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Exhibit A, Statement of Work Page 1 of 2 Contract Number CLH31015 <br />Template September 2021 <br />Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br /> <br />DOH Program Name or Title: ELC COVID-19 - Effective January 1, 2022 Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: CLH31015 <br />SOW Type: Original Revision # (for this SOW) Funding Source <br /> Federal Subrecipient <br /> State <br /> Other <br />Federal Compliance <br />(check if applicable) <br /> FFATA (Transparency Act) <br /> Research & Development <br />Type of Payment <br /> Reimbursement <br /> Fixed Price Period of Performance: January 1, 2022 through April 22, 2022 <br />Statement of Work Purpose: The purpose of this statement of work is to build and strengthen epidemiology, laboratory and health information systems capacity in local health <br />jurisdictions. The funding allocation is the actual carryforward amount. <br />Revision Purpose: N/A <br /> <br />DOH Chart of Accounts Master Index Title <br />Master <br />Index <br />Code <br />Assistance <br />Listing <br />Number <br />BARS <br />Revenue <br />Code <br />LHJ Fund <br />Start Date <br />ing Period <br /> End Date <br />Current <br />Allocation <br />Allocation <br />Change <br />Increase (+) <br />Total <br />Allocation <br />FFY19 COVID CARES 1891029B 93.323 333.93.32 01/01/22 04/22/22 0 174 174 <br /> 0 0 0 <br /> 0 0 0 <br /> 0 0 0 <br /> 0 0 0 <br /> 0 0 0 <br />TOTALS 0 174 174 <br /> <br />Task <br /># Activity Deliverables/Outcomes Due Date/Time <br />Frame <br />Payment <br />Information <br />and/or Amount <br />1 Establish a spending plan and staffing proposal to support the work of COVID-19 case <br />investigation and contact tracing. The spending plan and staffing proposal should include <br />proposed positions and define roles. <br />Submit spending plan and <br />staffing proposal summary to the <br />DOH Contract Manager. <br />August 15, <br />2020 – update if <br />necessary <br />Payment for all <br />tasks will be <br />reimbursement for <br />actual expenses <br />up to the <br />maximum <br />available within <br />the funding <br />periods for each <br />source described <br />in the Funding <br />Table above. <br /> <br />2 Hire, orient and/or train staff based on the negotiated staffing proposal. Develop a training <br />plan in consultation with DOH that is consistent with the DOH COVID-19 guideline. <br />Training plan will be flexible depending on staff experience and based on for onboarding <br />into new systems. <br /> <br />Staff summary and training plan September 30, <br />2020 <br />3 Conduct case investigations, contact tracing and monitoring in accordance with DOH <br />COVID-19 Infection Reporting and Surveillance Guidelines (DOH 420-107), Appendix 1: <br />Case and Contact Investigation, pages 16-21: <br />https://www.doh.wa.gov/Portals/1/Documents/5100/420-107-Guideline-COVID-19.pdf <br />Data collected and reported into <br />DOH systems <br />Daily