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AMENDMENT #17 <br />Exhibit A, Statements of Work Page 9 of 42 Contract Number CLH18249-17 <br />Revised as of September 15, 2020 <br />Task <br />Number Task/Activity/Description *May Support PHAB <br />Standards/Measures Deliverables/Outcomes Due Date/Time <br />Frame <br />Payment <br />Information and/or <br />Amount <br /> LHJ Performance Measure data will be due <br />October 30, 2020. DOH will gather data for <br />PMs 4 and 5. <br />17 Domain 5 Surge Management <br />Capability 10 Medical Surge <br /> <br />Engagement with regional Health Care Coalition <br />(HCC) <br />Participate in: <br />- At least one regional HCC meeting, in <br />person or virtually. <br />- The information sharing process during <br />incidents. <br />- At least one planning process or exercise <br />conducted to inform on the roles and <br />responsibilities of public health. <br />- Reviewing HCC plans for alignment with <br />local ESF8 plans. <br /> <br />Note: This task doesn’t need to be completed until <br />June 30, 2021. LHJs may begin work in this <br />Statement of Work period, or may opt to do all the <br />work in the next Statement of Work period. <br /> Mid-year report on template <br />provided by DOH. <br /> <br />End-of-year report on template <br />provided by DOH. <br />December 31, 2020 <br /> <br /> <br />June 30, 2021 <br />18 Domain 5 Surge Management <br />Capability 10 Medical Surge <br /> <br />Gather and submit data for LHJ performance <br />measure 8: Percent of Critical Healthcare Facilities <br />whose functional status can be assessed by the <br />local health jurisdiction in an emergency. <br /> <br />Notes: <br /> “Critical Healthcare Facilities” are hospitals, <br />skilled nursing facilities, blood centers, and <br />dialysis centers. <br /> DOH will provide additional guidance about <br />submitting performance measure data. <br /> LHJ performance measure data <br />(PM 8) <br />October 30, 2020 <br /> <br /> <br />