PSA between Kittitas County Public Health and Comm Health of Central WA

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Task *May Support PHAB Payment Number Task! Activity /Description StandardslMeasures Delivera bles/Outcomes Due DatelTime Frame Information and/or Amount identified during the initial VFC compliance site Follow all corrective action visit. Follow-up may include another physical and follow-up guidance *See Restrictions on site visit or verification by email, phone, fax, or provided by VFC-PEAR for Funds below mail that corrective actions were completed. each incorrect response. Documentation that all VFC Site Visit corrective actions have been completed must be available c) Submit copy of signed c) upon completion of to DOH upon request. Acknowledgement of Receipt each training Participate in all DOH/CDC trainings required d) Document completion of each for site visit reviewers and supervisors (a list of required training required trainings will be provided by DOH). 7 a) Conduct AFIX (Assessment, Feedback, a) Enter the following data in the a) At the time of the Reimbursement for Incentive, and Exchange) visits with one (1) AFIX Online Tool: AFlX visit or within actual costs incurred, provider sites in your jurisdiction per • General Site Visit ten (10) business not to exceed total instructions at this link. Visits can be Information. days of the AFIX funding consideration conducted in-person, by telephone, or by • Questionnaire responses. visit. amount. webinar. All AFIX visits must be conducted • Coverage assessment results by September 30th. (from CoCASA reports). Funds available for • Feedback visit information. this task*: b) Conduct AFIX follow-up visits with provider sites that choose to implement b) Enter the following data in the b) At the time of the FFY15 AFIX, quality improvement strategies during their Exchange tab of the AFIX AFIX follow-up visit 74205250 initial AFIX visit. Continue following up Online Tool for follow-up or within ten (10) with provider sites until they fully visits: business days ofthe *See Restrictions on implement their selected quality • Clinic progress on AFIX follow-up visit Funds below improvement activities. Follow-up visits implementing quality can be conducted in-person, by telephone, improvement strategies. or by webinar. • Follow-up coverage assessment results (from CoCASA reports). 8 a) Tn coordination with hospitals, health care Enter information for each case By the 15th of each Reimbursement for providers, and health plans (if applicable), identified into the Perinatal month actual costs incurred, conduct activities to prevent perinatal hepatitis B Hepatitis B module of the WA not to exceed total infection in accordance with the Perinatal Immunization Information System funding consideration Hepatitis B Prevention Program Guidelines, amount. including the following: I I) identification ofHBsAg-positive Annual Perinatal Hepatitis B December 15th Funds available for pregnant women, and pregnant women with Outreach Summary this task*: WlknOwn HBsAg status (DOH 348 268) 2) reporting of HBsAg-positive women and FFY 317 Ops their infants 74201250 3 ) case management for infants born to Exhibit A , Statements of Work Page 17 of 19 Contract Number C17114