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Restrictions on Funds (i.e., disallowed expenses or activities, indirect costs, etc.): 1. At least 30% of federalTitle V funds must be used for preventive and primary care services for children and at least 30% must be used services for children with special healthcare needs. [Social Security Law, Sec. 505(a)(3)]. 2. Funds may not be used for: a. Inpatient services, other than inpatient services for children with special health care needs or high risk pregnant women and infants, and otherpatient services approved by Health Resources and Services Administration (HRSA). b. Cash payments to intended recipients of health services. c. The purchase or improvement of land, the purchase, construction, or permanent improvement of any building or other facility, or the purchase of majormedical equipment. d. Meeting other federa I matching funds requirements. e. Providing funds for research or training to any entity other than a public or nonprofit private entity. f. Payment for any services furnished by a provider or entity who has been excluded under Title XVIII (Medicare), Title XIX (Medicaid), or Title XX (social services block grant).[Social Security Law, Sec 504(b)]. 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 be imposed with respect to services provided to low income mothers or children; and will be adjusted to reflect the income, resources, and family size of t he individual provided the services. [Social Security Law, Sec. 505 (1) (D)]. Monitoring Visits: Telephone calls with DOH contract manager as needed. Billing Requirements: Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable Al -IA invoice voucher. Payment to completely expend the "Total Consideration" fora specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted quarterly by the 30th of each month following the 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 "Total Consideration" will notbe accepted orapproved. Special Instructions: Contact DOH contract manager below for approval of expenses not reflected in approved budget workbook. MCHBG funds may be expended on COVID-19 response activities that align with maternal and child health priorities. Examples may include: • Providing support in educatingthe MCH population about COVID- 19 through partnerships with other local agencies, medical providers, and health care organizations. • Working closely with state and local emergency preparedness staff to assure that the needs of the MCH population are represented. • Funding infrastructure that supports the response to COVID-19. For example, Public Health Nurses who are routinely supported through the Title V program maybe able to be mobilized, using Title V funds or separate emergency funding, to support a call center or deliver health services. • Partnering with parent networks and health care providers to provide accura to and reliable information to all families. • Engaging community leaders, including faith -based leaders, to educate community members about strategies forpreventing illness Restrictions listed above continue to apply. Exhibit A, Statement of Work Page 3 of 3 Contract NumberCLH31015 Template Created September 2021