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DOH Program Name or Title: Infectious Disease-Syndernic Prevention Services-" ssP -En aiu"Ju*i.vl. zozq <br />Exhibit A <br />Statement of Work <br />Contract Term : 2022-2024 <br />Local Health Jurisdiction Name: Kittitas Countv Public Health DeDartment <br />Contract Number: CLH3l0l5 <br />SOW Type: Oriqinal Revision # (for this SOW)Funding Source <br />Federal <Select One> <br />State <br />Other <br />Federal Compliance <br />(check if applicable) <br />nn FFATA (Transparency Act) <br />Research & Development <br />Type of Payment <br />[l Reimbursement <br />! Fixed Price <br />Period of Performance: January l. 2024 through December 3 l. 2024 <br />Statement ofWork Purpose: The purpose ofthis statement ofwork (SOW) is to provide Syndemic Prevention Services for infectious diseases (HIV, STI, and Adult Viral <br />Hepatitis), supporting the Office of Infectious Disease (OID) within Deparhnent of Health (DOH), Awarded through OID's 2024 Syndemic RFA process. <br />Revision Purpose: N/A <br />Exhibit A, Statement of Work Page I of9 Contract Number CLH3 l0l 5-Amendment l7 <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 Funding Period <br />start Date End Date <br />Current <br />Allocation <br />Allocation <br />Change <br />Increase (+) <br />Total <br />Allocation <br />SFY24 DRUG USER I-IEALTH PROGRAM 12405140 N/A 134 04 91 01/o1t24 06t30t24 0 37.750 37.750 <br />SFY25 DRUG USER HEALTH PROGRAM t240sts0 N/A 334.04.91 07101/24 12t31/24 0 37 -750 3l.7so <br />0 0 0 <br />0 0 0 <br />0 0 0 <br />0 0 0 <br />TOTALS 0 75.500 75.500 <br />Task <br />#Activity Deliverahles/f)utcomes Due Date/Time Frame Payment Information <br />and/or Amount <br />Syringe Services Programs (SSP): Support for Operations <br />Provide comprehensive SSP to people who use drugs <br />(PWUD). This plan of action is directed to distribute <br />syringes to communities that use drugs to prevent <br />transmission of infectious disease. SSPs will operate during <br />scheduled hours to provide all required harm reduction <br />supplies, naloxone, and syringes to prevent transmission of <br />disease and overdose. SSPs will offer referrals to address <br />social determinants of health. <br />SSP operations outcomes include <br />delivering services and tracking: <br />. number ofsterile syringes distributed <br />. number of naloxone kits distributed <br />. number ofparticipant encounters <br />. number of refenals to health and <br />social services <br />Enter deliverable data into the <br />DOH/OID issued database for <br />tracking SSP activities by the <br />l5th ofeach month following <br />service. <br />Reimbursement of <br />actual costs incurred, <br />not to exceed $75,500 <br />based on funding split <br />below. <br />$37,750 for <br />1/v24-6/30n4 <br />$37,750 for <br />7^/24-12/3t/24