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AMENDMENT #17 <br />Exhibit A, Statements of Work Page 24 of 42 Contract Number CLH18249-17 <br />Revised as of September 15, 2020 <br /> <br />3. If any charges are imposed for the provision of health services using Title V (MCH Block Grant) funds, such charges will be p ursuant to a public schedule of charges; will not <br />be imposed with respect to services provided to low income mothers or children; and will be adjusted to reflect the income, re sources, and family size of the individual <br />provided the services. [Social Security Law, Sec. 505 (1) (D)]. <br /> <br />Monitoring Visits (frequency, type) <br />Telephone calls with contract manager at least one every quarter, and annual site visit. as needed. <br /> <br />Special Billing Requirements <br />Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19 -1A invoice voucher. Payment to completely expend the “Total Consideration” <br />for a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly quarterly by the 30th of each <br />month following the month quarter in which the expenditures were incurred and must be based on actual allowable program costs. Billing for services on a monthly fraction of the <br />“Total Consideration” will not be accepted or approved. <br /> <br />Special Instructions <br />Contact DOH contract manager below for approval of expenses not reflected in approved budget workbook. <br /> <br />MCHBG funds may be expended on COVID-19 response activities that align with maternal and child health priorities. Examples may include: <br /> Providing support in educating the MCH population about COVID-19 through partnerships with other local agencies, medical providers, and health care organizations. <br /> Working closely with state and local emergency preparedness staff to assure that the needs of the MCH population are represen ted. <br /> Funding infrastructure that supports the response to COVID -19. For example, Public Health Nurses who are routinely supported through the Title V program may be <br />able to be mobilized, using Title V funds or separate emergency funding, to support a call center or deliver health services. <br /> Partnering with parent networks and health care providers to provide accurate and reliable information to all families. <br /> Engaging community leaders, including faith-based leaders, to educate community members about strategies for preventing illness <br />Restrictions listed above continue to apply. <br /> <br />DOH Program Contact <br />Mary Dussol, Community Consultant <br />Office of Family and Community Health Improvement <br />Washington State Department of Health <br />Street Address: 310 Israel Rd SE, Tumwater, WA 98501 <br />Mailing Address: PO Box 47848, Olympia, WA 98504 <br />Telephone: 360-236-3781 / Fax: 360-236-3646 <br />Email: Mary.Dussol@doh.wa.gov