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Exhibit A, Statements of WorkRevised as ofSeptember 15,2020AMENDMENT #17PaymentInformation and/orAmountMCHBG Assessment and EvaluationReimbursement foractual costs, not toexceed total fundingconsideration.See ProgramSpecificRequirements andSpecial BillingRequirements.MCHBG ImplementationReimbursement foractual costs, not toexceed total fundingconsideration.Action Plan andProgress ReportsDue Date/Time FrameDecember 4, 2020May 2 I, 202 ISeptember 10,2021September 30, 2018September 30,2019September 30,2020September 30, 2021January 15,2018April 15,2018July 15,2018October 15,2018May 24,2019Draft August 16,2020Final September 6,2020Draft August 17,2018Final- September 5,201 8Monthly, on or beforethe l5'h ofthe followingmonthDeliverables/OutcomesSubmit actual expenditures using theMCHBG Budget Workbook to DOHcontract managerSubmit actual expenditures using theMCHBG Budget l4/orkbook to DOHcontract manager.Submit MCHBG Budget Workbookto DOH contract managerDocumentation using reporttemplate provided by DOHDocumentation using reporttemplate provided by DOHSubmit Needs Assessmentdocumentation to DOH contractmanager using templates providedby DOHInclude health equity planin2020-2021 MCHBG Action Plan usingDOH- provided template.Submit MCHBG Action Plan toDOH contract managerSubmit Action Plan monthly reportsto DOH contract manager*May Support PIIABStandards/IVIeasuresTas k/Activity/DescriptionReport actual expendituresfor October 1,2019through September 30, 2020Report actual expendituresfor the six monthperiodfrom October 1,2020 through March 31,202 IDevelop 2021-2022 MCHBG Budget Workbookfor October I, 2021 through September 30, 2022using DOH provided template.Participate in project evaluation activitiesdeveloped and coordinated by DOH, asrequested.Report program level strategy measure data(CSHCN, UDS, ACEs).Conduct a Maternal and Child Health (MCH)Needs Assessment.Explore health equity approaches to maternal andchild health and develop implementation planDevelop 2018-2019 MCHBG Action Plan forOctober 1,2018 through September 30,2019using DOH-provided template.Report activities and outcomes of 2017-2018MCHBG Action Plan using DOH- providedtemplate.TaskNumberIkilIm2a2b2c2d3a3bPage21 of 42Contract Number CLHI 8249 - | 7