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AMENDMENT #4 Task *May Support PHAB Due Date/Time Payment Task/ Activity/Description Deliverables/Outcomes Information and/or Number Standards/Measures Frame Amount 7 Provide notification to the DOH Duty Officer at Submit mid-year and end-of-year December 31, 2018 360-888-0838 or hanalert@doh.wa.gov for all progress reports and June 28, 2019 response incidents involving utilization of emergency response plans (ERPs) and structures. Documentation that notification to June 28, 2019 DOH was provided; or statement that no incident response occurred. 8 Provide LHJ situation reports to DOH during all Submit mid-year and end-of-year December 31, 2018 incidents involving an emergency response by the progress reports and June 28, 2019 LHJ. Submit Situation Reports. During all responses 9 Submit essential elements of information (EEis) Submit mid-year and end-of-year December 31, 2018 during incident response upon request by DOH. progress reports and June 28, 2019 Provide information upon request. Upon request by DOH 10 Participate in the regional healthcare coalition Submit mid-year and end-of-year December 31, 2018 (HCC) and attend coalition meetings as necessary. progress reports and June 28, 2019 Provide a summary of participation June 28, 2019 in coalition activities. 11 For all LHJs that have identified a Hub for receipt Submit mid-year and end-of-year December 31, 2018 of medical countermeasures from DOH during progress reports and June 28, 2019 disasters: • Participate in the 2019 T-Rex medication Documentation of participation in June 28, 2019 distribution exercise by receiving a shipment the exercise of exercise medications from DOH at the designated local Hub • LHJ are not required to test dispensing, transportation, or redistribution during the T-Rex exercise. *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: httn://www.phaboard.org/wp-comeru/up !oads/PHA.B-Standards-and-lwlt:asures-Version-1.0.pdf Program Specific Reg uirements/N arrative Any subco ntract/s must be approv€d by DOH 2rior to executing the contract/s. Deli verables are to be suhJ111ittcd to ihe ConCon de-Jiverable s mailbox at ccm 0o nde1ive.1.rbles(a d.oh. wa.gov Special Requirements Exhibit A, Statements of Work Revised as of July 16, 2018 Page 14 of32 Contract Number CLH18249-4