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AMENDMENT #5 Task *May Support PHAB Payment Number Task! Activity /Description StandardslMeasures Deliverables/Outcomes Due Date/Time Frame Information and/or Amount I) identification of HBsAg-positive (DOH 348-268 ) this task*: pregnant women, and pregnant women with unknown HBsAg status FFY 16 317 Ops 2) reporting of HBsAg-positive women 74110261 and their infants 3) case management for infants born to *See Restrictions on HBsAg-positive women to ensure Funds below administration ofHBIG and hepatitis B vaccine within 12 hours of birth, the completion of the 3-dose hepatitis B vaccine series, and post-vaccination serologic testing. b) Provide technical assistance to birthing hospitals to encourage administration of the hepatitis B birth dose to all newborns within 12 hours of birth, in accordance with Advisory Committee on Immunization Practices (AClP) recommendations. c) Report all perinatal hepatitis B investigations, including HBsAg-positive infants, in the Perinatal Hepatitis B Module of the WA lIS. *For Information Only: Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: http://www .phaboard.orglwp-content/uploads/PHAB-Standards-and-Measures-Version-l .0 .pdf Program Specific Requirements/Narrative • All LHJ staff who conducts VFC Compliance Site Visits and AFIX visits must participate in an annual VFC and AFIX training, conducted by DOH Office of Immunization and Child Profile (OlCP) staff or their designee. • All new LHJ site visit reviewers are required to have at least one (1) observational visit conducted by DOH OICP staff or their designee . DOH OlCP staff (or designee) will periodically conduct observational VFC/AFIX site visits with all other LHJ reviewers who conduct VFC Compliance Site Visits . • LHJ staff that conducts VFC Compliance Site Visits must participate in at least one (1) joint (observational) VFC compliance visit with DOH staff every other year. The observational visit will occur during a regularly scheduled site visit conducted by the LHJ reviewer. DOH will determine the Observational visit. • Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP. Exhibit A, Statements of Work Revised as of November 16,2015 Page 7 of 10 Contract Number C17114-5