91 Other
305.10
292.00
305.90
292.83
292.89
292.81
292.11
292.82
292.12
292.84
292.90
292.89
Nicotine
dependence
withdrawal
Other or unspecified psychoactive substance
abuse/intoxication
amnestic disorder
anxiety disorder
delirium
delusional disorder
dementia
hallucinosis
mood disorder
organic mental disorder NOS
personality disorder
Commissioners Minutes Continued. January 20, 2010
185
Michigan Department of Community Health Page 19 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
DRUG CODE DRUG DIAGNOSIS CODE DIAGNOSIS
292.00
304.90
withdrawal
Psychoactive substance dependence NOS
Polysubstance (Must specify at least a
primary and a secondary drug from list
above)
304.80 Polysubstance dependence
Commissioners Minutes Continued. January 20, 2010
186
Michigan Department of Community Health Page 20 of 31
TEDS Data Reporting Submission for Substance Abuse Services Programs
(Rev. 09.16.08)
SA County Codes
Code County Code County
46 Lenawee 00 Out of State (Out of state other than
those listed in codes 85-89) 47 Livingston
01 Alcona 48 Luce
02 Alger 49 Mackinaw
03 Allegan 50 Macomb
04 Alpena 51 Manistee
05 Antrim 52 Marquette
06 Arenac 53 Mason
07 Baraga 54 Mecosta
08 Barry 55 Menominee
09 Bay 56 Midland
10 Benzie 57 Missaukee
11 Berrien 58 Monroe
12 Branch 59 Montcalm
13 Calhoun 60 Montmorency
14 Cass 61 Muskegon
15 Charlevoix 62 Newaygo
16 Cheboygan 63 Oakland
17 Chippewa 64 Oceana
18 Clare 65 Ogemaw
19 Clinton 66 Ontonagon
20 Crawford 67 Osceola
21 Delta 68 Oscoda
22 Dickinson 69 Otsego
23 Eaton 70 Ottawa
24 Emmet 71 Presque Isle
25 Genesee 72 Roscommon
26 Gladwin 73 Saginaw
27 Gogebic 74 St. Clair
28 Grand Traverse 75 St. Joseph
29 Gratiot 76 Sanilac
30 Hillsdale 77 Schoolcraft
31 Houghton 78 Shiawassee
Commissioners Minutes Continued. January 20, 2010
187
Michigan Department of Community Health Page 21 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Code County Code County
32 Huron 79 Tuscola
33 Ingham 80 Van Buren
34 Ionia 81 Washtenaw
35 Iosco 82 Wayne (excluding city of Detroit)
36 Iron 83 Wexford
37 Isabella 84 City of Detroit
38 Jackson 85 Wisconsin
39 Kalamazoo 86 Indiana
40 Kalkaska 87 Ohio
41 Kent 88 Illinois
42 Keweenaw 89 Canada
43 Lake 96 Homeless
44 Lapeer 97 Unknown
45 Leelanau
Commissioners Minutes Continued. January 20, 2010
188
Michigan Department of Community Health Page 22 of 31 TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Substance Abuse TEDS Edits
SA Admission Data Element Edits
The following is the list of SA Admission data element edits listed in the order of the input file format.
Note: All Errors reported in this document will cause the record to be rejected. Every Data Element
having a detectable error will produce a copy of the Record in error with appropriate error
messages appended. Error records will be stored in the SA Error Master Tables on the Oracle
Database. These errors will be returned to the submitter via the 4827 file on the Data Exchange
Gateway (DEG).
Error # Error Description Field Name
A001 Invalid Admission Record Length - should be 188. Input File
A100 Duplicate Admission record - Submission Type equals A and record
already exists.
A122 Admission Submission Type equals A and Date of
Admission/Admission Time of Day is equal or prior to prior
Discharge Date of Discharge/Discharge Time of Day - cannot add the
Admission
A118 Admission Submission Type equals A and client is already in
Admitted Status – cannot add the Admission.
A138 Admission Submission Type equals C and an Admission record not
found - cannot process the change.
A137 Admission Submission Type equals D and no Admission exits
A124 Admission Submission Type equals D and Discharge exists with Date
of Discharge/Discharge Time of Day greater than Admission Date of
Admission/Admission Time of Day - cannot process delete.
Admission Key
CA Code, License Number,
Social Security Number, CA
Client ID, Admission Date,
Admission Time of Day
A002 Invalid Admission Record Type - should be A.
A127 Transition-in window is not open – Admission record type is Y and
transition-in transactions are not currently allowed.
A128 Transition-in record exists – Regular admission record cannot modify
transition-in record.
A129 Admission record exists – Transition-in record cannot modify regular
admission record.
A130 Admission is not allowed after transition-out has occurred.
Record Type
A003 Invalid Admission Submission Type - should be A, C, D, E. Submission Type
A139 Invalid Admission CA Code - not a valid CA Payer Identifier.
A105 Admission CA Payer Identifier and Bureau ID do not match.
CA Code
A005 Invalid Admission License number - should be 6-digit. License Number
A006 Invalid Admission Social Security Number - Should be 9-digit or
blank.
Social Security Number
A140 Invalid Admission CA Client Identifier - not permitted to be spaces or
null.
CA Client Identifier
A008 Invalid Admission Medicaid ID - should be 10-digit or blank. Medicaid Identifier
A009 Invalid Admission Type - should be 1 or 2. Admission Type
Commissioners Minutes Continued. January 20, 2010
189
Michigan Department of Community Health Page 23 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
A010 Invalid Admission Co-Dependent Code - should be 1 or 2. Co-Dependent
A011 Invalid Admission Date of Admission - should be valid date and less
than current date.
A069 Admission Admit Date less than Birth Date - Date of Admission date
should be greater than birth date.
A106 Admission Date of Admission is too old.
Date of Admission
A012 Invalid Admission Service Category - should be 11, 21, 22, 24, 31. Service Category
A013 Invalid Admission Number of Prior Treatments - should be 00-96. Number of Prior Treatments
A014 Invalid Admission Referral Source - should be valid code of 01, 05-
06, 09-10, 13-14, 18, 29-49, 90.
Referral Source
A016 Invalid Admission County of Residence - should be 00-89, 96-97. County of Residence
A017 Invalid Admission Date of Birth - should be valid date and less than
current date.
Date of Birth
A018 Invalid Admission Sex - should be 1 or 2. Sex
A019 Invalid Admission Race - should be 0-6, 8-9. Race
A020 Invalid Admission Ethnicity - should be 0-5. Ethnicity
A021 Invalid Admission Marital Status - should be 1-5. Marital Status
A022 Invalid Admission Military Status - should be 1 or 2. Military Status
A023 Invalid Admission Education - Should be 00-25. Education
A024 Invalid Admission Currently in Training/Education - Should be 0, 4,
6-7.
Currently in
Training/Education
A025 Invalid Admission Employment Status - should be 1-4, 6, 8.
A073 Admission Employed and Total Annual Income zero or blank - if
Employment Status equals 1 or 2 then Total Annual Income is to be
greater than 0.
Employment Status
A015 Admission Primary Substance (PSA) and Other Factor do not match -
if PSA equals 00 and Co-Dependent equals 2 (no), one of the Other
Factors should be 2-3.
A026 Invalid Admission Primary Substance (PSA) - should be valid code of
00, 10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81, 91.
A082 Admission Primary Substance of 10, 20, 41, 42, 45, 50-52 and
Primary Initial Prescription equals 1 - Primary Substance can’t be a
prescription.
A085 Admission Primary Substance and Secondary Substance are the same
- PSA cannot be same as SSA.
A088 All 3 Admission Substance values are the same - PSA, SSA, TSA
cannot be the same.
A107 Admission Primary Substance equals 00, Primary Route must be 0.
A110 Admission Primary Substance equals 00 and Primary Age at First Use
not equal 98.
Primary Substance
A027 Invalid Admission Primary Route - should be 0-5. Primary Route
A028 Invalid Admission Primary Age at First Use - should be 00-98. Primary Age at First Use
Commissioners Minutes Continued. January 20, 2010
190
Michigan Department of Community Health Page 24 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
A067 Admission Primary Age at First Use greater than current age - Primary Age at First Use should be less than current age.
A029 Invalid Admission Primary Frequency of Use - Should be 00 - 30 or
98.
A093 Invalid Admission Primary Frequency of Use - if Primary Substance
equals 00, Primary Frequency of Use must be 98.
Primary Frequency of Use
A030 Invalid Admission Primary Initial Prescription - should be 0 - 2. Primary Initial Prescription
A031 Invalid Admission Secondary Substance e (SSA) - should be valid
code of 00, 10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81, 91.
A083 Admission Secondary Substance of 10, 20, 41, 42, 45, 50-52 and
Secondary Initial Prescription equals 1 - Secondary Substance can’t
be a prescription.
A087 Admission Secondary and Tertiary Substance are the same - SSA
cannot be the same as TSA.
A091 Invalid Admission Secondary Substance - if PSA equals 00, SSA
should be 00.
A108 Admission Secondary Substance equals 00, Secondary Route must be
0.
A111 Admission Secondary Substance equals 00, Secondary Age at First
Use must be 98.
Secondary Substance
A032 Invalid Admission Secondary Route - should be 0 - 5. Secondary Route
A033 Invalid Admission Secondary Drug Age First Use - should be 00-98.
A075 Admission Secondary Drug Age First Use greater than current age -
Secondary Age at First Use should be less than current age.
Secondary Age at First Use
A034 Invalid Admission Secondary Frequency of Use - should be 00-30.
A094 Invalid Admission Secondary Frequency of Use - if Secondary
Substance equals 00, Secondary Frequency of Use must be 98.
Secondary Frequency of Use
A035 Invalid Admission Secondary Initial Prescription - should be 0-2. Secondary Initial Prescription
A036 Invalid Admission Tertiary Substance (TSA) - should be valid code of
00, 10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81, 91.
A084 Admission Tertiary Substance of 10, 20, 41, 42, 45, 50-52 and
Tertiary Initial Prescription equals 1 - Tertiary Substance can’t be a
prescription.
A086 Admission Primary Substance and Tertiary Substance are the same -
PSA cannot be same as TSA.
A087 Admission Secondary Substance and Tertiary Substance are the same
- SSA cannot be same as TSA.
A092 Invalid Admission Tertiary Substance - if PSA or SSA equals 00, TSA should be 00.
A109 Admission Tertiary Substance equals 00, Tertiary Route must be 0.
A112 Admission Tertiary Substance equals 00, Tertiary Age at First Use
must be 98.
Tertiary Substance
A037 Invalid Admission Tertiary Route - should be 0 - 5. Tertiary Route
A038 Invalid Admission Tertiary Age at First Use - should be 00-98. Tertiary Age at First Use
Commissioners Minutes Continued. January 20, 2010
191
Michigan Department of Community Health Page 25 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
A089 Admission Tertiary Age at First Use greater than current age - Tertiary Age at First Use should be less than current age.
A039 Invalid Admission Tertiary Frequency of Use - should be 00-30.
A095 Invalid Admission Tertiary Frequency of Use, if Tertiary Substance
equals 00, Tertiary Frequency of Use must be 98.
Tertiary Frequency of Use
A040 Invalid Admission Tertiary Drug Initial Prescription - should be 0-2. Tertiary Initial Prescription
A041 Invalid Admission Total Annual Income - should be 000000-999999,
or blank.
Total Annual Income
A042 Invalid Admission Number of Dependents - should be 00-99 or blank. Number of Dependants
A043 Invalid Admission Program Eligibility - Able to pay - should be 1 or
2.
Program Eligibility: Able to
pay
A044 Invalid Admission Program Eligibility: Commercial insurance -
should be 1 or 2.
Program Eligibility:
Commercial insurance
A045 Invalid Admission Program Eligibility: Services contract - should be
1 or 2.
Program Eligibility: Services
contract
A046 Invalid Admission Program Eligibility: Medicare - should be 1 or 2. Program Eligibility: Medicare
A047 Invalid Admission Program Eligibility: Medicaid - Should be 1 or 2. Program Eligibility: Medicaid
A048 Invalid Admission Program Eligibility: Workers compensation -
Should be 1 or 2.
Program Eligibility: Workers
Compensation
A049 Invalid Admission Program Eligibility: Other public sources - Should
be 1 or 2.
Program Eligibility: other
public sources
A050 Invalid Admission Program Eligibility: CA resources - Should be 1 or
2.
Program Eligibility: CA
Resources
A141 Invalid Admission Program Eligibility: State Medical Plan - should be
1 or 2.
Program Eligibility: State
Medical Plan
A051 Invalid Admission Program Eligibility:- MI Child - should be 1 or 2. Program Eligibility: MI Child
A052 Invalid Admission Program Eligibility: Medicaid Children’s Waiver -
should be 1 or 2.
Program Eligibility: Medicaid
Children’s Waiver
A053 Invalid Admission Program Eligibility:- Other Program Eligibility -
should be 1 or 2.
Program Eligibility: Other
Program Eligibility Not
Listed Above
A054 Invalid Admission Correctional Status - should be 00-10, 98. Correctional Status
A055 Invalid Admission Total Arrests – 30 days - should be 00-99.
A061 Invalid Admission Total Arrests – 30 days - should be equal or
greater than Admission Arrests -Possession/Sales – 30 days plus
Admission Arrests - DUI/DWI – 30 days.
Total Arrests – 30 days
A056 Invalid Admission Arrests - Possession/Sales – 30 days - should be
00-99.
Arrests - Possession/Sales –
30 days
A057 Invalid Admission Arrests - DUI/DWI – 30 days - should be 00-99. Arrests - DUI/DWI – 30 days
A058 Invalid Admission Total Arrests - 5 years - should be 00-99.
A062 Invalid Admission Total Arrests - 5 years - should be equal or greater
than Admission Arrests - Possession/Sales - 5 years plus Admission
Arrests - DUI/DWI - 5 years.
Total Arrests - 5 years
Commissioners Minutes Continued. January 20, 2010
192
Michigan Department of Community Health Page 26 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
A104 Invalid Admission Total Arrests - 5 years - should be equal or greater than Admission Total Arrests - 6 months.
A059 Invalid Admission Arrests - Possession/Sales - 5 years - should be 00-
99.
A063 Invalid Admission Arrests - Possession/Sales - 5 years - should be
equal or greater than Admission Arrests - Possession/Sales - 6
months.
Arrests - Possession/Sales - 5
years
A060 Invalid Admission Arrests - DUI/DWI - 5 years - should be 00-99.
A064 Invalid Admission Arrests - DUI/DWI s - 5 years - should be equal or
greater than Admission Arrests - DUI/DWI - 6 months.
Arrests - DUI/DWI - 5 years
A065 Invalid Admission Living Arrangement - should be 1-3
A074 Admission Living arrangement doesn’t match County of Residence -
if county is 96, then Living Arrangement must be 3 (homeless).
Living Arrangement
A068 Invalid Admission Methadone Part of Treatment - should be 1 or 2. Methadone Part of Treatment
A116 Invalid Admission Primary Diagnosis, must be a valid diagnosis code.
A097 Invalid Admission Primary Substance and Primary Diagnosis
combination - Primary Diagnosis should match Primary Substance.
Primary Diagnosis
A117 Invalid Admission Secondary Diagnosis format Secondary Diagnosis
A066 Invalid Admission Pregnant value - Should be 1 or 2.
A070 If Admission pregnant equals 1, then sex must equal 2.
Pregnant
A078 Invalid Admission Other Factor 1 - should be 0, 2-9, or blank.
A079 Admission Other Factor 1 equals Other Factor 2 - Other factor 1 and 2
cannot be the same.
A080 Admission Other Factor 1 equals Other Factor 3 - Other factor 1 and 3
cannot be the same.
Other Factor 1
A134 Invalid Admission Other Factor 2 - should be 0, 2-9 or blank.
A081 Admission Other Factor 2 equals Other Factor 3 - Other factor 2 and 3
cannot be the same.
A076 Admission Other Factor 2 not blank or zero - if other factor 1 equals 0
or blank, Other Factor 2 should be zero or blank.
Other Factor 2
A135 Invalid Admission Other Factor 3 - should be 0, 2-9 or blank
A077 Admission Other Factor 3 not blank or zero - If Other Factor 1 or
Other Factor 2 equals 0 or blank, Other Factor 3 should be zero or
blank.
Other Factor 3
A096 Admission Time Waiting to Enter Treatment cannot be missing Time Waiting to Enter
Treatment
A136 Invalid Admission Primary Language Spoken. Primary Language Spoken
A131 Invalid Admission Time of Day – should be valid time (24-hour) Admission Time of Day
A151 Invalid Detailed Not in Labor – Should be a valid code of 01, 02, 03,
04, 05, 06, 07.
A152 Invalid Detailed Not in Labor – Employment Status equals 04,
Detailed Not in Labor should be a valid code of 01, 02, 03, 04, 05, 06,
07.
Detailed Not in Labor
Commissioners Minutes Continued. January 20, 2010
193
Michigan Department of Community Health Page 27 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
A153 Invalid Admission Detailed Not in Labor Code - If Employment Status is not equal to 04 then Detailed Not in Labor Code must be 98.
A098 Invalid Admission Error ID - should be 8-digit number or blank.
A101 Invalid Admission Error ID - should be valid Error ID or blank.
Error ID
A154 Invalid Date of 1st Contact. Must be equal to or less than admission
date.
A157 Days Waiting to Enter Treatment must equal Admission Date – Date
of 1st Request
Date of 1st Contact
A155 Invalid Women’s Specialty Program Code. Must be 1 or 2. Women’s Specialty Program
Code
A156 Invalid Child Welfare Involvement. Must be 1 or 2. Child Welfare Involvement
A158 Invalid Days of Social Support. Must be 00, 02, 06, 18, 30, or 98 Days of Social Support
SA Discharge Data Element Edits
The following is the list of SA Discharge data element edits listed in the order of the input file format.
Note: All Errors reported in this document will cause the record to be rejected. Every Data Element
having a detectable error will produce a copy of the Record in error with appropriate error
messages appended. Error records will be stored in the SA Error Master Tables on the Oracle
Database. These errors will be returned to the submitter via the 4827 file on the Data Exchange
Gateway (DEG).
Error # Error Description Field Name
D001 Invalid Discharge Record Length - should be 123. Input File
D098 No matching Discharge record - if Submission Type equals C or D, a
matching record should exist.
D099 Discharge Submission Type equals A and a Discharge already exists -
cannot add the Discharge.
D101 Discharge Submission Type equals A and an Admission record does
not exist - a valid Admission record must exit.
D113 Discharge Submission Type equals A and an Admission exists and
Discharge Date of Discharge/Discharge Time of Day not greater than
Admission Date of Admission/Admission Time of Day - cannot add
the Discharge.
D108 Discharge Submission Type equals C and Discharge Date of
Discharge/Discharge Time of Day being changed to less than or equal Admission Date of Admission/Admission Time of Day on prior
Admission or greater than or equal Admission Date of
Admission/Admission Time of Day on subsequent Admission -
cannot process the change.
D120 Discharge Submission Type equals C and a Discharge record not
found - cannot process the change.
D106 Discharge Submission Type equals D and an Admission record exists
with an Admission Date of Admission/Admission Time of Day
greater than the Discharge Date of Discharge/Discharge Time of Day
- delete of Discharge would create two consecutive Admissions.
D118 Discharge Submission Type equals D and a Discharge record does not
exist - cannot process the delete.
Discharge Key
CA Code, License Number,
Social Security Number, CA
Client ID, Admission Date,
Admission Time of Day
Commissioners Minutes Continued. January 20, 2010
194
Michigan Department of Community Health Page 28 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
D002 Invalid Discharge Record Type - should be D.
D125 Transition-out window is not open – Discharge record type is X and
transition-out transactions are not currently allowed.
D126 Transition-out record exists – Regular discharge record cannot modify
transition-out record.
D127 Discharge record exists – Transition-out record cannot modify regular
discharge record.
Record Type
D003 Invalid Discharge Submission Type - should be A, C, D, E. Submission Type
D102 Discharge CA Payer Identifier and Bureau ID do not match.
D116 Invalid Discharge CA Code - not a valid CA Payer Identifier.
CA Code
D005 Invalid Discharge License Number - should be 6-digit. License Number
D006 Invalid Discharge Social Security Number - should be 9-digits or
blank.
Social Security Number
D117 Invalid Discharge CA Identifier - not permitted to be spaces or null. CA Client Identifier
D008 Invalid Discharge Medicaid ID - should be 10-digit or blank. Medicaid Identifier
D011 Invalid Discharge Date of Admission - should be valid date and less
than current date.
D069 Invalid Discharge Date of Admission/Admission Time of Day -
should be less than Discharge Date of Discharge/Discharge Time of
Day.
Discharge Date of Admission
D012 Invalid Discharge Service Category - should be 11, 21, 22, 24, 31.
D122 Discharge service category does not match admission service
category.
Discharge Service Category
D025 Invalid Discharge Employment Status - should be 1-4, 6, 8. Employment Status
D026 Invalid Discharge Primary Substance (PSA) - should be valid code of
00, 10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81, 91
D084 Discharge Primary Substance and Secondary Substance are the same -
PSA cannot be same as SSA.
D087 All 3 Discharge Substance values are the same - PSA, SSA, TSA
cannot be the same.
D103 Discharge Primary Substance equals 00, Primary Route must be 0.
PSA Code
Primary Substance
D027 Invalid Discharge Primary Route - should be 0-5. PSA Route
Primary Route
D029 Invalid Discharge Primary Frequency of Use - Should be 00 - 30 or
98 and equal or less than the number of days between admission and
discharge.
D092 Invalid Discharge Primary Frequency of Use - if Primary Substance
equals 00, Primary Frequency of Use must be 98.
PSA Frequency of Use
Primary Frequency of Use
D031 Invalid Discharge Secondary Substance (SSA) - should be valid code of 00, 10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81, 91.
D090 Invalid Discharge Secondary Substance - if PSA equals 00, SSA
should be 00.
SSA Code Secondary Substance
Commissioners Minutes Continued. January 20, 2010
195
Michigan Department of Community Health Page 29 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
D104 Discharge Secondary Substance equals 00, Secondary Route must be 0.
D032 Invalid Discharge Secondary Route - should be 0-5. SSA Route
Secondary Route
D034 Invalid Discharge Secondary Frequency of Use - should be 00-30 or
98 and equal or less than the number of days between admission and
discharge.
D093 Invalid Discharge Secondary Frequency of Use - if Secondary
Substance equals 00, Secondary Frequency of Use must be 98.
SSA Frequency of Use
Secondary Frequency of Use
D036 Invalid Discharge Tertiary Drug (TSA) - should be valid code of 00,
10, 20-22, 30-34, 41-45, 50-54, 60-61, 70, 72, 81,91.
D085 Discharge Primary Substance and Tertiary Substance are the same -
PSA cannot be same as TSA.
D086 Discharge Secondary Substance and Tertiary Substance are the same
– SSA cannot be same as TSA.
D091 Invalid Discharge Tertiary Substance - if PSA or SSA equals 00, TSA
should be 00.
D105 Discharge Tertiary Substance equals 00, Tertiary Route must be 0.
TSA Code
Tertiary Substance
D037 Invalid Discharge Tertiary Route - should be 0-5. TSA Route
Tertiary Route
D039 Invalid Discharge Tertiary Frequency of Use - should be 00-30 or 98
and equal or less than the number of days between admission and discharge.
D094 Invalid Discharge Tertiary Frequency of Use, if Tertiary Substance
equals 00, Tertiary Frequency of Use must be 98.
TSA Frequency of Use
Tertiary Frequency of Use
D054 Invalid Discharge Correctional Status - Should be 00-10, 98 Correctional Status
D055 Invalid Discharge Total Arrests – 30 days – should be 00-99.
D061 Invalid Discharge Total Arrests – 30 days – should be equal or greater
than Discharge Arrests -Possession/Sales – 30 days plus Discharge
Arrests - DUI/DWI – 30 days.
Total Arrests – 30 days
D056 Invalid Discharge Arrests - Possession/Sales – 30 days - should be 00-
99.
Arrests - Possession/Sales –
30 days
D057 Invalid Discharge Arrests - DUI/DWI – 30 days - should be 00-99. Arrests - DUI/DWI – 30 days
D065 Invalid Discharge Living Arrangement - should be 1-3. Living Arrangement
D009 Invalid Discharge Date - Should be valid date and less than current
date
D111 Discharge Date of Discharge is too old.
Discharge Date of Discharge
D010 Invalid Discharge Reason - should be 01-11 Discharge Reason
D123 Invalid Admission Time of Day – should be valid time (24-hour) Admission Time of Day
D124 Invalid Discharge Time of Day – should be valid time (24-hour) Discharge Time of Day
D130 Invalid Detailed Not in Labor – Should be a valid code of 01, 02, 03, 04, 05, 06, 07.
D131 Invalid Detailed Not in Labor – Employment Status equals 04,
Detailed Not in Labor should be a valid code of 01, 02, 03, 04, 05, 06,
07.
Detailed Not in Labor
Commissioners Minutes Continued. January 20, 2010
196
Michigan Department of Community Health Page 30 of 31
TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Error # Error Description Field Name
D132 Invalid Discharge Detailed Not in Labor Code - If Employment Status is not equal to 04 then Detailed Not in Labor Code must be 98.
D133 Invalid Women’s Specialty Program Code. Must be 1 or 2. Women’s Specialty Program
D134 Invalid Child Welfare Involvement. Must be 1 or 2. Child Welfare Involvement
D135 Invalid Days of Social Support. Must be 00, 02, 06, 18, 30, or 98 Days of Social Support
D097 Invalid Error ID - Should be 8-digit number or blank.
D100 Invalid Discharge Error ID - should be valid Error ID or blank.
Error ID
Commissioners Minutes Continued. January 20, 2010
197
Michigan Department of Community Health Page 31 of 31 TEDS Data Reporting Submission for
Substance Abuse Services Programs
(Rev. 09.16.08)
Commissioners Minutes Continued. January 20, 2010
198
Att E_Performance Indicators_SUDs FY2010 Initial.doc Page 1 of 5
PERFORMANCE INDICATORS FOR SUBSTANCE ABUSE SERVICES
ELECTRONIC SUBMISSION FORMS
DATA REPORT FORMS
The data are collected quarterly for each substance abuse services regional area by
means of a report form for each Performance Indicator. They are viewed as starting
points for a long-term effort to improve quality of services and enhance accountability of
the substance abuse treatment system.
The quarterly due dates for these reports are as follows:
Time Periods Due Dates
October - December _______(year) February 28
January - March _______ May 31
April - June _______ August 31
July - September _______ November 30
Commissioners Minutes Continued. January 20, 2010
199
Att E_Performance Indicators_SUDs FY2010 Initial.doc Page 2 of 5
MICHIGAN SUBSTANCE ABUSE SERVICES
PERFORMANCE INDICATOR SYSTEM, 5.2
DATA REPORT
For
________________ Coordinating Agency
ACCESS: PENETRATION RATES FOR SELECTED POPULATIONS
Time Periods Due Dates
October - December _______(year) February 28
January - March _______ May 31
April - June _______ August 31
July - September _______ November 30
FY 2005 Quality Improvement Performance Indicators: Number of persons served age 12-17 who received services that are supported in whole or in part by funding provided in SA contract with MDCH and PIHPs divided by number in area census age 12-17. Number of persons served who are women of child-bearing age (ages 11-44) who received services that are supported in whole or in part by funding provided in SA contract with MDCH and PIHPs divided by number in area census who are women of child-bearing age. Number of persons served of ethnic minority groups who received services that are supported in whole or in part by funding provided in SA contract with MDCH and PIHPs. divided by number in area census of ethnic minority groups. Number of persons served who are injecting drug users who received services that are supported in whole or in part by funding provided in SA contract with MDCH and PIHPs divided by estimated number in area census of persons who are injecting drug users.
Population
1.
# Persons
Served
2.
# in Area
2000 Census
3.
Penetration
Rate
Persons Age 12-17
Women of Child-Bearing
Age
Persons of Ethnic
Minorities
See Next Page See Next Page See Next
Page
# Persons Served Estimated # in
Area
Penetration
Rate
Persons who Inject Drugs
Commissioners Minutes Continued. January 20, 2010
200
Att E_Performance Indicators_SUDs FY2010 Initial.doc Page 3 of 5
ACCESS: PENETRATION RATES FOR SELECTED POPULATIONS (cont.)
Definitions:
“Served” means received treatment services that are supported in whole or in part by
funding provided in SA contract with MDCH and PIHPs.
Include those persons who reside in the CA region who were served (i.e. had services
paid for by the CA) out of the CA region; do not include those served in the CA region
who reside out of the CA region (and whose services were paid for by another CA).
CAs should ensure that total persons served is greater than the sum of the persons in a
subset of the total population. The number will be greater when family members/
significant others and persons with no current substance abuse are included in the
treatment.
“Ethnic Minority” categories are:
• Native American
• Asian or Pacific Islander
• African American/Black
• Hispanic
“Persons who Inject Drugs” means those who have used a needle and syringe to inject
drugs at least once in the past 30 days.
Cases are to be discharged if 30 days pass without the client receiving services. The
discharge date is the last date services were provided.
Ethnic Minority Categories
Population
1.
# Persons
Served
2.
# in Area
2000 Census
3.
Penetration
Rate
Native American
Asian or Pacific Islander
African American/Black
Hispanic
Commissioners Minutes Continued. January 20, 2010
201
Att E_Performance Indicators_SUDs FY2010 Initial.doc Page 4 of 5
MICHIGAN SUBSTANCE ABUSE SERVICES
PERFORMANCE INDICATOR SYSTEM 5.2
DATA REPORT
For
________________ Coordinating Agency
ACCESS: PENETRATION RATE OF POTENTIAL SERVICES NEED WITH
PERSONS SERVED
Time Periods Due Dates
October - December _______(year) February 28
January - March _______ May 31
April - June _______ August 31
July - September _______ November 30
Quality Improvement Performance Indicators:
Persons served age 18 or older meeting a diagnosis of substance abuse or dependency
who received services that are supported in whole or in part by funding provided in SA
contract with MDCH and PIHPs divided by the projected substance abuse or
dependency prevalence.
Population
1.
Unduplicated # of Persons
Served for Substance
Abuse
2.
Estimated
Substance Abuse
or Dependency
3.
Penetration
Rate
Persons Aged > 18
Definitions:
“Served” means received treatment services that are supported in whole or in part by
funding provided in SA contract with MDCH and PIHPs.
Include those persons who reside in the CA region who were served (i.e. had services
paid for by the CA) out of the CA region; do not include those served in the CA region
who reside out of the CA region (and whose services were paid for by another CA).
“Persons Served for Substance abuse or Dependency” mean those persons who
received a diagnosis within these classifications under the American Psychiatric
Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
(DSM-IV).
All CAs need to ensure that all admission records from funded treatment programs are
reported and that client discharge records for all admissions are received on a timely
basis.
“Penetration Rate” is found by dividing column 1 by column 2.
Commissioners Minutes Continued. January 20, 2010
202
Att E_Performance Indicators_SUDs FY2010 Initial.doc Page 5 of 5
MICHIGAN SUBSTANCE ABUSE SERVICES
PERFORMANCE INDICATOR SYSTEM, 5.2
DATA REPORT
For
________________ Coordinating Agency
OUTCOMES: SATISFACTION - CONSUMER SATISFACTION
Time Periods Due Dates
October - December _______(year) February 28
January - March _______ May 31
April - June _______ August 31
July - September _______ November 30
Quality Improvement Performance Indicators:
The percentage of persons 18 and over with a substance abuse or dependency
diagnosis who received services that are supported in whole or in part by funding
provided in SA contract with MDCH and PIHPs who report satisfaction with services.
The percentage of persons under age 18 and/or their families who received services
that are supported in whole or in part by funding provided in SA contract with MDCH
and PIHPs who report satisfaction with services.
Population
1.
# Surveyed
2.
# Responded
to Survey
3.
# Satisfied
4.
% Satisfied of
Responders
Persons Aged >18 %
Persons Aged <18 %
Definitions:
Include those persons who reside in the CA region who were served (i.e. had services
paid for by the CA) out of the CA region; do not include those served in the CA region
who reside out of the CA region (and whose services were paid for by another CA).
All CAs must implement client satisfaction surveys and collect this necessary
information. Although collecting this information can be frustrating, it must be done.
All CAs must continue administering surveys for those both in treatment and those
discharged.
The percentage recorded in column 4 must be mathematically possible (for example, if
10 clients respond to a survey, then 95% of them can NOT be satisfied).
Commissioners Minutes Continued. January 20, 2010
203
Att E_Sentinel Events Data Rpt_Guide Fillable FY2010 Initial.doc Page 1 of 4
Michigan Department of Community Health
Mental Health And Substance Abuse Services
Guidance on Sentinel Event Reporting
Reporting Periods and Data Submission Due Dates
Six-Month Reporting Period
Due Date for Data Submission
October 1 through March 31
April 30 April 1 through September 30 October 31
I. REQUIREMENT
The Michigan [Department of Community Health] will require CAs to report,
review, investigate, and act upon sentinel events for persons living in 24-hour
specialized settings and those living in their own homes receiving ongoing and
continued personal care services.
II. DEFINITIONS
A. Incident is any of the following which should be reviewed to determine
whether it meets the criteria for sentinel event in B. below.
• death of a recipient
• serious illness requiring admission to hospital
• alleged cause of abuse or neglect
• accident resulting in injury to recipient requiring emergency room
visit or hospital admission
• behavioral episode
• arrest and/or conviction
• medication error
B. Sentinel Event is an “unexpected occurrence involving death or
serious physical or psychological injury, or the risk thereof. Serious
injury specifically includes loss of limb or function. The phrase, ‘or risk
thereof’ includes any process variation for which a recurrence would carry
a significant chance of a serious adverse outcome." (JCAHO, 1998)
C. 24-hour Specialized Setting means substance abuse residential treatment
programs.
D. Own Home for purposes of sentinel event reporting means supported
independence program for persons with mental illness or developmental
disabilities regardless of who holds the deed, lease, or rental agreement;
Commissioners Minutes Continued. January 20, 2010
204
Michigan Department of Community Health
Mental Health And Substance Abuse Services
Guidance on Sentinel Event Reporting (Cont’)
Att E_Sentinel Events Data Rpt_Guide Fillable FY2010 Initial.doc Page 2 of 4
as well as own home or apartment for which the consumer has a deed,
lease, or rental agreement in his/her own name. Own home does not
mean a family's home in which the child or adult is living.
E. Ongoing and continuous in-home assistance means assistance with
activities of daily living provided in the person's own home at least once a
week, and six months or longer.
F. Death: that which is not by natural cause or does not occur as a natural
outcome to a chronic condition (e.g. terminal illness) or old age.
G. Accidents resulting in injuries that result in death or loss of limb or function
and which required visits to emergency rooms, rnedi-centers and urgent
care clinics/centers and/or admissions to hospital should be included in
the reporting. In many communities where hospitals do not exist, medi-
centers and urgent care clinics/centers are used in place of hospital
emergency rooms.
H. Physical illness resulting in admission to a hospital does not include
planned surgeries, whether inpatient or outpatient. It also does not
include admissions directly related to the natural course of the person's
chronic illness, or underlying condition. For example, hospitalization of an
individual who has a known terminal illness in order to treat the conditions
associated with the terminal illness is not a sentinel event.
I. Serious challenging behaviors are those not already addressed in a
treatment plan and include significant (in excess of $ 100) property
damage, attempts at self-inflicted harm or harm to others, or unauthorized
leaves of absence that result in death or loss of limb or function to the
individual or risk thereof. All unauthorized leaves from residential
treatment are not sentinel events in every instance) Serious physical
harm is defined by the Administrative Rules for Mental Health (330.7001)
as "physical damage suffered by a recipient that a physician or registered
nurse determines caused or could have caused the death of a recipient,
caused the impairment of his or her bodily functions, or caused the
permanent disfigurement of a recipient."
J. Medication errors mean a) wrong medication; b) wrong dosage; c) double
dosage; or d) missed dosage which resulted in death or loss of limb or
function or the risk thereof. It does not include instances in which
consumers have refused medication.
Commissioners Minutes Continued. January 20, 2010
205
Michigan Department of Community Health
Mental Health And Substance Abuse Services
Guidance on Sentinel Event Reporting (Cont’)
Att E_Sentinel Events Data Rpt_Guide Fillable FY2010 Initial.doc Page 3 of 4
III. APPLICATION
All incidents should be reviewed to determine if the incidents meet the criteria
and definitions (in II. above) for sentinel events and if they are related to practice
of care. The outcome of this review is a classification of incidents as either a)
sentinel events, or b) nonsentinel events.
An "appropriate response" to a sentinel event "includes a thorough and credible
root cause analysis, implementation of improvements to reduce risk, and
monitoring of the effectiveness of those improvements." (JCAHO, 1998) A root
cause analysis (JCAHO) or investigation (per CMS approval and MDCH
contractual requirement) is "a process for identifying the basic or causal factors
that underlie variation in performance, including the occurrence or possible
occurrence of a sentinel event. A root cause analysis focuses primarily on
systems and processes, not individual performance." (JCAHO, 1998)
Following completion of a root cause analysis or investigation, a CA must
develop and implement either a) a plan of action (JCAHO) or intervention (per
CMS approval and MDCH contractual requirement) to prevent further occurrence
of the sentinel event; or b) presentation of a rationale for not pursuing an
intervention. A plan of action or intervention must identify who will implement and
when, and how implementation will be monitored or evaluated.
IV. MDCH MANAGEMENT OF SENTINEL EVENT REPORTING
Data collection: CAs will submit semiannually aggregate data by event category
for number of sentinel events and plans of action or interventions which occurred
during the 6-month period. MDCH will analyze the data and prepare a report on
the # of sentinel events (by category) per thousand persons served who meet the
population definition. As with all performance indicators, MDCH will review
performance, with potential follow-up by contract managers to determine what
quality improvement action is taking place; and/or to develop performance
objectives aimed at reducing the risk of sentinel events occurring; and/or to
impose other sanctions.
Commissioners Minutes Continued. January 20, 2010
206
Att E_Sentinel Events Data Rpt_Guide Fillable FY2010 Initial.doc Page 4 of 4
Sentinel Events Data Report
Substance Abuse Residential Services
1.
Category
2.
# of Sentinel
Events in
the Period
3.
# of Events
for Which
There Was
Intervention
1. Death of Recipient
2. Accidents requiring emergency room visits and/or
admissions to hospitals
3.
Physical illness requiring admissions to hospitals
4.
Arrest or conviction of recipients
5.
Serious challenging behaviors
6.
Medication errors
Definitions:
1. Sentinel Event is an “unexpected occurrence involving death or serious physical or
psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or
function. The phrase, ‘or the risk thereof,’ includes any process variation for which recurrence
would carry a significant chance of a serious adverse outcome.” (JCAHO 1998)
2. Serious challenging behaviors include property damage, attempts at self-inflicted harm or
harm to others, or unauthorized leaves of absence that increase the risk of serious physical or
psychological harm to the consumer.
3. Medication errors mean a) wrong medication; b) wrong dosage; c) double dosage; or d)
missed dosage. It does not include instances in which consumers have refused medication.
Notes:
1. Reporting is required for: 1) persons living in 24-hour specialized residential substance
abuse treatment settings.
2. Accidents treated at medi-centers and urgent care clinics/centers should be included in the
accident reporting along with those treated in emergency rooms. In many communities in the
state where hospitals do not exist, medi-centers and urgent care clinics/centers are used in
place of emergency rooms.
3. Planned surgeries, whether outpatient or inpatient, are not considered unexpected
occurrences and therefore are not included in the reporting of illnesses requiring admissions to
hospitals.
4. Report arrests and convictions as separate incidents.
Number of persons served during the time
period who meet criteria in Note #1 below:
Time Period (check one) Due Date
October 1 through March 31
April 30
April 1 through September 30
October 31
Coordinating Agency:
Commissioners Minutes Continued. January 20, 2010
207
SUBSTANCE ABUSE ENCOUNTER REPORTING
HCPCS and Revenue Codes
Overview for Fiscal Year 2010
This encounter code and modifier chart, effective 10/1/2009, describes how submitted
encounter codes and modifiers will be interpreted by MDCH and its actuarial team.
A list of 12 modifiers is included on the last page of the coding chart. These modifiers can be
used in combination with any of the HCPCS codes. “HD” is required for all qualified Women’s
Specialty Services. “HH” is required for qualifying Integrated Substance Abuse/Mental Health
Services.
A modifier for Telemedicine (GT) has been added. Telemedicine is the use of an electronic
media to link beneficiaries with health professionals in different locations. The examination of
the beneficiary is performed via a real-time interactive audio and video telecommunications
system. The beneficiary must be able to see and interact with the off-site practitioner at the
time services are provided.
The AMS initial screening functions will no longer be reported under H0002 or H0049
Coding options for Sub-acute Detoxification Services allows three separate codes based on
ASAM level: H0010 (Medically Monitored III.7-D); H0012 (Clinically Managed III.2-D); and
H0014 (Ambulatory without Extended Monitoring II.D.).
The HCPCS Code of H0022 will designate Early Intervention Services.
The HCPCS Code of T1012 will designate Recovery Support Services.
Residential Room and Board will be reported under the S9976 per diem code.
A selection of non-emergency Transportation HCPCS codes (T2001 through T2005, S0215,
A0100, A0110) have been added to the chart.
The T1009 code for Child Sitting Services has been added to the chart to allow CAs to report
child care service encounter under qualified Women’s Specialty Services.
Att E_SA Encounter Rpting_HCPCS-Rev Codes.xls Page 1 of 5
Commissioners Minutes Continued. January 20, 2010
208
SUBSTANCE ABUSE ENCOUNTER REPORTINGHCPCS and Revenue CodesService Description HCPCS or CPT Codes Revenue Codes Reporting Code Description Reporting Units Reporting Technique Claim Format (ASC X12N 837) CoverageAssessment H0001 N/AH0001- Individual face-to-face alcohol and/or drug assessment at the licensed provider level for the pupose of identifying functional and treatment needs and to formulate the basis for the Individualized Treatment Plan. Encounter (1 hour minimum) Line Professional State Plan Block, PA2Individual Outpatient H0004, 90804 - 90815, 90826, H2035, H20360900, 0914, 0915, 0916, 0919H0004- Behavioral health counseling and therapy, per 15 minutes. 90804-90815, 90826 – Psychotherapy (individual).H2035- An hour of outpatient alcohol/other drug treatment services. H2036- Per diem outpatient alcohol/other drug treatment services.Refer to code descriptions Series/Line (depends on other payers) Institutional or Professional (depends on other payers) State Plan Block, PA2Group Outpatient H0005, 90846, 90847, 90849 90853, 90857, H2027, H2035, H20360900, 0914, 0915, 0916, 0919H0005- Alcohol and/or drug services; group counseling by a clinician. Family or group therapy90846, 90847, 90849, 90853, 90857 - Psychotherapy (group).H2027- Didactics - 15 minute units H2035- An hour of outpatient alcohol/other drug treatment services. H2036- Per diem outpatient alcohol/other drug treatment services.Refer to code descriptions Series/Line (depends on other payers) Institutional or Professional (depends on other payers) State Plan Block, PA2Outpatient (Combination) H0015 0906H0015- Alcohol and/or drug services; intensive outpatient (from 9 to 19 hours of structured programming per week based on an individualized treatment plan), including assessment, counseling, crisis intervention, and activity therapies or education. 0906 – Intensive Outpatient Services – Chemical Dependency. Day Series/Line (depends on other payers) Institutional or Professional (depends on other payers) State Plan Block, PA2Pharmacologic Support – MethadoneH0020 N/AH0020- Alcohol and/or drug services; Methadone administration and/or service (provision of the drug by a licensed program). Encounter Line Professional State Plan Block, PA2Subacute Detoxification H0010 , H0012, H00141002H0010- Alcohol and/or drug services; subacute detoxification; medically monitored residential detox (ASAM Level III.7-D).H0012- Alcohol and/or drug services; subacute detoxification; clinically managed residential detox; non-medical or social detox setting (ASAM Level III.2-D). H0014 - Alcohol and/or drug services; ambulatory detoxification without extended onsite monitoring (ASAM Level I.D). 1002 – Residential treatment – chemical dependency. Day (refer to code descriptions) Series Institutional or Professional (depends on other payers) Additional b3, Block, PA2Att E_SA Encounter Rpting_HCPCS-Rev Codes.xlsPage 2 of 5Commissioners Minutes Continued. January 20, 2010209
SUBSTANCE ABUSE ENCOUNTER REPORTINGHCPCS and Revenue CodesService Description HCPCS or CPT Codes Revenue Codes Reporting Code Description Reporting Units Reporting Technique Claim Format (ASC X12N 837) CoverageResidential Treatment H0018, H0019 1002H0018- Alcohol and/or drug services; short-term residential (non-hospital residential treatment program). H0019- Alcohol and/or drug services; long-term residential (non-medical, non-acute care in residential treatment program where stay istypically longer than 30 days).1002 – Residential treatment – chemical dependency. Day Series Institutional or Professional (depends on other payers) Additional b3, Block, PA2Early InterventionH0022 N/AH0022 - Alcohol and/or drug services; Intervention Service (Early Intervention). Any planned intervention that may assist a person to abstain for AOD use.Encounter Line Professional State Plan Block, PA2Recovery Support ServicesT1012, H0038N/AT1012 - Alcohol and/or drug services; Recovery Support and Skills Development. Activities to develop client community integration andrecovery support. H0038 - Peer services, per 15 minutes T1012: Encounter H0038: 15 minutesLine Professional State Plan, Block, PA2Residential Room and BoardS9976 N/AS9976 - Lodging, per diem, not otherwise specified.Day Series Institutional or Professional (depends on Block, PA2Case Management H0006 N/AH0006- services provided to link clients to other essential medical, educational, social and/or other services. Encounter Line Professional Block, PA2Laboratory Tests H0003, H0048, 80100, 80101N/AH0003 - Laboratory analysis of specimens to detect presence of alcohol or drugs.H0048 - Alcohol and drug testing, collection and handling only, specimens other than blood.80100-80101 - Drug Screen.Encounter Line Professional Block, PA2, State Plan under methadoneTransportationT2001 - T2005, S0215, A0100, A0110N/A Non-emergency transportation services. Refer to code descriptions Line Professional Block, PA2Psychiatric Evaluation90801, 90802 N/A90801- Diagnostic interview examination.90802- Diagnostic interview examination using play equipment, physical devices, language interpreter or other mechanisms of communication. Encounter Line Professional Block, PA2Child Sitting ServicesT1009 N/AT1009 - Care of the children of the individual receiving alcohol and/or substance abuse services.Encounter Line Professional Block, PA2Att E_SA Encounter Rpting_HCPCS-Rev Codes.xlsPage 3 of 5Commissioners Minutes Continued. January 20, 2010210
SUBSTANCE ABUSE ENCOUNTER REPORTINGHCPCS and Revenue CodesService Description HCPCS or CPT Codes Revenue Codes Reporting Code Description Reporting Units Reporting Technique Claim Format (ASC X12N 837) CoveragePharmacologic Support – Buprenorphine or SuboxoneH0033N/AH0033 -Oral medication administration, direct observation. (Use for Buprenorphine or Suboxone administration and/or service - provisionof the drug). Encounter Line Professional Block, PA2, Mediciad SavingsAccupuncture97810-97811N/A97810 - Accupuncture, 1 or more needles, initial 15 minutes.97811 - Accupuncture, 1 or more needles, each additional 15 minutes.Encounter Line Professional Block, PA2Physician Evaluation 99203-99205 N/A99203 - Physician Evaluation/Exam (30 mins face-to-face).99204 - Physician Evaluation/Exam (45 mins face-to-face).99205 - Physician Evaluation/Exam (60 mins face-to-face). Encounter Line Professional Block, PA2, State Plan under methadoneMedication Review90862 N/A90602 - Review of current mdications.Encounter (face-to-face)Line Professional Block, PA2Att E_SA Encounter Rpting_HCPCS-Rev Codes.xlsPage 4 of 5Commissioners Minutes Continued. January 20, 2010211
SUBSTANCE ABUSE ENCOUNTER REPORTINGHCPCS and Revenue CodesModifierGTHAHBHCHDHGHHHJHQHRHSH9Modifiers for Substance Abuse HCPCS CodesDescriptionTelemedicine the use of an electronic media to link beneficiaries with health professionals in different locations. The examination of the beneficiary is performed via a real-time interactive audio and video telecommunications system. The beneficiary must be able to see and interact with the off-site practitioner at the time services are provided via telemedicine.Child- Adolescent Program (services designed for persons under the age of 18).Adult Program- Non-Geriatric (services designed for persons age 18-64).Geriatric Program (services designed for adults age 65 and older).Women's Specialty Services Pregnant/Parenting Women Program: (services provided in a program that treats pregnant women or women with dependent children).Opioid Addiction Treatment Program (program specifically designed to provide opioid-treatment services (including but not limited to the provision of methadone).Family/Couple without Client Present (services provided to multiple persons in a single treatment event in which some of the persons served share familial or significant other relationships, without the client present).Court-ordered (indicates that services were ordered by a court, probation officer and/or parole officer).Integrated Mental Health/Substance Abuse Program (program specifically designed to provide integrated services to persons who need both mental health and substance abuse services, as planned in an integrated, individualized treatment plan.Employee Assistance Program (designates a service associated with and EAP.Group Setting (services provided to more than one client in a single treatment event, such that the clients have no particular relationship).Family/Couple with Client Present (services provided to more than one client in a single treatment event, such that persons served share familial or significant other relationships).Att E_SA Encounter Rpting_HCPCS-Rev Codes.xlsPage 5 of 5Commissioners Minutes Continued. January 20, 2010212
Updated April 29, 2008
Substance Use Disorder Prevention Data System (PDS)
For information regarding the functioning of the data system, please refer to the Manual available on the
website. The following information is designed to provide guidance on the context of data captured by the
data system. If you have questions regarding the content of this document please contact the Prevention
Coordinator at your coordinating agency.
TABLE OF CONTENTS
SECTION 1: BACKGROUND INFORMATION
• What is the Substance Use Disorder Prevention Data System?....................................2
• About this Document.....................................................................................................2
• Activities Eligible for Entry .........................................................................................2
• Additional Record Keeping...........................................................................................3
SECTION 2: DATA ENTRY
A. Nature of Event ...........................................................................................................4
B. Group Name ................................................................................................................4
C. Was more than one strategy used during this event? ..................................................4
D. Was the same group of participants present for all strategy activities? ......................4
E. Did more than one staff member participate in this activity event? .............................5
F. Service Date .................................................................................................................5
G. Service Location ...........................................................................................................5
H. Staff Name ....................................................................................................................5
I. Staff Time .....................................................................................................................5
J. Strategy Codes
• Alternatives .......................................................................................................6
• Community Based.............................................................................................7
• Education...........................................................................................................9
• Information Dissemination..............................................................................10
• Problem Identification & Referral...................................................................12
• Environmental.................................................................................................13
K. Funding Source ........................................................................................................15
L. Population Type ........................................................................................................15
M. Service Domain .........................................................................................................15
N. Evidence Based Practice (EBP) Service Type ..........................................................16
O. Service Type..............................................................................................................17
P. Service Population ..................................................................................................18
Q. Attendee Count..........................................................................................................21
R. Demographic Information ........................................................................................21
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SECTION 1: BACKGROUND INFORMATION
The following section provided information about the intent and design of the Substance Use Disorder
Prevention Data System (PDS) which can be accessed at www.sudpds.com. It also provides guidance on
what type of prevention activities are eligible for entry into the data system and additional record keeping
requirements.
• What is the Substance Use Disorder Prevention Data System (PDS)?
The prevention data system is a staff activity reporting system that collects information about the recipients
of service and type of activity. Activities are reported at the individual staff level. For convenience, there
is a provision for up to 3 staff to be identified in a single record when both the activity and participants are
the same.
PDS is designed to assist the Michigan Department of Community Health/Office of Drug Control Policy
(MDCH/ODCP) in collecting and reporting the data required by the Substance Abuse and Mental Health
Services Administration (SAMHSA).
Records entered into PDS will be available for review by staff at your agency, your coordinating agency,
and the staff at MDCH/ODCP.
• About this document
This document is designed to provide information to guide data entry into the Michigan Substance
Use Disorder Prevention Data Set at www.sudpds.com. This document was developed by
Prevention Coordinators in partnership with MDCH/ODCP.
The following document provides interpretation of terms and procedures for consistent
demographic data collection.
It is imperative that data be reported consistently throughout the state and across coordinating
agency regions. Each data element is intended to be interpreted in the same way by each
coordinating agency. This will allow Michigan to have meaningful data and provider agencies
contracting with multiple coordinating agencies will be guided by consistent requirements.
The document contains:
o Definitions for all terms used in the data system
o Rules for what to “count” in various situations
o Helpful examples
• Activities Eligible for Entry:
All direct service activities funded in whole or part, through the coordinating agency (CA) must be reported
in the PDS system.
The Prevention Data System is designed to capture staff activity in face-to-face activities. Not all
activity performed by prevention staff will be captured by this system, only activities that meet the
requirements detailed in this section will be captured. It is understood by MDCH/ODCP and
coordinating agencies that time in activities reported will not equal the amount of hours worked per
staff person.
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A staff activity must meet the following requirements to qualify as an activity eligible for entry:
o Must be quantifiable as staff time.
The system is designed to capture staff time in activities, and not the outcome or product of
the activity.
For example: Time spent by staff working with partners in the community to coordinate the
adoption and implementation of a smoke-free policy would be entered as a direct service
activity. The actual adoption of a smoke-free policy is not quantifiable in terms of staff time
and would therefore, not be considered directs service activity and would therefore NOT be
entered into PDS.
o Must be Face-to-Face: Time spent in activities that support the implementation of a
prevention activity but is not in direct contact with a recipient or community partner would
NOT count as direct service and would NOT be entered into PDS. In addition, activities
that are done with co-workers do not count as direct service activity. Therefore, these
activities would not be entered into PDS.
OR
Telephone or video conferencing alternatives may count as direct service and be a
reportable activity if the activity would have met the definition of a direct service if the
activity had been conducted face-to-face.
Examples to help you determine whether a telephone or video conference would be counted as an
activity to be entered in PDS:
- A phone call to engage a participant in future face to face activity - NO
- A phone call to plan programming or provide administrative oversight - NO
- Attending a standard coalition meeting by phone or video rather than in person - YES.
- Providing training via conference call - YES
- A conference call to plan an upcoming training - NO
- Coordinating a community planning team (a group which is not a formalized coalition) meeting
by video/conference -YES
o Volunteer/intern service activities: Services and activities conducted by unpaid volunteers and/or
interns cannot be entered into PDS as activities. If a provider agency provides the supplies that a
volunteer or intern uses to provide a service, but does not pay the volunteer/intern, then the activity
should NOT be entered in PDS.
If a volunteer or intern receives a stipend from the provider agency to provide services, then their
activities would be entered into PDS.
• Record Keeping: In addition to entry into PDS, it is expected that there be a source of
verification that the activity reported in the system actually took place. This record is not
expected to be duplicative of the information reported in PDS and is not expected to consist of
narrative reports. Each coordinating agency will provide specific guidance regarding their
requirements regarding record keeping
Examples of documentation:
• sign in sheets
• sign-out sheets for program participation
• agendas and/or meeting notes from coalition meetings
• Contact Log identifying someone able to verify the activity (eg. teacher school based activity).
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SECTION 2: DATA ENTRY
The following section provides guidance for each data element collected by the data system,
including the answer categories, definitions, and rules of interpretation.
A. Nature of Event:
Answer Categories
• One-Time: the event occurs only once and is not ongoing
For example: one-time presentation, Health fair participation, etc.
• Ongoing-Other: activities that are ongoing events or activities that do not require or expect
sequential participation.
For example, Coalition meetings, open-ended education groups, etc.
• Ongoing – Sequential: a program consisting of the application of a curriculum consisting of
multiple events in a planned sequence. Can consist of multiple applications of a curriculum
sequence.
For example: Educational programming such as Botvin’s Life Skills or Project Alert
B. Group Name:
A list of pre-named groups will be available in the drop down list. The drop down list will include all
group names that have previously been named in the ‘Add Group’ section of the data system. If the
group is not available within the list then you will need to go to the ‘Add Group’ tab and add the group
prior to adding the activity.
Group names in the drop down list are specific to the ‘nature of event’ selected when naming groups.
C. Was more than one strategy used during this event?
Answer Categories:
• Yes – Answer “Yes” if more than one strategy or more than one sub-strategy was used.
• No - Answer “No” if only one sub-strategy was used.
For more information on strategies and sub-strategies please refer to Strategy Code Section J.
Note: If you select “Yes” the system will direct you to enter a separate activity record for each strategy
or sub-strategy used.
D. Was the same group of participants present for all strategy activities?
Participants refer to the people participating in the activity that is being reported. This data element
refers to the same actual persons, not whether they were of the same population category.
Answer Categories
• Yes - Answer “Yes” if the same persons participated in all portions of the prevention activity.
• No - Answer “No” if the group of participants changed during the activity. Please note that for
reporting purposes, the activity must be for the same participants. If the participants changed, then a
separate activity record for each of the session received by a distinct group of participants is
required.
If the staff and participants split into separate groups with different activities within the overall
activity, a separate activity record must be entered for each distinct group of participants. If staff
and a group of participants meet more than once within the larger service delivery: one activity
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record may be entered for the entire duration of both sessions where that distinct group of
participants was served so long as it is for the same date of service and the same event.
Example 1: If you provide three sessions in a row of Project ALERT with three different classes of
5th grade students you would answer “No” to this question.
Example 2: During a Strengthening Families session the entire group, consisting of both parents and
youth, start out the session together for 30 minutes and then split into separate groups (one for the
parents and one for the youth) for one hour, and then come back together for 45 minutes as wrap-up.
In this case three activity records would be entered. There first activity record would be entered for
the two times periods when the parents and youth were all combined for 1 hour and 15 minutes, and
a second activity record for an hour provided to parents, and a third activity record for one hour
provided to youth.
E. Did more than one staff member participate in this activity event?
Answer Categories:
• Yes – Select “Yes” if more than one staff participated in the activity.
Please note that if you select yes on this item you will be required to enter information for more than
one staff on the following data entry page.
• No – Select “No” if only one staff person participated in the activity.
Please note that if you answer “No” to this item you will not be allowed to enter information for
more than one staff on the following data entry page.
Note: If more than three staff participates in an activity then entry of multiple activity records would be
required to capture all staff that participated. Demographic information should be entered for ALL
participants in each of the activity records since each of the 4 staff provides service activity to all of the
participants.
For example: If 50 persons were served by four staff then two activity records would be entered and 50
persons would be counted as served under both of the activity records.
F. Service Date – Enter the date that the activity occurred.
G. Service Location – Select the county in which the service occurred.
H. Staff Name – Select the staff that participated in the activity from a drop down list. The list will include
all staff that has been assigned a username in the system by your coordinating agency. If you have
indicated that more than one staff was involved on the first page of data entry you will be required to
select more than one staff person.
Each person providing service must have their own staff name. This includes consultants or volunteers
receiving a stipend.
I. Staff Time: Enter the amount of time in hours and minutes for each staff that participated in the activity.
J. Strategy Code: For each staff that participated in the activity you will be required to select a sub-
strategy. The following section and tables provide detailed information for each strategy and sub-
strategy allowable within the PDS system.
Note: Examples provided for each strategy code are not intended to provide an exhaustive list of
possibilities.
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217
Page 6 • Alternative Strategies: This strategy provides participation in positive activities that exclude alcohol and other drugs. The purpose is to meet the needs filled by alcohol and other drugs with healthy activities and to discourage the use of alcohol and drugs through these activities. Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities to Enter into PDS A01 Supervision, guiding ATOD- free recreational event This activity provides for participation in recreational activities that exclude ATOD and promotes healthy activities that lend themselves to the building of resiliency among youth and families. Supervision/coordination of: • Drug Free Dances and Parties • Project Graduation • After School Activities • ATOD-free School Events • Community Drop In Centers • ATOD-free Family Activities A03 Supervision, guiding Community events This activity is intended to prevent substance use by involving youth and adults in a variety of community service projects. Supervision/coordination of: ● Community Service Activities ● Community Clean-up Activities ● Events to Repair or Re-build Neighborhoods ● Fundraising for Charitable Causes ● Support to the Elderly, Handicapped, Ill, Etc. A04 Supervision, guiding Youth-Adult Leadership events This activity provides a means to character building and promoting healthy relationships between youth and adults. It provides services through which youth/adult role models work with youth to prevent substance use/abuse. Supervision/coordination of: ● Tutoring Programs ● Adult Mentoring Activities ● Youth/Adult Leadership Activities ● Coaching Activities Commissioners Minutes Continued. January 20, 2010218
Page 7 • COMMUNITY BASED: This strategy provides ongoing networking activities and technical assistance to community groups or agencies. It encompasses neighborhood-based grassroots empowerment models using action planning and collaborative systems planning. This strategy works to enhance the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco and other drug abuse disorders. Types of activities that should be entered into PDS include: planning, interagency collaboration, coalition building, community planning teams, and networking that are done to enhance efficiency and effectiveness of services implementation. Please remember that activities must be in direct contact with a recipient or community partner to be eligible for entry as an activity. For more information regarding this requirement refer to section C. Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities to Enter into PDS C01 Development of funding and service alternatives (involving community members) Increasing or improving a communities prevention and treatment service capacity by developing resources to support those services • Working with your local coalition to apply for a Prevention Network (PN) grant • Collaborative planning meeting to develop a community plan for a grant application. C02 Implementing needs assessment tools (involving community members) Doing a needs assessment in your community, focus area, etc. to do one or more of the following: • Determine priority prevention needs, • Identify at-risk and high-risk populations, or • Determine priority prevention populations and/or geographical areas for service delivery. Working with others in your community to develop and/or collect: • Mass survey data • Focus group information • Key stakeholder interviews C04 Conducting Training Service Delivering structured substance abuse prevention training events intended to develop proficiency in prevention program design, development, and delivery skills. (Not including educational activities designed to directly educate individuals about ATOD issues) • Capacity building through training of volunteers • Neighborhood action training, • Training of key people in the system • Staff/official training • Prevention training programs • Training of trainers Commissioners Minutes Continued. January 20, 2010219
Page 8 C05 Community coalition building and facilitating. (including: collaboratives, task forces, and community planning teams) To form, develop, or facilitate community coalitions. Activities or services conducted with or on behalf of community coalitions for the purpose of fostering, supporting, or enhancing community prevention services • Staff conducts one-on-one meetings to recruit coalition members • Staff chairs a local coalition meeting • Joint planning meeting between two or more agencies C06 Coalition meeting participation. (including: collaboratives, task forces, and community planning teams) Staff participation in a formalized community coalition meeting concerned with fostering common interests and advocacy for prevention services. Staff attend: ● MADD ● MCRUD ● Interagency Councils ● Multi-agency Task Forces ● Local prevention coalition ● A coalition subcommittee workgroup C07 Coalition Technical Assistance. (including: collaboratives, task forces, and community planning teams) Services provided by staff intended to give technical guidance to prevention programs, community organizations, and individuals to conduct, strengthen, or enhance activities to promote prevention ● Staff provide expertise to help with a coalition activity ● Assisting in the development of an action plan● Quality assurance and improvement guidance for coalition improvement C08 Coordinating and monitoring volunteers (including mentors) Structured prevention activities to impart information and teach organizational development skills to individuals or community groups ● Community volunteer services ● Coordinating volunteers for a prevention event ● Monitoring volunteers for mentoring services ● Neighborhood action services Commissioners Minutes Continued. January 20, 2010220
Page 9 • Education Strategies: Two-way communication that is distinguished from disseminating information by the fact that it is based on an interaction between the educator and the participant. These activities generally are curriculum based or have at minimum, goals and objectives that aim to affect knowledge, concepts, principles, critical life and/or social skills, including decision making, refusal skills, and critical analysis. Note: Only recurring events can be counted as Educational Strategy, one-time events cannot be considered Education Strategy. Examples of methods used for this strategy include the following: - Classroom education - Small group education - Parenting and family management classes - Peer Leader and peer helper programs - Education programs for youth groups (ie: anger management, life skills, safe dates, etc) Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities to Enter into PDS E02 Classroom curriculum. Within school day. In regular classroom students. To affect knowledge, concepts, principles, critical life and/or social skills, including decision making, refusal skills, and critical analysis through two-way communication with students in a classroom setting during the school-day as a part of the classroom curriculum with students that have not been selected due to individual need or characteristics. • Teaching Botvin’s Life Skills to a 5th grade class room as a part of their general class time. • Teaching Project Alert to students in an 8th grade classroom setting as a part of their general class time. E03 Other Group Education To affect knowledge, concepts, principles, critical life and/or social skills, including decision making, refusal skills, and critical analysis through two-way communication with participants in any setting outside of a school classroom curriculum. Includes “pull-out” groups of identified students even if they are served in a classroom setting during the regular school day. • Teaching Botvin’s Life Skills to a group of selected students “pulled out” of their classroom. • Teaching Project ALERT after school to a select group of 8th Grade students. • Teaching Anger Management to students at an alternative high school. • Providing educational programs for older adults about the interaction of alcohol with medications. • Teaching an educational program for parents/caregivers of children with FASD challenges. • Teaching Strengthening Families Program to parents. Commissioners Minutes Continued. January 20, 2010221
Page 10 • Information Dissemination Strategies: Provides knowledge and increases awareness of the nature and extent of alcohol and other drug use, abuse and addiction as well as their effects on individuals, families, and communities. It also provides knowledge and increases awareness of available prevention and treatment programs and services. It is characterized by one-way communication from the source to the audience, with limited contact between the two. If a staff person is working to develop materials or resources (eg. resource guide, website, PSA) in partnership with a collaborative group the activity should be counted as Information Dissemination. Avenues of disseminating information may include: Clearinghouse, information resources centers, resource directories, Media campaigns, Brochures, Radio and TV public service announcements, Speaking engagements, Health fairs and other health promotion (e.g. conferences, meetings, seminars), Information lines/hot lines. While there are many avenues to disseminate information it is important to note that only time spent in activities conducted by staff that are designed to disseminate information will be entered into the PDS system. The number of materials distributed would not be entered as an activity because PDS is a tool to capture staff time spent in activities. For example, if you coordinate a clearinghouse and an order is placed online, there would be no activity entry in PDS. In addition, remember that only face-to-face activity with persons from outside of your agency is entered into PDS. Time spent in developing materials or organizing distribution by yourself or with other staff within your agency would not be entered as an activity in PDS. Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities to Enter into PDS N01 Distribution of materials at events. (brief) presentation, interaction with participants To hand out ATOD related materials, answer questions, and possibly do a brief present6ation associated with the materials being distributed. • Manning a booth at a health fair • Manning a drug-free pledge table at a HS football game. • Brief presentation at a health event. • Community round table event. N02 Supervision and technical assistance for development of PSA and other PI materials Develop materials designed to increase knowledge and increase awareness of the nature and extent of alcohol and other drug use, abuse and addiction as well as their effects on individuals, families, and communities. • Supervise/work with a collaborative to develop and implement a media campaign • Supervise/guide the development of PSA or other materials with participants • Work w/ a coalition to develop a resource guide.• Provide technical assistance to a collaborative effort to develop and maintain a resource listing of Federal, State, and local funding programs. Commissioners Minutes Continued. January 20, 2010222
Page 11 N06 Speaking engagement - (direct) - Presentation about SUD Planned presentations with a defined topic/focus provided directly to the intended audience. • One-time classroom presentation • Scheduled presentation as a part of the scheduled agenda at a coalition meeting, town hall meeting, PTA meeting, etc. N07 Speaking engagement-indirect - (radio or tv interview) Planned presentation with a defined topic/focus indirectly to the audience through radio, TV, or print media. • Interview with a journalist • Video conference presentation Commissioners Minutes Continued. January 20, 2010223
Page 12 • Problem Identification & Referral Strategies: Aims at identification of those who have engaged in illegal/age-inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. This strategy does not include any diagnostic or problem assessment activity (although individuals may be identified for whom referral to treatment might be appropriate). Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities to Enter into PDS P01 Employee Assistance provision or referral Services intended to provide substance abuse information for individuals whose substance abuse-related problems may be interfering with work performance. Activities conducted as a component of an Employee Assistance Program, which may include: • Risk reduction education for work-related problems involving substance abuse • Health education and health promotion programs for employees • Supervisor training to assist them in recognizing employees in need of assistance. • Conducting assessments to identify employee substance use disorder problems • Meeting with employees to make referral to designated helpers • Conducting support groups for students P02 Student Assistance Program, case finding, provision, or referral Structured prevention programs intended to provide substance abuse information for students whose substance abuse-related problems may be interfering with their school performance. Activities conducted as a component of a Student Assistance Program, which may include: • Conducting assessments to identify student problems • Screening for referral • Meeting with students to make referral to designated helpers • Conducting support groups for students P03 Conducting DUI/DWI/MIP classes Structured prevention education programs intended to change the behavior of youth and adults who have been involved in the use of alcohol and/or other drugs while operating a motor vehicle. • Alcohol-related highway traffic safety classes • Court-mandated alcohol and other drug awareness and education programs P04 Prevention assessment and referral Refers to those activities intended to provide a risk screening, assessment, and referral to prevention service populations for placement in prevention or other appropriate services. • Providing substance use disorder screening at a community health event • Screening in jail or prison settings • Screening and referral for FAS (any age) Commissioners Minutes Continued. January 20, 2010224
Page 13 • Environmental Strategies: Activities working, with other individuals, to establish or change written and unwritten community standards, codes and attitudes, thereby influencing alcohol and other drug use among the general population. Typically the environmental strategy focuses on changing the shared environment through three interrelated factors: norms, availability, and regulations. Environmental approaches seek to create communities and societies that are more conducive to bringing about and maintaining desired behavior changes. Effective environmental strategies will focus on entire populations, enhance prevention messages directed at individuals, and have potential for long-term change. Environmental strategies are an exception among the six strategies: When determining whether an activity is the environmental strategy, it is necessary to examine the objective, rather than the methodology. Activities that seek to reduce access, change community norms or policies (including laws and regulations), or enforce related laws should be considered the Environmental Strategy. Environmental strategies include: - Policy Change: Changing environmental codes, ordinances, regulations, and legislation in order to limit access to substances and to decrease the problems associated with their use. - Enforcement: Laws and regulations must be accompanied by significant penalties and they must be enforced in order to be effective. - Education: when in relation to training of individuals such as servers and merchants about the laws, penalties, and their responsibilities. - Reduce youth access to substances, including alcohol and tobacco. - Reduce alcohol and tobacco advertising. - Social Norms: Comprehensive efforts designed to change community norms regarding substance use disorder. Sub-Strategies: Strategy Code Code Description Purpose of Activity Examples of Activities V01 Technical Assistance in relation to community norms or public policy change Providing guidance/supervision/technical assistance for activities designed to change norms, availability, and policies (regulations/laws/ ordinances). (Walking a collaborative through the processes of making environmental change) • Meeting with key stakeholders to gain support for a policy change. • Presentation to key stakeholder groups to gain support for a policy change. • Guiding a collaborative group through the steps necessary to create policy change (eg. Tobacco coalition to implement a smoke-free ordinance). • Assisting schools with the development and adoption of drug-free campus policies • Providing technical assistance to a collaborative in designing a media campaign to change community norms re. ATOD use. Note: Providing general education (how/why/skills/media literacy) about environmental change should be entered as the Education strategy. Note: The entire meeting time must be focused on this initiative to be reported as V01. Commissioners Minutes Continued. January 20, 2010225
Page 14 V02 Prevention of Underage Sales Tobacco - SYNAR (vendor education, law enforcement education, compliance activities) Efforts to reduce the ability of youth to purchase tobacco from a retailer. • Vendor education training • Conducting compliance checks • Training law enforcement to conduct compliance checks • Training youth inspectors to conduct compliance checks • Age testing youth inspectors in the community. V03 Prevention of Underage Sales Alcohol - (vendor education, law enforcement education, compliance activities) Efforts to reduce the ability of youth to purchase alcohol from a retailer. • Vendor education training • Conducting compliance checks • Training law enforcement to conduct compliance checks • Training youth inspectors to conduct compliance checks • Age testing youth inspectors in the community Commissioners Minutes Continued. January 20, 2010226
Page 15
K. Funding Source:
All eligible service activities funded in whole or part, through the coordinating agency (CA) must be
reported in the PDS system.
Answer Categories:
• SPF-SIG funded: Select this is the salary of the staff conducting the activity is paid through the
SPF/SIG grant.
• Not SPF-SIG Funded: Select this if the salary of the staff conducting the activity is paid
through any funding source other than the SPF/SIG grant.
L. Population Type:
Answer Categories:
• Universal: The general public or a whole population group that has not been identified on the
basis of individual risk; also the population of a geographic area as a whole. All efforts using
community based or environmental strategies would target this population type.
• Selective: Individuals or a subgroup of the population whose risk of developing a substance use
disorder is significantly higher than average.
• Indicated: Persons who have begun experimenting/using substances but are not in need of
treatment for a diagnosable addiction.
For example: minors in possession, persons in recovery maintenance, etc.
Note: Children of addicted parents who have not begun experimenting with substance abuse
should be categorized as Selective and not indicated.
Helpful Hint: Selective and indicated may only be selected if you are providing Population-Direct
or Individual-Direct service (ie. working directly with the persons whose behaviors you are trying to
change, refer to Section O: Service Type for more information). For all Universal-Indirect services
such as collaborative efforts and environmental change you must select Universal as the Population
Type.
M. Service Domain: This refers to the domain that the prevention service is directly impacting and not
a secondary population who may be the intended beneficiary of prevention efforts. Think about
what your activity is, rather than the intended outcomes.
Answer Categories:
• Individual: Services designed to impact an individual person’s knowledge, skills, etc.
Example: Life skills training for youth.
• Family: Services designed to improve family functioning
Example: Program to teach parenting skills to parents.
• Peer: Services designed to influence peers.
Example: Peer mentoring activities and peer-led social norming campaigns.
• School/Work: Services/activities designed to change the school or work environment.
Example: Efforts to change school policies and practices, or train school personnel to provide
prevention curricula.
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• Community: Services/activities designed to change the way in which a community and its
systems function.
Example: Coalition efforts to increase prevention programming or prevention funding in the
community.
• Society/Environment: Activities designed to change the environmental conditions.
Example: Coalition efforts to change public policy, activities to reduce access to substances, or
media campaigns to change community attitudes and beliefs regarding substances.
N. Evidence Based Practice (EBP) Service Type: Intended to identify the nature of the evidence
based practice being applied. Providers must be able to document that evidence-based criteria have
been met to the coordinating agency upon request.
When determining which category of evidence-based criteria to select for a specific activity,
consider whether the activity is an integral part of a planned project that has been documented as
evidence-based through the planning and approval process of your coordinating agency. If the
activity is part of a group of services that when combined, meet the criteria for Evidence-based then
select the evidence-based category that the group of services falls within.
Examples:
• Staff attending a delivery of the Botvin’s Life Skills curriculum delivered by a volunteer for the
purposes of monitoring fidelity of implementation. The evidence-based category for the staff
time spent monitoring the delivery would be ‘NREPP Listed’ because Botvin’s Life Skills meets
the criteria for this category of Evidence-Based.
• Hosting a community town hall meeting to increase participation and engage community
members in your coalition. If the plan approved by your coordinating agency documents the
coalition work as ‘Community Based Process Best Practice’ then select this category for the
town hall meeting.
• Manning a booth at a health fair to promote your agency but not specific to the furtherance of a
specific plan approved by your coordinating agency. This activity would be entered as ‘none of
the above’.
Answer Categories:
• NREPP Listed: A program that was previously listed on the SAMHSA model program list or
currently listed on NREPP with positive outcomes demonstrated. Note: Programs will be placed
on the NREPP website whether outcomes are positive or negative. Therefore, it is imperative
that agencies critically review the outcomes detailed and the strength of the evaluation described
in the NREPP review.
• Other Federal Agency: The program/model is listed by NIDA, OJJDP, US DOE, or another
federal agency as an effective prevention program/model.
• Peer Reviewed Journal: The program has appeared in a peer-reviewed journal and was found
to have positive outcomes. This option should only be selected if your activities are closely
replicating the key components of the program described in the Peer-reviewed journal.
• Local (CA) Evidence: This option should be selected if the specific service has documented
proven results impacting targeted factors (causal factors, intervening variables and/or
risk/protective factors) through an evaluation process. These results must be available to the
coordinating agency upon request.
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In addition to having local evidence, the project is required to meet each of the following three
criteria:
1. Intervention is based on solid theory or theoretical perspective that has been validated by
research;
2. The intervention is supported by a documented body of knowledge – a converging
accumulation of empirical evidence of effectiveness – generated from similar or related
interventions that indicate effectiveness; and
3. The intervention is judged by a consensus among informed experts to be effective, based
on a combination of theory, research, and practice experience.
• CBP (community based process) Best Practice: Community Based Process includes activities
conducted through formal coalitions, task forces, community planning teams, or collaborative
groups.
This option of evidence- based category may be selected for collaborative activities, but only if
the project meets each of the following three criteria:
1. The project is conducted using community based process (eg. coalitions, collaborative,
taskforces); and
2. The collaborative has substance abuse specific, measurable objectives to be completed
during the fiscal year; and
3. The collaborative process is compatible with the five-step prevention planning process,
which includes: Assessment, Capacity Building, Planning, Implementation, and
Evaluation.
In addition to these three criteria, the following should be considered when conducting
community based processes:
o Membership: The collaborative must be inclusive in its membership/make-up and
engage key community stakeholders. The coalition should have appreciation for local
involvement and authority in choosing and carrying out actions.
o Evidence of Effectiveness: Projects implemented through the community-based process
effort need to show evidence of being effective at the following:
- Contributing to the identified desirable outcome,
- Impacting the identified community problem/consequence,
- Improving the ability of the prevention system to deliver Substance abuse services.
o Clear Purpose: Projects implemented through the community-based process effort should
begin with a clear understanding of their purpose and should consider the following
initiatives:
- Comprehensive services coordination (improving the nature and delivery of services);
- Community mobilization (generate community activism to address substance abuse
and related problems/consequences;
- Create both system level change and individual behavior change; and
- Create community linkages (connecting resources within a community and/or
connecting persons to resources.
• None of the above: This option should be selected for all activities that do not meet any of the
categories listed above. Stand alone events that are not connected to a larger plan with evidence
based documentation provided to your coordinating agency are likely to fall within this category.
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O. Service Type:
Activities can be categorized as either Indirect or Direct: An activity is Indirect if you are NOT
working with the individuals whose behavior you are trying to change. Activities are Direct if you
are working with the individuals whose behaviors you are trying to change.
For example:
o Indirect: Working with a coalition to improve resources for parents in the community.
o Direct: Working with parents to improve their parenting skills.
Indirect Services all fall into one service type category:
• Universal-Indirect: Interventions that support population-based programs and strategies
including the provision of information. Including coalition activity, population based
environmental change strategies.
Helpful Hint: If you selected “universal” as the population type and you are not working
directly with the persons you are trying to impact then you would select Universal-Indirect
for the Service type. If you selected Selective or Indicated as the population type but are not
working directly with the persons you are trying to impact then you would need to correct
population type to be universal because you are not working directly with the population of
intended impact.
Note: If you select Universal-Indirect you will not enter the demographic information for
Gender, Age, Race, and Ethnicity.
Direct Services are broken into two categories:
• Population – Direct: Planned and deliberate goal-oriented practices designed to change
behavioral outcomes that work directly with a group of participants, but the participants have
not been identified for services based on an identified risk. Services are provided over a
period of time in a planned sequence of activities that are designed to inform, educate,
develop skills or alter risk behaviors.
Note: If Population Type is Universal, and you are working face to face with the persons
whose behavior you are trying to impact then you would select Population-Direct as the
Service Type.
Example: Life skills curricula provided in a classroom setting, parenting education with
self-referred families, etc.
• Individual – Direct: Planned and deliberate goal-oriented practices designed to change
behavioral outcomes among a defined population, and the participants have been identified
for services based on an identified risk. Services are provided over a period of time in a
planned sequence of activities that are designed to inform, educate, develop skills or alter risk
behaviors.
Example: Life skills curricula provided to youth with court involvement, Parent Education
with families referred by DHS.
Helpful Hint: If you selected either Selective or Indicated as the Population Type and you are
working directly with the persons you are trying to impact then you would select this category.
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P. Service Population: Up to three service populations may be selected per activity. The populations
selected should be selected in the order of prevalence, with the most prevalent population listed as
service population #1 and so on.
For your convenience, the population type has been identified for each service population listed.
High-Risk Populations: The following are the federal population categories, considered to
be at-risk.
Population
Type
04 Children of substance abusers: Youth and adults who are children of substance
abusers. Examples are adult children of alcoholics, children whose parents abuse alcohol
or other drugs, and children raised in or chronically exposed to situations involving
substance abuse.
Selective
05 Delinquent/Violent Youth: Youth who display risk factors for delinquency or violence
or who have been determined to be delinquent or violent. Examples are youth declared
delinquent by a State child welfare system, youth who have been arrested for juvenile
delinquent behavior, youth who are chronically truant, and youth who display chronic or
periodic violent behavior, including youth who display antisocial behavior (e.g., chronic
fighting, hitting, using weapons).
Selective
06 Economically Disadvantages: Youth and adults considered to be underprivileged in
material goods due to poor economic conditions. Examples are youth and adults living in
poor housing conditions or who are enrolled in state or Federal public assistance
programs.
Selective
13 Homeless or runaway youth: Youth (and adults) who do not have a stable residence or
who have fled their primary residence. Examples are street youth (and adults), youth (and
adults) in homeless shelters, and youth in unsupervised living situations.
Selective
16 People using substances: Youth and adults who may have used or experimented with
alcohol, tobacco, or other drugs. Examples are youth or adults charged with driving
under the influence (DUI), driving while intoxicated (DWI), or being a minor in
possession (MIP); social or casual users of illicit substances; and youth and adults who
smoke tobacco or consume alcoholic beverages but who are not yet in need of treatment
services.
Indicated
17 People with disabilities: Youth and adults who have disabilities. Examples are
individuals who are physically handicapped, hearing impaired, speech impaired, or
visually impaired.
Selective
18 People with mental health problems: Youth and adults with mental health problems.
Examples are persons with diagnosable mental illness such as depression, severely
emotionally disturbed youth, and the educable mentally retarded.
Selective
19 Physically/emotionally abused: Youth and adults who have experienced physical or
emotional abuse. Examples are victims of physical abuse, sexual abuse, incest, emotional
abuse, and domestic abuse.
Selective
20 Pregnant/Women of childbearing age: Women who are of the physiological age to
bear children and for whom the intent of prevention services is to ensure healthy
newborns.
Selective
24 School dropouts: Youth under the age of 18 who have not graduated from school or
earned a general educational development certificate and/or who are not enrolled in a
public or private learning institution.
Selective
98 Children exposed prenatally to ATOD Selective
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Non-High Risk Groups: The following are the federal population categories, considered
not at risk.
Population
Type
30 Youth/Minors: Children under age 18 who are not otherwise counted under one of the
school grade categories. Examples are youth in recreation programs (camps
Universal
31 Students: Youth enrolled in public or private schools Universal
32 Older adults: Adults considered being older (in general persons over 65 years of age?.
Examples are older persons who are living independently or residing in a nursing home
or an assisted living facility.
Universal
33 Parents and families: Parents and families, including biological parents, adoptive
parents, and foster parents; grandparents, aunts and uncles, or other relatives in charge of
or concerned with the care and raising of youth; nuclear families; and mixed families.
Universal
34 Gays/lesbians: – Individuals who identify themselves as emotionally and physically
attracted to others of the same gender.
Universal
35 Persons in recovery: Indicated
36 Business and Industry: Individuals who manage or work in for-profit or not-for-profit
businesses or industry. Examples are small businesses, companies, corporations,
industrial plants, and unions.
Universal
37 Civic groups: Members of civic and nonprofit organizations. Examples are men's and
women's state or local civic groups (eg. Lions Club), and nonprofit agency boards of
directors or staff.
Universal
38 Coalition: Members of community, regional or statewide coalition groups, community
task forces, alliances, and similar community organizations.
Universal
39 Religious group: Individuals involved with or employed in religious denominations or
organized religious groups such as churches, synagogues, temples, or mosques. Examples
are members, deacons, elders, clergy, religious associations, ministerial associations,
ecumenical councils or organizations, lay leaders, and religious education staff.
Universal
40 Government/Elected officials: Individuals holding government positions, including
those who have been elected to public office. Examples are government workers;
mayors; city administrators; city or county commissioners; supervisors, freeholders, or
other elected officials; state legislators and staff; and members of the U.S. Congress and
their legislative staff.
Universal
41 Health professionals: Individuals employed by or volunteering for health care services.
Examples are physicians, nurses, medical social workers, medical support personnel,
medical technicians, and public health personnel.
Universal
42 SUD (substance use disorder) Prevention/Treatment professionals: Individuals
employed as substance abuse prevention or treatment professionals. Examples are
counselors, therapists, prevention professionals, clinicians, prevention or treatment
supervisors, and agency directors.
Universal
43 Teachers/Administrators/Counselors (education): Individuals employed in the
education field. Examples include teachers, coaches, deans, principals, faculty, and
counselors.
Universal
44 Law Enforcement/Military: Individuals employed in law enforcement agencies or in
one of the U.S. Armed Services. Examples are police, sheriffs, state law enforcement
personnel, and members of the National Guard, Army, Navy, Marines, Air Force, and
Universal
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Coast Guard.
45 General population: Youth and adult citizens of a state rather than a specific group
within the general population.
Universal
Q. Attendee Counts:
• Total Attendees- Enter the total number of attendees present for the activity. For recurring
sessions this will include all attendees present, including the new and returning participants.
Note: For information dissemination (N07) – Speaking Engagement to Indirect audiences, enter
the estimated ‘reach’ of the media outlet.
For information dissemination activities with large audiences, estimate the number of attendees.
• New Attendees – For the first session of a series all participants would be counted as ‘new
attendees’. For following sessions only participants that are attending their first session would
be counted as a ‘new attendee’.
• Number completing the Series:
o For Ongoing-Sequential activities enter the number of participants completing the series of
sessions in the last session of the series. For all other sessions, enter “0”.
o For open-ended groups enter the number of participants that have completed all required
sessions during the session being reported.
o For activities that are not comprised of a number of set sessions, enter “0” for all activities.
Note: An agency must be able to document completion through sign-in sheets or other record
keeping.
R. Demographic Information:
For activities where the selected population type is Universal, and the Service Type selected is
Universal-Indirect you will not enter the gender, age, race, and ethnicity (for more info on
Universal-Indirect please refer to Section O: Service Type on page 17)
• New Male/Female Attendees - Enter the number of new attendees that were male, and the
number of new attendees that were female. Do not complete for Universal-Indirect activities.
• Participants by Age in Years: Enter the number of new participants by age group. Do not
complete for Universal-Indirect activities.
Answer Categories:
o Less than 12
o 12-17
o 18-20
o 21-25
o 26-64
o 65+
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• Race: Enter the number of new participants by Race. Do not complete for Universal-Indirect
activities.
Answer Categories:
o American-Indian/Alaskan-Native,
o Asian
o Hawaiian/Pacific-Islander
o African-American
o White
o Multi-Racial
o Unknown/Other
• Ethnicity: Enter the number of new participants by Ethnicity. The numbers entered into these
categories must be equal to the number of new participants. Do not complete for Universal-
Indirect activities.
Answer Categories:
o Hispanic/Latino
o Arab-American/Chaldean
o Not-listed (All participants that do not fall within one of the above categories must be
counted under this answer category.)
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234
MDCH Supplemental Instructions to Substance Abuse
Coordinating Agencies for 837 Encounter Data Submission
MICHIGAN DEPARTMENT OF
COMMUNITY HEALTH
SUPPLEMENTAL INSTRUCTIONS
TO
SUBSTANCE ABUSE
COORDINATING AGENCIES
FOR
837 ENCOUNTER
DATA SUBMISSION
Fiscal Year 2010
Commissioners Minutes Continued. January 20, 2010
235
MDCH Supplemental Instructions to Substance Abuse (Rev. August 2007) Coordinating Agencies for 837 Encounter Data Submission
Table of Contents
Page
1.0 Introduction 1
2.0 837 Encounter Data Reporting 1
2.1 HIPAA Background 1
2.2 Encounter Data Reporting Format 2
2.3 Data Submission Process 3
2.4 Implementation Timeline 4
2.5 Year-End Reconciliation Process 5
2.6 Reporting Requirements 5
2.7 Encounter Data Edits 5
2.8 Rejection Criteria 6
2.9 Correction Process 7
2.10 837 Encounter Data Elements 9
Appendices
A Encounter Error Listing 17
B Encounter Error Return File 32
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236
MDCH Supplemental Instructions to Substance Abuse Page 1 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
1.0 Introduction
The Michigan Department of Community Health (MDCH) requires that Substance Abuse Coordinating
Agencies (CAs) report encounters and quality improvement (QI) data for every consumer served by the
CA. The Reporting Requirements can be found in Appendix A. Encounter reporting is required no
matter what the payment arrangement with the provider (i.e., fee-for-service, per diem, case rate, sub-
capitation, net cost contract, etc.).
Historically CAs have been submitting activity and demographic data using a proprietary format. As
MDCH moves towards meeting the mandates set forth under the Health Insurance Portability and
Accountability Act (HIPAA), many national standards for health care transactions are being adopted. As
a result MDCH is implementing a standardized format for encounter (activity) data reporting. MDCH
will require that encounters be submitted in the American National Standards Institute (ANSI) Accredited
Standards Committee (ASC) X12N 837, version 4010, Professional, Institutional, and Dental Healthcare
Claim formats. MDCH will use the provider-to-payer-to-payer coordination of benefits (COB) data
model for encounter reporting. In addition, CAs will be required to continue to report demographic, or
quality improvement (QI) data, using essentially the same format and process they have been.
The purpose of these instructions is to provide guidelines to CAs for submitting both encounter and QI
data. The information provided in this manual that is specific to encounter data reporting is intended to
supplement information contained in the ANSI ASC X12N 837 Implementation Guides. The
Implementation Guides must be adhered to for creating 837 encounter transactions.
2.0 837 Encounter Data Reporting
2.1 HIPAA Background
In August 1996, the United States Congress adopted the Health Insurance Portability and
Accountability Act (HIPAA). The Act includes Administrative Simplification components with
provisions to improve the efficiency and effectiveness of the health care system by establishing
standards for the electronic exchange of certain administrative and financial transactions and to
protect the security and privacy of transmitted health information.
A federal regulation pertaining to transaction standards and code sets was adopted in August 2000.
This regulation mandates the use of electronic data interchange (EDI) standard transactions for many
of the more common communications used in health care administration, as well as the use of
standard code sets. The transaction standards and code sets regulation has an effective date of
October 2002. Subsequent legislation allows the effective date to be extended to provide more time
to covered entities to be fully compliant. Entities that request extensions to the effective date for
transactions and code sets will have until October 2003 to implement the regulation.
It is important to note that while an extension allows the CA increased time to meet the
transaction and code set mandates set forth by HIPAA, MDCH is implementing the new ASC
X12N 837 version 4010 format for encounters effective with dates of service on or after October
1, 2002. Contracted entities will be required to meet these requirements as outlined in their
contracts with MDCH.
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237
MDCH Supplemental Instructions to Substance Abuse Page 2 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
2.2 Encounter Data Reporting Format
Beginning with services incurred on or after October 1, 2002, CAs will report encounters to MDCH
using the transaction sets developed by the ANSI ASC for EDI. Many EDI transaction sets are
identified by numeric designations, such as the 837 healthcare claim and encounter transaction.
There may also be numerous versions of an EDI transaction and the version required by MDCH for
837 encounter reporting is version 4010. Therefore, CAs reporting encounters to MDCH must use
the implementation standards of the ANSI ASC X12N 837, version 4010 transactions.
In addition, the CAs are required to follow the provider-to-payer-to-payer coordination of benefits
(COB) data model outlined in the implementation guides. This means the provider originates the
transaction and sends claim or encounter information to the CA. The CA will reformat the
transaction and send it to MDCH. The CA has ultimate responsibility for sending 837 encounter
information on to MDCH. The 837 provider-to-payer-to-payer COB model promotes the handling of
coordination of benefits data. It is important to note that if there is another payer identified as
primary, such as Medicare or another Commercial carrier, the provider must send the claim to the
primary payer for adjudication prior to sending the claim or encounter information on to the CA. The
CA must include the primary payer’s adjudication information, as well as their own, in the 837
transaction being sent to MDCH. Implementation guides contain notes on each COB-related data
element specifying when it is used. This manual will provide guidelines for those data elements
identified as most important to MDCH.
Depending on the type of service provided, encounter transactions may need to be submitted using
either the Institutional (X096), Dental (X097) or Professional (X098) Industry Identifier of the 837
Encounter Transaction. As a general rule, if the service provided is billed using the Health Care
Financing Administration Common Procedural Coding System (HCPCS) codes, including the
American Medical Association’s (AMA’s) Current Procedural Terminology (CPT) codes, it is billed
as an 837 professional claim and reported as an 837 professional encounter. If billing rules require
the service to be billed using a National Uniform Billing Committee (NUBC) Revenue Code, or
Revenue Code and HCPCS code, the format for the claim and encounter would be the 837
institutional. When billing for the service requires the American Dental Association’s (ADA’s) Code
on Dental Procedure and Nomenclature, contained in the Current Dental Terminology (CDT-3) user
guide, the claim and encounter would be the 837 dental transaction.
Implementation instructions are contained in detailed manuals known as implementation guides. The
implementation guides provide specific instructions on how each loop, segment, and data element in
the specified transaction sets should be used. These guides are available from the Washington
Publishing Company. You can order these guides by contacting:
Washington Publishing Company
PMB 161
5284 Randolph Road
Rockville, MD 20852-2116
Phone (301) 949-9740
The guides may also be ordered on line or downloaded at no charge at http://www.wpc-
edi.com/hipaa/HIPAA_40.asp. Note that the guides are quite large and could take some time to
download.
The implementation guides are the primary source of information on how to implement the 837
encounter, provider-to-payer-to-payer COB data model.
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238
MDCH Supplemental Instructions to Substance Abuse Page 3 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
MDCH has published Data Clarifications for the 837 Institutional, Professional and Dental
Encounter, Version 4010. These documents are companion documents to the implementation guides;
they supplement and clarify parameters when the implementation guide provides options or
“situations”. They also provide identifiers to be used when a national standard has not been adopted.
The information in the Data Clarification documents will be helpful to the CAs as they develop
outbound 837 encounter transactions. These clarification documents can be found at
http://www.michigan.gov/mdch. Once you have reached the web site, click Providers, HIPAA,
Health Plan Materials-Reporting/Reimbursements. There are Data Clarifications for 837 Claims and
for 837 Encounters available. The CAs should make certain they are using the Data Clarifications for
encounters when developing their 837 encounter transaction. In addition, CAs should check the web
site regularly for updates or changes to these documents.
2.3 Data Submission Process
Encounter data submitted in the 837 format will be submitted through the MDCH Data Exchange
Gateway (DEG) on a monthly basis, at a minimum. CAs may submit encounter data more frequently
if necessary.
In order to communicate electronically with MDCH, the CA must first obtain an Identification
Number and password from the MDCH Automated Billing Unit. For general instructions on how to
obtain that Identification Number and password, please refer to the “MDCH Electronic Submission
Manual”, which can be found on the web at www.michigan.gov/mdch. Once you have reached the
web site, click Providers, Information for Medicaid Providers, Electronic Billing.
Before an encounter file can be submitted to MDCH for processing, the file must be prepared.
Instructions can be found in the MDCH Electronic Submission Manual, Section 4, Preparing
Electronic Claim Files. It is important to note that all ANSI X12 files have header and trailer data
built into them.
Professional, institutional and dental encounters may be combined in one file, or may be transmitted
in separate files. Each file must include an Interchange Envelope, containing various ISA elements as
specified in the implementation guide. The encounter file must specify ENCOUNTER in the
Interchange Receiver ID (ISA08) element and P in the Usage Indicator (ISA15) element.
The Interchange Envelope may contain one or more Functional Groups. Each Functional Group will
specify whether that Functional Group contains Institutional, Dental or Professional encounter
transactions. In the Application Receiver’s Code (GS03) element of each Functional Group, you
must specify ENCOUNTER. The Version/Release/Industry Identifier Code (GS08) element of each
Functional Group must contain 004010X096, 004010X097, or 004010X098, indicating whether that
group contains institutional, dental, or professional encounter transactions, respectively.
To submit the 837 v 4010 encounter file, log onto the DEG (Data Exchange Gateway), using the
instructions outlined in the MDCH Electronic Submission Manual, Section 5, Using the Data
Exchange Gateway.
When you send an Encounter file to the DEG, take the following steps.
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1. Type:
Put<space> <volume>\<directory>\<file> <space> <file number>@<location>
For example, put<space>c:\dos\4951@dchedi, where c is the hard drive, DOS is the
directory, 4951 is the file for the CA encounter, followed by a space, the @ sign, and a
location of dchedi (dch indicates the Department of Community Health, and edi indicates the
American National Standards Institute X12 837 transaction format). The submitter would
type:
PUT C:\DOS\4951 4951@DCHEDI
2. Once the file is transferred to dchedi, translation begins immediately and an ANSI X12 997
Functional Acknowledgement is produced and moved to the sender’s mailbox.
3. Enter the dir command to see the ANSI X12 997 Functional Acknowledgement with the
name of the file sent.
4. Download the ANSI X12 997 Functional Acknowledgement by entering a get command,
being careful to change the file name for the destination system so the file sent is not written
over. For example, adding an “a” to the file name would indicate that it has been
acknowledged.
After you have issued the PUT command and the file has been transferred, you can do a “DIR”
(Directory Command) to see if the 4951 file exists in your Mailbox.
CAs should copy transferred files immediately as a back up for their site. It is the agent’s
responsibility to retain back-up files until the party at the final destination has verified and backed up
the files. Should the file not be received in its entirety, it may have to be resent using the back up.
As mentioned, after the file has been received by MDCH, a 997 Functional Acknowledgement
transaction will be generated and submitted to the CA’s mailbox. It can be retrieved via the DEG.
The Functional Acknowledgment contains segments that can identify the acceptance or rejection of
the functional group, transaction sets or segments. It is important that the CA retrieve the 997
acknowledgements to determine if MDCH has received the ASC X12 837 transaction sets, and
identify transmissions that have not been acknowledged.
2.4 Implementation Timeline
For all services incurred on or after October 1, 2002, the CA is required to send data monthly on post-
adjudicated encounters in the new 837 format. Encounter data is required to be submitted by the last
day of the month following the month in which it was adjudicated.
To assist in the transition MDCH will allow encounters for claims adjudicated in the months of
October, November, and December 2002 and January 2003 to be submitted by March 3, 2003.
Submission is due by 5:00 p.m. on the last day of the month following the month it was adjudicated.
Services that have been provided but for some reason are still in the adjudication process will be
reported using a year-end reconciliation process. The year-end reconciliation process is described in
Section 2.5 below.
MDCH will be retiring its current proprietary encounter format November 2002. CAs must have all
FY2002 data or updates submitted by November 15, 2002.
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2.5 Year-End Reconciliation Process
Substance abuse encounters are required to be submitted by the last day of the month following the
month it was adjudicated. Any encounter that has not been reported by the end of the fiscal year
because the adjudication process is incomplete, must be reconciled within 90 days of the last month
of the fiscal year. That means the CA will have 90 days following the end of the fiscal year to submit
the encounter data. For example, if the date of service is January 20, 2003 and by September 30,
2003 still has not been adjudicated by the primary payer, the CA is required to submit an encounter
reporting the services provided with $0 reported in the approved and paid amount fields by December
31, 2003. The claim or service line adjudication date, whichever is applicable to the encounter being
submitted, should be reported with a date value of 99999999. This will allow the transaction to be
processed without indicating adjudication has taken place.
The CA will then be required to submit a replacement encounter by the last day of the month
following the month it was adjudicated, once it is finally adjudicated.
2.6 Reporting Requirements
MDCH requires CAs to report encounters for all consumers whose services are paid for in whole or in
part with MDCH administered funds. CAs are not required to submit encounters in the following
instances:
children’s waiver services that are billed fee-for-service directly to Michigan Medicaid, (QI
data files are still required to be submitted), and,
room and board reimbursed through State Disability Assistance (SDA) funds.
In situations where the client has dual eligibility (i.e., Medicare/Medicaid), the CA is required to
submit encounter data for the services provided.
2.7 Encounter Data Edits
To ensure the usefulness of the data submitted, the data must meet minimum thresholds of data
quality. One of the most basic tests of data quality is editing. All data currently submitted to MDCH
are subjected to an editing process. All 837 encounter data will also be subjected to an editing
process. Appendix B, Encounter Error List, lists the 837 encounter edits that correspond to errors
identified during the encounter data warehouse editing process.
Encounter data edits can have one of the following results:
1. The data pass all edits and is accepted into the data warehouse,
2. The data contain a minor error(s); an informational edit report is generated and the data is
accepted into the data warehouse, or
3. The data contain a fatal error that results in its rejection.
Output from the edit process is an Error Return File that will be available to the CAs at their mailbox
through the DEG. The file layout, including header and trailer records, can be found in Appendix C.
This report is different than the 997 Functional Acknowledgment discussed earlier. The report will
advise of the status of the records submitted in a particular file. If the records result in any errors
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being identified in the editing process, the report will specify the records that contain errors and the
nature of the errors.
When retrieving the Error Return File from the DEG, you must use the “get” command. Once your
logon has been accepted, the prompt ftp> appears, type dir to select the directory of files available.
From the list of files that may be shown, look at the column labeled APPL, these are the files ready to
be retrieved. The 837 Encounter Error Return File APPL ID is 4950. Therefore, you would type:
get 4950 c:\download\4950
This will move the oldest 4950 file to the sender’s PC. The file will downloaded to the C drive, in the
“download” directory, to file 4950.
All Error Return Files will reference the data submission number. It is critical that the CA track their
data submission number.
2.8 Rejection Criteria
MDCH will reject encounters that fail to meet specified edit criteria. The following outlines
situations that will result in the rejection of an entire batch, an individual encounter, or a specific
service line.
A. Batch
There are minimal structural requirements that must be met to allow an entire batch to be properly
read and interpreted. If a transmitted batch fails to meet any of the following criteria, the entire
batch will be rejected:
1. Submitter Identifier (Loop 1000A, NM109) is missing or invalid
2. Submission Number (HDR, BHT03) is missing
3. Submission Number (HDR, BHT03) is not alphanumeric
4. Submission Number (HDR, BHT03) has been used on a previous batch
5. Transaction Type Code (HDR, BHT06) is not “RP”, encounters
6. Transmission Type Code (HDR, REF02) is missing or invalid
MDCH will not reject an entire batch based on the contents of individual records within the file.
B. Encounter
Rejections below the batch level may occur for an entire encounter. An encounter is defined as
all of the services incurred under the same claim/encounter identifier assigned by the provider or
the CA. The following situations will result in rejection of the encounter, including all of the
services that are part of the encounter:
1. The data in any of the following fields is missing or invalid:
a. Other Payer Primary Identifier (Loop 2330B, NM109)
b. Submitter Primary Identifier (Loop 1000A, NM109) is not valid for the Other
Payer Primary Identifier (Loop 2330B, NM109)
c. Other Payer Secondary Identifier – Encounter Reference Number (Loop 2330B,
REF02)
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d. Service Line Number - Counter (Loop 2400, LX01)
e. Claim Frequency Type Code - Original, Void, Replacement (Loop 2300,
CLM05-3)
f. Subscriber Primary Identifier (Loop 2010BA, NM109)
g. Admission Date (Institutional transactions only) (Loop 2300, DTP03)
h. Principal Diagnosis Code (Institutional transactions only) (Loop 2300, HI01-2)
2. The encounter is a duplicate of a previously submitted encounter.
3. The encounter is a void or replacement of an encounter that does not exist in the data
warehouse.
C. Service Line
It is possible MDCH will reject only a service line from a submitted encounter. The reason for
this is to keep the data warehouse as complete as possible while awaiting corrected encounters. If
an edit fails a service line, only the failing service line will be rejected, all other data will be
stored on the warehouse. If there is only one service line on an encounter and that service line is
rejected, the entire encounter will be rejected. The following are examples of situations in which
a service line will be rejected for missing or invalid values.
1. Service Date (Loop 2400, DTP03)
2. The first Diagnosis Code Pointer “points” to an invalid diagnosis code (Professional
Loop 2400, SV107-1)
3. Procedure Code (Professional Loop 2400, SV101-2, Dental Loop 2400, SV301-2, and
those Institutional [Loop 2400, SV202-2] transactions where services require both a
Revenue Code and a HCPCS code)
4. Revenue Code (Institutional Loop 2400, SV201)
5. Units (Professional Loop 2400, SV104, Dental Loop 2400, SV306, Institutional Loop
2400, SV205)
2.9 Correction Process
Resubmission is the process the CA uses when the encounter has not made it through the translator or
processing and there is subsequently no data stored in the data warehouse. The CA will need to
resubmit when a 997 Functional Acknowledgement is received indicating the submission was not
accepted or if the Error Return File contains messages that result in an action of “Reject Batch” or
“Reject Encounter”, indicating the submission could not be processed.
Replacement is the process the CA uses when the encounter has made it through the translator and
processing system and is stored in the data warehouse, but for some reason needs to have corrections
made to the data originally submitted. The CA will need to replace an encounter if the Error Return
File contains a message that results in an action of “Reject Line”, if there has been a change in the
number of units originally reported, if there has been a change in the monetary amounts originally
reported, if the claim has been adjudicated since the encounter was reported using the year-end
reconciliation process, and if there has been a change in the client’s eligibility changing the funding
source reported in the original encounter (i.e., General Fund to Medicaid).
Batches, encounters or service lines that were rejected by the system must be corrected and
resubmitted within 30 days of the date the Error Return File was created. Refer to Appendix C, 837
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Encounter Error Return File, for the “Creation Date” element reported in the Error Return File header
and trailer records.
When MDCH rejects an entire batch, the CA must make the necessary corrections and resubmit
the batch. The individual transactions in the resubmitted file must have the same Claim Frequency
Code (Loop 2300, CLM05-3) designation (i.e., original, void, or replacement) as what was reported
on the rejected file. These should not be designated as replacement encounters. Since the contents of
a rejected batch are not retained in the data warehouse, there is no record to replace in the warehouse.
When MDCH rejects the encounter, the CA must correct the identified error(s) and resubmit the
encounter. As with a rejected batch, a rejected encounter is not stored in the data warehouse, so the
corrected encounter will be submitted with the same Claim Frequency Code designation as was coded
on the first submission. If the rejected encounter was an original encounter, the “corrected” encounter
should also be an original encounter.
When MDCH rejects a service line, the CA must correct the identified error(s) and replace the
entire encounter, including those service lines that were accepted by the data warehouse in the
original submission. The MDCH encounter data warehouse processing system will replace in the
warehouse the entire original encounter with the data submitted on the replacement encounter. The
Claim Frequency Type Code is a “claim” level code, which means the entire claim/encounter is
designated as either original, void, or replacement; this designation cannot be applied to an individual
service line.
If MDCH rejects a service line and there are multiple service lines on the encounter, the service lines
that pass the edits will be retained in the data warehouse. While MDCH may reject only one service
line reported on an encounter that contains multiple service lines, the CA may not correct a single
service line on an 837 encounter transaction. The CA has two options:
1. The CA may replace the entire encounter once the errors have been corrected. The entire
encounter (the service line that originally contained errors and all associated services) will be
completely replaced in the data warehouse. The following information must be included
within the 837 encounter:
a. The Claim Frequency Type Code (Loop 2300, CLM05-3) on the replacement
encounter must now be designated as replacement.
b. The Replacement Claim Number (Loop 2300 REF02 and Loop 2330B REF02) must
be the same as the claim number on the original claim.
Since service line numbers within the 837 encounter must begin at “1” and increment by “1”,
any attempt to correct a single line in a previously submitted and accepted encounter that
contained multiple services would result in the replacement encounter deleting all of the
previously accepted services.
2. The CA may leave the original encounter minus the rejected service(s) “as is” in the
warehouse and create a new encounter reporting only the corrected service line(s). The new
encounter must report a different claim number and should report a Claim Frequency Type
Code of “Original”. CAs should NOT use this option for correcting a service that is already
in the data warehouse, as it would result in the service being duplicated.
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If the CA must replace or void a service that has been accepted into the data warehouse, it must do so
by replacing or voiding the entire encounter on which the service originally appeared. The claim
number for the replacement or void encounter must be the same as the original claim number.
An encounter that was submitted by the CA can only be voided if the CA identifies that the client
identified in the original encounter is not correct or if the CA identifies that the CA identified as the
“Other Payer” in the encounter is not correct. The CA would never void an encounter to replace an
encounter. To replace an encounter follow the steps outlined above. To void an encounter, the CA
would change the encounter designation to void (Loop 2300, CLM05-3 value of “8”) and the Original
Reference Number must be used (Loop 2300, REF02 and 2330B, REF02). When an encounter is
voided, the CA must submit a new “original” encounter to report the service requiring reporting.
2.10 837 Encounter Data Elements
The 837 transaction contains a number of required and situational data elements. It is MDCH’s
intention to use many of these data elements to enhance the information available in the data
warehouse. This section outlines many of the data elements that are of particular interest to MDCH,
those that may be used in the processing of the 837 encounters, and those that have resulted in many
questions from CAs.
These supplemental instructions do not address all of the data elements in the 837 transaction. Note
that implementation of the 837 encounter must include all required and applicable situational data
elements identified in the implementation guide, not just those mentioned in this section.
2.10.1 Transaction Type Code (HDR, BHT06)
All 837 transactions require the coding of a claim or encounter indicator. Transaction Type Code,
which performs this function, appears in the Header Table portion of the transaction set. Specifically
the BHT, or Beginning Hierarchical Transaction, segment must include data element BHT06. CAs
must code this data element to a value of “RP” for all encounter data reporting. The value of “RP”
should be reported whether the CA reimburses the provider on a fee-for-service, per diem, other
payment basis.
2.10.2 Insured Group Name (Loop 2000B, SBR04)
To report that the client is enrolled in the MIChild program, the CA must report the value
“MICHILD” in SBR04, Insured Group Name.
2.10.3 Subscriber Primary Identifier (Loop2010BA, NM109)
CAs are reporting on a number of clients, many enrolled in various Medicaid programs, many not
enrolled in Medicaid at all but whose services are paid through a variety of funding sources, and some
enrolled in MIChild. Clients are identified in these programs through the use of different unique
identifiers. Since there is no national or MDCH standard subscriber primary identifier, CAs should
follow these guidelines:
If the client is enrolled in Medicaid, report their 8-digit Medicaid ID number
If the client is enrolled in MIChild, report their 8-character Client Identification Number
(CIN) assigned by the enrollment broker
For persons not enrolled in Medicaid or MIChild, report their 9-digit Social Security Number
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Use the CA’s unique identifier (CA Client Identifier) only when the person is not enrolled in
Medicaid or MIChild, and the Social Security Number is not known. The CA Client
Identifier must be 11-characters. It may be alphanumeric. If necessary, right justify and zero
fill to the left to create an 11-character value.
2.10.4 Contract Information (Loop 2300, Segment CN1 and Loop 2400, Segment CN1)
When the contract arrangement between the CA and their providers is anything other than fee-for-
service, MDCH recommends that this situational segment be reported to help explain monetary
amounts and adjudication information provided within the 837 transaction. This information is
optional at this time, however, if the CA chooses to report contract information the following
guidelines should be used.
2.10.4.1 Contract Type Code (Loop 2300, CN101 and Loop 2400, CN101)
Report one of the values as indicated in the standard code list provided. MDCH anticipates that many
of the contract type codes reported may fall into the category of “Other”, value “09”.
2.10.4.2 Contract Amount Code (Loop 2300, CN102 and Loop 2400, CN102)
The CA should report the contract amount as indicated by the instructions in the implementation
guide. Report the contract amount for the Contract Type indicated in Loop 2300, CN101 or Loop
2400, CN101. If the Contract Type Code is “Per Diem”, the per diem rate would be reported in this
element.
2.10.4.3 Contract Percent Code (Loop 2300, CN103 and Loop 2400, CN103)
The CA should report a percent in this element only if the Contract Type Code reported in Loop
2300, CN101 or Loop 2400, CN101 is “Percent”. The value represents the contract percentage or
charge percent.
2.10.5 Principal Diagnosis (Loop 2300, HI01)
The 837 transaction sets allow a large number of diagnosis codes to be reported – over 14 on
institutional encounters and eight on professional encounters. MDCH will collect up to 14 diagnosis
codes for institutional encounters (the primary diagnosis, the admitting diagnosis, and twelve
additional diagnosis codes) and up to eight diagnosis codes for professional encounters. The
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) is the
standard code set CAs must use for reporting diagnosis codes. MDCH expects that all encounters
will have a diagnosis reported.
The diagnosis represents the reason for the encounter. Therefore it could be signs, symptoms,
diagnosis if available, or other reason for the encounter. CAs should not ignore the V-series codes
identified by ICD-9-CM. These codes include diagnoses that relate to encounters for various reasons,
including administrative.
The ICD-9-CM Diagnosis Code for Other Unknown and Unspecified Cause (799.9) may be used
only in the following situations:
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The client has a relationship with a client receiving substance abuse services and is receiving
services for co-dependency.
2.10.6 Type of Bill (Institutional Loop 2300, CLM05)
For institutional services, Type of Bill is a standard field that has been required on the UB-92 form
and that provides several different pieces of information. The first digit of this data element identifies
the type of facility (hospital, office, home, etc.). The second digit is referred to as the bill
classification and conveys information on the place of service. The third digit is the frequency code
and identifies the type of billing (e.g., original, interim, final, adjustment, void). MDCH will be using
the components of Type of Bill to identify Record Type (original, void, replacement) and institutional
place of service codes.
2.10.7 Facility Type Code (Loop 2300, CLM05-1 and Loop 2400 SV105 Professional and
Dental)
The data element identifies the type of facility where services were performed. CAs must refer to the
standard code sets from the National Electronic Media Claims National Standard Format available
from http://cms.hhs.gov/states/poshome.asp.
2.10.8 Diagnosis Code Pointers (Professional Loop 2400, SV107-1, SV107-2, SV107-3,
SV107-4)
Diagnosis codes for both institutional and professional transactions are provided at the claim level in
the 837 transactions. For professional services, the 2400 service loop provides segments that contain
diagnosis code pointers. These pointer data elements contain a value of one through eight. These
values “point to” the diagnoses coded at the claim level that most closely correspond to each service
line. Each service line can have up to four diagnosis pointers, or four separate diagnosis codes for
each service. Each service may point to a different set of four diagnosis codes.
2.10.9 Rendering Provider Primary Identifier (Loop 2310B, NM109)
With the implementation of the 837 transaction, CAs will need to report at least two identifiers for
servicing (or rendering) providers. The servicing (or rendering) provider is the person or entity that
actually provided the service. For rendering providers, the NM1 segment is required and will be used
to report either the Employer Identification Number (EIN) or Social Security Number (SSN) of the
provider. Note that this will be the case until the National Provider Identifier or NPI is adopted and
all NM1 provider segments will then require the use of the NPI.
2.10.10 Rendering Provider Secondary Identifier (Professional Loop 2310B, REF02)
Secondary identifiers are carried in the REF segment and MDCH requires CAs to report either the
Medicaid ID or State License Number for all in-state providers. The 837 institutional encounter
requires the identification of the service facility where services were provided (Loop 2310E, REF02).
The nine-character Payer Identification number should never be used to report the rendering provider
secondary identifier.
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2.10.11 Other Subscriber Information (Loop 2320) Segment SBR
Loop 2320, Segment SBR reports information primarily about the Other Subscriber. This loop is
required when there are known other payers potentially responsible for payment of the services
reported. This loop repeats. MDCH will always be the receiver identified in Loop 1000B, therefore,
none of the information reported here is specific to MDCH. The CA is an “other payer” and
information specific to their responsibility and the subscriber’s relationship to them would be reported
in the SBR segment. Any other commercial payer or Medicare would be reported in an iteration of
this loop as well.
2.10.12 Payer Responsibility Sequence Number Code (Loop 2320, SBR01)
This element identifies the level of financial responsibility all other payers have with respect to the
services reported. Appropriate values to report are “P” for primary, “S” for secondary, and “T” for
tertiary. The transaction must always have one payer identified as primary. If there are multiple
payers, the level of responsibility for each must be determined. If the consumer has Medicare or a
commercial carrier with financial responsibility, the commercial carrier or Medicare would be the
primary payer and therefore “P” would be reported for them. In this example, the CA would be
reported as the secondary payer, “S”. If there is Medicare and a commercial payer, the commercial
carrier would be identified as primary, “P”, and Medicare secondary, “S”. The CA would then be
reported with a value of “T”, tertiary. Tertiary can be reported multiple times if needed.
2.10.13 Other Insured Identifier (Loop 2330A Other Subscriber Name – NM109 Other
Insured Identifier)
All substance abuse encounters will require the reporting of the CA Client Identifier in Loop 2330A,
NM109. This element is intended to report the unique member number assigned by the plan or other
payer (CA). The CA Client Identifier must be reported here even when it was used as the subscriber
primary identifier in Loop 2010BA, NM109. The CA Client Identifier must be 11-characters in
length. Right justify and zero fill to the left if required to create an 11-character CA Client Identifier.
2.10.14 Other Payer Primary Identifier (Loop 2330B Other Payer Name – NM109 Other
Payer Primary Identifier)
The contract between MDCH and the CAs for capitated substance abuse services places responsibility
on the CA for the management of client services and payment for services rendered by contracted
providers. The CA is reported as an Other Payer (Loop 2330B). A Payer Identification (PI) number
is required in Loop 2330B, NM109 of the 837 to identify the Other Payer(s). MDCH will enroll CAs
as payers. They will receive a nine-character number (for example, 17XXXXXXX) that identifies
them as an MDCH health plan. This number will be required to be reported as their Payer ID until
such time as the national standard Plan ID is implemented. MDCH will use this identifier to identify
the CA within the encounter transaction. This number is also used to link the 837 Encounter with the
client’s corresponding QI data file. This number is different than the Provider Identifier used to
identify the direct care provider.
To report other commercial payers, the CA should use the carrier code assigned by MDCH. The
carrier codes can be found in a listing posted on the MDCH website, www.michigan.gov/mdch.
Click Providers, Information for Medicaid Providers, then Third Party Liability. Medicare does not
have an MDCH assigned carrier code. When reporting Medicare as an Other Payer, the following
numbers should be used to report the Other Payer Primary Identifier:
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Medicare Part A (United Government Services), use “00452”
Medicare Part B (Wisconsin Physician Services), use “00953”
2.10.15 Procedure Code (Professional Loop 2400, SV101-2, Dental Loop 2400,
SV301-2, and Institutional Loop 2400, SV201 for Revenue Code and SV202-2 for
Service Line)
MDCH has developed a list of procedure and revenue codes to be used when submitting 837
encounter and claims data for substance abuse services. The Centers for Medicare and Medicaid
Services (CMS) has not yet approved all the codes for substance abuse that the states have requested.
The requested codes will not be approved and available for use in time for implementation of the
ASC X12N 837 version 4010 encounter format. Therefore the code crosswalk developed by MDCH
will be used for reporting revenue codes and procedure codes on 837 encounters and claims until
otherwise notified. The code crosswalk for substance abuse services is posted on the MDCH website
which should be checked regularly for updates. The code crosswalk can be found at the following
address:
http://www.michigan.gov/documents/SubAbuseCodeChart8-15-03_71938_7.pdf
2.10.16 Financial/Adjudication Data Elements
The provider-to-payer-to-payer COB data model of the 837 is being used and will provide MDCH
with expanded financial information on encounter records. The loops in the 837 HIPAA
implementations that are used to convey information regarding adjudication are the 2320 (Other
Subscriber Information) and 2430 (Service Line Adjudication Information). Reporting of financial
data is voluntary through September 2003. If CAs choose to report financial data for FY03
encounters, the following guidelines should be followed.
The financial, or adjudication fields that MDCH requests the CAs to report include:
Submitted Line Item Charge Amount (Provider Billed Amount)
Approved Amount (Allowable Amount)
Paid Amount
Adjustment Amounts
Adjustment Group and Reason Codes
2.10.16.1 Submitted Line Item Charge Amount (Professional Loop 2400, SV102, Institutional
Loop 2400, SV203)
MDCH expects CAs to report the provider submitted charge amount or billed amount. This charge
generally represents the provider’s usual and customary amount for the service. There have been no
situations identified where substance abuse services would not have a charge. Therefore, the amount
coded in the Submitted Charge Amount data element should not be “0” (zero).
Institutional encounters also accommodate reporting total submitted charges (COB Total Submitted
Charges) within Loop 2320, AMT02.
Commissioners Minutes Continued. January 20, 2010
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2.10.16.2 COB Approved (Allowed) Amount (Professional Loop 2320, AMT02 and Loop
2400, AMT02, Institutional Loop 2320, AMT02 [COB Total Allowed Amount])
CAs should report their fee schedule amount, or what they would have paid for the service (maximum
allowable amount), whether or not the service was covered with the provider on a per diem, case rate,
prepaid or other payment basis. If the CA never covers the specific service reported, the Approved
Amount may be “0” (zero).
2.10.16.3 COB Payer Paid Amount (Loop 2320, AMT02 and Loop 2430, SVD02)
If the CA paid the provider for the service, the Paid Amount should reflect the amount paid. If the
service was not covered by the CA, or was covered under a contract payment methodology such as
prepaid or per diem, “0” (zero dollars) may be an appropriate Paid Amount.
2.10.16.4 Other Payer Adjustment Amount (Loop 2320, CAS03, CAS06…CAS18 and Loop
2430, CAS03, CAS06…CAS18)
If the Paid Amount reflects any adjustment to the billed amounts, the adjustment amount, as well as
adjustment reasons must be reported.
2.10.16.5 Other Payer Adjustment Group Code (Loop 2320, CAS01 and Loop 2430, CAS01)
This data element identifies the general category of payment adjusted. The CA must use the values
identified in the implementation guide. Code values include, “CO” for contractual obligation, “OA”
for Other Adjustments, and “PR” for patient responsibility.
2.10.16.6 Other Payer Adjustment Reason Code (Loop 2320, CAS02, CAS05…CAS17 and
Loop 2430, CAS02, CAS05…CAS17)
This element is required to report the detailed reason for any adjustment to the submitted line item
charge amount. CAs must use the standard Claim Adjustment Reason Codes available at www.wpc-
edi.com.
Example A: CA “A” pays a contracted provider on a fee-for-service basis for all services. The CA
uses a fee schedule to determine its approved (allowed) amount. John Doe is seen for Individual
Therapy, adult or child, 45-50 minutes and the provider submits a claim to CA “A”. CA “A”
adjudicates the claim and then reformats and sends an 837 encounter to MDCH.
Submitted
Charge
Approved
Amount
Paid Amount Adjustment Reason Adjustment
Amount
$100 $55 $55 42 - charges exceed our fee-
schedule or maximum
allowable amount
$45
Example B: CA “B” has a per diem contract arrangement with a local facility to provide intensive
outpatient (IOP) services. The per diem rate is $100 per day. John Doe receives 13 days of IOP
services. There is no other payer. CA “B” submits the encounter to MDCH.
Submitted Approved / Paid Amount Adjustment Reason Adjustment
Commissioners Minutes Continued. January 20, 2010
250
MDCH Supplemental Instructions to Substance Abuse Page 15 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
Charge Allowed
Amount
Amount
$2500 $1300 $0 A2 – contract adjustment $2500
Any time the charge amount does not equal the paid amount, the CA must report the adjustment amount
and the adjustment reason.
When reporting financial data CAs should heed the balancing requirements outlined in the
Implementation Guides.
Commissioners Minutes Continued. January 20, 2010
251
MDCH Supplemental Instructions to Substance Abuse Page 16 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
Appendices
Commissioners Minutes Continued. January 20, 2010
252
MDCH Supplemental Instructions to Substance Abuse Page 17 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Appendix A Encounter Error Listing Encounter Error Listing As Of 02/19/03 Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20000 File contains unreadable characters. RB Reject batch General file edit D/I/P 20015 Submitter Identifier is missing (is spaces or blanks). 20016 Submitter Identifier is not a valid submitter ID. 20017 Submitter Identifier is inconsistent between ISA06 and 1000A NM109 RB Reject batch 1000A, NM109 D/I/P Submitter Name Submitter Primary Identification Number 20020 Submission Number is missing (is spaces or blanks). 20021 Submission Number is not an alphanumeric value. 20022 Submission Number has already been used on a prior batch. RB Reject batch HDR, BHT03 D/I/P Beginning Of Hierarchical Transaction Originator Application Transaction ID 20025 Transaction Type Code not for encounters. RB Reject batch HDR, BHT06 D/I/P Beginning Of Hierarchical Transaction Claim or Encounter ID (Transaction Type Code) 20030 Transmission Type Code (Record Category) is missing (is spaces or blanks). Cannot edit the remainder of the record. 20031 Transmission Type Code (Record Category) is not equal to 004010X096, 004010X097 or 004010X098 for record category D, I or P. Cannot edit the remainder of the record. RB Reject batch HDR, REF02 D/I/P Transmission Type Identification Transmission Type Code 20050 Other Payer Primary Identifier (e.g., Health Plan ID) is missing (is zero, spaces, blanks, or null) for record category D, I or P. 20051 None of the Other Payer Primary Identifiers are valid Capitated Plans for record category D, I or P. 20052 There is an invalid combination of Other Payer Primary Identifiers. The valid combinations are: • Exactly one MQHP, CA, or PHP • Exactly one PHP and one CMHSP Any other combination of Other Payer Primary Identifiers (including none or more than two) is ambiguous and will cause this error. 20053 The Capitated Plan Identifier is not valid for the Submitter Identifier for record category D, I or P. RE Reject encounter 2330B, NM109 D/I/P Other Payer Name Other Payer Primary Identifier Commissioners Minutes Continued. January 20, 2010253
MDCH Supplemental Instructions to Substance Abuse Page 18 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20055 Other Payer Secondary Identifier (Encounter Reference Number) is missing (is spaces, blanks or zeroes) for record category D, I or P. 20056 Other Payer Secondary Identifier (Encounter Reference Number) is not an alphanumeric value for record category D, I or P. RE Reject encounter 2330B, REF02 D/I/P Other Payer Secondary Identification and Reference Number Other Payer Secondary Identifier 20057 Service Line Counter (Encounter Detail Line Number) is missing (is spaces, blanks or zeroes) for record category D, I or P. 20058 If record category I, Service Line Counter (Encounter Detail Line Number) is not between 01 and 999. If record category D or P Encounter Detail Line Number is not between 01 and 50. 20059 Service Line Counter(s) [Encounter Detail Line Number(s)] not started with one or not sequentially numbered. RE Reject encounter 2400, LX01 D/I/P Service Line Number Line Counter 20060 Claim Frequency Code (Record Type) is missing (is spaces, blanks or zeroes) for record category D, I or P. 20061 Claim Frequency Code (Record Type) is invalid for record category D, I or P. RE Reject encounter 2300, CLM05-3 D/I/P Claim Information Claim Frequency Code 20100 Subscriber Primary Identifier (Medicaid ID) is missing (is spaces, blanks or zeroes) and MQHP encounter for record category D, I or P. 20101 Subscriber Primary Identifier (Medicaid ID) does not exist in the Medicaid eligibility file and MQHP encounter for record category D, I or P. RE Reject encounter 20102 Subscriber Primary Identifier (Medicaid ID) is missing (is spaces, blanks or zeroes) and CMH or SA encounter for record category D, I or P. 20103 Subscriber Primary Identifier (Medicaid ID) does not exist in the Medicaid eligibility file and CMH or SA encounter for record category D, I or P. IO Info only 2010BA, NM109 D/I/P Subscriber Name Subscriber Primary Identifier (Medicaid ID) 20104 Subscriber SSN ID present, not numeric and MQHP encounter for record category D, I or P. RE Reject encounter 2010BA, NM109 2010BA, REF02 D/I/P Subscriber Name Subscriber Primary Identifier/Supplemental Identifier (SSN ID) 20105 Batch is for CMH or SA and Other Insured Identifier (Submitter's Subscriber Unique ID) is missing (is spaces, blanks or zeroes) for record category D, I or P. 20106 Batch is for SA and Other Insured Identifier (Submitter's Subscriber Unique ID) present and does not exist in the applicable SA QI file for record category I, D or P. RE Reject encounter 2330A, NM109 D/I/P Other Subscriber Name Other Insured Identifier Commissioners Minutes Continued. January 20, 2010254
MDCH Supplemental Instructions to Substance Abuse Page 19 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20107 Batch is for CMH and no match to the applicable CMH QI file for record category D, I or P can be made for the combination of: • Other Insured Identifier (Submitter's Subscriber Unique ID), • Other Payer Primary Identifier equal to the QI PHP identifier, • Other Payer Primary Identifier equal to the QI CMH identifier, and • From Service Date falls within the fiscal year of the last reporting date QI data sent for the applicable fiscal year. 20108 Subscriber Primary Identifier ( Child Identification Number) is missing (is spaces, blanks or zeroes) and MIChild encounter for record category D, I or P. 20109 Subscriber Primary Identifier ( Child Identification Number) does not exist in the MIChild eligibility file and MQHP, BC/BS, or capitated dental MIChild encounter for record category D, I or P. RE Reject encounter 2010BA, NM109 D/I/P Subscriber Name Subscriber Primary Identifier ( Child Identification Number) 20140 Admission Date is missing but yet the revenue code has a Room and Board Designation for record category I for Inpatient Type of Bill. 20141 Admission Date present - Invalid date or date is in an invalid format for record category I for Inpatient Type of Bill. 20142 Admission Date present and is not less than or equal to the run date of this edit run for record category I for Inpatient Type of Bill. 20143 Admission Date present and is greater than the Discharge date for record category I for Inpatient Type of Bill. RE Reject encounter I 20144 Admission date is not equal or less than run date for record category D or P. 20145 Admission Date present but an invalid date or date is in an invalid format for record category D or P. IO Info only 2300, DTP03 (P, D and I for inpatient encounters only) D/ P Admission Date/Hour Admission Date and Hour/ Related Hospitalization Admission Date 20148 Statement Through Date/Related Hospitalization Discharge Date is missing but yet the Revenue Code indicates an admission with Room and Board charges and the Discharge Status indicates that a discharge occurred for record category I for Inpatient Type of Bill. 20149 Statement Through Date/ Related Hospitalization Discharge Date exists but yet Admission Date is missing for record category I for Inpatient Type of Bill. RE Reject encounter 2300, DTP03 (I for inpatient encounters only) I Statement Dates Statement Through Date/ Related Hospitalization Discharge Date Commissioners Minutes Continued. January 20, 2010255
MDCH Supplemental Instructions to Substance Abuse Page 20 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20150 Statement Through Date/ Related Hospitalization Discharge Date is an invalid date for record category I for Inpatient Type of Bill. 20151 Statement Through Date/ Related Hospitalization Discharge Date is less than the Admission Date for record category I for Inpatient Type of Bill. 20152 Statement Through Date/ Related Hospitalization Discharge Date is not less than or equal to the run date of this edit run for record category I for Inpatient Type of Bill. 20155 Patient Status Code (Discharge Status) is not a valid code for record category I for Inpatient Type of Bill. 20156 Patient Status Code (Discharge Status) is missing but yet the revenue code has a Room and Board Designation for record category I for Inpatient Type of Bill. IO Info only 2300, CL103 (I only) I Institutional Claim Code Patient Status Code 20170 Service Date is missing (is spaces, blanks or zeroes) for record category D or P or I for Outpatient Type of Bill. 20171 Service Date - Invalid date or date is not in the format CCYYMMDD for record category D or P or I for Outpatient Type of Bill. 20172 Service Date is not less than or equal to the run date of this Edit Run for record category D or P or I for Outpatient Type of Bill. RL Reject line 2300, DTP03 (D only) 2400, DTP03 D/I/P Date - Service (D only) Service Line Date Service Date 20175 Statement From Date is missing (is spaces, blanks or zeroes) for record category I. 20176 Statement From Date - Invalid date or date is not in the format CCYYMMDD for record category I. 20177 Statement From Date is not less than or equal to the run date of this Edit Run for record category I. RE Reject encounter 2300, DTP03 (I only) I Statement Dates Statement From Date 20190 Taxonomy Code is not a valid taxonomy code for record category I IO Info only 2000A, PRV03 2310E, PRV03 (I only) I Servicing Facility Provider Specialty Information Servicing Facility Provider Taxonomy /Specialty Code 20191 Taxonomy Code is not a valid taxonomy code for record category D or P IO Info only 2000A, PRV03 (D and P only) 2310B, PRV03 (D and only) 2420A, PRV03 (D and only) D/P Billing/Rendering Provider Specialty Information Rendering (Servicing) Provider Taxonomy /Specialty Code Commissioners Minutes Continued. January 20, 2010256
MDCH Supplemental Instructions to Substance Abuse Page 21 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20200 Primary Diagnosis Code is not a valid diagnosis code for record category I. RE Reject encounter 20201 Primary Diagnosis Code is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20202 Primary Diagnosis Code is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. IO Info only 20203 Primary Diagnosis Code is missing (is zeroes, blanks or spaces) for record category I. RE Reject encounter 2300, HI01-2 I Health Care/ Principle, Admitting, E-Code and Patient Reason For Visit Diagnosis Information Diagnosis Code 20204 Admission Diagnosis Code is present and the Revenue Code indicates an admission with Room and Board charges and admission diagnosis code is not valid for record category I. 20205 Admission Diagnosis Code is missing (is zeroes, blanks or spaces) but the Revenue Code indicates an admission with Room and Board charges for record category I. 20206 Admission Diagnosis Code is not appropriate for the subscriber’s age on the applicable QI or Medicaid eligibility file for record category I. 20207 Admission Diagnosis Code is not a valid diagnosis code for record category I. 20208 Admission Diagnosis Code is not appropriate for the subscriber’s gender for record category I according to the QI or Medicaid eligibility file. IO Info only 2300, HI02-2 (I only) I Principle, Admitting, E-Code and Patient Reason For Visit Diagnosis Information Diagnosis Code 20209 Other Diagnosis Code 1 exists but yet Primary Diagnosis Code is missing for record category I. 20210 Other Diagnosis 1 Code is not a valid diagnosis code for record category I. 20211 Other Diagnosis Code 1 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20212 Other Diagnosis Code 1 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2300, HI01-2 I Health Care/ Other Diagnosis Information Diagnosis Code Other - 1 20213 Other Diagnosis Code 2 exists but yet one of the previous Diagnosis Codes are missing for record category I. IO Info only 2300, HI02-2 (I only) I Health Care/ Other Diagnosis Diagnosis Code Other - 2 Commissioners Minutes Continued. January 20, 2010257
MDCH Supplemental Instructions to Substance Abuse Page 22 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20214 Other Diagnosis Code 2 is not a valid diagnosis code for record category I. 20215 Other Diagnosis Code 2 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20216 Other Diagnosis Code 2 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20217 Other Diagnosis Code 2 exists but yet, Primary Diagnosis Code is missing for record category I Information 20218 Other Diagnosis Code 3 exists but yet one of the previous Diagnosis Codes are missing for record category I. 20219 Other Diagnosis Code 3 is not a valid diagnosis code for record category I. 20220 Other Diagnosis Code 3 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20221 Other Diagnosis Code 3 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20222 Other Diagnosis Code 3 exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI03-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 3 20223 Other Diagnosis Code 4 exists but yet one of the previous Diagnosis Codes are missing for record category I. 20224 Other Diagnosis Code 4 is not a valid diagnosis code for record category I. 20225 Other Diagnosis Code 4 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files e. 20226 Other Diagnosis Code 4 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20227 Other Diagnosis Code 4 exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI04-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 4 Commissioners Minutes Continued. January 20, 2010258
MDCH Supplemental Instructions to Substance Abuse Page 23 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20228 Other Diagnosis Code 5 exists but yet one of the previous Diagnosis Codes are missing for record category I. 20229 Other Diagnosis Code 5 is not a valid diagnosis code for record category I. 20230 Other Diagnosis Code 5 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20231 Other Diagnosis Code 5 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20232 Other Diagnosis Code 5 exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI05-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 5 20233 Other Diagnosis Code 6 exists but yet one of the previous Diagnosis Codes are missing for record category I. 20234 Other Diagnosis Code 6 is not a valid diagnosis code for record category I. 20235 Other Diagnosis Code 6 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20236 Other Diagnosis Code 6 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20237 Other Diagnosis Code 6 exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI06-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 6 20238 Other Diagnosis Code 7 exists but yet one of the previous Diagnosis is missing for record category I. 20239 Other Diagnosis Code 7 is not a valid diagnosis code for record category I. 20240 Other Diagnosis Code 7 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20241 Other Diagnosis Code 7 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2300, HI07-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 7 Commissioners Minutes Continued. January 20, 2010259
MDCH Supplemental Instructions to Substance Abuse Page 24 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20242 Other Diagnosis Code 7 exists but yet, Primary Diagnosis Code is missing for record category I. 20243 Other Diagnosis Code 8 exists but yet one of the previous Diagnosis is missing for record category I. 20244 Other Diagnosis Code 8 is not a valid diagnosis code for record category I. 20245 Other Diagnosis Code 8 is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20246 Other Diagnosis Code 8 is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20247 Other Diagnosis Code 8 exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI08-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 8 20248 Other Diagnosis 9 Code exists but yet one of the previous Diagnosis Codes are missing for record category I. 20249 Other Diagnosis 9 Code is not a valid diagnosis code for record category I. 20250 Other Diagnosis 9 Code is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20251 Other Diagnosis 9 Code is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20252 Other Diagnosis 9 Code exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI09-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 9 20253 Other Diagnosis 10 Code exists but yet one of the previous Diagnosis Codes are missing for record category I. 20254 Other Diagnosis 10 Code is not a valid diagnosis code for record category I. 20255 Other Diagnosis 10 Code is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2300, HI10-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 10 Commissioners Minutes Continued. January 20, 2010260
MDCH Supplemental Instructions to Substance Abuse Page 25 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20256 Other Diagnosis 10 Code is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20257 Other Diagnosis 10 Code exists but yet, Primary Diagnosis Code is missing for record category I. 20260 Other Diagnosis 11 Code exists but yet one of the previous Diagnosis Codes are missing for record category I. 20261 Other Diagnosis 11 Code is not a valid diagnosis code for record category I. 20262 Other Diagnosis 11 Code is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20263 Other Diagnosis 11 Code is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20264 Other Diagnosis 11 Code exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI11-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 11 20270 Other Diagnosis 12 Code exists but yet one of the previous Diagnosis Codes are missing for record category I. 20271 Other Diagnosis 12 Code is not a valid diagnosis code for record category I. 20272 Other Diagnosis 12 Code is not appropriate for the subscriber’s age for record category I according to the applicable Medicaid Eligibility File or QI Files. 20273 Other Diagnosis 12 Code is not appropriate for the subscriber’s gender for record category I according to the applicable Medicaid Eligibility File or QI Files. 20274 Other Diagnosis 12 Code exists but yet, Primary Diagnosis Code is missing for record category I. IO Info only 2300, HI12-2 (I only) I Health Care/ Other Diagnosis Information Diagnosis Code Other - 12 20280 Diagnosis Code Pointer 1 missing or invalid (assumed to be primary diagnosis pointer for the line) for record category P. 20281 Diagnosis Code Pointer 1 valid but points to invalid or missing diagnosis code. RL Reject line 2400, SV107-1 (P only) P Professional Service Diagnosis Code Pointer 1 Commissioners Minutes Continued. January 20, 2010261
MDCH Supplemental Instructions to Substance Abuse Page 26 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20282 Diagnosis Code Pointer 1 points to a diagnosis code that is not appropriate for the subscriber’s age for record category P according to the applicable Medicaid Eligibility File or QI Files. 20283 Diagnosis Code Pointer 1 points to a diagnosis code that is not appropriate for the subscriber’s gender for record category P according to the applicable Medicaid Eligibility File or QI Files. IO Info only 20284 Diagnosis Code Pointer 2 invalid pointer. 20285 Diagnosis Code Pointer 2 valid but points to invalid or missing diagnosis codes. 20286 Diagnosis Code Pointer 2 points to a diagnosis code that is not appropriate for the subscriber’s age for record category P according to the applicable Medicaid Eligibility File or QI Files. 20287 Diagnosis Code Pointer 2 points to a diagnosis code that is not appropriate for the subscriber’s gender for record category P according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2400, SV107-2 (P only) P Professional Service Diagnosis Code Pointer 2 20288 Diagnosis Code Pointer 3 invalid pointer. 20289 Diagnosis Code Pointer 3 valid but points to invalid or missing diagnosis codes. 20290 Diagnosis Code Pointer 3 points to a diagnosis code that is not appropriate for the subscriber’s age for record category P according to the applicable Medicaid Eligibility File or QI Files. 20291 Diagnosis Code Pointer 3 points to a diagnosis code that is not appropriate for the subscriber’s gender for record category P according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2400, SV107-3 (P only) P Professional Service Diagnosis Code Pointer 3 20292 Diagnosis Code Pointer 4 invalid pointer. 20293 Diagnosis Code Pointer 4 valid but points to invalid or missing diagnosis codes. 20294 Diagnosis Code Pointer 4 points to a diagnosis code that is not appropriate for the subscriber’s age for record category P according to the applicable Medicaid Eligibility File or QI Files. 20295 Diagnosis Code Pointer 4 points to a diagnosis code that is not appropriate for the subscriber’s gender for record category P according to the applicable Medicaid Eligibility File or QI Files. IO Info only 2400, SV107-4 (P only) P Professional Service Diagnosis Code Pointer 4 20301 Principal Procedure Code was not yet valid at time of service for record category I. IO Info only 2300, HI01-2 (I only) I Principal Procedure Information Principal Procedure Code Commissioners Minutes Continued. January 20, 2010262
MDCH Supplemental Instructions to Substance Abuse Page 27 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20302 Principal Procedure Code was no longer valid at time of service for record category I. 20310 Service Line Revenue Code is missing (is zeroes, blanks or spaces) for record category I. 20311 Service Line Revenue Code is invalid for record category I. 20312 Service Line Revenue Code was not yet valid at time of service record category I. 20313 Service Line Revenue Code was no longer valid at time of service record category I. RL Reject line 2400, SV201 (I only) I Institutional Service Line Service Line Revenue Code 20314 Record category I and hospital outpatient type-of-bill and Procedure Code (HCPCS or local procedure codes for CMH and CA data) not present and valid. IO Info only 20315 Record category I and home health services type-of-bill, and Procedure Code (HCPCS or local procedure codes for CMH and CA data) not present and valid. RL Reject line 20316 Procedure Code (HCPCS or local procedure codes for CMH and CA data) was not yet valid at time of service for record category I. 20317 Procedure Code (HCPCS or local procedure codes for CMH and CA data) was no longer valid at time of service for record category I. IO Info only 2400, SV202-2 (I only) I Institutional Service Line Procedure Code (HCPCS) 20319 Service Line Procedure Code is missing (is zeroes, blanks or spaces) for record category P. 20320 Service Line Procedure Code is invalid for record category D or P. 20321 Service Line Procedure Code was not yet valid at time of service record category D or P. 20322 Service Line Procedure Code was no longer valid at time of service record category D or P. RL Reject line 2400, SV301-2 (D only) 2400, SV101-2 (P only) D/P Dental/Professional Service Procedure Code 20330 Procedure Code Modifier 1 exists but yet Procedure Code is missing (is zeroes, blanks or spaces) for record category I or P. 20331 Procedure Code Modifier 1 is not a valid HCPCS procedure code modifier for record category I or P. IO Info only 2400, SV202-3 (I only) 2400, SV101-3 (P only) I/P Institutional/Professional Service Line Procedure Modifier 1 20334 Procedure Code Modifier 2 exists but yet Procedure Code is missing (is zeroes, blanks or spaces) for record category I or P. 20335 Procedure Code Modifier 2 exists but yet Procedure Code Modifier 1 is missing (is zeroes, blanks or spaces) for record category I or P. IO Info only 2400, SV202-4 (I only) 2400, SV101-4 (P only) I/P Institutional/Professional Service Line Procedure Modifier 2 Commissioners Minutes Continued. January 20, 2010263
MDCH Supplemental Instructions to Substance Abuse Page 28 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20336 Procedure Code Modifier 2 is not a valid HCPCS procedure code modifier for record category I or P. 20340 Procedure Code Modifier 3 exists but yet Procedure Code is missing (is zeroes, blanks or spaces) for record category I or P. 20341 Procedure Code Modifier 3 exists but yet one of the prior Procedure Code Modifiers is missing (is zeroes, blanks or spaces) for record category I or P. 20342 Procedure Code Modifier 3 is not a valid HCPCS procedure code modifier for record category I or P. IO Info only 2400, SV202-5 (I only) 2400, SV101-5 (P only) I/P Institutional/Professional Service Line Procedure Modifier 3 20345 Procedure Code Modifier 4 exists but yet Procedure Code is missing (is zeroes, blanks or spaces) for record category I or P. 20346 Procedure Code Modifier 4 exists but yet one of the prior Procedure Code Modifiers is missing (is zeroes, blanks or spaces) for record category I or P. 20347 Procedure Code Modifier 4 is not a valid HCPCS procedure code modifier for record category I or P. IO Info only 2400, SV202-6 (I only) 2400, SV101-6 (P only) I/P Institutional/Professional Service Line Procedure Modifier 4 20350 Product Or Service (Procedure) ID Qualifier missing and there is a procedure code for record category P or D. 20351 Product Or Service (Procedure) ID Qualifier missing and there is a HCPCS Procedure Code for record category I. IO Info only 2400, SV202-1 (I only) 2400, SV301-1 (D only) 2400, SV101-1 (P only) D/I/P Institutional/Dental/Professional Service Product/Service ID Qualifier 20400 Facility Type Code (Place of Service) is missing (is zeroes, blanks or spaces) for record category D or P. IO Info only 2300, CLM05-1 (D and P only) 2400, SV303 (D only) 2400, SV105 (P only) D/P Claim Information Dental/Professional Service Facility Type Code 20401 Facility Type Code (First Two Digits of Type of Bill) is not a valid UB place of service code per the UB92 Type of Bill valid values for record category I. IO Info only 2300, CLM05-1 (I only) 2300, CLM05-3 (I only) I Claim Information Facility Type Code 20402 Facility Type Code (Place of Service) is not a valid place of service code for record category D or P. IO Info only 2300, CLM05-1 (D and P only) 2400, SV303 (D only) 2400, SV105 (P only) D/P Claim Information Dental/Professional Service Facility Type Code 20403 Facility Type Code (First Two Digits of Type of Bill) is missing (is zeros, blanks or spaces) for record category I. IO Info only 2300, CLM05-1 (I only) 2300, CLM05-3 (I only) I Claim Information Facility Type Code Commissioners Minutes Continued. January 20, 2010264
MDCH Supplemental Instructions to Substance Abuse Page 29 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20410 Service Line Units (Quantity) is missing (is zeroes, blanks or spaces) for record category D, I or P. 20411 Service Line Units (Quantity) is less than 0 or not numeric for record category D, I or P. RL Reject line 2400, SV205 (I only) 2400, SV306 (D only) 2400, SV104 (P only) D/I/P Institutional/Dental/Professional Service Line Service Line Units/Procedure Count 20420 Adjudication Date is missing (is spaces, blanks or zeroes) for a payer at both the encounter and service line level for record category D, I or P. Value changed to null. 2430, DTP03 2330B, DTP03 Service Line Adjudication Date Claim Adjudication Date Adjudication Or Payment Date 20421 Claim Adjudication Date - Invalid date or date is not in the format CCYYMMDD for record category D, I or P. Value changed to null. 2330B, DTP03 Claim Adjudication Date Adjudication Or Payment Date 20423 Service Line Adjudication Date - Invalid date or date is not in the format CCYYMMDD for record category D, I or P. Value changed to null. IO Info only 2430, DTP03 D/I/P Service Line Adjudication Date Adjudication Or Payment Date 20471 Reference Identification/Billing Provider Secondary ID Number (Medicaid ID) is missing and a Medicaid encounter for record category D, I or P. IO Info only 2010AA, REF02 D/I/P Billing Provider Secondary Identification Reference Identification/Billing Provider Secondary ID Number (Medicaid ID) 20500 Billing Provider Qualifier (Billing Provider SSN or EIN ID) is missing (is spaces, blanks or zeroes) for record category D, I or P for MQHP or SA. IO Info only 2010AA, NM108 D/I/P Billing Provider Name Identification Code Qualifier 20501 Billing Provider Primary ID Number (SSN or EIN) missing for record category D, I or P for MQHP or SA. RE Reject encounter 2010AA, NM109 D/I/P Billing Provider Name Billing Provider Primary Identifier 20502 Laboratory or Facility Primary Identifier missing for record category I for MQHP. RE Reject encounter 2010AA, NM109 (I only) 2010AB, NM109 (I only) 2310E, NM109 (I only) I Service Facility Name Laboratory or Facility Primary Identifier 20503 Rendering Provider Identification (SSN or EIN) missing for record category D or P for MQHP. RL Reject line 2010AA, NM109 (D and P only) 2010AB, NM109 (D and P only) 2310B, NM109 (D and P only) 2420A, NM109 (D and P only) D/P Rendering Provider Name Rendering Provider Primary Identifier Commissioners Minutes Continued. January 20, 2010265
MDCH Supplemental Instructions to Substance Abuse Page 30 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20530 Rendering Provider Secondary Identification Number (State License Number or Medicaid ID) is missing and a Medicaid encounter for record category D or P. 2010AA, REF02 (D and P only) 2010AB, REF02 (D and P only) 2310B, REF02 (D and P only) 2420A, REF02 (D and P only) Billing/Pay-to/Rendering Provider Name Reference Identification/Billing/Pay-to/Rendering Provider Secondary Identification Number (State License Number ID or Medicaid ID) 20531 Servicing Facility Provider Secondary Identification Number (State License Number or Medicaid ID) is missing and a Medicaid encounter for record category I. IO Info only 2010AA, REF02 (I only) 2010AB, REF02 (I only) 2310E, REF02 (I only) D/I/P Billing/Pay-to Provider or Service Facility Name Reference Identification/Billing/Pay-To/Service Facility Provider Secondary Identification Number (State License Number ID or Medicaid ID) 20570 Submitted Charge Amount (Monetary Amount) missing - blank or null for record category D or P. IO Info only 2400, SV302 (D only) 2400, SV102 (P only) D/P Dental/Professional Service Submitted Charge Amount 20571 Line Item Charge Amount (Monetary Amount) missing - blank or null for record category I. IO Info only 2400, SV203 (I only) I Institutional Service Line Line Item Charge Amount 20572 COB Payer Paid Amount and Service Line Paid Amount both missing (blank or null) for record category P or D. IO Info only 2320, AMT02 2430, SVD02 D/P COB Payer Paid Amount Line Adjudication Information Payer Paid Amount Service Line Paid Amount 20573 Other Payer Allowed Amount missing (blank or null) for record category I, P, or D. IO Info only 2320, AMT02 D/I/P COB Allowed Amount Allowed Amount 20574 Adjusted Amount missing (blank or null) at both the claim level and the service line level and the Total Submitted Charges do not equal the COB Payer Paid Amount for record category P, or D IO Info only 2320, CAS03 2430, CAS03 D/I/P Claim Level Adjustments Line Adjustment Adjusted Amount - Claim Level Adjusted Amount - Line Level 20590 Revenue Code equal 100-219 and Service Line Rate Amount (Unit Rate) blank or null for record category I. IO Info only 2400, SV206 (I only) I/P Institutional Service Line Service Line Rate Amount 20610 Special Program Code not a valid value, value set to null for record category D or P. IO Info only 2300, CLM12 (D and P only) D/P Claim Information Special Program Code 20611 EPSDT Indicator not a valid value (Y or N), value set to null for record category P. IO Info only 2400, SV111 (P only) P Claim Information EPSDT Indicator 20612 Oral Cavity Designation Code is missing for record category D. IO Info only 2400, SV304 D Dental Service Oral Cavity Commissioners Minutes Continued. January 20, 2010266
MDCH Supplemental Instructions to Substance Abuse Page 31 of 34 Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007) Error Number Error Description Msg Type Msg Type Description Loop, Data Element D/I/P Segment Description 20613 Oral Cavity Designation Code is not valid for record category D. Designation Code 20614 Tooth Number is present, but is not a valid value for record category D. RL Reject line 2400, TOO02 D Tooth Information Tooth Number 20615 Tooth Surface Code is present, but is not a valid value for record category D. RL Reject line 2400, TOO03 D Tooth Information Tooth Surface Code 20700 Original Other Payer Secondary Identifier (Encounter Reference Number) - encounter already exists for record category D, I or P. 20701 Replacement Other Payer Secondary Identifier (Encounter Reference Number) - no encounter exists to replace for record category D, I or P. 20702 Void Other Payer Secondary Identifier (Encounter Reference Number) - no encounter exists to void for record category D, I or P. RE Reject encounter 2330B, REF02 D/I/P Other Payer Secondary Identification and Reference Number Other Payer Secondary Identifier (Encounter Reference Number) 20703 All service lines for the encounter were rejected; therefore, encounter rejected for record category D, I or P. RE Reject encounter 20704 This record was superceded by another input record for record category D, I or P. IO Info only General file edit D/I/P 20801 SA Encounter HCPCS procedure code not compatible with admission service category RE Reject encounter 2400, SV202-2 (I only) 2400, SV101-2 (P only) I/P Institutional Service Line/ Professional Service Procedure Code (HCPCS) 20802 SA Encounter reflect HCPCS of assessment and the service date not while subscriber was in an admitted status or within one month after SARF date of admission 20803 SA Encounter reflect HCPCS other than assessment and the service date not while subscriber was in an admitted status RE Reject encounter 2400, DTP03 I/P Service Line Date Service Date 20807 Subscriber SSN ID present, not numeric and CMH or SA encounter for record category D, I or P. IO Info only 2010BA, NM109 2010BA, REF02 D/I/P Subscriber Name Subscriber Primary Identifier/Supplemental Identifier (SSN ID) 99999 This is the last message of your batch transmission. IO Info only General file edit D/I/P Commissioners Minutes Continued. January 20, 2010267
MDCH Supplemental Instructions to Substance Abuse Page 32 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
Appendix B 837 Encounter Error Return File
B.1 837 Encounter Error Return File Header
This 837 Error Return File EDI Header is a single record that precedes the error report (Error Return File)
that gives the entity that submitted data files detail on error detected by the Encounter Data Warehouse
edits process.
Table B-1: 837 Encounter Error Return File Header Layout
Field Name Type Size Begin End Comments
EDI-HEADER-RECORD
EDI-TYPE X(4) 4 1 4 Value “HDDR
EDI-APP X(4) 2 5 6 Value “MA”
EDI-USER X(4) 4 7 10 Value “MMIS
EDI-USER-ID X(4) 4 11 14 Value “00XX” (“XX” = Service
Bureau Claim ID
EDI-DATE-CYMD X(8) 8 15 22 Creation Date (format is
YYYYMMDD)
EDI TRANSFER DATE Transfer date or use creation date
TRANSFER-YYYY X(4) 4 23 26
TRANSFER-MM X(2) 2 27 28
TRANSFER-DD X(2) 2 29 30
TRANSFER-HH X(2) 2 31 32
TRANSFER-MINUTE X(2) 2 33 34
EDI-FILE
EDI-FILE-BEG X(4) 4 35 38 Value "4950"
EDI-RUN-TYPE X(1) 1 39 39 Value “P” for production or
“T” for test
EDI-BATCH X(3) 3 40 42 Unique batch identifier
FILLER 9(10) 10 43 52
FILLER X(101) 101 53 152
B.2 837 Encounter Error Return File Detail Record
The following defines the 837 Error Return File that reflects the errors detected by the Encounter Data
Warehouse edit process. Information on each error is included in the fields that are part of a record that
describes the error.
Table B-2: CA 837 Encounter Error Return File Detail Record Layout
Field Name Type Size Begin End Comments
ENCOUNTER-ERROR-RETURN-RECORD
SUBMITTER-ID X(4) 4 1 4 Also called “autobiller ID” or “service
bureau” - identifier of the organization
that physically transmits the data.
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268
MDCH Supplemental Instructions to Substance Abuse Page 33 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
Field Name Type Size Begin End Comments
CAPITATED-PLAN-ID X(20) 20 5 24 Also called “Health Plan ID” or
“Primary Payer ID”, this is the ID of the Qualified Health Plan, Community
Mental Health Services Provider or
Coordinating Agency, etc.
RELATED-PLAN-ID X(20) 20 25 44 Plan ID of a related plan, if any (e.g.
the Prepaid Health Plan corresponding
to a CMHSP.)
SUBMISSION-NUMBER X(20) 20 45 64 Number identifying a batch - may not
be reused by the same capitated health
plan.
ENCOUNTER-REFERENCE-NUMBER X(30) 30 65 94 The Encounter Reference Number
assigned by the capitated health plan.
ENCOUNTER-LINE-NUMBER X(3) 3 95 97 The Encounter Line Number assigned
by the capitated health plan.
Values are:
“O” = Original
“R” = Replacement
RECORD-TYPE X(1) 1 98 98
“V” = Void
Values are:
“P” = Professional
“I” = Institutional
RECORD-CATEGORY X(1) 1 99 99
“D” = Dental
ERROR-NUMBER X(5) 5 100 104 Format is “20nnn”. Reference Section
Refer to Appendix B for Edit Error
List.
Values are:
“RB” = Reject batch
“RE” = Reject encounter
“RL” = Reject line
ERROR-SEVERITY X(2) 2 105 106
“IO” = Information only
ERROR-FIELD X(20) 20 107 126 First 20 positions of erroneous field
BATCH-SEQUENCE-NUMBER X(8) 8 127 134 An internally generated number
indicating the relative position of a
batch within an input file
ASSIGNED-SEQ-ERN X(13) 13 135 147 ASSIGNED-SEQ-ERN, ASSIGNED-
SEQ-TYPE and ASSIGNED-SEQ-
ELN are internal Encounter Reference
Numbers, Types and Line Numbers
assigned by the edit program for its
own use. However, the ASSIGNED-SEQ-ERN values will be assigned
sequentially in the order in which the
encounters appear in the input file, so
it can also be used as a sequence
number to sort the error results in that
order.
Commissioners Minutes Continued. January 20, 2010
269
MDCH Supplemental Instructions to Substance Abuse Page 34 of 34
Coordinating Agencies for 837 Encounter Data Submission (Rev. August 2007)
Field Name Type Size Begin End Comments
Type field indicating source of
encounter:
“60” = CMH
“61” = SA
“62” = MIChild
“63” = Medicaid
ASSIGNED-SEQ-TYPE X(2) 2 148 149
“64” = Delta Dental
ASSIGNED-SEQ-ELN X(3) 3 150 152 Internal ELN assigned to this
encounter line by the system
B.3 837 Encounter Error Return File Trailer Record
This 837 Error Return File EDI Trailer record follows the errors detected by the Encounter Data
Warehouse edit process.
Table B-3: CA 837 Encounter Error Return File Trailer Record Layout
Field Name Type Size Begin End Comments
EDI-HEADER-RECORD
EDI-TYPE X(4) 4 1 4 Value “TRLR”
EDI-APP X(4) 2 5 6 Value “MA”
EDI-USER X(4) 4 7 10 Value “MMIS”
EDI-USER-ID X(4) 4 11 14 Value “00XX” (“XX” = Service
Bureau Claim ID
EDI-DATE-CYMD X(8) 8 15 22 Creation Date (format is
YYYYMMDD)
EDI TRANSFER DATE Transfer date or use creation date
TRANSFER-YYYY X(4) 4 23 26
TRANSFER-MM X(2) 2 27 28
TRANSFER-DD X(2) 2 29 30
TRANSFER-HH X(2) 2 31 32
TRANSFER-MINUTE X(2) 2 33 34
EDI-FILE
EDI-FILE-BEG X(4) 4 35 38 Value "4950"
EDI-RUN-TYPE X(1) 1 39 39 Value “P” for production or
“T” for test
EDI-BATCH X(3) 3 40 42 Unique batch identifier
FILLER 9(10) 10 43 52
FILLER X(101) 101 53 152
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MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
OFFICE OF DRUG CONTROL POLICY
PREVENTION POLICY # 01
SUBJECT: Synar
ISSUED: October 1,2006
EFFECTIVE: October 1, 2006
PURPOSE:
The purpose of this policy is to specify Coordinating Agency (CA) requirements with regard to
federal Substance Abuse Prevention and Treatment (SAPT) Block Grant Synar compliance.
This policy applies to Regional Substance Abuse Coordinating Agencies (CAs) and their Synar-
related provider network, including Designated Youth Tobacco Use Representatives (DYTUR),
which are a part of substance abuse services administered through the Michigan Department of
Community Health, Office of Drug Control Policy (MDCHIODCP).
States must show compliance with federal requirements to be considered eligible for the SAPT
Block Grant. States are also required to submit an annual report and an implementation plan
with regard to Synar related activities. These requirements are incorporated in the annual SAPT
block grant application. The state may be penalized up to 40 percent of the State's federal
(SAPT) Block Grant award for non-compliance.
The Synar Requirements are summarized as follows:
1) States must enact a youth access to tobacco law restricting the sale and distribution of
tobacco products to minors. The Michigan Youth Tobacco Act (YTA) satisfies this
requirement by restricting the sale and distribution of tobacco products to minors.
2) States must actively enforce their youth access to tobacco laws.
3) The State must conduct a formal Spar survey annually, to determine retailer compliance
with the tobacco youth access law and to measure the effectiveness of the enforcement of the
law.
4) The State must achieve and maintain a youth tobacco sales rate of 20 percent or less to
underage youth during the formal Synar survey.
In addition, the Substance Abuse and Mental Health Services Administration, Center for
Substance Abuse Prevention (SAMHSAICSAP) requires that an accurate listing of tobacco retail
outlets be maintained, including periodic tobacco retail outlet coverage studies intended to
confirm the accuracy of the list and establishes Synar sampling requirements.
Commissioners Minutes Continued. January 20, 2010
309
PREVENTION POLICY # 01
EFFECTIVE: October 1, 2006
Page 2 of 4
It is the responsibility of the CA to implement tobacco access prevention measures to achieve
and maintain a youth tobacco sales rate of 20 percent or less within their region. In doing so, it is
required that the CA will:
1) Use best practices relative to reducing access to tobacco products by underage youth;
2) Incorporate use of data specific to the CA region including youth sales data, analysis of the
effectiveness of Synar related activities; and
3) Collaborate with local partners including law enforcement.
Activities associated with Synar best practices and other evidenced based prevention such as
conducting inspections, and providing merchant or vendor education are defined as
prevention services and must be carried out by a licensed substance abuse prevention
program.
Specific responsibilities include the following:
1) Develop and implement a regional plan of Synarltobacco prevention activity that will restrict
youth access to tobacco and surpass the 80 percent non-sales rate.
2) Conduct activities necessary to ensure the Tobacco Retailer Master List is correct and
participate in the Clarification and Improvement Initiative, as well as the CSAP Mandated
Coverage Study. Submit to ODCP all information as required by the ODCPICA contract
agreement.
3) Annually conduct and complete the Formal Synar Survey to all outlets in the sample draw
listing during the designated time period and utilize the official ODCP protocol.
Additionally, edit the Survey Compliance Check forms and submit all required information
to ODCP as required by the ODCPICA contract agreement.
4) Contribute to enforcement of the Michigan YTA at tobacco outlets within the CA region by
conducting non-Synar enforcement checks with law enforcement participation. When law
enforcement involvement is not feasible, then by conducting non-Synar enforcement activity
through civilian checks.
It is recommended that checks be carried out in no less than 10 percent of the outlets in the
CA region with priority to vendors who have historically had a higher sell rate to minors,
e.g., Gas Stations, BarILounges, and Restaurants.
Commissioners Minutes Continued. January 20, 2010
310
PREVENTION POLICY # 01
EFFECTIVE: October 1, 2006
Page 3 of 4
For CAs with a 20 percent or higher "sell rate" in two or more of the last three Synar surveys,
the requirement is that no less than 25 percent of the outlets within the CA region will each
have at least one enforcement check activity during the fiscal year subsequent to the year in
which the CA failed to meet this threshold.
Note: SAPT Block Grant funds can't be used for law enforcement, this includes Formal
Synar and non-Synar activities.
5) Conduct Vendor Education activities, utilizing the ODCP approved vendor education
protocol, with not less than 10 percent of the total outlets within the CA region.
For CAs with a 20 percent or higher sell rate in two or more of the last three Synar surveys,
the requirement is that no less than 25 percent of the outlets within the CA region will each
have at least one vendor education activity during the fiscal year subsequent to the year in
which the CA failed to meet this threshold.
6) Develop relationships with stakeholders for the purposes of developing joint initiatives
andlor for collaboration in changing community norms to impact sales trends to youth and by
changing the community norms and conditions.
7) Identify a DYTUR agency to implement Synar-related activities. The agency identified as
the DYTUR, and the individual identified as a DYTUR, must have knowledge in the area of
youth tobacco access reduction and related Synar prevention initiatives.
8) Provide information to satisfy federal reporting requirements including information about
law enforcement activities relative to violations of the YTA. Correspondingly, it is the
responsibility of the CA to develop and implement a procedure for, or demonstrate a good
faith effort to, obtaining and reporting this information. Documentation of good faith effort
is required if the CA cannot provide the required information.
REPORTING REQUIREMENTS:
See the MDCHICA agreement and Action Plan Guidelines for CA reporting requirements.
Identification and implementation of activities, and local data collection and evaluation
procedures, are left to the discretion of the CA with the exception of the Formal Synar Survey
Protocol (to be used for all enforcement checks), the Vendor Education Protocol, the Synar
Tobacco Retailer Master List Clarification, and Improvement/Coverage Study Procedures
complete with methodology and practices requirements. All associated protocols are placed on
the ODCP website, and updated as needed.
Technical assistance to CAs in development of local procedures is available through ODCP.
Commissioners Minutes Continued. January 20, 2010
311
PREVENTION POLICY # 01
EFFECTIVE: October 1,2006
Page 4 of4
Office of Drug Control Policy. (2006). Formal Synar Survey Protocol. Lansing, MI: Michigan
Department of Community Health, ODCP. Can be found on website:
http://w~~.n~ichigan.gov/odc~
Office of Drug Control Policy. (2006). Vendor Education Protocol. Lansing, MI: Michigan
Department of Community Health, ODCP. Can be found on website:
http://www.michigan.gov/odcp
Outlets (for best practice on compliance checks). Retrieved 511 8/06 from Substance Abuse and
Mental Health Services Administration, Center for Substance Abuse Prevention,
TobaccoISYNAR, Retail Outlet Guidance Documents website:
http://prevention.samhsa.gov/tobacco/guidance.aspx
State Law Regarding the Sales of Tobacco Products to Individuals Under Age of 18: United
States Code of Federal Regulations, Title 45, Part 96, $130, Washington, D.C. (1996).
Can be found on website: http://ecfi-.gpoaccess.gov/cgi/t/text/text-
idx?c=ecfr&sid=ef508eeflb9flO497fS7166182488 1 ee&rgn=div8&view=text&node=45 :
1.0.1.1.53.12.33.11&idno=45
Substance Abuse and Mental Health Services Administration, Center for Substance Abuse
Prevention, Tobacco/SYNAR website: http://prevention.samhsa.gov/tobacco/default.aspx
Tobacco and Nicotine Health and Safety Act of 1992: PL102-321, Section 1926 State Law
Regarding the Sales of Tobacco Products to Individuals Under Age of 18, United States
Senate, 102"~ Congress, Washington, DC. (July 10, 1992). Can be found on website:
http://www.brock~ort.edu~-govdoc/SocPol/p11023c.pdf
Tobacco Regulation for Substance Abuse Prevention and Treatment Block Grants: Federal
Register, Volume 61, Number 13, pp 1491-1509, Final Rule, United States
Superintendent of Documents. (January 19, 1996). Can be found on website:
http://www..;poaccess.gov/fr/advanced.html [Check: 1996 FR, Vol. 61, enter: "page 1491-1509"l
Youth Tobacco Act 31 of 191 5, MCL19 15 PA3 1, Michigan Legislature, 19 15-1 91 6 Legislative
Session, Lansing, MI. (Amended September 1,2006). Can be found on website:
http://www.le~islature.n1i.gov/(c32puon1 tntsa355dn3zq]ip)/rnileg.aspx?page=MC LPASe
gCJ
i
: 1 APPROVED BY: p, L%&/UL J LJ&-
Donald L. Allen, Jr., Director
Office of Drug Control Policy
Commissioners Minutes Continued. January 20, 2010
312
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
OFFICE OF DRUG CONTROL POLICY
PREVENTION POLICY # 02
SUBJECT: Addressing Communicable Disease Issues in the Substance Abuse Network
ISSUED: October 1,2006
EFFECTIVE: October 1, 2006
This policy establishes Regional Substance Abuse Coordinating Agency (CA) requirements with
regard to addressing communicable disease. The primary charge of communicable disease
efforts is to prevent the further spread of infection in the substance using population. This
converts guidelines issued in the 2004 Action Plan Guidelines document to a policy requirement.
This policy applies to CAs and their provider network, which are a part of substance abuse
services administered through the Michigan Department of Community Health, Office of Drug
Control Policy (NIDCHIODCP).
Given the causal relationship between HIVIAIDS, hepatitis, other communicable diseases and
substance abuse, and the importance of recognizing the role of communicable disease assessment
in the development of substance abuse treatment plans for clients, a comprehensive approach is
the most effective strategy for preventing infections in the drug using population and their
communities
The CA must provide persons with substance use disorders at risk for andlor living with
HIVIAIDS, sexually transmitted diseases (STDs), tuberculosis (TB), hepatitis C and other
communicable disease the opportunity for access to culturally sensitive and appropriate
substance abuse prevention and treatment to address their multiple needs in a respectful and
dignified manner. Additionally, this policy is intended to assist the client to gain knowledge,
skills and resources needed to achieve personalized goals in relation to their substance use
disorder and its impact on their life.
Although a Substance Abuse Prevention and Treatment (SAPT) set-aside for early intervention
(EIP) services is not required for Michigan, an emphasis on the provision of services for persons
with or at risk of communicable diseases has been maintained
Prior to Fiscal Year (FY) 2005, the primary intent of EIP designated funding was to provide
early intervention services to substance abusing persons living with HIVIAIDS (whether or not
they were aware of their status) and to prevent HIV infection in the substance using population.
Beginning in FY 2005, the state extended this responsibility to other communicable diseases
including HIVIAIDS, hepatitis C, TB, and STDs.
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PREVENTION POLICY # 02
EFFECTIVE: October 1,2006
Page 2 of 6
Staffing
Each CA must assure staff knowledge and skills in the provider network are adequate and
appropriate for addressing communicable disease related issues in the client population, as
appropriate to each position within each provider, in accordance with the "Minimum Knowledge
Standards for Substance Abuse Professionals - Communicable Disease Related" below.
Whenever possible and cost effective, provider staff training is to be at the provider site.
Any Health EducatiodRisk Reduction, HIV counseling testing and referral, and outreach service
must ensure staff administering these interventions have successfully completed the MDCH,
Division of Health, Wellness and Disease Control, HIVJAIDS Prevention and Intervention
Section (HAPIS) training and certification program(s) for the appropriate intervention and must
adhere to HAPIS Quality Assurance Standards for HIV Prevention Intervention.
Minimum Knowledge Standards for Substance Abuse Professionals - Communicable Disease
Related
ODCP mandates that licensed provider staff have at least a basic knowledge of HIVJAIDS, TB,
Hepatitis, STD and the relationship to substance abuse. The following are the minimal standards
of knowledge necessary to meet this Level 1 requirement.
At a minimum, all substance abuse program staff should have basic knowledge regarding
communicable diseases, including:
HIVJAIDS, TB, Hepatitis (especially A, B, and C) and STDs as they related to the
agency target population;
Modes of transmission (risk factors, myths and facts, etc.);
Linkage between substance abuse and these communicable diseases;
Overview of treatment possibilities; and
Local resources available for further information / screening.
It is anticipated the above Level 1 requirements could be adequately covered in a two-hour
session, with update trainings every two years, and may be provided by agency staff that
have completed Level 2 training.
In addition to the above basic knowledge training, clinicians serving clients in a treatment setting
are required to have an expanded level of training on HIVJAIDS, TB, Hepatitis and STD. This
expanded Level 2 of training is to include:
1. Expanded basics of HIVJAIDS, TB, and Hepatitis C:
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PREVENTION POLICY # 02
EFFECTIVE: October 1,2006
Page 3 of 6
A. Statistics (statewide and local geographic area, modes of transmission, how to
interpret).
B. HIVIAIDS, TB and Hepatitis C (what they are, cause, definition, types).
C. Stagesphases of HIVIAIDS and Hepatitis infection (immune response and viral
load, impact on other body organs, co-factors, signs and symptoms of related
disease, including those specific to women and children, related infections and
cancers).
D. Factors for assessing risk and willingness and/or ability for client behavior change
(ways to eliminatelreduce risk; infection control).
2. Treatment options/possibilities (anti-retrovirals, prophylaxis, anti-infectives, immune-
modulators, clinical trials, nutrition, complementary/altemative treatments, impact of
substance use on medicationltreatment effectiveness).
3. Testing:
A. HIV Antibody testing (philosophy, goals, legal requirements, benefitslrisks, types
(i.e. serum, OraSure), laboratory tests used, limitations, overview of testing
processes).
B. Hepatitis testing and vaccines.
C. TB testing and treatment.
D. Options for STD screeningltesting.
4. Overview of psychosocial Issues:
A. Psychosocial Framework (issues for people with HIVIAIDS).
B. Overview of Psychological Issues (social isolation, alteration in quality of life,
self esteem, intensity of emotion, control, denial, financial and employment
issues).
5. Professional Challenges (discussion on what some key issues may be for clinicians in a
substance abuse treatment program, conceptions, attitudes/values, etc.).
6. Confidentiality, especially for HIVIAIDS (felony, partner notification, testing, reporting,
ADA, HIPPA).
7. Resources (local, state, federal).
It is anticipated the above Level 2 requirements could be adequately covered in a three-hour
session, with two-hour update trainings every two years. This level of training would require
a more advanced level of expertise for the trainer, which could be achieved through the
MDCH, HAPIS, HIV Specialist training certification process. Targeted and focused training
on one or two specific topics from the above list may be appropriate based on need identified
within a region or specific agency, once basic level of training has been achieved.
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PREVENTION POLICY # 02
EFFECTIVE: October 1,2006 Page 4 of 6
Services
I. All persons receiving substance abuse services who are infected by mycobacteria
tuberculosis must be referred for appropriate medical evaluation and treatment. The
CA's responsibility extends to ensuring that the agency to which the client is referred has
the capacity to provide these medical services or to make these services available, based
on ability to pay. If no such agency can be identified locally (within reasonable
distance), the CA must notify MDCHIODCP.
2. All clients entering residential treatment and residential detoxification must be tested for
TB upon admission. With respect to clients who exhibit symptoms of active TB, policies
and procedures must be in place to avoid the potential spread of the disease. These
policies and procedures must be consistent with the Centers for Disease Control (CDC)
guidelines andlor communicable disease best practice.
3. All pregnant women presenting for treatment must have access to STDs and HIV testing.
4. Each CA is required to assure that all substance abuse clients entering treatment have
been appropriately screened for risk of HIVIAIDS, STDs, TB, and hepatitis, and that they
are provided basic information about risk.
5. For those clients entering substance abuse treatment identified with high-risk behaviors,
additional information about the resources available and referral to testing and treatment
(with follow-up) must be made available.
6. For those clients identified with high-risk behaviors, CAs are required to assure
communicable disease related health education and risk reduction activities are available
for all at-risk clients enrolled in treatment programs.
7. All clients with a history of injecting drug use (IDU) must be referred for Hepatitis C
testing.
8. Communicable disease priority populations include all clients with a history of IDU and
pregnant women presenting for treatment. Additionally, women, African Americans, and
other communities of color are considered high risk.
9. CAs must ensure that the recipients of communicable disease services that are funded
through this agreement are persons with substance use disorders. This restriction does
not apply to referral services.
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PREVENTION POLICY # 02
EFFECTIVE: October 1,2006 Page 5 of 6
Outreach
If HIV outreach services are justified as needed in a CA region, these services must be directed
to substance (ab)users in high HIV prevalence areas of the CA region. These services must be
administered with the goal of referring contacts to treatment services and be conducted in
conjunction with a substance abuse treatment or prevention provider. Outreach is also intended
to enhance understanding of risks for HIV and Hepatitis C, methods of prevention, and to
promote awareness of and facilitate access to other needed services.
Financial Requirements
Funds allocated to the CA for communicable disease services may be used for counseling,
testing, and referral only when the client is not eligible for these services through other funding
sources or the counseling and testing services are an integral component of the substance abuse
treatment services provided to the client. It is expected that CA testing-related policy associated
with the use of state allocations be discriminate to individuals screened to be at high risk for
infection.
The CA shall not use any funds provided through the MDCHICA agreement for the treatment of
communicable diseases, that is, for primary medical care.
REPORTING REQUIREMENTS:
See the MDCHICA agreement and Action Plan Guidelines for CA reporting requirements.
The CA must submit client data consistent with HAPIS data collection methods including the
Uniform Reporting System (URS) CareWare for case management client level data and the HIV
Event System for Counseling, Testing, and Referral (CTR), and other prevention services as
required, in real time using the HIV Event System.
Procedures to meet these requirements are at the discretion of the CA.
Center for Substance Abuse Treatment. (Reprinted 2000). Substance Abuse Treatment for
Persons With HIV/AIDS, Treatment Improvement Protocol (TIP) Series 37. Rockville,
MD: U.S. Department of Health and Human Services, Substance Abuse and Mental
Health Services Administration.
Center for Substance Abuse Treatment. (Reprinted 1995). Screening for Infectious Disease
Among Substance Abusers, Treatment Improvement Protocol (TIP) Series 6. Rockville,
Commissioners Minutes Continued. January 20, 2010
317
PREVENTION POLICY # 02
EFFEC'TIVE: October 1,2006
Page 6 of 6
HIVIAIDS Prevention and Intervention Section. Quality Assurance Standards for HIV
Prevention Intervention. Lansing, MI: Michigan Department of Community Health,
Division of Health, Wellness and Disease Control.
HIV Event System - HAPIS Integrated Data Collection System, HIVIAIDS Prevention and
Intervention Section website: www.hapis.org
I I
APPROVED BY: '/L d/nu~4 dLL
Donald L. Allen, Jr., Director
Office of Drug Control Policy
Commissioners Minutes Continued. January 20, 2010
318
CA COUNTY NAMECOUNTY CODEOVER-THE-COUNTER (OTC),VENDING MACHINE (VM) orUNKNOWN (UNK)VENDORTYPE OF RETAILER(01-06)STORE NAME STREET CITY STATE ZIP PHONE COMMENTSDATE REVISED:DATE SUBMITTED:Tobacco Retailer Master List UpdatesNEWWhen entering data, MUST USE ALL CAPS.Att E_Tobacco Retailer Master.xls / NEWCommissioners Minutes Continued. January 20, 2010319
CURRENT MASTER LIST CODECA COUNTY NAMECOUNTY CODEOVER-THE-COUNTER (OTC),VENDING MACHINE (VM) orUNKNOWN (UNK)VENDORTYPE OF RETAILER(01-06)STORE NAME STREETCITY STATE ZIPPHONE COMMENTSWhen entering data, MUST USE ALL CAPS.Tobacco Retailer Master List UpdatesOUT OF BUSINESSDATE REVISED:DATE SUBMITTED:Att E_Tobacco Retailer Master.xls / OUT OF BUSINESSCommissioners Minutes Continued. January 20, 2010320
CURRENT MASTER LIST CODECA COUNTY NAMECOUNTY CODEOVER-THE-COUNTER (OTC),VENDING MACHINE (VM) orUNKNOWN (UNK)VENDORTYPE OF RETAILER(01-06)STORE NAME STREET CITY STATE ZIP PHONE COMMENTSDATE SUBMITTED:DATE REVISED:Tobacco Retailer Master List UpdatesCHANGESWhen entering data, MUST USE ALL CAPS.Att E_Tobacco Retailer Master.xls / CHANGESCommissioners Minutes Continued. January 20, 2010321
Instructions for Completion of Tobacco Retailer Master List Updates
Must Use ALL CAPS
NEW
Include any completely new businesses which sell tobacco. Fill out every column completely so the data can
be copied and pasted as a TRL “green” addition at the state level, where new numbers will be assigned.
Be sure to enter:
A) Type of Retailer:
01=Grocery
02=Convenience
03=Gas Station
04=Restaurant
05=Bar/lounge
06=Other (Specify in “Comments” section.)
B) Note in OTC/VM/UNK Column whether it is Over-the-Counter, Vending Machine or Unknown.
OUT OF BUSINESS
Include any businesses which went completely out of business. This does not include new ownership, no
longer selling, etc. Fill out every column completely so the data can be copied and pasted as a TRL “red liner”
into the master list to make changes at the state level.
CHANGES
Include ONLY what the new entry should look like with all necessary changes made. Fill out every column
completely so the data can be copied and pasted as a TRL “blue liner” into the master list at the state level.
Refer to codes noted above for Type of Retailer and OTC/VM coding.
Use ONE of the following codes in the comment section to designate a change in eligibility or validity for Synar
Checks (continued inclusion on TRL will be determined at state level):
I2=Does not sell tobacco products
I3=Inaccessible by youth
I4=Private club/residence
I5=Temporary Long Term Closure
I7=Wholesale/carton only
I9=Duplicate,
N2=Unsafe to access
N6=Drive through only
Att E_Tobacco Retailer Master.xls / TRL Instructions
Commissioners Minutes Continued. January 20, 2010
322
Code County Code County
1 Alcona 48 Luce
2 Alger 49 Mackinaw
3 Allegan 50 Macomb
4 Alpena 51 Manistee
5 Antrim 52 Marquette
6 Arenac 53 Mason
7 Baraga 54 Mecosta
8 Barry 55 Menominee
9 Bay 56 Midland
10 Benzie 57 Missaukee
11 Berrien 58 Monroe
12 Branch 59 Montcalm
13 Calhoun 60 Montmorency
14 Cass 61 Muskegon
15 Charlevoix 62 Newaygo
16 Cheboygan 63 Oakland
17 Chippewa 64 Oceana
18 Clare 65 Ogemaw
19 Clinton 66 Ontonagon
20 Crawford 67 Osceola
21 Delta 68 Oscoda
22 Dickinson 69 Otsego
23 Eaton 70 Ottawa
24 Emmet 71 Presque Isle
25 Genesee 72 Roscommon
26 Gladwin 73 Saginaw
27 Gogebic 74 St. Clair
28 Grand Traverse 75 St. Joseph
29 Gratiot 76 Sanilac
30 Hillsdale 77 Schoolcraft
31 Houghton 78 Shiawassee
32 Huron 79 Tuscola
33 Ingham 80 Van Buren
34 Ionia 81 Washtenaw
35 Iosco 82 Wayne (excluding city
of Detroit)
36 Iron 83 Wexford
37 Isabella 84 City of Detroit
38 Jackson 97 Unknown
39 Kalamazoo
40 Kalkaska
41 Kent
42 Keweenaw
43 Lake
44 Lapeer
STATE OF MICHIGAN
County Codes
Att E_Tobacco Retailer Master.xls / County Codes
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323
Code County Code County
45 Leelanau
Att E_Tobacco Retailer Master.xls / County Codes
Commissioners Minutes Continued. January 20, 2010
324
CA:Provider:CA Contact Person andE-mail Address:Estimated Number of Individuals to Receive ServicesEstimated Number of Sessions to be ProvidedNumber ofIndividualsWho ReceivedServicesNumber ofSessionsProvidedNumber ofIndividualsWho ReceivedServicesNumber ofSessionsProvidedColumn AColumn B Column C Column D Column E Column F Column GLevel 1 Provider Network TrainingLevel 2 Provider Network TrainingHE/RR HIV/AIDS Information SessionHE/RR Individual Level Prevention CounselingHE/RR Skills Building Workshops (single session)HE/RR Skills Building Workshops (multi-session)HE/RR Other Event FormatHIV CTRS at Substance Abuse Provider (1)HIV CTRS at Other Locations (1)OutreachTOTALS 000000Number of Interventions that will result in referral to substance abuse treatmentNumber of referred individuals that follow-through on referralsNumber of HIV tests (CTRS) to be conductedNumber (percentage) of HIV CTRS anticipated to be positive resultsNo. of CD Providers Under Contract with the CA:OUTREACH ONLYEVENTReportDue Date: Jan. 31, 20110%0%ReportDue Date: April 30, 2010Plan2nd Six Months--Actual #'s1st Six Months--Actual #'sEstimates0%COMMUNICABLE DISEASE PROVIDER INFORMATION PLAN/REPORTFiscal Year 2010For each intervention listed below and provided in the CA's region, please complete the following information:Report1st Six Months--Actual #'sDue Date: April 30, 2010Report2nd Six Months--Actual #'sDue Date: Jan. 31, 2011Plan: Original Plan Due Date October 31, 2009Date Submitted/ Revised: OriginalRevised OriginalRevisedAtt E_CD Provider Info Plan_Rpt FY2010 Initial.xlsPage 1 of 2Commissioners Minutes Continued. January 20, 2010325
III. Report Due Dates
The 1st six-month CD Provider Information Report is due on April 30, 2010. The 2nd six-month CD Provider Information
Report is due on January 31, 2011. See Attachment C—Reporting Requirements for report submission directions.
If there are questions or assistance is needed on these forms, contact Brenda Stoneburner, ODCP Communicable Disease
Specialist at 517-335-0121 or email to StoneburnerB@ michigan.gov.
Communicable Disease Provider Information Plan/Report Instructions
Fiscal Year 2010
On the CD Provider Information Plan/Report Form, there are various communicable disease intervention/services that are
eligible to be funded by MDCH based on Coordinating Agency (CA) need and priority. (1) If HIV CTRS is identified as being
provided, on a seperate sheet identify the site type and site number for each location testing occurs.
I. Completing the Plans
The completion of Columns B and C (Estimated Number of Individuals to Receive Services, Estimated Number of Sessions to
be Provided and Outreach Estimates) will be submitted to MDCH by October 31, 2009.
Please use the check box provided to identify the CD Provider Information Plans as "Original" at the initial submission of the
CD Provider Information Plan.
If the CD Provider Information Plan data should change, please use the check box provided to identify that the Plan was
"Revised" when submitting either the 1st six-month report or 2nd six-month report.
II. Completing the Reports
When submitting the first six-month report, maintain the "Plan" data on the report form. When submitting the 2nd six-month
report, maintain the "Plan" data and the 1st six-month report data on the report form.
1st Six-month Period of the Fiscal Year (October-March)
For those services/events that an identified CD provider will conduct for the CA, post the number of individuals who received
the services and the number of sessions provided, in the first six months, in Columns D and E.
In the Outreach section, post the data for the four items under the column for the 1st six-months.
2nd Six-month Period of the Fiscal Year (April-September)
For those services/events that an identified CD provider will conduct for the CA, post the number of individuals who received
the services and the number of sessions provided, in the last six months, in Columns F and G.
In the Outreach section, post the data for the four items under the column for the 2nd six-months.
If more than one provider will be offering these services in the CA's region, please complete a separate CD Provider
Information Plan/Report Form for each provider.
Att E_CD Provider Info Plan_Rpt FY2010 Initial.xls Page 2 of 2
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326
Att E_HIV Data Reporting Req FY2010 Initial.doc Page 1 of 1
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
HIV Data Reporting Requirements
In accordance with Prevention Policy #02, Addressing Communicable Disease Issues in
the Substance Abuse Network, issued and effective October 1, 2006, the following are
reporting requirements outlined in that policy and referenced by contract:
1) See the MDCH/CA agreement and Action Plan Guidelines for CA reporting
requirements; and
2) The CA must submit client data consistent with HAPIS data collection methods
including the Uniform Reporting System (URS) CareWare for case management
client level data and the HIV Event System for Counseling, Testing, and Referral
(CTR), and other prevention services as required, in real time using the HIV
Event System.
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329
State Allocation Local Other Other
SAPT + State (PA2, fees) State Federal
Information Dissemination $0
Education $0
Alternatives $0
Problem Identification and Referral $0
Community-Based Process $0
Environmental $0
Section 1926-Tobacco $0
Sub Total Expenditures $0 $0 $0 $0 $0
Other Expenditures $0
Grand Total $0 $0 $0 $0 $0
In the Space Below Provide:
Prevention Expenditures by Strategy Report
Questions should be directed to: (Name/Phone Number) _______________________________________
Strategy TOTAL
Coordinating Agency __________________________________
Source of Funds
(2) A description of how costs by strategy were determined
(1) A description of expenditures included in the "other expenditures" row
Fiscal Year __________
Attachment E-Prevention Expenditures by Strategy Report.8.05.xls Page 1 of 1
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330
Att E_Prev Expend by Strategy Rpt Instr FY2010 Initial.doc Page 1 of 3
Prevention Expenditure by Strategy Report – Instructions
This form requires the CA to report expenditures by federal prevention strategy. The
information submitted by the CAs on this form will be used to complete the federal
SAPT block grant application requirements.
Row Instructions:
Expenditure information must be reported by federal strategy. The following describes
each of these as guidance to the CA in reporting these expenditures.
Information Dissemination -- This strategy provides awareness and knowledge of the nature and extent of ATOD use, abuse, and addiction and their affect on individuals, families, and communities and also provides knowledge and awareness of available prevention programs and services. This strategy is characterized by one-way communication from the source to the audience with limited contact between the two. Examples of Information dissemination include: Resource directories Media campaigns Brochures Radio/TV public service announcements Speaking engagements Health fairs/health promotion Information line Education -- This strategy is characterized by two-way communication and is distinguished from the Information Dissemination in that interaction between the educator/facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis of media messages and systematic and judgmental abilities. Examples of Education include: Ongoing classroom and/or small group session (all ages) Parenting and family management classes Peer leader/helper programs Education programs for youth groups Children of Substance Abusers (COSA) groups Alternatives -- This strategy provides for the participation of the target population in activities that exclude ATOD. The assumption is that constructive activities offset the attraction to ATOD. State administered funds (SAPT and State funds) may not be used for this strategy. Examples of Alternatives include: Drug-free dances and parties Youth/adult leadership retreats Community drop-in centers Community service activities Problem Identification and Referral -- This strategy aims at identification of youths who have indulged in illegal/age-inappropriate use of tobacco or alcohol and in the first
Commissioners Minutes Continued. January 20, 2010
331
Att E_Prev Expend by Strategy Rpt Instr FY2010 Initial.doc Page 2 of 3
use of illicit drugs. They are assessed to determine whether their behavior can be reversed through education or whether they need professional help for treatment of a more deep-seated, potentially abusive behavior pattern. Activities under this strategy include screening for tendencies toward substance abuse and minimal preemptive counseling for curbing such tendencies. Activities cannot include AAR functions such as eligibility determination or use of ASAM criteria to determine LOC Examples of Problem identification and referral include: Employee Assistance Programs Student Assistance Programs Driving Under the Influence/Driving While Intoxicated (DUI/DWI) Education Programs Community-Based Process -- This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for ATOD disorders. Activities in this strategy include organizing, planning, enhancing the efficiency and effectiveness of services implementation, interagency collaboration, coalition building and networking. Examples of Community-based processes include: Community and volunteer training such as neighborhood action training, Training of key people in the system, staff/officials training Systematic planning Multi-agency coordination and collaboration Accessing services and funding Community team building Environmental -- This strategy establishes or changes written and unwritten community standards, codes, and attitudes, thereby influencing incidence and prevalence of ATOD use in the general population. Examples of Environmental strategies include: Promoting the review of ATOD policies in schools Technical assistance to communities to maximize local enforcement procedures governing availability and distribution of alcohol, tobacco, and other drugs Modifying alcohol and tobacco advertising practices Product pricing strategies Section 1926-Tobacco – Use this row to identify all prevention expenditures for activity targeting the reduction of youth access to tobacco including, but not limited to: law enforcement inspections; civilian inspections; official Synar inspections; vendor education and training; conferences convened by the CA; town hall meetings convened by the CA; collaborative planning and programming efforts with tobacco and/or drug free coalitions; media campaigns; community mobilization; environmental initiatives; and education and training of other stakeholder agencies. Sub-Total –This is the sum of information by strategy as reported in previous rows. Other Prevention Expenditures Use this row to identify all other prevention expenditures including, for example, costs associated with local needs assessment, prevention coordinators which cannot otherwise be distributed to the strategy(ies). Note-an explanation of the costs included in this row must be provided with the report.
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332
Att E_Prev Expend by Strategy Rpt Instr FY2010 Initial.doc Page 3 of 3
Grand Total Prevention Expenditures. This row should be the sum of the subtotal and other prevention expenditures. Column Instructions: Five columns for reporting expenditure information by fund source are provided. This prevention strategy report requires total funding be reported. However, source of funds have been aggregated from previous prevention expenditure reports. Column 2: State Allocation. -- Enter the expenditures, by row, of total SAPT block grant and state funding. Enter the amounts in whole dollars. Column 3: Local Funds including Fees -- This includes funding designated as local; such as, government entities, cities, other municipalities, special tax districts, local match, counties, and Public Act 2. Column 4: Other State Funds -- This includes any state funds expended by the CA other than the CA allocation reported in column 2. Column 5: Other Federal Funds -- This includes all other federal funds for substance abuse services. Examples are Public Health Service (PHS) or other federal categorical grant funds; Medicare; other public welfare funds, such as Food Stamps; other public third party funds, such as Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); the Social Services Block Grant (Title XX); and the Maternal and Child Health Block Grant. Column 6: Total-is the sum of the previous four columns. Special Note: The total prevention funds reported in this report is expected to reconcile to the final Expenditures Report for the CA. If the report does not reconcile, provide an explanation of the differences under the description section of the Prevention Expenditures by Strategy Report form.
Commissioners Minutes Continued. January 20, 2010
333
Coordinating Agency Name: Contact Name: E-mail: Phone number: Fiscal Year for which the table applies: StrategyExpend-itures# Partici-pantsCost Per Partici-pantEstimate Expend-itures# Partici-pantsCost Per Partici-pantEstimate Expend-itures# Partici-pantsCost Per Partici-pantEstimate Expend-itures# Partici-pantsCost Per Partici-pantEstimate Expend-itures# Partici-pantsCost Per Partici-pantInfo Dissemination - - Education----Alternatives-- --Problem ID & Ref- --Comm. Based Process--Environmental --Other-----Total $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0% of Total Estimated Expenditures that are SAPT dollars for Evidence-based Programs/StrategiesExpenditures by Strategy and Intervention Type, and Cost per Participant Comments and Explanation:Fiscal Year Total Number and Cost per Participant by Intervention Type Universal Indirect Universal Direct Selective Indicated Att E_Prev Rpt for SAPT_BG FY2010 Initial.xlsPage 3 of 4Commissioners Minutes Continued. January 20, 2010334
Att E_Prev Rpt for SAPT_BG Instr FY2010 Initial.doc Page 1 of 3
Prevention Report for SAPT Block Grant
Definitions, Descriptions, and Instructions
The federal SAPT Block Grant application provides the following terms and definitions:
Intervention Type:
Universal-direct: Interventions directly serve participants who have not been
identified on the basis of individual risk
Universal-indirect: Interventions support population-based activities and the
provision of information and technical assistance
Selective: Activities targeted to individuals or a subgroup of the population whose
risk of developing a disorder is significantly higher than average
Indicated: Activities targeted to individuals in high-risk environments, identified as
having minimal but detectable signs or symptoms foreshadowing disorder, or
having biological markers indicating predisposition for disorder, but not yet
meeting diagnostic levels.
Strategies:
Information Dissemination: Provides knowledge and increases awareness of the
nature and extent of alcohol and other drug use, abuse, and addiction as well as
their effects on individuals, families and communities. It also provides knowledge
and increases awareness of available prevention and treatment programs and
services. It is characterized by one-way communication from the source to the
audience, with limited contact between the two.
Education: Builds skills through structured learning processes. Critical life and
social skills include decision making, peer resistance, coping with stress, problem
solving, interpersonal communication and systematic and judgmental abilities.
There is more interaction between facilitators and participants than in the
information strategy.
Alternatives: Provides participation in activities that exclude alcohol and other
drugs. The purpose is to meet the needs filled by alcohol and other drugs with
healthy activities and to discourage the use of alcohol and drugs through these
activities
Problem Identification and Referral: Aims at identification of those who have
indulged in illegal/age-inappropriate use of tobacco or alcohol and those
individuals who have indulged in the first use of illicit drugs in order to assess if
their behavior can be reversed through education. This strategy does not include
any activity designed to determine if a person is in need of treatment.
Community Based Process: Provides ongoing networking activities and technical
assistance to community groups or agencies. It encompasses neighborhood-
based grassroots empowerment models using action planning and collaborative
systems planning.
Environmental: Establishes or changes written and unwritten community
standards, codes and attitudes, thereby influencing alcohol and other drug use
by the general population.
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335
Prevention Report for SAPT Block Grant
Definitions, Descriptions, and Instructions (Cont’)
Att E_Prev Rpt for SAPT_BG Instr FY2010 Initial.doc Page 2 of 3
Crosswalk Chart:
The following chart provides a “crosswalk” between strategies, program and intervention
types.
An “X” in the cell identifies the strategy for which the program and intervention types
would apply.
Program Type Intervention Type
Strategy Population Individual Univ-
Direct
Univ-
Indirect
Selective Indicated
Info
Dissemination XXXXXX XXXXXX
Education XXXXXX XXXXXX XXXXXX XXXXXX
Alternatives XXXXXX XXXXXX XXXXXX XXXXXX
Problem
ID/Referral XXXXXX XXXXXX XXXXXX
Community
Based XXXXXX XXXXXX
Environmental XXXXXX XXXXXX
Program: The Block Grant application uses the term “program type” to distinguish
between population and individual. However, with regard to reporting expenditures,
the application defines program as an activity, a strategy or an approach intended
to prevent an outcome or to alter the course of an existing condition. Michigan will
use each of the CA’s six strategies as the operational definition of a “program.”
Correspondingly, Michigan will report on a maximum of 96 programs (16x6).
Participant: Block Grant application guidance for prevention “participant” counts is as
follows:
Participants in Individual Based Programs: For individuals participating in
recurring services/curriculum, count each participant only once—an unduplicated
count (or each “new” participant) in the series. Duplicate counts across
curriculums or services are acceptable.
Participants in Population Based Programs: Participant counts in population
based programs should be based on either actual number of persons
participating or estimates of persons served. Census Bureau data may be used
if an identifiable subset of the population, either by age or geography, can be
identified. As examples, this includes program participants, “reach” for media,
and census for community policy development.
Cost Per Participant: The SAPT Block Grant requires the calculation of a cost per
participant for prevention services, by program (Michigan will use strategy as the
program) and by intervention type. For the 2011 SAPT Block Grant application,
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Prevention Report for SAPT Block Grant
Definitions, Descriptions, and Instructions (Cont’)
Att E_Prev Rpt for SAPT_BG Instr FY2010 Initial.doc Page 3 of 3
information about services and expenditures in the state fiscal year (FY) 2008 --
October 1, 2008 through September 30, 2009-- is required.
Instructions for Completion of Table Entitled:
“Expenditures by Strategy and Intervention Type, and Cost per
Participant”
Please use the following general instructions for completion of this table; provide
comments and/or other narrative explanation as necessary to describe the information
provided.
Corresponding to the crosswalk chart on page 2, the cells in this table have been
shaded to indicate that information for that cell would not be expected. For example, no
participant data, or cost per participant would be expected under the alternatives
strategy for the universal-indirect intervention type.
For each Intervention Type, enter an estimate of the percent of the FY Total Estimated
Expenditures that are SAPT Block Grant dollars spent on evidence-based
programs/strategies.
Completion of this table will enable the Office of Drug Control Policy to complete SAPT
Block Grant application requirements.
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Att E_Priority Pop Waiting List Def Rpt Instr FY2010 Initial.doc Page 1 of 2
Instructions for Completing the Federal Priority Populations Waiting List Certification Form The purpose of this report is for federal block grant reporting on programs providing treatment for pregnant women and Injecting Drug Users (IDUs). This report monitors compliance with Sections 1923(a)(2) and 1927(b)(2) of Public Law 102-321, as amended: 1923(a)(2) Treat Within Specified Number of Days. - Each individual who requests and is in need of treatment for intravenous drug abuse must be admitted to a program of such treatment not later than (A) 14 days after making the request for admission to such a program; or (B) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services are made available to the individual not later than 48 hours after such request. 1927(b)(2) Treat Within Specified Number of Days. Each pregnant woman who seeks and would benefit from substance abuse treatment services must be admitted to such program that (A) has the capacity to provide treatment services to the woman; or (B) if no program has the capacity to admit the woman, make interim services available to the woman not later than 48 hours after such request. The Office of Drug Control Policy requires that this report be uploaded to the Electronic Grants Administration and Management System (EGrAMS) as an ‘Attachment Report’ at the end of the month following the month in which a Coordinating Agency and/or its provider network has not met these Federal Requirements.
In situations where one or more priority population clients did not receive services as required, the following information must be provided: Program Name - Enter the legal name of the provider at which the client was placed on a waiting list – this can be the provider choice or where the client presented for services Column A: Client Identifier - Enter a client identifier number. Column B: Priority Code – Enter the client type by using one of the following codes: 1 – Pregnant injecting drug user 2 – Pregnant non-injecting drug user 3 – Injecting drug user Column C: Service Request Date - Enter date client first requested services. Column D: Date LOC Determined – Enter the date the Level of Care Determination was completed Column E: Days on Waiting List - Indicate the number of days the client has been (was) on a waiting list for treatment. This starts with the day service was requested and goes to the date of the first appointment. Column F: Service Required – Enter the services requested – this should be the service that the client chose: OP – Outpatient IOP – Intensive Outpatient Meth – Methadone program
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Att E_Priority Pop Waiting List Def Rpt Instr FY2010 Initial.doc Page 2 of 2
Res – Residential Det – Sub-Acute Detox Column G: Meth Drug Free - Check the box if the client waiting for services was involved in drug-free treatment Column H: Meth Ref. Drug Free - Indicate if the client waiting for a methadone slot has declined drug-free services by checking the box. Column I: Interim Services Provided - Indicate if interim services were provided as required by checking the box
Column J: Interim Services Refused - Check the box if the client refused interim
services
Column K: Type of Interim Services - Indicate what type of interim services were
provided to the client – leave blank if none
If the services that the client requested were different than what the LOC
determination indicated, explain why they are different.
The CA must provide a reason for why they were not in compliance with the
Federal Waiting List Requirement for each client on the list – specific barriers
should be identified.
The CA must describe what plans they are putting or have put into place to ensure
future compliance with this requirement.
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Att E_Womens Spec Serv Rpt Instructions FY2010 Initial.doc Page 1 of 1
Michigan Department of Community Health
Guidelines for Completing the Women, Pregnant Women, and Women with Dependent
Children Progress Report Form
As indicated on the form, this is an annual report due no later than January 31 for the prior
fiscal year and it must be submitted electronically through EGrAMS Attachment Reports, at
http://egrams-mi.com/dch. In the spaces provided at the top of the page, indicate the CA
name and the fiscal year the report covers.
Unduplicated Treatment Services Provided
In the table, provide the name of the service provider, both designated women’s providers
and other providers considered to be gender competent, and then the corresponding
information in each column. Please do not leave any blanks in a row, if a column does not
apply, just indicate with a “0”.
*Please include providers out of region also, unless they are statewide providers (Odyssey,
Salvation Army)
Coordinating Agency Specific Information
This information should be provided by the CA for their entire region, as well as those clients
sent out of region, and include all referrals and services provided by all providers not just
Designated Women’s Providers (DWPs).
Outcome Information
This information is for all programs that provide services to pregnant women. Please indicate
which programs are DWPs by checking the box and then provide the corresponding
information for each column.
Program Information
This information is necessary if any programs changed treatment services/criteria during the
fiscal year. Complete the requested information for each provider that changed. If no changes
occurred in any programs, this section can be left blank
The remaining questions are related to expectations from Federal requirements and state site
visits. If information or data is not available, indicate why and how this is going to be
addressed in the future.
Incomplete reports will be returned for corrections, and will not be considered submitted
until corrections are completed and resubmitted.
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Att E_Credentialing_Staff Qual Req FY2010 Initial.doc Page 1 of 14
Michigan Department of Community Health
Credentialing and Staff Qualification Requirements
For
the CA Provider Network
This contract attachment outlines requirements for credentialing and staff qualifications
throughout the CA provider network. It is organized as follows:
I. CA Credentialing Requirements
II. Provider Staff Certification Requirements
III. Staff Qualifications for Substance Use Disorder Prevention Services
IV. Staff Qualifications for Substance Use Disorder Treatment Services
V. Other Staff-Related Definitions
I. CA CREDENTIALING REQUIREMENTS
In implementing staff qualifications requirements, the CA must:
1) Adopt and disseminate policy with respect to required professional qualifications
for prevention and treatment direct service personnel in the CA network,
applicable both to salaried and contractual personnel. In general, the
requirements contained herein are expected to represent the minimum standards
for substance use disorder prevention and treatment services. However it is
recognized that specialized services may require enhanced staff qualifications.
When establishing requirements for qualifications or training for staff that do not
require certification, CAs are expected to:
a) Recognize and utilize credible web-based training for fundamentals in
addiction treatment and prevention
b) Recognize in-service and provider new staff orientation
c) Recognize and provide reciprocity for training provided through other
CAs or PIHPs that address relevant topic and content areas.
2) Assure that staff qualifications are met throughout the provider panel through CA
policy and procedures.
CAs must consider use of deemed status, reciprocity and delegation provisions
when permissible in order to establish a single credentialing and associated
monitoring requirements for the provider and reduce administrative burden on
both the provider and the CA. Whenever possible, it is preferable that CAs
permit deemed status or reciprocity and that a single responsible CA be identified
when multiple CAs contract with a single provider.
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3) Assure that criminal background checks are conducted as a condition of
employment for its own potential employees and for network provider employees.
Although criminal background checks are required, it is not intended to imply that
a criminal record should necessarily bar employment. The verification of these
checks and a justification for the decisions that are made should be documented
in the employee personnel or interview file. CAs may also establish criteria for
criminal background checks for individuals during employment episodes.
4) Recognize and comply with state health care licensing professional scope of
practice and supervision requirements.
Credentialing Responsibilities
Primary responsibility for assurance that staff qualification requirements are met rests
with the individual and the provider agency that directly employs or contracts with the
individual to provide prevention or treatment services.
Responsibilities of the individual, provider agency and the CA are generally as follows:
1) The individual is responsible for achieving and maintaining his or her certification.
2) The provider agency that directly employs or contracts with the individual to
provide prevention or treatment services is responsible for verifying the ongoing
certification status of the employee. This includes verification of the credential(s),
monitoring staff development plans and compliance with continuing education
requirements.
3) The CA is responsible for establishing certification-related contractual obligations
with their provider network consistent with these requirements. With the intended
locus of responsibility resting with the provider agency, the CA has responsibility
for provider agency performance monitoring to assure these obligations have
been met.
Although it is not intended that CAs maintain primary source verification functions or
individual certification or credentialing files on behalf of their provider network, it is
recognized that this may represent a prudent or necessary business practice of the CA.
CAs maintaining primary source verification files may be asked to provide their
justification for doing so.
Compatibility with PIHP Requirements
CA policy and procedures with regard to credentialing should be compatible with PIHP
credentialing and re-credentialing business processes. MDCH has issued a PIHP
credentialing policy entitled Credentialing and Re-Credentialing Processes (Attachment
P.6.4.3.1 of the MDCH PIHP contract). This policy defines organizational providers as
entities that directly employ and/or contract with individuals to provide health care
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services. These services include treatment of substance use disorders. In this regard,
CAs are considered to be organizational providers.
The PIHP credentialing policy outlines two requirements associated with credentialing of
organizational providers:
1) Each PIHP must validate, and re-validate at least every 2 years that the
organizational provider is licensed or certified as necessary to operate in the
state and has not been excluded from Medicaid or Medicare participation.
2) The PIHP must ensure that the contract between the PIHP and any
organizational provider requires that the organizational provider credential and
re-credential their directly employed and subcontracted direct service providers in
accordance with the PIHP’s policies and procedures (which must conform to
MDCH’s credentialing process).
Added clarification for CAs that are not PIHPs: This policy intends that credentialing
responsibilities are carried out and associated records are maintained at the provider
organization level. If a CA employs individual practitioners for the purposes of providing
treatment or prevention services, the CA is an organizational provider. The CA is not
required by the MDCH policy to perform the credentialing functions on behalf of its
providers. When CAs contract with providers that meet the organizational provider
definition, then the CA must:
1) Ensure that the contract between the CA and their organizational provider
requires that the provider credential and re-credential their directly employed and
subcontracted providers in accordance with the policy, and
2) Ensure that the provider has not been excluded from Medicaid or Medicare
participation.
II. PROVIDER STAFF CERTIFICATION REQUIREMENTS
The following provides detailed information regarding the certification requirements for
the CA provider network.
General
These certification requirements represent the standards for individual CA provider
network requirements. Special consideration can be made for both special population
needs (such as those of adolescents) and for specialty services (such as provision of
methadone to women that are pregnant).
Also, it is expected that reimbursement rates reasonably acknowledge the cost
implications of certification requirements and recognize workforce development
obligations already incorporated in provider accreditation requirements. CAs may
consider rate incentives for enhanced staffing requirements for specialty services.
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Application
Certification requirements apply to the entire CA provider network for services directed
to the prevention and treatment of substance use disorders. This includes staff working
for or within local governmental units such as intermediate school districts, local health
departments or community mental health service board programs when these are under
contract to the CA as a provider and/or funded through the DCH/CA master agreement,
depending on the scope of their work, as described in this document.
Certification requirements do not apply to staff solely engaged in:
1) Synar tobacco compliance checks or vender education or
2) Provision of communicable disease prevention and education services.
Refer to Prevention Policy #2-Addressing Communicable Disease Issues in the
Substance Abuse Network for information about communicable disease staff training
requirements.
Certification requirements apply on the basis of staff role and responsibility regardless
of employee status or type. Examples of employee status include: direct employee,
contractual, or volunteer. Examples of type include: full time, part time, intermittent or
seasonal.
An individual’s certification requirements are determined on the basis of each of their
job responsibilities. That is, situations in which an individual’s responsibilities cross
roles and responsibilities as outlined below, and each role category independently
determines the associated certification requirement. For example, an individual
functioning as a case manager (certification not required) and as a treatment clinician
would be required to be certified even though their responsibilities include functions for
which certification is not required.
Unless an exception is specified below under the various staff types, individuals who
are timely in the process of completing their registered development plan for the
specified credential are considered to meet certification requirements. For example, a
recent MSW graduate working in a position providing treatment to persons with
substance use disorders with an approved development plan would be considered to
meet certification requirements. Development plans are required to include time frames,
milestones, be date-specific and appropriate to the experience requirements associated
with the certification credential. For example, a development plan must recognize hours
of experience requirements in the context of the employees status (full, part time).
However, development plans must contain prompt and reasonable time frames for
completion.
As of June 2007, the accepted equivalent credentials to the Michigan Certification
Board for Addiction Professionals (MCBAP) certification are as follows:
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• For prevention: Certified Health Education Specialist (CHES) through the
National Commission for Health Education Credentialing
• For treatment: Certification through the Upper Midwest Indian Council on
Addiction Disorders (UMICAD)
• For medical doctors: American Society of Addiction Medicine (ASAM) (Some
physicians, depending on the scope of their work performed at the agency, will
function in the category of Specifically Focused Staff as described in this
document)
• For psychologists: American Psychological Association (APA) specialty in
addiction
This listing will be updated, and CAs notified in writing, should additional equivalent
credentials be identified.
Should a situation arise with an established provider where there are no longer
employees available that meet the credentialing requirements, the provider and the CA
are responsible for developing a “time-limited exception plan” appropriate to the
situation to ensure that the established clients with the provider continue to receive
services. An example of such a situation would be a provider that has one or more
credentialed clinicians leave resulting in the remaining staff not being able to provide
services to the clients. The CA and provider could then enter into an exception plan
agreement where a qualified but non-credentialed person can provide services to those
clients until credentialed staff are hired, return from leave, etc. The length of the plan
should be adequate to serve the immediate need of the affected clients but should not
exceed 120 days in an initial agreement. For administrative efficiency, when providers
participate in multiple CA provider panels, the affected CAs should jointly determine an
appropriate exception plan.
MCBAP Staff Certification Requirements – By Staff Function
As of October 1, 2008, all individuals performing staff functions outlined below must:
1) Be certified appropriate to their job responsibilities under one of the credentialing
categories or an approved alternative credential; or
2) Must have a registered development plan and be timely in its implementation; or
3) Be functioning under a time limited exception plan approved by the CA as
described earlier in this document.
Individuals under any of these three categories will be considered to meet MCBAP
certification requirements. Note that a development plan is timely when there is
evidence that steps or activities included in the development plan are being
implemented and can be expected to be completed within a reasonable period of time.
The supervisor of the individual is responsible for regularly monitoring the status of the
development plan. MCBAP maintains a list of individuals who have active development
plans and this can be accessed through their website at mcbap.com.
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Staff functions for which these requirements apply are Prevention Professionals,
Prevention Supervisors, Treatment Specialists, Treatment Practitioners and Treatment
Supervisors. The following chart outlines certification, supervision and licensure
requirements. It is intended to assist in the determination of MCBAP certification
requirements in the provider network, licensing requirements may still apply depending
on the nature of the work duties and scope of practice.
Job Function and
Description
MCBAP Certification Required
for the Job Function
Supervision
Required for the
Job Function
Treatment Supervisors
Commonly described as
Supervisors, Managers or
Clinical Supervisors. This
represents individuals
directly supervising staff,
including all levels (first,
second line, etc) of clinical
services.
Certified Clinical Supervisor –
Michigan (CCS-M)
Certified Clinical Supervisor –
IC&RC (CCS-R)
Professional
Licensure
requirements may
apply, depending on
the nature of the
work duties and
scope of practice.
Treatment Specialists
Commonly described as
clinicians, therapists, or
counselors. This represents
direct clinical treatment
service provider staff not
identified as specifically
focused.
Certified Addictions Counselor –
Michigan (CAC-M)
Certified Addictions Counselor –
IC&RC (CAC-R)
Certified Advanced Addiction
Counselor – IC&RC (CAAC)
Certified Criminal Justice
Professional – IC&RC – (CCJP-R)
Certified Co-Occurring Disorders
Professional – IC&RC – (CCDP) –
Bachelors level only
Certified Co-Occurring Disorders
Professional Diplomat – IC&RC –
(CCDP-D) – Masters level only
MCBAP supervisory
credential – CCS-M
or CCS-R, an
approved alternative
certification or a
registered
development plan to
obtain the MCBAP
credential
Treatment Practitioners
Commonly described as
treatment staff providing
direct service to clients like
education and support; or
they may be new to the field.
A registered development plan that
is timely in its implementation
MCBAP supervisory
credential – CCS-M
or CCS-R, an
approved alternative
certification or a
registered
development plan to
obtain the MCBAP
credential
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Job Function and
Description
MCBAP Certification Required
for the Job Function
Supervision
Required for the
Job Function
Prevention Supervisors
Commonly described as
prevention program
supervisors and represent
individuals responsible for
overseeing prevention staff
and/or prevention services.
Certified Prevention Consultant –
Michigan (CPC-M)
Certified Prevention Consultant –
IC&RC (CPC-R)
Certified Prevention Specialist –
Michigan (CPS-M)
Certified Prevention Specialist –
IC&RC (CPS-R) – only if credential
effective prior to 10-01-2008
No state
requirements
specified
Prevention Professionals
Commonly described as
Program or Prevention
Coordinator, Prevention
Specialist or Consultant, or
Community Organizer and
have responsibility for
implementing a range of
prevention plans, programs
and services.
Certified Prevention Specialist –
Michigan (CPS-M)
Certified Prevention Consultant –
Michigan (CPC-M)
Certified Prevention Specialist –
IC&RC (CPS-R)
Certified Prevention Consultant –
IC&RC (CPC-R)
Supervision by
MCBAP prevention
credentialed staff or
an approved
alternative
certification
Supervision Requirements for Non-Certified Staff
Individuals with staff functions outlined below are not required to be MCBAP certified,
but are required to be supervised by MCBAP certified staff.
Specifically Focused Treatment Staff
This category includes Case Managers, Recovery Support Staff as well as staff who
provide ancillary health care services such as nurses, occupational therapists, psychiatrists
and children’s services staff in women’s specialty programs. Licensing requirements may
apply depending on the nature of the work duties and scope of practice.
Specifically Focused Prevention Staff
Staff that consistently provide a specific type of prevention service. They do not have
responsibilities for implementing a range of prevention plans, programs or services.
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Treatment Adjunct Staff
Commonly described as: Resident Aide, Pharmacy Techs or Child Care Aides or program
aides/techs. Adjunct staffs are involved with the client but not at a clinical treatment
services level. It is recognized that some treatment adjunct staff provide didactic or skill
development services. Licensing requirements may apply to adjunct staff depending on the
nature of the work duties and scope of practice; they may also work under the direction of
appropriately licensed and/or credentialed staff.
Interns for the Provision of Services
Interns are individuals who, as part of an educational curriculum while in the process of
obtaining a degree related to the substance use disorder field, provide prevention or
treatment services to clients. These services must be provided under the supervision of a
MCBAP treatment credentialed staff (or an approved alternative certification) and any
specific licensing requirements for the degree being sought. All services provided by interns
may be allowable and billable as long as the intern is being appropriately supervised.
The MCBAP certification requirements do not replace or supersede state licensure
scope of practice and supervision requirements for health care professionals such
as social workers, counselors or psychologists
Certification Requirements for Temporary or Supervisory Assignments
Cross-over work assignments occur in those situations when an individual staff’s roles
and responsibilities have different MCBAP certification requirements on a temporary,
time-limited basis (less than 120 days). Temporary work assignments include, for
example, working out of class, temporary assignments to a higher or different position
during the time required to fill a vacancy, providing coverage for a staff person on leave
status or similar situations. Examples of temporary work assignments are: assignment
of a treatment clinician to clinical supervisory responsibilities or a prevention
professional assigned to supervisory prevention activities due to a vacant position or
employee leave of absence.
During the temporary work assignment period, the individual performing the duties of
the absent/vacant staff position will not be required to meet the MCBAP certification
requirement for that temporary position. However, the individual with the temporary
work assignment must have the certification or development plan appropriate to their
current roles and responsibilities. For example, an individual temporarily assigned to
clinical supervision would be required to be treatment-certified and an individual
assigned to prevention supervisory responsibilities would be expected to be prevention-
certified.
When the provider does not have any suitable employee available, or does not have the
capacity to meet these requirements, the provider and the CA are responsible for
developing and implementing a “time-limited exception plan”. The CA and provider
should enter into an exception plan agreement where a qualified but non-credentialed
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person can provide adequate and appropriate supervision services to those
credentialed staff currently providing services to clients. The length of the plan should
be adequate to serve the immediate need of the provider and clients but should not
exceed 120 days in an initial agreement.
Supervisory exception plans may include purchase of supervisory services on a short-
term basis, cross-CA or provider staff support or other actions appropriate to the
situation and health care professional licensure requirements. For administrative
efficiency, when providers participate in multiple CA provider panels, the affected CAs
should jointly determine an appropriate plan.
Considerations Due To Availability of Certified Supervisory Staff
It is expected that certified supervisory staff may not be available during the
implementation period, or the size/scope of some providers (i.e. single provider in a
rural setting) result in shared supervision of either prevention and treatment programs or
other unique arrangements. In these situations, the responsible CA and provider must
develop a plan that recognizes that general supervisory responsibilities (such as
approval of time off, etc) are at the discretion of the provider. However, a plan
addressing how “content specialty” supervision will be provided must be developed and
implemented. The plan as feasible and appropriate to the situation may consider hiring
qualifications for new staff, supervised practical training, use of mentors or consultants,
use of regional/other resources, development of a regional cadre for the content area or
continuing education.
Diversity and Workforce Development
The development of a diverse pool of candidates and a workforce that is representative
of the community and service population is valued and encouraged as is the
development of career ladders that assist individuals in gaining the knowledge and skills
that enable career advancement. The development of opportunities for peers as
mentors and recovery specialists is also encouraged.
III. STAFF QUALIFICATIONS FOR SUBSTANCE USE DISORDER
PREVENTION SERVICES
The staff qualifications that follow reflect changes that went into effect October 1, 2008.
Definitions
Prevention Professional:
An individual who has one of the following Michigan specific (MCBAP) or International
Certification & Reciprocity Consortium (IC&RC) credentials:
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• Certified Prevention Specialist – Michigan (CPS-M)
• Certified Prevention Consultant – Michigan (CPC-M)
• Certified Prevention Specialist – IC&RC (CPS-R)
• Certified Prevention Consultant – IC&RC (CPC-R)
OR – An individual who has an approved Alternative Certification:
• Certified Health Education Specialist (CHES) through the National Commission
for Health Education Credentialing (NCHEC)
OR – An individual who has a registered development plan, for a CPS credential, and is
timely in its implementation leading to certification.
Prevention Supervisor:
An individual who has one of the following Michigan specific (MCBAP) or International
Certification & Reciprocity Consortium (IC&RC) credentials:
• Certified Prevention Consultant – Michigan (CPC-M)
• Certified Prevention Consultant – IC&RC (CPC-R)
• Certified Prevention Specialist – Michigan (CPS-M)
• Certified Prevention Specialist – IC&RC (CPS-R) – only if credential effective
prior to 10-01-2008
OR – An individual who has an approved Alternative Certification:
• Certified Health Education Specialist (CHES) through the National Commission
for Health Education Credentialing (NCHEC)
IV. STAFF QUALIFICATIONS FOR SUBSTANCE USE DISORDER
TREATMENT SERVICES
The staff qualifications that follow reflect changes that went into effect October 1, 2008.
Definitions
Substance Abuse Treatment Specialist (SATS):
An individual who has licensure in one of the following areas AND is working within his
or her licensure-specified scope of practice:
Physician (MD/DO), Physician Assistant (PA), Nurse Practitioner (NP), Registered
Nurse (RN), Licensed Practical Nurse (LPN), Licensed Psychologist (LP), Limited
Licensed Psychologist (LLP), Temporary Limited Licensed Psychologist (TLLP),
Licensed Professional Counselor (LPC), Limited Licensed Counselor (LLC), Licensed
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Marriage and Family Therapist (LMFT), Limited Licensed Marriage and Family
Therapist (LLMFT), Licensed Masters Social Worker (LMSW), Limited Licensed
Masters Social Worker (LLMSW), Licensed Bachelor’s Social Worker (LBSW), or
Limited Licensed Bachelor’s Social Worker (LLBSW); AND they have a registered
development plan and are timely in its implementation leading to certification OR they
are functioning under a time limited exception plan approved by the CA as detailed in
this document.
OR – An individual who has one of the following Michigan specific (MCBAP) or
International Certification & Reciprocity Consortium (IC&RC) credentials:
• Certified Addictions Counselor – Michigan (CAC-M)
• Certified Addictions Counselor – IC&RC (CAC-R)
• Certified Advanced Addiction Counselor – IC&RC (CAAC)
• Certified Criminal Justice Professional – IC&RC (CCJP-R)
• Certified Co-Occurring Disorders Professional – IC&RC (CCDP) – Bachelors
level only
• Certified Co-Occurring Disorders Professional Diplomat – IC&RC (CCDP-D) –
Masters level only
OR – An individual who has an approved Alternative Certification:
• For medical doctors: American Society of Addiction Medicine (ASAM)
• For psychologists: American Psychological Association (APA)
• Certification through the Upper Midwest Indian Council on Addiction Disorders
(UMICAD)
A Physician (MD/DO), Physician Assistant (PA), Nurse Practitioner (NP), Registered
Nurse (RN) or Licensed Practical Nurse (LPN) who is not providing treatment services
to clients beyond the scope of practice of their licensure are considered to be
Specifically Focused Treatment Staff and are not required to obtain the MCBAP
credentials. If one of these individuals wanted to provide substance use disorder
treatment services to clients, outside the scope of their licensure, then the MCBAP
certification requirements would apply.
Substance Abuse Treatment Practitioner (SATP):
An individual who has a registered MCBAP certification development plan that is timely
in its implementation AND is supervised by an individual with a CCS-M, CCS-R or a
registered development plan to obtain the supervisory credential, while completing the
requirements of the plan (6000 hours).
Treatment Supervisor:
An individual who has one of the following Michigan specific (MCBAP) or International
Certification & Reciprocity Consortium (IC&RC) credentials:
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• Certified Clinical Supervisor – Michigan (CCS-M)
• Certified Clinical Supervisor – IC&RC (CCS-R)
OR – An individual who has an approved Alternative Certification:
• For medical doctors: American Society of Addiction Medicine (ASAM)
• For psychologists: American Psychological Association (APA)
OR – An individual who has a registered development plan, for the supervisory
credential and is timely in its implementation leading to certification.
V. Other Staff-Related Definitions
Individual Licensure Requirements – Refers to the supervision requirements set forth
in the public health code for each category of licensed professions. The licensed
individual is responsible for ensuring that he/she is involved in the appropriate
supervision as designated by the licensing rules of his/her profession.
Clinical Addiction Services – Those counseling services in substance use disorder
treatment that involve individual or group interventions, that have a focus on developing
insight into behaviors and developing skills in understanding and changing those
behaviors, and that require specially trained and educated clinicians to conduct them.
The therapy process is defined as the actions involved in assessment, diagnosis, or
treatment of mental, emotional, or behavioral disorders, conditions, addictions, or other
bio-psychosocial problems; and may include the involvement of the intra-psychic, intra-
personal, or psychosocial dynamics of individuals.
Other Services – Those services in substance use disorder treatment that involve
directing, assisting, and teaching skills necessary for recovery from substance use
disorders to clients.
Individual/Clinical Supervision – Refers to the intervention that is provided by a
senior member of a profession to a junior member or members of the same profession.
This service is focused on enhancing the professional functioning of the junior
member(s) and monitoring the quality of the professional services offered to clients by
the junior member(s).
In Michigan, to provide supervision in the substance use disorder prevention and
treatment fields, an individual must have one of the following MCBAP credentials or an
established development plan leading to certification in one of the credentials:
• Certified Prevention Consultant – Michigan (CPC-M)
• Certified Prevention Consultant – IC&RC (CPC-R)
• Certified Prevention Specialist – Michigan (CPS-M)
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• Certified Prevention Specialist – IC&RC (CPS-R) – only if credential effective
prior to 10-01-2008
• Certified Health Education Specialist (CHES) through the National Commission
for Health Education Credentialing (NCHEC)
• Certified Clinical Supervisor – Michigan (CCS-M)
• Certified Clinical Supervisor – IC&RC (CCS-R)
• For medical doctors: American Society of Addiction Medicine (ASAM)
• For psychologists: American Psychological Association (APA)
Program Supervision – An administrative function that ensures agency compliance
with laws, rules, regulations, policies and procedures that have been established for the
provision of substance use disorder prevention and treatment services.
Treatment Billing Codes Based on Qualifications
Prevention billing is maintained by a statewide agreement and data system.
All services provided by a SATS or SATP must be performed under appropriate
supervision for billing to occur.
Billing
Code Code Description
Substance Abuse
Treatment
Specialist (SATS)
Substance Abuse
Treatment
Practitioner (SATP)
H0001
Alcohol and/or drug assessment face-to-face service for the purpose of identifying functional
and treatment needs and to formulate the basis for the Individualized Treatment Plan
X X
H0004 Behavioral health counseling and therapy, per 15
minutes X X
H0005 Alcohol and/or drug services; group counseling by a clinician X X
H0010 Alcohol and/or drug services; sub-acute
detoxification; medically monitored residential detox (ASAM Level III.7-D) X X
H0012
Alcohol and/or drug services; sub-acute
detoxification; clinically monitored residential detox; non-medical or social detox setting (ASAM
Level III.2-D)
X X
H0014 Alcohol and/or drug services; ambulatory detoxification without extended on-site
monitoring (ASAM Level I-D) X X
H0015
Alcohol and/or drug services; intensive outpatient (from 9 to 19 hours of structured programming
per week based on an individualized treatment plan), including assessment, counseling, crisis intervention, and activity therapies or education
X X
H0018 Alcohol and/or drug services; short term
residential (non-hospital residential treatment program) X X
H0019
Alcohol and/or drug services; long-term
residential (non-medical, non-acute care in residential treatment program where stay is
typically longer than 30 days)
X X
H0022 Early Intervention X X
H2035 Substance abuse treatment services, per hour X X
H2036 Substance abuse treatment services, per diem X X
T1012 Peer recovery and recovery support * X X
90804-Psychotherapy (individual) X
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Billing
Code Code Description
Substance Abuse
Treatment
Specialist (SATS)
Substance Abuse
Treatment
Practitioner (SATP)
90815 Appropriate licensure may still apply
90826 Interactive individual psychotherapy X
Appropriate licensure may still
apply
90847 Family psychotherapy X
Appropriate licensure may still apply
90853 Group psychotherapy X
Appropriate licensure may still apply
90857 Interactive group psychotherapy X
Appropriate licensure may still
apply
0906 Intensive Outpatient Services – Chemical dependency X X
* Specially focused treatment staff may also provide and bill for this service
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MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
OFFICE OF DRUG CONTROL POLICY
TREATMENT TECHNICAL ADVISORY # 05
SUBJECT: Welcoming
ISSUED: October 1, 2006
PURPOSE:
The purpose of this technical advisory is to establish expectations for the implementation of a
welcoming philosophy.
SCOPE:
This technical advisory applies to the Regional Substance Abuse Coordinating Agencies (CAs)
and their provider network, as administered through the Michigan Department of Community
Health, Office of Drug Control Policy (MDCH/ODCP).
It is expected that all CA and provider network staff involved in the provision of substance abuse
services understand and take action to operate within these welcoming principles. These actions
consist of reviewing business practices, identifying areas in need of improvement, and
implementing identified changes.
BACKGROUND:
A welcoming philosophy is based on the core belief of dignity and respect for all people, while,
in turn, following good business practice. The concept of welcoming became popular in the
1990s, when there was an increased emphasis on co-occurring disorder treatment. In this context
welcoming was determined to be an important factor in contributing to successful client
outcomes.
The goal of addiction treatment is to move individuals along the path of recovery. There are two
main features of the recovery perspective. It acknowledges that recovery is a long-term process
of internal change and it recognizes that these internal changes proceed through various stages.
As addiction is a chronic disease, it is characterized by acute episodes or events that precipitate a
heightened need for an individual to change their behavior. It is important for the system to
understand and support the treatment-seeking client by providing an environment including
actions/behavior that foster entry and engagement throughout the treatment process and supports
recovery.
The Network for the Improvement of Addiction Treatment (NIATx) has expanded the
application of welcoming principles to include all customers of an agency (agency staff, referral
sources, client families). This technical advisory concurs with this expanded perspective. The
NIATx “Key Paths to Recovery” goals of reduced waiting, reduced no shows, increased
admissions, and increased continuation in treatment, incorporate an expectation for a welcoming
philosophy.
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TREATMENT TECHNICAL ADVISORY # 05
ISSUED: October 1, 2006
Page 2 of 5
RECOMMENDATIONS:
Welcoming is conceptualized as an accepting attitude and understanding of how people ‘present’
for treatment. It also reflects a capacity on the part of the provider to address the client’s needs
in a manner that accepts and fosters a service and treatment relationship. Welcoming is also
considered a best practice for programs that serve persons with co-occurring mental health and
substance use disorders.
The following principles list the characteristics/attitudes/beliefs that can be found at a program or
agency that is fostering a welcoming environment:
General Principles Associated with Welcoming
• Welcoming is a continuous process throughout the agency/program and involves access,
entry, and on-going services.
• Welcoming applies to all “clients” of an agency. Beside the individual seeking services
and their family, a client also includes the public seeking services; other providers
seeking access for their clients; agency staff; and the community in which the service is
located and/or the community resides.
• Welcoming is comprehensive and evidenced throughout all levels of care, all systems and
service authorities.
• A welcoming system is ‘seamless’. It enables service regardless of original entry point,
provider and current services.
• In a welcoming system, when resources are limited or eligibility requirements are not
met, the provider ensures a connection is made to community supports.
• A welcoming system is culturally competent and able to provide access and services to
all individuals seeking treatment.
Welcoming – Service Recipient
• There is openness, acceptance, and understanding of the presenting behaviors and
characteristics of persons with substance use disorders.
• For persons with co-occurring mental health problems, there is openness, acceptance, and
understanding of their presenting behaviors and characteristics.
• Welcoming is recipient-based and incorporates meaningful client participation and ‘client
satisfaction’ that includes consideration to the family members/significant others.
• Services are provided in a timely manner to meet the needs of individuals and/or their
families.
• Clients must be involved in the development of their treatment plans and goals.
Welcoming – Organization
• The organization demonstrates an understanding and responsiveness to the variety of
help-seeking behaviors related to various cultures and ages.
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TREATMENT TECHNICAL ADVISORY # 05
ISSUED: October 1, 2006
Page 3 of 5
• All staff within the agency integrates and participates in the welcoming philosophy.
• The program is efficient in sharing and gathering authorized information between
involved agencies rather than having the client repeat it at each provider.
• The organization has an understanding of the local community, including community
differences, local community involvement and opportunities for recovery support and
inclusion by the service recipient.
• Consideration is given to administrative details such as sharing paperwork across
providers, ongoing review to streamline paperwork to essential and necessary
information.
• A welcoming system is capable of providing follow-up and assistance to an individual as
they navigate the provider and the community network(s).
• Welcoming is incorporated into continuous quality improvement initiatives.
• Hours of operation meet the needs of the population(s) being served.
• Personnel that provide the initial contact with a client receive training and develop skills
that improve engagement in the treatment process.
• All paperwork has purpose and represent added value. Ingredients to managing
paperwork are the elimination of duplication, quality forms design and efficient
processing, transmission, and storage.
Welcoming – Environmental and Other Considerations
• The physical environment provides seating, space, and consideration to privacy, a
drinking fountain and/or other ‘amenities’ to foster an accepting, comfortable
environment.
• The service location is considered with regard to public transportation and accessibility.
• Waiting areas include consideration for family members or others accompanying the
individual seeking services.
Staff Competency Principles
• Skills and knowledge appropriate to staff and their roles throughout the system
(reception, clinical, treatment support, administrative).
• Staff should have the knowledge and skill to be able to differentiate between the person
and their behaviors.
• Staff should be respectful of client boundaries in regards to personal questions and
personal space.
• Staff uses attentive behavior, listening with empathy not sympathy.
Performance Indicators
CAs are expected to include a provision in their provider network contracts requiring welcoming
principles be implemented and maintained.
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TREATMENT TECHNICAL ADVISORY # 05
ISSUED: October 1, 2006
Page 4 of 5
Client satisfaction surveys are expected to incorporate questions that address the ‘welcoming’
nature of the agency and its services.
CAs include consideration to welcoming principles in their provider network site visit protocols.
MDCH/ODCP may review these provider network protocols during their visits to the CA.
REFERENCES:
5 Promising Practices Improving Timeliness. Retrieved July 6, 2006, from Network for the
Improvement of Addiction Treatment website: www.NIATx.net
5 Promising Practices Increasing Admissions. Retrieved July 6, 2006, from Network for the
Improvement of Addiction Treatment website: www.NIATx.net
5 Promising Practices Increasing Continuation. Retrieved July 6, 2006, from Network for the
Improvement of Addiction Treatment website: www.NIATx.net
5 Promising Practices Reducing No Shows. Retrieved July 6, 2006, from Network for the
Improvement of Addiction Treatment website: www.NIATx.net
Center for Substance Abuse Treatment. (2005). Substance Abuse Treatment for Persons With
Co-Occurring Disorders, Treatment Improvement Protocol (TIP) Series 42. Rockville,
MD: U.S. Department of Health and Human Services, Substance Abuse and Mental
Health Services Administration.
Key Pathways to Recovery. Retrieved July 6, 2006, from University of Wisconsin Madison
website: https://chess.chsra.wisc.edu/pathstorecovery/PathsToRecovery/TopPaths.asp
Key Pathways to Recovery – First Request for Service. Retrieved July 6, 2006, from University
of Wisconsin Madison website:
https://chess.chsra.wisc.edu/pathstorecovery/PathsToRecovery/FirstRequest.asp
Key Pathways to Recovery - Intake. Retrieved July 6, 2006, from University of Wisconsin
Madison website:
https://chess.chsra.wisc.edu/pathstorecovery/PathsToRecovery/Intake.asp
Key Pathways to Recovery – Moving Patients Into and Through Appropriate Levels of Care.
Retrieved July 6, 2006, from University of Wisconsin Madison website:
https://chess.chsra.wisc.edu/pathstorecovery/PathsToRecovery/LevelsCare.asp
Key Pathways to Recovery - Paperwork. Retrieved July 6, 2006, from University of Wisconsin
Madison website:
https://chess.chsra.wisc.edu/pathstorecovery/PathsToRecovery/Paperwork.asp
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MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
OFFICE OF DRUG CONTROL POLICY
TREATMENT POLICY #06
SUBJECT: Individualized Treatment Planning
ISSUED: September 22, 2006
EFFECTIVE: October 1, 2006
PURPOSE
The purpose of this policy is to establish the requirements for individualized treatment planning.
Treatment plans must be a product of the client’s active involvement and informed agreement. Direct
client involvement in establishing the goals and expectations for treatment is expected to ensure
appropriate level of care determination, identify true and realistic needs and increase the client’s
motivation to participate in treatment. Treatment planning requires an understanding that each client is
unique and each treatment plan must be developed based on the individual needs, goals, desires and
strengths of each client.
The treatment planning process can be limited by the information that is gathered in the assessment or
by actual treatment planning forms. These treatment forms should be reviewed on at least an annual
basis to ensure that the information that is being gathered or the manner in which it is recorded continues
to support the individualized treatment planning process.
SCOPE
This policy impacts the coordinating agency (CA) and its provider network of substance abuse treatment
and recovery support services.
BACKGROUND
Expectations for Individualized Treatment Planning have been advisory requirements in the contract
with the coordinating agencies for the past three years. This policy formalizes these expectations.
REQUIREMENTS
The Administrative Rules for Substance Abuse Programs in Michigan, promulgated under PA 368 of
1978, as amended, state, “A recipient shall participate in the development of his or her treatment plan.”
[Recipient Rights Rules, Section 305(1)].
All CA providers must also be accredited by one of four national accreditation bodies. Accreditation
standards also require evidence of client participation in the treatment planning process.
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TREATMENT POLICY # 06
EFFECTIVE: October 1, 2006
Page 2 of 4
PROCEDURE
Treatment planning begins at the time the client enters treatment – either directly or based on a referral
from an access system – and ends when the client is discharged. Treatment planning is a dynamic
process that evolves beyond the first or second session when required documentation has been
completed. Throughout the treatment process, as the client’s needs change, the treatment plan must be
revised to meet the new needs of the client.
The treatment plan is not limited to just the client and the counselor. The client can request any family
members, friends or significant others be involved in the treatment process. Once the treatment plan is
completed, the client, counselor, and other involved individuals must sign the form indicating
understanding of the plan and the expectations.
Establishing Goals and Objectives
The initial step in developing an individualized treatment plan involves the completion of a
biopsychosocial assessment. This is a comprehensive assessment that includes current and historical
information about the client. From this assessment, the needs and strengths of the client are
identified and it is this information that assists the counselor and client in establishing the goals and
objectives that will be focused on in treatment. The identified strengths can be used to help meet
treatment goals. Examples of strengths might be a healthy support network, stable employment,
stable housing, willingness to participate in counseling, etc. After strengths are identified, the
counselor assists the client in using these strengths to accomplish the identified goals and objectives.
Identifying strengths of the client can provide motivation to participate in treatment and may take the
focus off any negative situations that surround the client getting involved in treatment – legal
problems, work problems, relationship problems, etc.
Writing the Plan
Once the goals and objectives are jointly decided on, they are recorded in the treatment plan
document utilized by the provider. Goals must be stated in the client’s words. Each goal that is
written down should be directly tied to a need that was identified in the assessment. Once a goal has
been identified, then the objectives – the steps that need to be taken to achieve the goal – are
recorded. The objective must be developed with the client but do not have to be recorded in the
client’s exact words. The objectives need to be written in a manner in which they can be measured
for progress toward completion along with a targeted completion date. The completion dates must
be realistic to the client or the chances of compliance with treatment are greatly reduced.
Establishing Treatment Interventions
The next component of the plan is to determine the intervention(s) that will be used to assist the
client in being able to accomplish the objective. In other words – what action will the client take to
achieve it and what action will the counselor take to assist the client in achieving the goal. Again,
these actions must be mutually agreed upon to provide the best chance of success for the client.
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TREATMENT POLICY # 06
EFFECTIVE: October 1, 2006
Page 3 of 4
Framework for Treatment
The individualized treatment plan provides the framework by which the treatment should be
conducted. Any individual or group sessions that the client participates in must address or be related
to the goals and objectives in the treatment plan. When progress notes are written, the note should
reflect what goal(s)/objective(s) were addressed during a treatment episode. The progress notes are
also where to document any adjustments/changes to the treatment plan. Once a change is decided
on, it should then be added to the treatment plan in the format described above.
Treatment Plan Progress Reviews
Treatment plans must be reviewed and this review must be documented in the client record. The
frequency of the reviews can be based on the time frame in treatment (60, 90, 120 days) or on the
number of treatment episodes that have taken place since admission or since the last review (8, 10,
12 episodes) The reviews must include input from all clinicians/treatment providers involved in the
care of the client as well as any other individuals the client has involved in their treatment plan. This
review should reflect on the progress the client has made toward achieving each goal and/or
objective, the need to keep specific goals/objectives or discontinue them, and the need to add any
additional goals/objectives due to new needs of the client. As with the treatment plan, the client,
clinician, and other relevant individuals should sign this review.
The treatment plan and the treatment plan reviews not only serve as tools to provide treatment to the
client, they help in the administrative function of service authorization. All decisions concerning, but
not limited to, authorizations, length of stay, transfer, discharge, continuing care, and authorizations
by CAs must be based on individualized determinations of need and on progress toward treatment
goals and objectives. Such decisions must not be based on arbitrary criteria such as pre-determined
time or payment limits.
Policy Monitoring and Review
The CA will monitor compliance with individualized treatment planning and these reviews will be
made available to ODCP during site visits. ODCP will also review for individualized treatment
planning during provider site visits. Reviews of treatment plans will occur in the following manner:
• A review of the biopsychosocial assessment to determine where and how the needs were
identified
• A review of the treatment plan to check for:
1. Matching goals to needs – Needs from assessment to goals on the treatment plan
2. Goals are in the client’s words and are unique to the client – No standard or routine goals
that are used by all clients
3. Measurable objectives – The ability to determine if and when an objective will be
completed
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TREATMENT POLICY # 06
EFFECTIVE: October 1, 2006
Page 4 of 4
4. Target dates for completion – The dates identified for completion of the goals and
objectives are unique to the client and not just routine dates put in for completion of the
plan
5. Intervention strategies – the specific types of strategies that will be used in treatment –
group therapy, individual therapy, cognitive behavioral therapy, didactic groups, etc
6. Signatures – Client, counselor, and involved individuals.
• A review of progress notes to ensure documentation relates to goals and objectives
• A review of the treatment plan progress review to check for:
1. Progress note information matching what is in review
2. Rationale for continuation/discontinuation of goals/objectives
3. New goals and objectives developed with client input
4. Client participation/feedback present in the review
5. Signatures
REFERENCES
Mee-Lee, D., Shulman, G.D., Fishman, M., Gastfriend, D.R., & Griffith, J.H. (Eds.) (2001). ASAM
Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-
Revised (ASAM PPC-2R). Chevy Chase, MD: American Society of Addiction Medicine, Inc.
Miller, Scott, Mee-Lee, David, Plum, Bill and Hubble, Mark. (2005). “Making Treatment Count: Client-
Directed, Outcome Informed Clinical Work with Problem Drinkers”
National Institute on Drug Abuse (2000). Principles of Drug Addiction Treatment. Washington, D.C.:
NIDA.
Scott D. Miller, Barry L. Duncan. (2000). Paradigm Lost: From Model-Driven to Client-Directed,
Outcome-Informed Clinical Work. Institute for the Study of Therapeutic Change, Chicago, Illinois
APPROVED BY: __________________________________________________
Donald L. Allen, Director
Office Of Drug Control Policy
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ADDENDUM A
to
CONTRACT BETWEEN
STATE OF MICHIGAN, DEPARTMENT OF ENVIRONMENTAL QUALITY
AND
OAKLAND COUNTY HEALTH DIVISION
FOR THE PERIOD OF OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010
This Addendum modifies the intergovernmental agreement entitled, “CONTRACT
BETWEEN STATE OF MICHIGAN, DEPARTMENT OF ENVIRONMENTAL QUALITY
AND OAKLALND COUNTY HEALTH DIVISION FOR THE PERIOD OF OCTOBER 1,
2009 THROUGH SEPTEMBER 30, 2010” for Non-community Drinking Water Long
Term monitoring, and other monitoring services, as follows:
Article XI LIABILITY shall read:
(A) The Grantee, not the State, is responsible for all liabilities as a result of
claims, judgments, or costs arising out of activities to be carried out by the
Grantee under this Contract, if the liability is caused by the Grantee or anyone
employed by the Grantee.
(B) All liability as a result of claims, demands, costs, or judgments arising out of
activities to be carried out by the State in the performance of this Contract is the
responsibility of the State and not the responsibility of the Grantee if the liability is
caused by any State employee or agent.
(C) In the event that liability arises as a result of activities conducted jointly by the
Grantee and the State in fulfillment of their responsibilities under this Contract,
such liability is held by the Grantee and the State in relation to each party’s
responsibilities under these joint activities.
(D) Nothing in this Contract should be construed as a waiver of any
governmental immunity by the Grantee, the State, its agencies, or their
employees as provided by statute or court decisions.
(E) If the Grantee utilizes any subcontractors for services under this Contract, the
Grantee shall require subcontractors to be responsible for any claims, demands,
costs or judgments arising out of activities carried out by subcontractors under
this Contract and to indemnify the State of Michigan for any claims, demands,
costs or judgments arising out of activities carried out by subcontractors under
this Contract.
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Addendum to Contract between the Michigan Department of Environmental Quality and
Oakland County Health Division
Page 2 of 2, 12/18/09
Article XVI INSURANCE PARAGRAPH A shall read:
(A) The Grantee must maintain insurance or self insurance that will protect it
from claims that may arise from the Grantee’s actions under this contract.
Paragraph B shall remain unchanged.
Article XX CANCELLATION a new paragraph shall be inserted after the first
paragraph and it shall read:
The State shall notify Grantee in writing within thirty (30) calendar days of
becoming aware of the need for any modifications in agreement funding
commitments made necessary by action of the Federal Government, the
Governor or Legislature or the Department of Management and Budget on behalf
of the Governor or Legislature. Grantee and the State shall work together to
determine if Grantee’s obligations under the Contract can be modified to
accommodate a decrease in funding. Grantee shall have the right to terminate
this Contract if the State provides notice that funding shall cease.
The individual or officer signing this Agreement and Addendum certifies by his or
her signature that he or she is authorized to sign the Agreement and Addendum on
behalf of the responsible board or agency.
For the Grantee:
______________________________________________________________________
BILL BULLARD, JR., CHAIRPERSON DATE
OAKLAND COUNTY
BOARD OF COMMISSIONERS
For the State:
______________________________________________________________________
DATE
WATER BUREAU
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LOCAL HEALTH DEPARTMENT GRANT CONTRACT
BETWEEN THE
MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY
AND OAKLAND COUNTY HEALTH DIVISION
This Grant Contract (“Contract”) is made between the Michigan Department of Environmental Quality, (MDEQ),
Water Bureau (“State"), and Oakland County Health Division ("Grantee").
The purpose of this Contract is to provide funding in exchange for work to be performed for the project named
below. The State is authorized to provide grant assistance pursuant to Michigan Safe Drinking Water Act,
1976, PA 399, as amended; Natural Resources and Environmental Protection Act, 1994, PA 451, as
amended, Parts 117 and 201; Public Health Act, 1978, PA 368, as amended; and Federal Water Pollution
Control Act, 33 U.S.C. 1251 et seq. Legislative appropriation of Funds for grant assistance is set forth in
Public Act 118 of 2009. This Contract is subject to the terms and conditions specified herein.
Project Name: Local Health Department Master Grant Contract
Amount of grant: $$295,582 % of grant state $$255,327 / % of grant federal $$40,255
Start Date (date executed by MDEQ): 10/01/2009 End Date: 09/30/2010
GRANTEE CONTACT: STATE’S CONTACT:
Kathy Forzley, Manager Tom Hettinger
Name/Title
Oakland County Health Division Name/Title
Water Bureau
Organization
1200 N. Telegraph Rd., Dept. 432 Division/Bureau/Office
P.O. Box 30723
Address
Pontiac, MI 48341-0432 Address
Lansing, MI 48909-7773
Address
Address
517.241.1330
Telephone number
Telephone number
517.373.2040
Fax number
Fax number
Hettingert@michigan.gov
E-mail address
38-6004876 E-mail address
Federal ID number
The individuals signing below certify by their signatures that they are authorized to sign this Contract on behalf
of their agencies and that the parties will fulfill the terms of this Contract, including any attached appendices,
as set forth herein.
FOR THE GRANTEE:
Signature
Date
Name/Title
FOR THE STATE:
Signature
William Creal, Chief, Water Bureau
Date
Name/Title
I. PROJECT SCOPE
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This Contract and its appendices constitute the entire Contract between the State and the Grantee
and may be modified only by written agreement between the State and the Grantee.
(A) The scope of this project is limited to the activities specified in Appendix A and such activities as
are authorized by the State under this Contract. Any change in project scope requires prior written
approval in accordance with Section III, Changes, in this Contract.
(B) By acceptance of this Contract, the Grantee commits to complete the project identified in
Appendix A within the time period allowed for in this Contract and in accordance with the terms and
conditions of this Contract.
II. CONTRACT PERIOD
Upon signature by the State, the Contract shall be effective from the Start Date until the End Date on
page 1. The State shall have no responsibility to provide funding to the Grantee for project work
performed except between the Start Date and the End Date specified on page 1. Expenditures
made by the Grantee prior to the Start Date or after the End Date of this Contract are not eligible for
payment under this Contract.
III. CHANGES
Any changes to this Contract shall be requested by the Grantee in writing and approved in writing
by the State. The State reserves the right to deny requests for changes to the Contract or to the
appendices. No changes can be implemented without approval by the State.
IV. GRANTEE DELIVERABLES AND REPORTING REQUIREMENTS
The Grantee shall submit deliverables and follow reporting requirements specified in Appendix A of
this Contract.
(A) The Grantee must complete and submit reports according to a form and format prescribed by
the State. These reports shall be due according to the following:
Reporting Period Due Date
January 1 – March 31 April 30
April 1 – June 30 July 31
July 1 – September 30 Before October 15*
October 1 – December 31 January 31
*Due to the State’s year-end closing procedures, there will be an accelerated due date for the report
covering July 1 – September 30. Advance notification regarding the due date for the quarter ending
September 30 will be sent to the Grantee. If the Grantee is unable to submit a report in early
October for the quarter ending September 30, an estimate of expenditures through September 30
must be submitted to allow the State to complete its accounting for that fiscal year.
The forms provided by the State shall be submitted to the State’s contact at the address on page 1.
(B) The Grantee shall provide a final project report in a format prescribed by the State
(C) The Grantee must provide all products and deliverables in accordance with Appendix A.
V. GRANTEE RESPONSIBILITIES
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(A) The Grantee agrees to abide by all local, state, and federal laws, rules, ordinances, and
regulations in the performance of this grant.
(B) All local, state, and federal permits, if required, are the responsibility of the Grantee. Award of
this grant is not a guarantee of permit approval by the State.
(C) The Grantee shall be solely responsible to pay all taxes, if any, that arise from the Grantee’s
receipt of this grant.
(D) The Grantee is responsible for the professional quality, technical accuracy, timely completion,
and coordination of all designs, drawings, specifications, reports, and other services furnished by
the Grantee or its subcontractor under this Contract. The Grantee or its subcontractor shall,
without additional compensation, correct or revise any errors, omissions, or other deficiencies in
drawings, designs, specifications, reports, or other services.
(E) The State’s approval of drawings, designs, specifications, reports, and incidental work or
materials furnished hereunder shall not in any way relieve the Grantee of responsibility for the
technical adequacy of the work. The State’s review, approval, acceptance, or payment for any of
the services shall not be construed as a waiver of any rights under this Contract or of any cause of
action arising out of the performance of this Contract.
(F) The Grantee acknowledges that it is a crime to knowingly and willingly file false information with
the State for the purpose of obtaining this Contract or any payment under the Contract, and that
any such filing may subject the Grantee, its agents, and/or employees to criminal and civil
prosecution and/or termination of the grant.
VI. USE OF MATERIAL
Unless otherwise specified in this Contract, the Grantee may release information or material
developed under this Contract, provided it is acknowledged that the State funded all or a portion of
its development.
The State retains an irrevocable license to reproduce, publish, and use in whole or in part, and
authorize others to do so, any copyrightable material submitted under this grant whether or not the
material is copyrighted by the Grantee or another person. The Grantee will only submit materials
that the State can use in accordance with this paragraph.
Unless otherwise specified in this Contract, the Grantee may not patent products or processes
developed under this Contract.
VII. ASSIGNABILITY
The Grantee shall not assign this Contract or assign or delegate any of its duties or obligations under
this Contract to any other party without the prior written consent of the State. The State does not
assume responsibility regarding the contractual relationships between the Grantee and any
subcontractor.
VIII. SUBCONTRACTS
The State reserves the right to deny the use of any consultant, contractor, associate, or other
personnel to perform any portion of the project. The Grantee is solely responsible for all contractual
activities performed under this Contract. Further, the State will consider the Grantee to be the sole
point of contact with regard to contractual matters, including payment of any and all charges resulting
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from the anticipated Grant. All subcontractors used by the Grantee in performing the project shall be
subject to the provisions of this Contract and shall be qualified to perform the duties required.
IX. NON-DISCRIMINATION
The Grantee shall comply with the Elliott Larsen Civil Rights Act, 1976 PA 453, as amended,
MCL 37.2101 et seq., the Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended,
MCL 37.1101 et seq., and all other federal, state, and local fair employment practices and equal
opportunity laws and covenants that it shall not discriminate against any employee or applicant for
employment, to be employed in the performance of this Contract, with respect to his or her hire,
tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to
employment, because of his or her race, religion, color, national origin, age, sex, height, weight,
marital status, or physical or mental disability that is unrelated to the individual’s ability to perform
the duties of a particular job or position. The Grantee agrees to include in every subcontract
entered into for the performance of this Contract this covenant not to discriminate in employment.
A breach of this covenant is a material breach of this Contract.
X. UNFAIR LABOR PRACTICES
The Grantee shall comply with the Employers Engaging in Unfair Labor Practices Act, 1980 PA
278, as amended, MCL 423.321 et seq.
XI. LIABILITY
(A) The Grantee, not the State, is responsible for all liabilities as a result of claims, judgments, or
costs arising out of activities to be carried out by the Grantee under this Contract, if the liability is
caused by the Grantee, any subcontractor, or anyone employed by the Grantee.
(B) All liability as a result of claims, demands, costs, or judgments arising out of activities to be
carried out by the State in the performance of this Contract is the responsibility of the State and not
the responsibility of the Grantee if the liability is caused by any State employee or agent.
(C) In the event that liability arises as a result of activities conducted jointly by the Grantee and the
State in fulfillment of their responsibilities under this Contract, such liability is held by the Grantee and
the State in relation to each party’s responsibilities under these joint activities.
(D) Nothing in this Contract should be construed as a waiver of any governmental immunity by the
Grantee, the State, its agencies, or their employees as provided by statute or court decisions.
XII. CONFLICT OF INTEREST
No government employee, or member of the legislative, judicial, or executive branches, or member of
the Grantee’s Board of Directors, its employees, partner agencies, or their families shall benefit
financially from any part of this Contract.
XIII. ANTI-LOBBYING
If all or a portion of this Contract is funded with federal funds, then in accordance with OMB
Circular A-21, A-87, or A-122, as appropriate, the Grantee shall comply with the Anti-Lobbying Act,
which prohibits the use of all project funds regardless of source, to engage in lobbying the state or
federal government or in litigation against the State. Further, the Grantee shall require that the
language of this assurance be included in the award documents of all subawards at all tiers.
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If all or a portion of this Contract is funded with state funds, then the Grantee shall not use any of
the grant funds awarded in this Contract for the purpose of lobbying as defined in the State of
Michigan’s lobbying statute, MCL 4.415(2). “‘Lobbying’ means communicating directly with an
official of the executive branch of state government or an official in the legislative branch of state
government for the purpose of influencing legislative or administrative action.” The Grantee shall
not use any of the grant funds awarded in this Contract for the purpose of litigation against the
State. Further, the Grantee shall require that language of this assurance be included in the award
documents of all subawards at all tiers.
XIV. DEBARMENT AND SUSPENSION
By signing this Contract, the Grantee certifies to the best of its knowledge and belief that it, its
agents, and its subcontractors:
(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or the state.
(2) Have not within a three-year period preceding this Contract been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (federal, state, or local)
transaction or contract under a public transaction, as defined in 45 CFR 1185; violation of
federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen property.
(3) Are not presently indicted or otherwise criminally or civilly charged by a government entity
(federal, state, or local) with commission of any of the offenses enumerated in subsection (2).
(4) Have not within a three-year period preceding this Contract had one or more public
transactions (federal, state, or local) terminated for cause or default.
(5) Will comply with all applicable requirements of all other state or federal laws, executive
orders, regulations, and policies governing this program.
XV. AUDIT AND ACCESS TO RECORDS
The State reserves the right to conduct a programmatic and financial audit of the project, and the
State may withhold payment until the audit is satisfactorily completed. The Grantee will be required
to maintain all pertinent records and evidence pertaining to this Contract, including grant and any
required matching funds, in accordance with generally accepted accounting principles and other
procedures specified by the State. The State or any of its duly authorized representatives must have
access, upon reasonable notice, to such books, records, documents, and other evidence for the
purpose of inspection, audit, and copying. The Grantee will provide proper facilities for such access
and inspection. All records must be maintained for a minimum of five years after the final payment
has been issued to the Grantee by the State.
XVI. INSURANCE
(A) The Grantee must maintain insurance or self-insurance that will protect it from claims that may
arise from the Grantee’s actions under this Contract or from the actions of others for whom the
Grantee may be held liable.
(B) The Grantee must comply with applicable workers’ compensation laws while engaging in
activities authorized under this Contract.
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XVII. OTHER SOURCES OF FUNDING
The Grantee guarantees that any claims for reimbursement made to the State under this Contract
must not be financed by any source other than the State under the terms of this Contract. If
funding is received through any other source, the Grantee agrees to delete from Grantee's billings,
or to immediately refund to the State, the total amount representing such duplication of funding.
XVIII. COMPENSATION
(A) A breakdown of costs allowed under this Contract is identified in Appendix A. The State will pay
the Grantee a total amount not to exceed the amount on page 1 of this Contract, in accordance with
Appendix A, and only for expenses incurred. All other costs necessary to complete the project are
the sole responsibility of the Grantee.
(B) Expenses incurred by the Grantee prior to the Start Date or after the End Date of this Contract
are not allowed under the Contract, [unless otherwise specified in Appendix A].
(C) The State will approve payment requests after approval of reports and related documentation as
required under this Contract.
(D) The State reserves the right to request additional information necessary to substantiate payment
requests.
(E) Payments under this Contract may be processed by Electronic Funds Transfer (EFT). The
Grantee may register to receive payments by EFT at the Contract & Payment Express Web Site
(http://www.cpexpress.state.mi.us).
XIX. CLOSEOUT
(A) A determination of project completion, which may include a site inspection and an audit, shall be
made by the State after the Grantee has met any match obligations, satisfactorily completed the
activities, and provided products and deliverables described in Appendix A.
(B) Upon issuance of final payment from the State, the Grantee releases the State of all claims
against the State arising under this Contract. Unless otherwise provided in this Contract or by
State law, final payment under this Contract shall not constitute a waiver of the State’s claims
against the Grantee.
(C) The Grantee shall immediately refund to the State any payments in excess of the costs allowed
by this Contract.
XX. CANCELLATION
This Contract may be canceled by the State, upon 30 days written notice, due to Executive Order,
budgetary reduction, other lack of funding, upon request by the Grantee, or upon mutual
agreement by the State and Grantee. The State reserves the right to provide just and equitable
compensation to the Grantee for all satisfactory work completed under this Contract.
XXI. TERMINATION
(A) This Contract may be terminated by the State as follows.
(1) Upon 30 days written notice to the Grantee:
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a. If the Grantee fails to comply with the terms and conditions of the Contract, or with the
requirements of the authorizing legislation cited on page 1, or the rules promulgated
thereunder, or other applicable law or rules.
b. If the Grantee knowingly and willingly presents false information to the State for the
purpose of obtaining this Contract or any payment under this Contract.
c. If the State finds that the Grantee, or any of the Grantee’s agents or representatives,
offered or gave gratuities, favors, or gifts of monetary value to any official, employee, or
agent of the State in an attempt to secure a subcontract or favorable treatment in
awarding, amending, or making any determinations related to the performance of this
Contract.
d. During the 30-day written notice period, the State shall also withhold payment for any
findings under subparagraphs a through c, above.
e. If the Grantee or any subcontractor, manufacturer, or supplier of the Grantee appears in
the register of persons engaging in unfair labor practices that is compiled by the
Michigan Department of Labor and Economic Growth or its successor.
(2) Immediately and without further liability to the State if the Grantee, or any agent of the
Grantee, or any agent of any subcontract is:
a. Convicted of a criminal offense incident to the application for or performance of a State,
public, or private contract or subcontract;
b. Convicted of a criminal offense, including but not limited to any of the following:
embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving
stolen property, or attempting to influence a public employee to breach the ethical
conduct standards for State of Michigan employees;
c. Convicted under State or federal antitrust statutes; or
d. Convicted of any other criminal offense that, in the sole discretion of the State, reflects
on the Grantee’s business integrity.
e. Added to the federal or state Suspension and Debarment list.
(B) If a grant is terminated, the State reserves the right to require the Grantee to repay all or a
portion of funds received under this Contract.
FEDERALLY FUNDED PROGRAM-SPECIFIC BOILERPLATE
XXII FEDERAL FUNDING REQUIREMENTS
A maximum of $ $40,255 or 14 % of total disbursements, is funded with Federal Funding. See
Program Funding Section XXXI for funding by individual program. By accepting this contract, the
grantee agrees to comply with the requirements of the Statutory Authority and the requirements of
the Regulatory Authority found in the Program Funding Section XXXI. These regulations include,
but are not limited to the following:
(A) Grantees receiving $500,000 or more in federal funds in their fiscal year shall have a single
audit performed in compliance with OMB Circular A-133, Revised June 24, 1997, “Audits of
State, Local Governments, & Non-Profit Organizations. This audit must be performed and
copies provided to the appropriate agencies within nine months from the end of the
grantee’s fiscal year. The Grantee must submit a copy of the Audit Report to the Michigan
Department of Environmental Quality at the following address:
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Michigan Department of Environmental Quality
Finance and Business Services Division
Federal Aid Section
P.O. Box 30473
Lansing, MI 48909
Or, the grantee may also submit the single audit report electronically to the Michigan
Department of Treasury website (http://www.michigan.gov/treasury/0,1607,7-121-
1751_31038---,00.html.)
It is the responsibility of the Grantee to report the expenditures related to this grant on the
Grantee’s annual Schedule of Expenditures of Federal Awards.
(B) The Grantee agrees to fulfill conditions that the Federal Government has imposed on the
State as a condition of Federal funding as indicated herein and in all appendices.
(C) The Grantee will comply with the Hatch Political Activity Act, as amended, 5 USC §§ 1501-
1508, and the Intergovernmental Personnel Act of 1970 as amended by Title (6) of the Civil
Service Reform Act, 42 USC § 4728, which states that employees working in programs
financed with federal grants may not be a candidate for elective public office in a partisan
election, use official authority or influence to affect the result of an election, or influence a
state or local officer to provide financial support for a political purpose.
XXIII CONSULTANT CAP
Payment to consultants. EPA participation in the salary rate (excluding overhead) paid to
individual consultants retained by recipients or by a recipient’s contractors or
subcontractors shall be limited to the maximum daily rate for a Level IV of the Executive
Schedule (formerly GS-18), to be adjust annually. This limit applies to consultation services
of designated individuals with specialized skills who are paid at a daily or hourly rate. As of
January 1, 2009, the limit is $587.20 per day and $73.40 per hour. This rate does not
include transportation and subsistence costs for travel performed (the recipient will pay
these in accordance with their normal travel reimbursement practices),
Sub agreements with firms for services which are awarded using the procurement
requirements in 40 CFR 30 or 31, as applicable, are not affected by this limitation unless
the terms of the contract provided the recipient with responsibility for the selection,
direction, and control of the individuals who will be providing services under the contract at
an hourly or daily rate of compensation. See 40 CFR 31.36(j) or 30.27(b).
XXIV COPYRIGHTED MATERIAL
In accordance with 40 CFR 31.34 for State, local and Indian Tribal governments or 40 CFR
30.36 for other recipients, EPA has the right to reproduce, publish, use and authorize others
to use copyrighted works or other data developed under this assistance agreement for
Federal purposes.
Examples of a Federal purpose include but are not limited to: (1) Use by EPA and other
Federal employees for official Governmental purposes: (2) Use by Federal contractors
performing specific tasks for the Government; (3) Publication in EPA documents provided
the document does not disclose trade secrets (e.g. software codes) and the work is
properly attributed to the recipient through citation or otherwise; (4) Reproduction of
documents for inclusion in Federal depositories; (5) Use by State, tribal and local
governments that carry out delegated Federal environmental programs as “co-regulators’ or
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act as official partners with EPA to carry out a national environmental program within their
jurisdiction and; (6) Limited use by other grantees to carry out Federal grants provided the
use is consistent with the terms of EPA’s authorization to the other grantee to use the
copyrighted works or other data.
Under Item 6, the grantee acknowledges that EPA may authorize another grantee(s) to use
the copyrighted works or other data developed under this grant as a result of:
a. the selection of another grantee by EPA to perform a project that will involve the use
of the copyrighted works or other data or;
b. termination or expiration of this agreement.
In addition, EPA may authorize another grantee to use copyrighted works or other data
developed with Agency funds provided under this grant to perform another grant when such
use promotes efficient and effective use of Federal grant funds.
XXV DRUG-FREE WORKPLACE CERTIFICATION FOR ALL EPA RECIPIENTS
The recipient organization of this EPA assistance agreement must make an ongoing, good
faith effort to maintain a drug-free workplace pursuant to the specific requirements set forth
in Title 40 CFR 36.200-36.230. Additionally, in accordance with these regulations, the
recipient organization must identify all known workplaces under its federal awards, and
keep this information on file during the performance of the award.
Those recipients who are individuals must comply with the drug-free provision set forth in
Title 40 CFR 36.300
The consequences for violating this condition are detailed under Title 40 CFR 36.510.
Recipients can access the Code of Federal Regulations (CFR) Title 40 Part 36 at
http://www.access.gpo.gov/nara/cfr/waisidx_08/40cfr36_08.html
XXVI MBE/WBE REQUIREMENTS
In accordance with the USEPA’s Program for Utilization of Small, Minority and Women’s
Business Enterprises (MBE/WBE) in procurement under assistance programs, contained in
40 CFR, Part 33, the Grantee agrees to:
(1) Accept the applicable “fair share” goals negotiated with USEPA by the Michigan
Department of Environmental Quality as follows:
MBE 3% WBE 5%
Pursuant to 40 CFR, Section 33.301, the recipient agrees to the following good faith efforts
whenever procuring construction, equipment, services and supplies under this agreement,
and to ensure that sub-recipients, loan recipients and prime contractors also comply.
Records documenting compliance with the six good faith efforts shall be retained:
(a) Ensure Disadvantaged Business Enterprises (DBEs) are made aware of
contracting opportunities to the fullest extent practicable through outreach and
recruitment activities. For Indian Tribal, State and Local government recipients,
this will include placing DBEs on solicitation lists and soliciting them whenever
they are potential sources.
(b) Make information on forthcoming opportunities available to DBEs and arrange
time frames for contracts and establish delivery schedules, whether the
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requirements permit, in a way that encourages and facilitates participation by
DBEs in the competitive process. This includes whenever possible, positing
solicitations for bids or proposals for a minimum of 30 calendar days before the
bid or proposal closing date.
(c) Consider in the contracting process whether firms competing for large contracts
could subcontract with DBEs. For Indian Tribal, State and local government
recipients, this will include dividing total requirements when economically
feasible into smaller tasks or quantities to permit maximum participation by
DBEs in the competitive process.
(d) Encourage contracting with a consortium of DBEs when a contract is too large
for one of these firms to handle individually.
(e) Use the services and assistance of the Small Business Administration and the
Minority Business Development Agency of the Department of Commerce in
finding DBEs.
(f) If the prime contractor awards subcontracts, require the prime contractor to take
the steps in paragraphs (a) through (e) of this section.
The recipient agrees to complete and submit EPA Form 5700-52A, “MBE/WBE Utilization
Under Federal Grants, Cooperative Agreements and Interagency Agreements” beginning
with the Federal fiscal year reporting period the recipient receives the award, and
continuing until the project is completed. The reports must be submitted to the Project
Manager semiannually for the periods ending March 31 and September 30. Final
MBE/WBE reports must be submitted within 90 days after the project period of the grant
ends. EPA Form 5700-52A may be obtained from the program manager or on the Internet
at www.epa.gov/ogd/forms/forms.htm
The recipient agrees to comply with the contract administrations provisions of 40 CRF,
Section 33.302, which establishes that a prime contractor must pay its subcontractor by 30
days after the grant recipient has made payment.
XXVII PROCUREMENT OF RECYCLED PRODUCTS
Any State agency or agency of a political subdivision of a State which is using appropriated
Federal funds shall comply with the requirements set forth in Section 6002 of the Resource
Conservation and Recovery Act (RCRA) (42U.S.C. 6962). Regulations issued under RCRA
Section 6002 apply to any acquisition of an item where the purchase price exceeds $10,000
or where the quantity of such items acquired in the course of the preceding fiscal year was
$10,000 or more. RCRA Section 6002 requires that preference be given in procurement
programs to the purchase of specific products containing recycled materials identified in
guidelines developed by EPA. These guidelines are listed in 40 CFR 247.
XXVII RECYCLED PAPER
In accordance with the policies set forth in EPA Order 1000.25 and Executive Order 13423,
Strengthening Federal Environmental, Energy and Transportation Management (January,
24, 2007,) the recipient agrees to use recycled paper and double sided printing for all
reports which are prepared as a part of the agreement and delivered to EPA. This
requirement does not apply to reports prepared on forms supplied by EPA, or to Standard
Forms which are printed on recycled paper and are available through the General Services
Administration.
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XXVIII SMALL BUSINESS IN RURAL AREAS
By accepting this agreement, the recipient agrees to comply with Section 129 of Public Law
100-590, the Small Business Administration reauthorization and Amendment Act of 1988.
Therefore, if the recipient awards a contract under this assistance agreement, it will utilize
the following affirmative steps relative to Small Business in Rural Areas (SBRAs):
a. Placing SBRAs on solicitation lists:
b. Ensuring the SBRAs are solicited whenever they are potential sources;
c. Dividing total requirements when economically feasible, into small tasks or
quantities to permit maximum participation by SBRAs;
d. Establishing delivery schedules, where the requirements of work will permit,
which would encourage participation by SBRAs.
e. Using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce, as
appropriate; and
f. Requiring the contractor, if it awards subcontracts, to take the affirmative steps
in subparagraphs a. through e. of this condition.
XXIX HOTEL-MOTEL FIRE SAFETY
Pursuant to 40 CFR 30.18, if applicable, and 15 USC 2225a, the recipient agrees to ensure
that all space for conferences, meetings, conventions or training seminars funded in whole
or in part with federal funds complies with the protection and control guidelines of the Hotel
and Motel Fire Safety Act (PL 101-391, as amended). Recipients may search the Hotel-
Motel National Master List at http://www.usfa.dhs.gov/applications/hotel/ to see if a property
is in compliance (FEMA ID is currently not required), or to find other information about the
Act.
XXX SUBAWARDS
a. The recipient agrees to:
(1) Establish all subaward agreements in writing;
(2) Maintain primary responsibility for ensuring successful completion of the EPA-
approved project (this responsibility cannot be delegated or transferred to a
subrecipient);
(3) Ensure that any subawards comply with the standards in Section 210(a)-(d) of
OMB Circular A-133 and are not used to acquire commercial goods or services
for the recipient;
(4) Ensure that any subawards are awarded to eligible subrecipients and that
proposed subaward costs are necessary, reasonable, and allocable;
(5) Ensure that any subawards to 501(c)(4) organizations do not involve lobbying
activities;
(6) Monitor the performance of their recipients and ensure that they comply with all
applicable regulations, statutes, and terms and conditions which flow down in
the subaward;
(7) Obtain EPA’s consent before making a subaward to a foreign or international
organization, or a subaward to be performed in a foreign country; and
(8) Obtain approval from EOA for any new subaward work that is not outlined in the
approved work plan in accordance with 40 CFR Parts 30.25 and 31.30, as
applicable.
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b. Any questions about subrecipient eligibility or other issues pertaining to subawards
should be addressed to the recipient’s EPA Project Officer. Additional information
regarding subawards may be found at http://www.epa.gov/ogd/guide/subaward-policy-
part-2.pdf Guidance for distinguishing between vendor and subrecipient relationships
and ensuring compliance with Section (a)-(d) of OMB Circular A-133 can be found at
http://www.epa.gov/ogd/guide/subawards-appendix-b.pdf and
http://www.whitehouse.gov/omb/circulars/a133/a133.aspx#b
c. The recipient is responsible for selecting its subrecipients and, if applicable, for
conducting subaward competitions.
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PROJECT-SPECIFIC REQUIREMENTS – APPENDIX A
Title to equipment or other nonexpendable personal property supported in whole or in part by the
State with categorical funding and having a unit acquisition cost of less than $5,000 shall vest with
the Grantee upon acquisition. The State reserves the right to retain or transfer the title to all items
of equipment and nonexpendable personal property having a unit acquisition cost of $5,000 or
more to the extent that it is determined that the State’s proportionate interest in such equipment
and personal property supports such retention or transfer of title.
The Grantee, if a Local Health Department, shall comply with the local public health accreditation
standards and follow the accreditation process and schedule established by the Michigan
Department of Community Health (MDCH) to achieve full accreditation status. A Grantee
designated as “not accredited” may have their State allocations reduced for costs incurred in the
assurance of service delivery.
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XXXI PROGRAM FUNDING
Program A - Noncommunity (Type II):
Index 37338
1. Water Supply Requirements –PCA 41893; Amount $155,447
Funding Source: State Restricted
2. Operator Certification - PCA 41813; Amount $36,355 is funded with Federal
Funding. The Catalog of Federal Domestic Assistance (CFDA) title is “Operator
Certification Expense Reimbursement Grant”, and the CFDA number is 66.471.
The Federal Grant Number is CT975861 and the grant is funded with Federal funds
from the EPA awarded in 2002. By accepting this contract, the grantee agrees to
comply with the requirements of the Safe Drinking Water Act, Sec. 1419(d)
Amended 1996, PL 104-182 and the requirements found in the regulatory authority
40 CFR PART 31.
3. Capacity Development – PCA 41832; Amount $3,900 is funded with Federal
Funding. The Catalog of Federal Domestic Assistance (CFDA) title is “Cap Grant
for the Drinking Water Revolving Fund”, and the CFDA number is 66.468. The
Federal Grant Number is FS97548705 and the grant is funded with Federal funds
from the EPA awarded in 2005. By accepting this contract, the grantee agrees to
comply with the requirements of the By accepting this contract, the grantee agrees
to comply with the requirements of the Safe Drinking Water Act, Sec. 1419(d)
Amended 1996, PL 104-182 and the requirements found in the regulatory authority
40 CFR PART 31 & 35, subpart L.
Program B - Long-Term Monitoring:
Index 37307 PCA 30744; Amount $62,130 Funding Source: State Restricted
Program C – Great Lakes Beach Monitoring:
Index 37541, PCA 41239, Amount $0; is funded with Federal Funding. The Catalog of
Federal Domestic Assistance (CFDA) title is “Beach Monitoring and Notification
Program Grant”, and the CFDA number is 66.472. The Federal Grant Number is
CU00E259-01 and the grant is funded with Federal funds from the EPA awarded in
2007. By accepting this contract, the grantee agrees to comply with the
requirements of the Beaches Environmental Assessment and Coastal Health Act of
2000, PL 106-284 and the requirements found in the regulatory authority 40 CFR
PART 31.
Program D - Public Swimming Pool Requirements:
Index 37342 PCA 44402; Amount $32,700 Funding Source: State Restricted
Program E - Septage Requirements:
Index 37344 PCA 44106, Amount $4,500 Funding Source: State Restricted
Program H – Campground Requirements:
Index 37343 PCA 44502; Amount $550 Funding Source: State Restricted
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State of Michigan
2008 Homeland Security Grant Program
Grant Agreement for Citizen's Corps Program
October 1, 2009 to September 30,2010
CFDA Number: 97.067
Grant Number: 2008-GE-T8-0052
This Homeland Security Grant Program Citizen's Corp Program (HSGP-CCP) Grant Agreement is hereby entered
into between the Michigan Department of State Police, Emergency Management and Homeland Security Division
(hereinafter called the Subgrantor), and
COUNTY OF OAKLAND
(hereinafter called the Subgrantee)
I. Purpose
The purpose of this Grant Agreement is to provide federal pass-through funds to the County of Monroe through the
Subqrantee. The funding under this grant agreement will be allocated to the Subgrantee from the CCP allocation to
the State of Michigan. CCP funds are intended to engage and actively involve all citizens in hometown security
through personal preparedness, training, exercises, and volunteer service and to provide a structured opportunity
for citizens to augment loca l emergency response activ ities .
II. Objectives
The principal objective of this Grant Agreement is to provide financial assistance to the Subgrantee for allowable
costs in the CCP and the following specific program:
1. Community Emergency Response Teams (CERT)
2. Medical Reserve Corps (MRC)
3. Neighborhood Watch
4. Volunteer in Police Service (VIPS)
5. Fire Corps
Allowable Investments made in support of the programs listed above must fall into one of the following six
categories:
1. Planning
2. Organization
3. Equ ipment
4. Tra ining
5. Exercises
6. Personnel
For guidance on allowable costs for the CCP program areas, please refer to the 2008 Homeland Security
Grant Program (HSGP) Guidance, located at http://www.fema.gov/government/grant/hsgp/index08.shtm.
To assist Subgrantees, the Subgrantor, in conjunction with the Michigan Homeland Security Preparedness
Committee, has cre ated a list of priority projects that Subgrantees shall use their 2008 HSGP-CCP funds to
support. These projects were derived from the 10 Investment Justifications developed by Michigan that are to be
implemented at the regional/local level. Additional information is provided in the Mich igan FY 2008 HSGP
Supplemental Grant Guidance. Subgrantees must take a regional approach when determining the best use of FY
2008 HSGP-CCP funds. Subgrantees must consider the needs of local un its of government and applicable
volunteer organizations in the projects and activities included in their FY 2008 HSGP-CCP appli cation.
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2008 Citizen Corps Grant Agreement
County of Oakland (fiduciary for the County of Monroe)
Page 2 of 9
III. Statutory Authority
Funding for the Fiscal Year (FY) 2008 HSGP is authorized by the Consolidated Security, Disaster Assistance, and
Continuing Appropriations Act, 2009 (Public Law 110-329).
The Subgrantee agrees to comply with all HSGP-CPP program requirements in accordance with the Michigan
Emergency Management Act,Act 390, and PA of 1976, as amended ,located at
http://www.michigan.gov/documents/mspemd-Act_390_oC1976_7125_7.pdf. The Subgrantee also agrees to
comply with the following regulations:
A. Administrative Requirements
1. 44 CFR, Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments, located at http://eCFR.gpoaccess.gov/cgi/t/text/text
idx?c=ecfr&tpl=/ecfrbrowsefTitle44/44cfr13_main_02.tpl
2. 2 CFR, Part 215, Institutions of Higher Learning, Hospitals, and Other Non-Profit Organizations (OMB
Circular A-110), located at http://ecfr.gpoaccess.gov/cgi/t/text/text
idx?c=ecfr&sid=5f90b818356757091 bb65ea93f163c6a&tpl=/ecfrbrowsefTitle02/2cfr215_main_02.tpI
B. Cost principals
1. 2 CFR, Part 225, Cost Principals for State, Local, and Indian Tribal Governments (OMB Circular A-87)
located at http://ecfr.gpoaccess.govlegi/t/text/text
idx?c=ecfr&tpl=/ecfrbrowsefTitle02/2cfr225_main_02.tpl
2. 2 CFR, Part 220, Cost Principals for Educational Institutions (OMB Circular A-21) located at
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&rgn=div5&view=text&node=2:1.1 .2.3A&idno=2
3. 2 CFR, Part 230, Cost Principals for Non-Profit Organizations (OMB Circular A-122) located at
http://ecfr .gpoaccess .gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowsefTitle02/2cfr230_main_02.tpl
C. Audit Requirements
1.0MB Circular A-133 , Audits of States, Local Governments, and Non-Profit Organizations, located at
http://www.whitehouse.gov/omb/circulars/a133/a133.html
IV. Homeland Security Grant Program Award Amount and Restrictions
The COUNTY OF OAKLAND, as the Fiduciary Agent for County of Monroe , is awarded $3,327.00 in CCP funding
under the FY 2008 HSGP-CCP.
This Grant Agreement designates CCP funds for reimbursement of authorized costs . Grant Agreement funds shall
not be used for other purposes . The funds awarded in the Grant Agreement shall only be used to cover allowable
costs that are incurred during the FY 2008 Grant Agreement period. Allocations for the FY08 HSGP-CCP have
been determined on a regional basis through a funding methodology consistent with current Department of
Homeland Security (DHS) guidance. Regional Boards have been created to ensure that all jurisdictions within a
designated region have an equa l say in how funds are spent.
Final determination on how funds awarded by this grant agreement will be spent will be determined
through a review process by the State Administrative Agency (SAA) of projects submitted by the Region 2
Homeland Security Planning Board, not by the Subgrantee (Fiduciary agent).
V. Responsibilities of the Subgrantee
FY 2008 HSGP-CCP funds must supplement, not supplant, state or local funds. Federal funds will be used to
supplement existing funds ,and will not replace (supplant)funds that have been appropriated for the same purpose.
Potential supplanting will be carefully reviewed in the application review, in subsequent monitoring, and in the audit.
The Subgrantee may be required to supply documentation certifying that it did not reduce non-federal funds
because of receiving federa l funds . Federal funds cannot be used to replace a reduction in non-federal funds or
solve budget shortfalls in general fund programs.
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Fiduciary Agent Designation
The Subgrantee agrees to act as the designated Fiduciary Agent for the County of Monroe. As the designated
Fiduciary Agent for Monroe County, the Subgrantee agrees to follow all responsibilities in Section V of this grant
agreement. If the Subgrantee becomes unable to fulfill the responsibilities of Section V, refer to Section XI for
instruct ions on how to terminate this agreement. The Subgrantee agrees to comply with all applicable federal and
state regulations, including the following:
A. In addition to this 2008 HSGP-CCP Grant Agreement, Subgrantees shall complete, sign, and subm it to
Subgrantor the following documents, which are incorporated by reference into this Grant Agreement:
1. Standard Assurances
2. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and
Drug-Free Workplace Requirement
3. State of Michigan Audit Certification Form (EMD-053)
4. W-9 Request for Taxpayer Identification Number and Certification
5. Other documents that may be required by federal or state officials
B. The FY08 Homeland Security Grant covers eligible costs from October 1,2009 until September 30,2010.
Please refer to the Fiscal Year 2008 Homeland Security Grant Program Guidance, located at
http ://www.fema.gov/governmentlgrantlhsgp/index08.shtm, for a detailed list of what costs are eligible
under this grant. Allowable costs are specifically addressed in Appendix B of the Guidance.
C. Submit project applications to the Subgrantor, which have been prepared and approved by the Homeland
Security Regional Board, for evaluation and approval of projects prior to starting a project. All projects
must meet DHS & Emergency Management and Homeland Security Division (EMHSD) grant quidelines
and must be related to one of the 10 approved state investments, 8 required projects, and supported by an
assessment of at least one of the 37 targeted capabilities. Projects should be coordinated with Regional
Homeland Security Board activities. Any project that proposes a change in scope of work during the grant
performance period must be resubmitted to the Subgrantor for approval.
D. Make all purchases in accordance with grant guidance and local purchasing policies.
E. Submit an Allowable Cost Justification (ACJ) form for all costs that are part of approved projects prior to the
encumbering of the cost. If an ACJ is not submitted, the Subgrantee will be held responsible for all costs
determined to be ineligible by the Subgrantor or DHS .
F. Create and maintain an inventory of all FY08 HSGP-CCP equ ipment purchases that lists , at minimum, the
piece of equ ipment, the cost of the equipment, what agency the equipment is assigned to and the physical
location of the equipment for the grant period and at least three years after the grant is closed . Any
equipment purchased with HSGP-CCP funds must be prominently marked as purchased with funds
prov ided by the U.S. Department of Homeland Security.
G. Make FY08 HSGP-CCP equ ipment available for pick-up by other government agencies per equipment
assignments by the Region 2 Homeland Security Planning Board . This process needs to include legal
transfer of the equipment to the designated government agen cies. At minimum , the Subgrantee should
prepare documents, which when signed, will indicate other designated government agencies accept full
legal and financial responsibility for pieces of equipment.
H. At the end of the Fiscal Year , the Subgrantee must supply a document to the other local government
agencies reporting the dollar amount spent on their behalf; so the local government agencies can submit
the information on their Schedule of Expenditures of Federal Awards (SEFA) report. NOTE: Cop ies of
these documents must also be provided to the Michigan State Police , Emergency Management and
Homeland Security Division, Audit Unit , 4000 Collins Road , Lansing, Michigan 48910-5883
I. Submit the Reimbursement Cover Sheet (EMD-054) and all required attached documentation to the
Subgrantor at a minimum at the end of each quarter (or more frequently, as needed). The Subgrantee
must subm it the quarterly reimbursement request even if it has no expenditures for that quarter. The due
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dates for quarterly reimbursement requests are listed in Section VII of this agreement. Reimbursement
Cover Sheets must be filled out completely or they will be returned to the Subgrantee for proper
completion. The Reimbursement Cover Sheet (EMD-054) and other reimbursement forms can be found on
the EMHSD website at http://www.michigan.gov/msp/0.1607.7-123-1593_3507-113992--.00.html.
Please note: One Reimbursement Cover Sheet and related forms must be completed for each
exercise.
J. Submit quarterly progress reports to the Subgrantor on the status of all approved projects. Quarterly
progress reports, at minimum, need to contain a description of the project, the actions taken that quarter to
complete the project, a percentage estimate of the completeness of the project and an expected
completion date of the project. The due dates for quarterly work reports are listed in Section VII of this
agreement. The Subgrantor will provide the Subgrantee with a form to complete this report within 60 days
of issuing the grant agreement.
K. Submit updated project and allocation information on a regular basis through the Biannual Strategy
Implementation Reports (BSIR). The BSIR is due within 20 days after the end of the reporting period. The
due dates for the BSIR are on January 20,2009,July 20,2009,and January 20,2010. The reporting
periods are from January 1 through June 30 and July 1 through December 31. The final BSIR is due 90
days after the end date of the FY08 Homeland Security Grant award period.
L. Comply with FY08 NIMS implementation requirements and move towards completion by September 30,
2011. FY08 NIMS requirements must be fully complied with by September 30,2011. NIMS information is
available at http://www.fema.gov/emergency/nims.
M. Comply with applicable financial and admin istrat ive requirements set forth in the current edition of 44 CFR,
Part 13 including the following provisions:
1. Account for receipts and expenditures,maintain adequate financ ial records ,and refund expenditures
disallowed by federal or state audit.
2. Retain all financial records, supporting documents, statistical records, and all other records pertinent to
the FY08 HSGP-CCP for at least three years after the financial close-out date of this grant program, for
purposes of federal and/or state examination and audit.
3. Perform the required financial and compliance audits in accordance with the Single Audit Act of 1984,
as amended, and OMB Circular A-133 , "Audits of States, local Governments, and Non-Profit
Organizations," as further described in 44 CFR, Part 13. Random audits shall be performed to ensure
compliance with applicable provisions.
4. Subgrantor and Subgrantee FY08 HSGP-CCP information constitutes records subject to the Michigan
Freedom of Information Act (FOIA), MCl 15.231 et seq. However, section 13(1)(u) and (y), MCl
15.243(1 )(u) and (y) of the FOIA, permit the exemption from public disclosure of the records of a public
body's "security measures,including security plans ,security codes and combinations,passwords,
passes, keys, and security procedures, to the extent that the records relate to the ongoing security of
the public body;" and "of measures designed to protect the security or safety of persons or property,
whether public or private, including, but not limited to, buildinq, public works, and public water supply
designs to the extent that those designs relate to the ongoing security measures of a public body,
capabilities and plans for responding to a violation of the Michigan anti-terrorism act,...emergency
response plans,risk planning documents,threat assessments,and domestic preparedness strategies,
unless disclosure would not impair a public body's ability to protect the security or safety of persons or
property or unless the public interest in disclosure outweighs the public interest in nondisclosure in the
particular instance ."
Much of the information submitted in the course of applying for funding under this program , or provided
in the course of grant management activities, may be considered law enforcement sensitive or
otherwise critical to national security interests. This may include threat,risk ,and needs assessment
information ;and discussions of demographics,transportation,public works ,and industrial and public
health infrastructures. Therefore, each Subgrantee agency Freedom of Information Officer will need to
determine what information is to be withheld on a case-by-case basis .
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Note: The Subgrantee will only be held responsible for expenditures disallowed by federal or state
audit that are determined to be caused by the negligence of the Subgrantee or by the Subgrantee not
complying with the responsibilities of Section V.
N. Integrate individuals with disabilities into emergency planning, Executive Order 13347 .
O. Environmental and Historic Preservation Program (EHP) : Federal environmental and historic preservation
laws and Executive Orders provide the basis and direction for the implementation of federal environmental
and historic preservation review requirements for FEMA-funded projects. These laws and executive orders
are aimed at protecting our nation's water, air ,coastal, wildlife, land,agricultural,historical and cultural
resources, as well as minimizing potential adverse effects to children, low-income and minority populations.
Failure to comply with these laws could result in project delays and denial of funding. FEMA through the
Environmental and Historic Preservation Program engage s in a review process to ensure that FEMA
funded activities comply with these laws.
VI. Responsibilities of Subgrantor
The Subgrantor, in accordance with the general purposes and objectives of this Grant Agreement, will:
A. Adm inister the FY08 HSGP-CCP in accordance with all applicable federal and state regulations and
guidelines and provide quarterly reports documenting this administration.
B. Provide direction and technical assistance to the Subgrantee.
C. Provide to the Subgrantee any special report forms and report ing formats (templates) required for operation
of the program .
D. Reimburse the Subgrantee in accordance with this Grant Agreement based on appropriate documentation
submitted by the Subgrantee.
E. Independently, or in conjunction with DHS, conduct random on-site reviews with Subgrantee(s).
F. Subgrantor and Subgrantee FY08 HSGP-CCP information constitutes records subject to the Michigan
Freedom of Information Act (FOIA), MCl 15.231 et seq . However, section 13(1)(u) and (y), MCl
15.243(1)(u) and (y) of the FOIA permits the exemption from public disclosure of the records of a public
body's "security measures,including security plans ,security codes and combinations,passwords,passes ,
keys, and security procedures, to the extent that the records relate to the ongoing security of the public
body;" and "of measures designed to protect the security or safety of persons or property, whether public or
private,including,but not limited to,building ,public works,and public water supply designs to the extent
that those designs relate to the ongoing security measures of a public body, capabilities and plans for
responding to a violation of the Michigan anti-terrorism act,...emergency response plans , risk planning
documents, threat assessments, and domestic preparedness strategies, unless disclosure would not impair
a public body's ability to protect the security or safety of persons or property or unless the public interest in
disclosure outweighs the public interest in nondisclosure in the particular instance."
Much of the information submitted in the course of applying for funding under this program, or provided in
the course of grant management activities, may be considered law enforcement sensitive or otherwise
critical to national security interests. This may include threat,risk ,and needs assessment information;and
discussions of demographics, transportation, public works, and industrial and public health infrastructures.
Therefore, each Subgrantee agency Freedom of Information Officer will need to determine what
information is to be withheld on a case-by-case basis .
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VII. Payment and Reporting Procedures
The Subgrantee agrees to prepare the Reimbursement Cover Sheet (EMD-054) and all required attached
documentation, including all required authorized signatures, and submit it at a minimum at the end of each quarter
(or more frequently, as needed) if there are eligible expenses to be reimbursed . See below quarterly report
schedule for due dates. Please note: One Reimbursement Cover Sheet and related forms must be
completed for each grant project, solution area, allocation type, and individual exercise. Please refer to the
Reimbursement Requirements in order to meet the documentation requirements.
THE QUARTERS ARE AS FOLLOWS:
r" Quarter: October 1, 2009 to December 31, 2009
2nd Quarter: January 1, 2010 to March 31, 2010
3rd Quarter: April 1, 2010 to June 30, 2010
4th Quarter: July 1, 2010 to September 30, 2010
DEADLINES TO SUBMIT QUARTERLY REQUESTS FOR REIMBURSEMENT AND WORK REPORTS ARE AS
FOLLOWS:
1st Quarter: January 31, 2010
2nd Quarter: April 30, 2010
3rd Quarter: July 31,2010
4th Quarter: October 31, 2010
Reporting Requirements
The reporting requirements are designed to prov ide the EMHSD with sufficient information to monitor project
implementation and ensure proper use of federal funds . Accounting systems must allocate costs to the project
activities. Expenditures must be summarized, correspond with the project budget detail, scope of the project, or
work plan attached to the award, and be supported with source documentation, as appropriate.
Subgrantees are required to submit Quarterly Progress Reports by Project and supporting documentation for
expend itures in accordance with their project budget detail and project scope of work. Progress reports compare
actual expend itures to the project budget detail for the reporting period. Any significant cost deviations from the
approved budget detail and subsequent impact on the project, etc. shall be reported in the Narrative Progress
Report.
The Quarterly Progress Report must support the expenditures and financial activity in financial progress reports
and reimbursement requests. The information on this form will be used by the Subgrantor to monitor grantee cash
flow and encumbrances, grantee performance, project implementation, and compliance with 2 CFR, Part 215 (OMB
Circular A-110); 2 CFR, Part 220 (OI\.l1B Circular A-21); 2 CFR, Part 225 (OMB Circular A-8?); and 2 CFR, Part 230
(OMS Circular 122). This information will also be used to mon itor compliance with OMB Circulars A-102 and A
133, and with the U.S. Dept. of Homeland Security/Office of Grant Operations Financial Guide, to ensure proper
use of federal funds.
Quarterly Progress Reports are required whether or not expenditures are incurred.
Subgrantees failure to fulfill the quarterly reporting requirements,as requ ired by the grant, may result in the
suspension of grant activities until reports are received.
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Reimbursement requests and Quarterly Progress Reports should be mailed to the Michigan State Police,
Emergency Management and Homeland Security Division, 4000 Collins Road, Lansing MI 48910, unless the
Subgrantee is otherwise notified by the Subgrantor. Please refer to the Reimbursement Requirements in
order to meet the documentation requirements.
SUBGRANTEE WILL NOT BE REIMBURSED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS
AND REIMBURSEMENT DOCUMENTS ARE RECEIVED.
VIII. Employment Matters
Subgrantee shall comply with Title VI of the Civil Rights Act of 1964, as amended, the Elliott-larsen Civil Rights
Act, 1976 PA 453, as amended , MCl 37.2101 et seq., the Persons with Disab ilities Civil Rights Act, 1976 PA 220,
as amended , MCl 37.1101 et seq., and all other federal, state and local fair employment practices and equal
opportunity laws and covenants that it shall not discrim inate against any employee or applicant for employment, to
be employed in the performance of this Grant Agreement,with respect to his or her hire,tenure,terms,conditions,
or privileges of employment; or any matter directly or indirectly related to employment because of his or her race,
religion,color ,national origin, age, sex,height,weight,marital status,limited English proficiency,or handicap that is
unrelated to the individual's ability to perform the duties of a particular job or position. Subgrantee agrees to
include in every subcontract entered into for the perfor mance of this Gran t Agreement this covenant not to
discriminate in employment. A breach of this covenant is a material breach of the Grant Agreement.
The Subgrantee shall ensure that no subcontractor, manufacturer, or supplier of Subqrantee on this Project
appears in the register compiled by the Michigan Department of labor and Econom ic Growth , Bureau of
Commercial Services,Licensing and Enforcement Divisions,pursuant to 1980 PA 278,as amended , MCl 423.321
et seq. (State Contractors with Certain Employers Prohibited Act),or on the Federal excluded party list system
database located at www.epls.gov .
IX. Limitation of Liability
Subgrantor and Subgrantee to this Grant Agreement agree that each must seek its own legal representative and
bear its own costs, including judgments, in any litigation that may arise from performance of this contract. It is
specifically understood and agreed that neither party will indemnify the other party in such litigation.
This is not to be construed as a waiver of governmental immunity.
X. Third Parties
This Grant Agreeme nt is not intended to make any person or entity, not a party to this Grant Agreement, a third
party beneficiary hereof or to confer on a third party any rights or obligations enforceable in their favor .
XI. Grant Agreement Period
This Grant Agreeme nt is in full force and effect from September 1, 2008 through May 31 , 2011 . No costs eligible
under this Grant Agreement shall be incurred before the starting date of this Grant Agreement except with prior
written approval. This Grant Agreement consists of two identical sets simultaneously executed ; each is cons idered
an original having identical legal effect. This Grant Agreement may be terminated by either party by giving thirty
(30) days written notice to the other party stating reasons for term ination and the effective date,or upon the failure
of either party to carry out the terms of the Grant Agreement. Upon any such termination , the Subgrantee agrees
to return to the Subgrantor any funds not authorized for use,and Subgrantee shall have no further obligation to
make payments .
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XII. Entire Grant Agreement
This Grant Agreement is governed by the laws of the state of Mich igan and supersedes all prior agreements,
documents, and representations between Subgrantor and Subgrantee, whether expressed, implied, or oral. This
Grant Agreement constitutes the entire agreement between the parties and may not be amended except by written
instrument executed by both parties prior to the termination date set forth in Section XI above. No party to this
Grant Agreement may assign this Grant Agreement or any of his/her/its rights, interest, or obligations hereunder
without the prior consent of the other party . Subgrantee agrees to inform Subgrantor in writing immed iately of any
proposed changes of dates, budget, or services indicated in this Grant Agreement, as well as changes of address
or personnel affecting this Grant Agreement. Changes in dates , budget , or services are subject to prior written
approval of Subgrantor. If any provision of this Grant Agreement shall be deemed void or unenforceable, the
remainder of the Grant Agreement shall remain valid.
The State may suspend or terminate subgrant funding, in whole or in part, or other measures may be imposed for
any of the following reasons:
• Failure to expend funds in a timely manner consistent with the grant milestones, quidance and assurances.
• Failure to comply with the requirements or statutory objectives of federal or state law.
• Failure to make satisfactory progress toward the goals or objectives set forth in the subgrant application .
• Failure to follow grant agreement requirements or special conditions .
•Proposal or implementation of substantial plan changes to the extent that, if originally submitted,the project would
not have been approved for funding.
• Failure to subm it required reports.
• Filing of a false certification in the application or other report or document.
• Failure to adequately manage, monitor or direct the grant funding activities of their subrecipients.
Before taking action, the Subgrantor will provide the Subgrantee reasonable notice of intent to impose corrective
measures and will make every effort to resolve the problem informally.
XIV. Business Integrity Clause
The Subgrantor may immediately canc el the grant without further liability to the Subgrantor or its employees if the
Subgrantee, an officer of the Subgrantee, or an owner of a 25% or greater share of the Subgrantee is convicted of
a criminal offense incident to the application for or performance of a State, public , or private grant or subcontract; or
convicted of a criminal offense, including but not limited to any of the following: embezzlement, theft, forgery,
bribery, falsification or destruction of records, receiv ing stolen property, attempting to influence a publ ic employee
to breach the ethical conduct standards for State of Michigan employees ; convicted under State or Federal antitrust
statutes; or convicted of any other criminal offense which, in the sole discretion of the Subgrantor, reflects on the
Subgrantee's business integrity .
XIV. Freedom of Information Act (FOIA)
DHS recognizes that much of the information submitted in the course of applying for funding under this program , or
provided in the course of its grant management activities, may be considered law enforcement sensitive or
otherwise important to national security interests. This may include threat, risk, and needs assessment information,
and discussions of demographics, transportation,public works,and industrial and public health infrastructures.
While this information, under Federal control, is subject to requests made pursuant to the Freedom of Information
Act (FOIA), 5. U.S.C. §552, all determinations concerning the release of information of this nature are made on a
case-by-case basis by the DHS FOIA Offi ce, and may likely fall within one or more of the available exemptions
under the Act. The applicant is encouraged to consult its own State and local laws and regulations regarding the
release of information, which should be considered when reporting sensitive matters in the grant application, needs
assessment and strategic planning process. The applicant may also consult G&T regarding concerns or questions
about the release of information under State and local laws. The grantee should be familiar with the regulations
governing Protected Critical Infrastructure Information (6 CFR Part 29) and Sensitive Security Information (49 CFR
Part 1520), as these designations may provide additional protection to certain classes of homeland security
information.
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2008 Citizen Corps Grant Agreement
County of Oakland (fiduciary for the County of Monroe)
Page 9 of 9
XV. Official Certification
For the Subgrantee. The individual or officer signing this Grant Agreement certifies by his or her signature that he
or she is authorized to sign this Grant Agreement on behalf of the jurisdiction he or she represents.
County of Oakland
Name of Jurisdiction
Printed Name Title
Signature Date
For the Subgrantor (Michigan State Police -Emergency Management and Homeland Security Division)
Deputy State Director of Emergency
Capt. W . Thomas Sands Management and Homeland Security
Printed Name Title
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NOT SPECIFIED /OTHER
1. Award No.
2. Modification No.
3. Effective Date 4. CFDA No.
DE-EE0000750 11/17/2009 81.128
ASSISTANCE AGREEMENT
OAKLAND POINTE, 250 ELIZABETH LAKE ROAD, SUIT
7. Period of Performance
11/17/2009
through
11/16/2012
6. Sponsoring Office
Golden Field Office
U.S. Department of Energy
Golden Field Office
1617 Cole Blvd.
Golden CO 80401
PONTIAC MI 483410414
Attn: SCOTT GUZZY
OAKLAND, COUNTY OF
5. Awarded To
Other
Cooperative Agreement
Grant
PL 111-5, Recovery Act 2009
PL 110-140, EISA 2007 10EE000920
10. Purchase Request or Funding Document No.9. Authority8. Type of Agreement
X
11. Remittance Address 12. Total Amount 13. Funds Obligated
OAKLAND, COUNTY OF
Attn: SCOTT GUZZY
PONTIAC MI 483410414
Govt. Share: $4,879,700.00
Cost Share : $0.00
Total : $4,879,700.00
This action: $4,879,700.00
Total : $4,879,700.00
OAKLAND POINTE, 250 ELIZABETH LAKE ROAD, SUIT
Jason Randall
Golden CO 80401-3393
1617 Cole Blvd.
Golden Field Office
U.S. Department of Energy
Golden Field Office
Phone: 303-275-4847Phone: 248-858-0160
Art Holdsworth
14. Principal Investigator 15. Program Manager 16. Administrator
See Attachment #2
19. Submit Reports To18. Paying Office17. Submit Payment Requests To
20. Accounting and Appropriation Data
EECBG
21. Research Title and/or Description of Project
RECOVERY ACT: COUNTY OF OAKLAND, MI ENERGY EFFICIENCY AND CONSERVATION BLOCK GRANT
For the Recipient For the United States of America
22. Signature of Person Authorized to Sign 25. Signature of Grants/Agreements Officer
23. Name and Title 24. Date Signed 26. Name of Officer 27. Date Signed
11/23/2009Melissa Y. Wise
NOT SPECIFIED /OTHER
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NOT SPECIFIED /OTHER
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED OFPAGE
NAME OF OFFEROR OR CONTRACTOR
(A)
ITEM NO.
(B)
SUPPLIES/SERVICES QUANTITY
(C)
UNIT
(D)
UNIT PRICE
(E)
AMOUNT
(F)
2 DE-EE0000750
OAKLAND, COUNTY OF
3
DUNS Number: 136200362
In addition to this Assistance Agreement, this
award consists of the items listed in the Special
Terms and Conditions, Provision 2, Award
Agreement Terms and Conditions.
In Block 7 of the Assistance Agreement, the
Period of Performance reflects the beginning of
the project through the end of the current Budget
Period, shown as 11/17/2009 through 11/16/2012.
Blocks 12 and 13 of this Assistance Agreement
indicate the Total Obligated Amount of this
project, which is the Recipient's total
allocation. The funds available in ASAP to the
Recipient through this action are limited to $0,
due to the restrictions in Provision Number 15,
National Environmental Policy Act (NEPA)
Requirements; Provision Number 19, Subgrants and
Loans; and Provision Number 20, Justification of
Budget Costs, in the Special Terms and
Conditions. Once these conditions have been met,
the funds will be released to the Recipient.
DOE Award Administrator: Yolanda C. Ramirez
E-mail: Yolanda.Ramirez@go.doe.gov
Phone: 303-275-4908
DOE Project Officer: Jason Randall
E-mail: Jason.Randall@go.doe.gov
Phone: 303-275-4847
Recipient Business Officer: Art Holdsworth
E-mail: Holdswortha@oakgov.com
Phone: 248-858-0160
Recipient Principal Investigator: Art Holdsworth
E-mail: Holdswortha@oakgov.com
Phone: 248-858-0160
Electronic signature or signatures as used in
this document means a method of signing an
electronic message that--
(A) Identifies and authenticates a particular
person as the source of the electronic message;
(B) Indicates such person's approval of the
information contained in the electronic message;
Continued ...
July 2004
NOT SPECIFIED /OTHER
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532
NOT SPECIFIED /OTHER
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED OFPAGE
NAME OF OFFEROR OR CONTRACTOR
(A)
ITEM NO.
(B)
SUPPLIES/SERVICES QUANTITY
(C)
UNIT
(D)
UNIT PRICE
(E)
AMOUNT
(F)
3 DE-EE0000750
OAKLAND, COUNTY OF
3
and,
(C) Submission via FedConnect constitutes
electronically signed documents.
ASAP: Yes Extent Competed: NOT AVAIL FOR COMP
Davis-Bacon Act: YES
Delivery Location Code: 03601
Golden Field Office
U.S. Department of Energy
Golden Field Office
1617 Cole Blvd.
Golden CO 80401-3393
Payment:
OR for Golden
U.S. Department of Energy
Oak Ridge Financial Service Center
P.O. Box 4517
Oak Ridge TN 37831
Fund: 05796 Appr Year: 2009 Allottee: 31 Report
Entity: 200835 Object Class: 41020 Program:
1005115 Project: 2004350 WFO: 0000000 Local Use:
0000000 TAS Agency: 89 TAS Account: 0331
July 2004
NOT SPECIFIED /OTHER
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,, State of Michigan
2008 Homeland Security Grant Program
Grant Agreement for Citizen's Corps Program
October 1, 2009 to September 30, 2010
CFDA Number: 97,067
Grant Number: 2008-GE-T8-0052
This Homeland Security Grant Program Citizen's Corp Program (HSGP-CCP) Grant Agreement is hereby entered
into between the Michigan Department of State Police, Emergency Management and Homeland Security Division
(hereinafter called the Subgrantor), and
COUNTY OF OAKLAND
(hereinafter called the Subgrantee)
I. Purpose
The purpose of this Grant Agreement is to provide federal pass-through funds to the Subqrantee. The funding
under this grant agreement will be allocated to the Subgrantee from the CCP allocation to the State of Mich igan.
CCP funds are intended to engage and actively involve all citizens in hometown security through personal
preparedness, training, exercises, and volunteer service and to provide a structured opportunity for citizens to
augment local emergency response activities.
II. Objectives
The principal objective of this Grant Agreement is to provide financial assistance to the Subgrantee for allowable
costs in the CCP and the following specific program :
1. Community Emergency Response Teams (CERT)
2. Medical Reserve Corps (MRC)
3. Neighborhood Watch
4. Volunteer in Police Service (VIPS)
5. Fire Corps
Allowable Investments made in support of the programs listed above must fall into one of the following six
categories:
1. Planning
2. Organization
3. Equipment
4. Training
5. Exercises
6. Personnel
For guidance on allowable costs for the CCP program areas, please refer to the 2008 Homeland Security
Grant Program (HSGP) Guidance, located at http ://www.fema.gov/government/grant/hsgplindex08.shtm.
To assist Subgrantees, the Subgrantor, in conjunction with the Michigan Homeland Security Preparedness
Committee, has created a list of priority projects that Subgrantees shall use their 2008 HSGP-CCP funds to
support. These projects were derived from the 10 Investment Justifications developed by Michigan that are to be
implemented at the regional/local level. Additional information is provided in the Michigan FY 2008 HSGP
Supplemental Grant Guidance. Subgrantees must take a regional approach when determining the best use of FY
2008 HSGP-CCP funds. Subgrantees must consider the needs of local units of government and applicable
volunteer organizations in the projects and activities included in their FY 2008 HSGP-CCP application.
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2008 Citizen Corps Grant Agreement
County of Oakland
Page 2 of 9
III. Statutory Authority
Funding for the Fiscal Year (FY) 2008 HSGP is authorized by the Consolidated Security, Disaster Ass istance, and
Continuing Appropriations Act, 2009 (Public Law 110-329).
The Subgrantee agrees to comply with all HSGP-CPP program requirements in accordance with the Michigan
Emergency Management Act , Act 390, and P.A. of 1976, as amended, located at
http://www.michigan.gov/documents/mspemd-Act_390_oC1976_7125_7 .pdf. The Subgrantee also agrees to
comply with the following regulations:
A. Admin istrative Requirements
1. 44 CFR, Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments, located at http://eCFR.gpoaccess.gov/cgi/t/text/text
idx?c=ecfr&tpl=/ecfrbrowsefTitle44/44cfr13_main_02. tpl
2. 2 CFR, Part 215, Institutions of Higher Learning, Hospitals, and Other Non-Profit Organizations (OMB
Circular A-110), located at http://ecfr.gpoaccess.gov/cgi/t/text/text
idx?c=ecfr&sid=5f90b818356757091 bb65ea93f163c6a&tpl=/ecfrbrowsefTitle02/2cfr215_main_02 .tpl
B. Cost principals
1. 2 CFR, Part 225, Cost Principals for State, Local, and Indian Tribal Governments (OMB Circular A-87)
located at http://ecfr.gpoaccess.gov/cgi/tltextltext
idx?c=ecfr&tpl=/ecfrbrowsefTitle02/2cfr225_main_02. tpl
2. 2 CFR, Part 220, Cost Principals for Educational Institutions (OMB Circular A-21) located at
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&rgn=div5&view=text&node=2:1.1.2.3.4&idno=2
3. 2 CFR , Part 230, Cost Principals for Non-Profit Organizations (OMS Circular A-122) located at
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowsefTitle02/2cfr230_main_02.tpl
C. Audit Requirements
1.0MB Circular A-133 , Audits of States, Local Governments, and Non-Profit Organizations, located at
http://www.whitehouse.gov/omb/circulars/a133/a133.html
IV. Homeland Security Grant Program Award Amount and Restrictions
The COUNTY OF OAKLAND is awarded $11,321.00 in CCP fund ing under the FY 2008 HSGP-CCP.
This Grant Agreement designates CCP funds for reimbursement of authorized costs. Grant Agreement funds shall
not be used for other purposes. The funds awarded in the Grant Agreement shall only be used to cover allowable
costs that are incurred during the FY 2008 Grant Agreement period . Allocations for the FY08 HSGP -CCP have
been determined on a regional basis through a funding methodology consistent with current Department of
Homeland Security (DHS) guidance. Regional Boards have been created to ensure that all jurisdictions within a
designated region have an equal say in how funds are spent.
Final determination on how funds awarded by this grant agreement will be spent will be determined
through a review process by the State Administrative Agency (SAA) ofprojects submitted by the Region 2
Homeland Security Planning Board, not by the Subgrantee.
V. Responsibilities of the Subqrantee
FY 2008 HSGP-CCP funds must supplement, not supplant, state or local funds. Federal funds will be used to
supplement existing funds, and will not replace (supplant) funds that have been appropriated for the same purpose.
Potential supplanting will be carefully reviewed in the application review, in subsequent monitoring, and in the audit.
The Subgrantee may be required to supply documentation certifying that it did not reduce non-federal funds
because of receiving federal funds . Federal funds cannot be used to replace a reduction in non-federal funds or
solve budget shortfalls in general fund programs.
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2008 Citizen Corps Grant Agreement
County of Oakland
Page 3 of 9
The Subgrantee agrees to follow all responsibilities in Section V of this grant agreement. If the Subgrantee
becomes unable to fulfill the responsibilities of Section V, refer to Section XI for instructions on how to terminate
this agreement. The Subgrantee agrees to comply with all applicable federal and state regulations, including the
following :
A. In addition to this 2008 HSGP-CCP Grant Agreement, Subgrantees shall complete, sign, and submit to
Subgrantor the following documents, which are incorporated by reference into this Grant Agreement:
1. Standard Assurances
2. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and
Drug-Free Workplace Requirement
3. State of Michigan Audit Certification Form (EMD-053)
4. W-9 Request for Taxpayer Identification Number and Certification
5. Other documents that may be required by federal or state officials
B. The FY08 Homeland Security Grant covers eligible costs from October 1,2009 until September 30, 2010 .
Please refer to the Fiscal Year 2008 Homeland Security Grant Program Guidance, located at
http ://www.fema.gov/governmentlgrantlhsgp/index08.shtm ,for a deta iled list of what costs are eligible
under this grant. Allowable costs are specifically addressed in Appendix B of the Guidance.
C. Submit project applications to the Subgrantor, which have been prepared and approved by the Homeland
Security Regional Board, for evaluation and approval of projects prior to starting a project. All projects
must meet DHS & Emergency Management and Homeland Security Division (EMHSD) grant guidelines
and must be related to one of the 10 approved state investments, 8 required projects, and supported by an
assessment of at least one of the 37 targeted capabilities. Projects should be coordinated with Regional
Homeland Security Board activities. Any project that proposes a change in scope of work during the grant
performance period must be resubmitted to the Subgrantor for approval.
D. Make all purchases in accordance with grant guidance and local purchasing policies.
E. Submit an Allowable Cost Justification (ACJ) form for all costs that are part of approved projects prior to the
encumbering of the cost. If an ACJ is not submitted, the Subgrantee will be held responsible for all costs
determined to be ineligible by the Subgrantor or DHS .
F. Create and maintain an inventory of all FY08 HSGP-CCP equipment purchases that lists, at minimum , the
piece of equipment, the cost of the equipment, what agency the equipment is assigned to and the physical
location of the equipment for the grant period and at least three years after the grant is closed . Any
equipment purchased with HSGP-CCP funds must be prominently marked as purchased with funds
provided by the U.S. Department of Homeland Security.
G. Make FY08 HSGP-CCP equipment available for pick-up by other government agencies per equipment
assignments by the Region 2 Homeland Security Planning Board . This process needs to include legal
transfer of the equipment to the designated government agencies . At minimum, the Subgrantee should
prepare documents, which when signed, will indicate other designated government agencies accept full
legal and financial responsibility for pieces of equipment.
H. At the end of the Fiscal Year , the Subgrantee must supply a document to the other local government
agencies reporting the dollar amount spent on their behalf; so the local government agencies can submit
the information on their Schedule of Expenditures of Federal Awards (SEFA) report. NOTE: Copies of
these documents must also be provided to the Michigan State Police, Emergency Management and
Homeland Security Division, Audit Unit, 4000 Collins Road , Lansing, Michigan 48910-5883
I. Submit the Reimbursement Cover Sheet (EMD-054) and all required attached documentation to the
Subgrantor at a minimum at the end of each quarter (or more frequently, as needed). The Subgrantee
must submit the quarterly reimbursement request even if it has no expenditures for that quarter. The due
dates for quarterly reimbursement requests are listed in Section VII of this agreement. Reimbursement
Cover Sheets must be filled out completely or they will be returned to the Subgrantee for proper
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2008 Citizen Corps Grant Agreement
County of Oakland
Page 4 of 9
completion. The Reimbursement Cover Sheet (EMD-054) and other reimbursement forms can be found on
the EMHSD website at http ://www.michigan.gov/msp/O.1507.7-123-1593_3507-113992--.00.htm!.
Please note: One Reimbursement Cover Sheet and related forms must be completed for each
exercise.
J. Subm it quarterly progress reports to the Subgrantor on the status of all approved projects . Quarterly
progress reports, at minimum, need to contain a description of the project, the actions taken that quarter to
complete the project, a percentage estimate of the completeness of the project and an expected
completion date of the project. The due dates for quarterly work reports are listed in Section VII of this
agreement. The Subgrantor will provide the Subgrantee with a form to complete this report within 50 days
of issuing the grant agreement.
K. Submit updated project and allocation information on a regular basis through the Biannual Strategy
Implementation Reports (BSIR). The BSIR is due within 20 days after the end of the reporting period. The
due dates for the BSIR are on January 20, 2009, July 20, 2009, and January 20, 2010 . The reporting
periods are from January 1 through June 30 and July 1 through December 31. The final BSIR is due 90
days after the end date of the FY08 Homeland Security Grant award period.
L. Comply with FY08 NIMS implementation requirements and move towards completion by September 30,
2011. FY08 NIMS requirements must be fully complied with by September 30, 2011. NIMS information is
available at http://www.fema.gov/emergency/nims.
M. Comply with applicable financial and administrative requ irements set forth in the current edition of 44 CFR,
Part 13 including the following provisions:
1. Account for receipts and expenditures, maintain adequate financial records, and refund expenditures
disallowed by federal or state audit.
2. Retain all financial records, supporting documents, statistical records, and all other records pertinent to
the FY08 HSGP-CCP for at least three years after the financial close-out date of this grant program, for
purposes of federal and/or state examination and audit.
3. Perform the required financial and compliance audits in accordance with the Single Audit Act of 1984,
as amended, and OMB Circular A-133, "Audits of States, local Governments, and Non-Profit
Organizations," as further described in 44 CFR, Part 13. Random audits shall be performed to ensure
compliance with applicable provisions.
4. Subgrantor and Subgrantee FY08 HSGP-CCP information constitutes records subject to the Michigan
Freedom of Information Act (FOIA), MCl 15.231 et seq. However, section 13(1)(u) and (y), Mel
15.243(1 )(u) and (y) of the FOIA, permit the exemption from public disclosure of the records of a public
body's "security measures, including security plans, security codes and combinations, passwords,
passes ,keys ,and security procedures, to the extent that the records relate to the ongoing security of
the public body;" and "of measures designed to protect the security or safety of persons or property,
whether public or private, including, but not limited to, buildinq, public works, and public water supply
designs to the extent that those designs relate to the ongoing security measures of a public body,
capabilities and plans for responding to a violation of the Michigan anti-terrorism act,...emergency
response plans, risk planning documents, threat assessments, and domestic preparedness strategies,
unless disclosure would not impair a public body's ability to protect the security or safety of persons or
property or unless the public interest in disclosure outweighs the public interest in nondisclosure in the
particular instance."
Much of the information submitted in the course of applying for funding under this program , or provided
in the course of grant management activities, may be considered law enforcement sensitive or
otherwise critical to national security interests. This may include threat, risk, and needs assessment
information;and discussions of demographics,transportation, public works ,and industrial and public
health infrastructures. Therefore, each Subgrantee agency Freedom of Information Officer will need to
determine what information is to be withheld on a case-by-case basis.
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2008 Citizen Corps Grant Agreement
County of Oakland
Page 5 of 9
Note : The Subqrantee will only be held responsible for expenditures disallowed by federal or state
audit that are determined to be caused by the negligence of the Subgrantee or by the Subgrantee not
complying with the responsibilities of Section V.
N. Integrate individuals with disabilities into emergency planning, Executive Order 13347 .
O. Environmental and Historic Preservation Program (EHP) : Federal environmental and historic preservation
laws and Executive Orders provide the basis and direction for the implementation of federal environmental
and historic preservation review requirements for FEMA-funded projects. These laws and executive orders
are aimed at protecting our nation's water, air, coastal, wildlife , land, agricultural, historical and cultural
resources , as well as minimizing potential adverse effects to children, low-income and minority populations.
Failure to comply with these laws could result in project delays and denial of funding. FEMA through the
Environmental and Historic Preservation Program engages in a review process to ensure that FEMA
funded activities comply with these laws .
VI. Responsibilities of Subgrantor
The Subgrantor, in accordance with the general purposes and objectives of this Grant Agreement, will:
A. Administer the FY08 HSGP-CCP in accordance with all applicable federal and state regulations and
guidelines and provide quarterly reports documenting this administration.
B. Provide direction and technical assistance to the Subgrantee.
C. Provide to the Subgrantee any special report forms and report ing formats (templates) required for operation
of the program .
D. Reimburse the Subgrantee in accordance with this Grant Agreement based on appropriate documentation
subm itted by the Subgrantee.
E. Independently, or in conjunction with DHS, conduct random on-site reviews with Subgrantee(s).
F. Subgrantor and Subgrantee FY08 HSGP-CCP information constitutes records subject to the Michigan
Freedom of Information Act (FOIA), MCl 15.231 et seq. However, section 13(1)(u) and (y), MCl
15.243(1)(u) and (y) of the FOIA permits the exemption from public disclosure of the records of a public
body's "security measures, including security plans, security codes and combinations, passwords, passes ,
keys, and security procedures, to the extent that the records relate to the ongoing security of the public
body;" and "of measures designed to protect the security or safety of persons or property, whether public or
private . including , but not limited to. building, public works, and public water supply designs to the extent
that those designs relate to the ongoing security measures of a public body, capabilities and plans for
responding to a violation of the Michigan anti-terrorism act....emergency response plans. risk planning
documents.threat assessments,and domestic preparedness strategies.unless disclosure would not impair
a public body's ability to protect the security or safety of persons or property or unless the public interest in
disclosure outweighs the public interest in nondisclosure in the particular instance."
Much of the information submitted in the course of applying for funding under this program . or provided in
the course of grant management activities, may be considered law enforcement sensitive or otherwise
critical to national security interests . This may include threat, risk, and needs assessment information; and
discussions of demographics. transportation, public works, and industrial and public health infrastructures.
Therefore, each Subgrantee agency Freedom of Information Officer will need to determine what
information is to be withheld on a case-by-case basis .
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2008 Citizen Corps Grant Agreement
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VII. Payment and Reporting Procedures
The Subgrantee agrees to prepare the Reimbursement Cover Sheet (EMD-054) and all required attached
documentation, including all required authorized signatures, and submit it at a minimum at the end of each quarter
(or more frequently, as needed) if there are eligible expenses to be reimbursed. See below quarterly report
schedule for due dates. Please note: One Reimbursement Cover Sheet and related forms must be
completed for each grant project, solution area, allocation type, and individual exercise. Please refer to the
Reimbursement Requirements in order to meet the documentation requirements.
THE QUARTERS ARE AS FOLLOWS:
1S1 Quarter: October 1,2009 to December 31, 2009
2nd Quarter: January 1, 2010 to March 31, 2010
3'd Quarter: April 1, 2010 to June 30, 2010
4th Quarter: July 1, 2010 to September 30, 2010
DEADLINES TO SUBMIT QUARTERLY REQUESTS FOR REIMBURSEMENT AND WORK REPORTS ARE AS
FOLLOWS:
1st Quarter: January 31, 2010
2nd Quarter: April 30, 2010
3'd Quarter: July 31, 2010
4th Quarter: October 31, 2010
Reporting Requirements
The reporting requirements are designed to provide the EMHSD with sufficient information to monitor project
implementation and ensure proper use of federal funds . Accounting systems must allocate costs to the project
activities. Expenditures must be summarized, correspond with the project budget detail , scope of the project, or
work plan attached to the award, and be supported with source documentation, as appropriate.
Subgrantees are required to submit Quarterly Progress Reports by Project and suppo rting documentation for
expenditures in accordance with their project budget detail and project scope of work . Progress repor ts compare
actual expenditures to the project budget detail for the reporting period . Any significant cost deviations from the
approved budget detail and subsequent impact on the project, etc. shall be reported in the Narrative Progress
Report.
The Quarterly Progress Report must support the expenditures and financial activ ity in financial progress reports
and reimbursement requests . The information on this form will be used by the Subgrantor to monitor grantee cash
flow and encumbrances, grantee performance, project implementation, and compliance with 2 CFR , Part 215 (OMB
Circular A-110);2 CFR, Part 220 (OMB Circular A-21 );2 CFR, Part 225 (OMB Circular A-8?);and 2 CFR ,Part 230
(OMB Circular 122). This information will also be used to monitor compliance with OMB Circulars A-102 and A
133, and with the U.S. Dept. of Homeland Security/Office of Grant Operations Finan cial Guide, to ensure proper
use of federal funds.
Quarterly Progress Reports are required whether or not expenditures are incurred.
Subgrantees failure to fulfill the quarterly reporting requirements,as requ ired by the grant,may result in the
suspension of grant activities until reports are received .
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Reimbursement requests and Quarterly Progress Reports should be mailed to the Michigan State Police,
Emergency Management and Homeland Security Division, 4000 Collins Road, Lansing MI 48910, unless the
Subgrantee is otherwise notified by the Subgrantor. Please refer to the Reimbursement Requirements in
order to meet the documentation requirements.
SUBGRANTEE WILL NOT BE REIMBURSED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS
AND REIMBURSEMENT DOCUMENTS ARE RECEIVED.
VIII. Employment Matters
Subgrantee shall comply with Title VI of the Civil Rights Act of 1964, as amended, the Elliott-larsen Civil Rights
Act, 1976 PA 453, as amended, MCl 37.2101 et seq ., the Persons with Disabilities Civil Rights Act, 1976 PA 220,
as amended, MCl 37.1101 et seq., and all other federal, state and local fair employment practices and equal
opportunity laws and covenants that it shall not discriminate against any employee or applicant for employment, to
be employed in the performance of this Grant Agreement, with respect to his or her hire, tenure, terms, conditions,
or privileges of employment; or any matter directly or indirectly related to employment because of his or her race,
religion,color, national origin, age, sex,height,weight,marital status ,limited English proficiency,or hand icap that is
unrelated to the individual's ability to perform the duties of a particular job or position. Subgrantee agrees to
include in every subcontract entered into for the performance of this Grant Agreement this covenant not to
discriminate in employment. A breach of this covenant is a material breach of the Grant Agreement.
The Subgrantee shall ensure that no subcontractor, manufacturer, or supplier of Subqrantee on this Project
appears in the register compiled by the Michigan Department of labor and Economic Growth, Bureau of
Commercial Services,Licensing and Enforcement Divisions,pursuant to 1980 PA 278,as amended, MCl 423.321
et seq. (State Contractors with Certain Employers Prohibited Act), or on the Federal excluded party list system
database located at www.epls.gov.
IX. Limitation of Liability
Subgrantor and Subgrantee to this Grant Agreement agree that each must seek its own legal representative and
bear its own costs, including judgments, in any litigation that may arise from performance of this contract. It is
specifically understood and agreed that neither party will indemnify the other party in such litigation.
This is not to be construed as a waiver of governmental immunity.
X. Third Parties
This Grant Agreement is not intended to make any person or entity, not a party to this Grant Agreement, a third
party beneficiary hereof or to confer on a third party any rights or obligations enforceable in their favor.
XI. Grant Agreement Period
This Grant Agreement is in full force and effect from September 1, 2008 through May 31, 2011 . No costs eligible
under this Grant Agreement shall be incurred before the start ing date of this Grant Agreement except with prior
written approval. This Grant Agreement consists of two identical sets simultaneously executed; each is considered
an original having identical legal effect. This Grant Agreement may be terminated by either party by giving thirty
(30) days written notice to the other party stating reasons for termination and the effective date , or upon the failure
of either party to carry out the terms of the Grant Agreement. Upon any such termination, the Subgrantee agrees
to return to the Subgrantor any funds not authorized for use, and Subgrantee shall have no further obligation to
make payments.
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XII. Entire Grant Agreement
This Grant Agreement is governed by the laws of the state of Mich igan and supersedes all prior agreements,
documents, and representations between Subgrantor and Subgrantee, whether expressed, implied, or oral. This
Grant Agreement constitutes the entire agreement between the parties and may not be amended except by written
instrument executed by both parties prior to the term ination date set forth in Section XI above. No party to this
Grant Agreement may ass ign this Grant Agreement or any of his/her/its rights, interest, or obligations hereunder
without the prior consent of the other party. Subgrantee agrees to inform Subgrantor in writing immediately of any
proposed changes of dates ,budget, or services indicated in this Grant Agreement,as well as changes of address
or personnel affecting this Grant Agreement. Changes in dates , budget, or services are subject to prior written
approval of Subqrantor. If any provision of this Grant Agreement shall be deemed void or unenforceable, the
remainder of the Grant Agreement shall remain valid .
The State may suspend or terminate subgrant funding, in whole or in part, or other measures may be imposed for
any of the following reasons:
• Failure to expend funds in a timely manner consistent with the grant milestones, guidance and assurances.
• Failure to comply with the requirements or statutory objectives of federal or state law.
• Failure to make satisfactory progress toward the goals or objectives set forth in the subgrant application.
• Failure to follow grant agreement requirements or special conditions.
• Proposal or implementation of substantial plan changes to the extent that, if originally submitted, the project would
not have been approved for funding .
• Failure to submit required reports.
• Filing of a false certification in the application or other report or document.
• Failure to adequately manage, monitor or direct the grant funding activities of their subrecipients.
Before taking action, the Subgrantor will provide the Subgrantee reasonable notice of intent to impose corrective
measures and will make every effort to resolve the problem informally.
XIV. Business Integrity Clause
The Subgrantor may immediately cancel the grant without further liability to the Subgrantor or its employees if the
Subgrantee, an officer of the Subgrantee, or an owner of a 25% or greater share of the Subgrantee is convicted of
a criminal offense incident to the application for or performance of a State, public, or private grant or subcontract; or
convicted of a criminal offense, including but not limited to any of the following: embezzlement, theft, forgery,
bribery, falsification or destruction of records, receiving stolen property, attempting to influence a public employee
to breach the ethical conduct standards for State of Michigan employees; convicted under State or Federal antitrust
statutes; or convicted of any other criminal offense which, in the sole discretion of the Subgrantor, reflects on the
Subgrantee's business integrity.
XIV. Freedom of Information Act (FOIA)
DHS recognizes that much of the information submitted in the course of applying for funding under this program, or
provided in the course of its grant management activities, may be considered law enforcement sensitive or
otherwise important to national secur ity interests. This may include threat, risk,and needs assessment information,
and discuss ions of demographics,transportation,public works ,and industrial and public health infrastructures.
While this information, under Federal control , is subject to requests made pursuant to the Freedom of Information
Act (FOIA),5.U.S.C. §552 ,all determinations concerning the release of information of this nature are made on a
case-by-case basis by the DHS FOIA Office, and may likely fall within one or more of the available exemptions
under the Act. The applicant is encouraged to consult its own State and local laws and regulations regarding the
release of information, which should be considered when reporting sensitive matters in the grant application, needs
assessment and strategic planning process. The appl icant may also consult G&T regarding concerns or questions
about the release of information under State and local laws. The grantee should be familiar with the regulations
governing Protected Critical Infrastructure Information (6 CFR Part 29) and Sensitive Security Information (49 CFR
Part 1520), as these designations may provide addit ional protection to certain classes of homeland security
information.
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XV. Official Certification
For the Subgrantee. The individual or officer signing this Grant Agreement certifies by his or her signature that he
or she is authorized to sign this Grant Agreement on behalf of the jurisdiction he or she represents.
County of Oakland
Name of Jurisdiction
Printed Name Title
Signature Date
For the Subgran or (Michigan State Police -Emergency Management and Homeland Security Division)
Deputy State Director of Emergency
Capt. W. Thomas Sands Management and Homeland Security
Printed Name Title
;I/~-~igna ture