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AMENDMENT #I7Exhibit A, Statements of WorkRevised as ofSeptember 15,2020PaymentInformation and/orAmountDue Date/TimeFrameDecember 31,2020June 30,2021October 30,2020Deliverables/OutcomesMid-year report on templateprovided by DOH.End-of-year report on templateprovided by DOH.LHJ performance measure data(PM 8)*May Support PIIABStandards/MeasuresTask/Activity/DescriptionaLHJ Performance Measure data will be dueOctober 30,2020. DOH will gather data forPMs 4 and 5.Domain 5 Surge ManagementCapability l0 Medical SurgeEngagement with regional Health Care Coalition(HCC)Participate in:- At least one regional HCC meeting, inperson or vitually.- The information sharing process duringincidents.- At least one planning process or exerciseconducted to inform on the roles andresponsibilities of public health.- Reviewing HCC plans for alignment withlocal ESF8 plans.Note: This task doesn't need to be completed untilJune 30, 2021. LHIs may begin work in thisStatement of Work period, or may opt to do all thework in the next Statement of Work period.Domain 5 Surge ManagementCapability l0 Medical SurgeGather and submit data for LHJ performancemeasure 8: Percent of Critical Healthcare Facilitieswhose functional status can be assessed by thelocal health jurisdiction in an emergency.Notes:r "Critical Healthcare Facilities" are hospitals,skilled nursing facilities, blood centers, anddialysis centers.r DOH will provide additional guidance aboutsubmitting performance measure data.TaskNumberl718Page 9 of 42Contract Number CLHI 8249 -1 7