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AMENDMENT #17 <br />Exhibit A, Statements of Work Page 23 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 Frame <br />Payment <br />Information and/or <br />Amount <br />approval to access Diagnostic and Treatment <br />funds to meet the need. <br /> <br />*For Information Only: <br />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 <br />Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that m ay apply can be found at: <br />http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf <br /> <br />Program Specific Requirements/Narrative <br /> <br />Special Requirements <br />Federal Funding Accountability and Transparency Act (FFATA) <br />This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Trans parency Act (FFATA or the Transparency Act). <br />The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are s pent. <br /> <br />To comply with this act and be eligible to perform the activities in this statement of work, the LHJ must have a Data Univer sal Numbering System (DUNS®) number. <br /> <br />Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282. <br /> <br />Program Manual, Handbook, Policy References <br />Children and Youth with Special Health Care Needs Manual - <br />https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthSystemResourcesandServices/LocalHealthResourcesandTo ols/MaternalandChildHealthBlockGrant/ <br />ChildrenandYouthWithSpecialHealthCareNeeds <br /> <br />Health Services Authorization (HSA) Form <br />http://www.doh.wa.gov/Portals/1/Documents/Pubs/910-002-ApprovedHSA.docx <br /> <br />Restrictions on Funds (what funds can be used for which activities, not direct payments, etc.) <br />1. At least 30% of federal Title V funds must be used for preventive and primary care services for children and at least 30% mus t be used services for children with <br />special health care needs. [Social Security Law, Sec. 505(a)(3)]. <br /> <br />2. Funds may not be used for: <br />a. Inpatient services, other than inpatient services for children with special health care needs or high risk pregnant women and infants, and other patient services approved by <br />Health Resources and Services Administration (HRSA). <br />b. Cash payments to intended recipients of health services. <br />c. The purchase or improvement of land, the purchase, construction, or permanent improvement of any building or other facility, or the purchase of major medical <br />equipment. <br />d. Meeting other federal matching funds requirements. <br />e. Providing funds for research or training to any entity other than a public or nonprofit private entity. <br />f. payment for any services furnished by a provider or entity who has been excluded under Title XVIII (Medicare), Title XIX (Med icaid), or Title XX (social services block <br />grant).[Social Security Law, Sec 504(b)].