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Home My WebLink AboutAmendment 8KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2018 -2020 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH18249 AMENDMENT NUMBER: 8 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT hereinafter referred to as "LHJ", pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED : That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows: ~ Adds Statements of Work for the following programs: • LSPAN-Local Strategies for Physical Activity & Nutrition -Effective February 19, 2019 ~ Amends Statements of Work for the following programs: • Childhood Lead Poisoning Prevention Program -Effective January 1, 2018 D Deletes Statements of Work for the following programs : 2. Exhibit B-8 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-7 Allocations as follows: ~ Increase of $58,500 for a revised maximum consideration of $335,654. D Decrease of for a revised maximum consideration of __ D No change in the maximum consideration of __ . Exhibit B Allocations are attached only for informational purposes. 3. Exhibit C-7 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-6. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof. KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT ~/IJ/Jq Date STATE OF WASHINGTON DEPARTMENT OF HEAL TH APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of 10 2018-2020 CONSOLIDATED CONTRACT EXHIBIT A STATEMENTS OF WORK TABLE OF CONTENTS AMENDMENT #8 DOH Program Name or Title: Childhood Lead Poisoning Prevention Program-Effective January 1, 2018 ............................................. : ........................................ 3 DOH Program Name or Title: LSP AN-Local Strategies for Physical Activity & Nutrition -Effective February 19, 2019 .............................................................. 7 Exhibit A, Statements of Work Revised as of March 15, 2019 Page 2 of 10 Contract Number CLH18249-8 Exhibit A Statement of Work Contract Term: 2018-2020 AMENDMENT #8 DOH Program Name or Title: Chil dhoo d Lead P o is oning. Prevent i on Program - Effective January 1, 2018 Local Health Jurisdiction Name: Kittitas County Public Health Department Contract Number: CLH18249 SOW Type : Revision Revision # (for this SOW) 2 Funding Source Federal Compliance Type of Payment D Federal <Select One> (check if applicable) [8J Reimbursement Period of Performance: January 1, 2018 through June 30. 2019 [8J State D FFATA (Transparency Act) D Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose ofthis statement of work is to support local interventions with the case management of elevated blood lead levels in children 14 years of age and younger. The focus of this program in 2018 is to build local capacity statewide to provide standard case management services to all children with elevated blood lead levels. Revision Purpose: The purpose of this revision is to decrease SFY2 funding and update the DOH Program Contact. Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total Revenue Index (LBJ Use Only) Consideration Decrease (-) Consideration Code Code Start Date End Date SFYI Lead Environments of Children (proviso funds) N IA 334.04.93 25715110 ovo1118 I 06/30/18 SFY2 Lead Environments of Children (proviso funds) N IA 334.04 .93 25715120 01101118 I 06/3011 9 TOTALS Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Number 1 Contact the provider to gather complete information on the assigned elevated blood lead case to conduct an environmental assessment a) Verify the blood lead level (BLL) is confirmed. Reference Centers for Disease Control and Prevention's (CDC's) confirmed case definition: ht!Os://wwwn.cdc .gov/nndss/conditions/lead- elevated-blood-levels/case-definition/2016/ b) Call family and schedule a home visit. If interpretation services are needed, contact DOH at lead@doh.wa.gov. Note: Interpretation services will not be reimbursed through the ConCon process. c) Visit the child's residence (or other sites where the child spends significant amounts of time) at least once Exhibit A, Statements of Work Revised as of March 15 , 2019 Standards/Measures Submit the updated Child Blood Lead Investigation Form via Washington Disease Reporting System (WDRS) available through WA DOH indicating: a) Confirmed BLL b) Date LHJ contacted the family c) Date the environmental assessment was completed d) Date the interview was completed e) Specify if the home is Section 8 or HUD Housing and if the child is Medicaid enrolled t) (If annlicable) IfDOH Page 3 of 10 2,000 0 2,000 1,500 -1,500 0 3,500 -1 ,500 2,000 Due Date/Time Payment Information and/or Frame Amount Submit as Reimbursement of up needed within 60 to $500 maximum days after per home visit, per completion. child. Up to two (2) home visits per child not to exceed total funding consideration. Note: this excludes indirect costs Contract Number CLH18249-8 Task Number Task/ Activity/Description d) Interview the caregivers using the Child Blood Lead Investigation Form and conduct an environmental assessment to identify factors that may impact the child's blood lead level. If laboratory services are needed, contact DOH at lead@doh.wa.gov. Note: Laboratory services will not be reimbursed through the ConCon process. e) Determine if the family lives in Section 8 or HUD Housing . If the child is Medicaid enrolled collect the Provider One number t) Provide educational material to the child's caregivers in the family's primary language g) (Optional) If warranted, contact DOH to request technical or environmental investigation assistance with an X-ray fluorescent (XRF) analyzer Have the child retested following the Pediatric Environmental Health Specialty Units (PEHSU) medical management guidelines . If the lead level remains ~5 µg /dL the LHJ will conduct a second home visit to connect the family to other service providers as needed. PEHSU medical management guidelines: htt12s://www.9ehsu.ner/ Librarv/facts/medical -m!?mJl.t- childhood-Iead-exposurce-J une-20 L3 .pelf If the second lead level drops to <5 µg/dL, the LHJ has the option to: 1) Mail the child's caregivers a letter recommending a developmental and nutritional screening, the letter will include providers in the child's residential area. The LHJ may then close the case. (DOH will provide a template letter.); or 2) proceed to Task 2 and conduct a second home visit. 2 The purpose of the second home visit is to connect the family to other service providers as needed: a) LHJ staff will facilitate and guide the child's caregiver in completing the WithinReach Exhibit A, Statements of Work Revised as of March 15, 2019 AMENDMENT #8 *May Support PHAB Due Date/Time Payment Standards/Measures Deliverables/Outcomes Frame Information and/or Amount assistance is requested, list the DOH contact and date contacted g) (If applicable) If the LHJ opts to close the case after verifying that the second lead level has dropped to <5 µg/dL , it must submit a copy of the letter mailed to the family Submit a written report summarizing the environmental assessment lab test results and a Plan of Care that lists recommendations on how to remove and remediate lead exposure via WDRS . Include the educational material provided to the family that addresses the child's needs. (DOH will provide a generic template.) The LHJ will upload a copy of the report to DOH via WDRS, and provide a copy to the child's caregivers and provider. I I Submit an updated Plan of Care to Submit as Reimbursement of up DOH via WDRS and provide a copy needed within 60 to $500 maximum to the child's caregivers and provider days after per home visit, per that includes: completion. child. Up to two (2) Page 4 of 10 Contract Number CLH18249-8 AMENDMENT #8 Task *May Support PHAB Due Date/Time Payment Task/ Activityillescription Deliverables/Outcomes Information and/or Number Standards/Measures Frame Amount Developmental Screening Questionnaire online a) Completion date and results of home visits per child ht!:Q://www.12arenthel12123.org/. The LHJ must the online WithinReach not to exceed total provide a hard copy of the developmental Developmental Screening funding screening in case it cannot be submitted online. In Questionnaire consideration. unusual, and DOH approved cases, in which the b) If blood lead testing of at-risk WithinReach assessment cannot be performed, family members was Note: this excludes the LHJ may refer the family to the child's recommended, list the indirect costs . physician or to another entity that is trained to individuals administer developmental screening tests c) The referral date and provider of b) Encourage blood lead testing of other children the nutritional assessment , less than 72 months of age and pregnant or include all other referrals nursing caregivers in the home d) The members of the case c) If appropriate, refer the child's caregivers to the management team, their Women, Infants, and Children (WIC) program or involvement, and the case a Registered Dietitian Nutritionist (RDN) for a information provided to them nutritional assessment and to other service providers as appropriate d) Coordinate services and communicate regularly with members of the case management team 3 DOH will reimburse LHJ staff for DOH-approved case Attend approved training and submit As needed Reimbursement for management related training opportunities and travel training invoices and receipts to DOH-approved including training fees if applicable and mileage, DOH training fees , mileage lodging and meals at the current federal GSA rates at and per diem not to the time of travel. exceed total funding consideration. (See Special Billing Requirements below.) *For Information Only: Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a Standard/Measure . More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: http://v,.rww .phaboardorg/wp-conu:inr/uploads/PRAB-Standards-and-Measures-Version-l .O'.pdf Program Specific Requirements/Narrative Program Manual, Handbook, Policy References Guide for Public Health Case Management of Children with Elevated Blood Lead Levels https:/ /www. doh. wa. gov/Portals/I/Documents/ 4000/3 34-414. 12df I A Targeted Approach to Blood Lead Screening in Children, Washington State Exhibit A , Statements of Work Page 5 of 10 Contract Number CLH18249-8 Revised as of March 15, 2019 AMENDMENT #8 2015 Expert Panel Recommendations hnus://wwW' .doh. wa.aovlPortals/ l /Documeuts/Pub~334-3 83 . pdf Special References (RCWs, WACs, etc) Laboratories are required to report to the Department of Health all Blood Lead test results (WAC 246-101-201). Elevated results (2':5 mcg/dL) must be reported within two (2) days; non-elevated results :S5 mcg/dL need to be reported within one (1) month. Monitoring Visits (frequency, type) Telephone calls with contract manager at least once every quarter. Definitions BLL-Blood Lead Level EBLL-Elevated Blood Lead Level PEHSU-Pediatric Environmental Health Specialty Units Special Billing Requirements Reimbursement for pre-approved travel expenses including mileage, lodging and meals will be calculated at the current federal General Services Administration (GSA) rates at the time of travel. Current per diem rates by state can be found at: bttps://w\Wi'.gsa.gov/travel/olan-book/p er-d:iem-ratesfo er-dlem-rates-lookuo Special Instructions Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable written report to include a plan of care. Payment to completely expend the "Total Consideration" for a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices may be submitted as needed within 60 days after home visit completion and must be based on actual direct program costs. Billing for services on a monthly fraction of the "Total Consideration" will not be accepted or approved. If needed, additional funding may be added upon request and DOH approval while funds are available. Contact lead@doh.wa.gov for additional information. Note: blood lead case management reimbursement excludes indirect costs. DOH Program Contact Afflceli Mendez Amy Bertrand, Health Services Consultant Office of Environmental Public Health Sciences Washington State Department of Health Street Address: 310 Israel Rd SE, Tumwater, WA 98501 Telephone: 360-236-3392 / Fax: 360-236-3059 Email: fR ".7-Celi .me,uie=@doJi. w6!.go1 1 (m 1v.benrand@.doh .wa.gov DOH Fiscal Contact Victoria Reyes, Management Analyst 1 Assistant Secretary's Office Telephone: 360-236-3071 Exhibit A, Statements of Work Revised as of March 15, 2019 Page 6 of 10 Contract Number CLH18249-8 AMENDMENT #8 Exhibit A Statement of Work Contract Term: 2018-2020 DOH Program Name or Title: L SPAN-Local Straie gl e s for Phvsical Activitv & Nutrition -Effective February 19. 2019 Local Health Jurisdiction Name: Kittitas County Public Health Department Contract Number: CLH18249 SOW Type: Original Revision # (for this SOW) Funding Source Federal Compliance Type of Payment ~ Federal Subrecipient (check if applicable) D Reimbursement Period of Performance: February 19, 2019 through September 29. 2019 D State ~ FFATA (Transparency Act) D Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose of this statement of work is to establish funding for Local Strategies for Physical Activity and Nutrition (LSPAN), a project of the State Physical Activity and Nutrition Program (SP AN). Revision Purpose: N/ A Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change !Total Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration Code Code Start Date End Date FFYl 8 PHYS ACTVTY & NUTRITION PROG 93.439 333.93.43 77440248 02119119 I 09;29119 0 60,000 60,_000 TOTALS 0 60,000 60,000 Task *May Support PHAB Payment Task/ Activity/Description Deliverables/Outcomes Due Date/Time Frame Information Number Standards/Measures and/or Amount la PROGRAM ADMINISTRATION: Designated KCPHD staff February 19, 2019-September 29, 2019 Reimbursement Participate in calls, at a minimum of once will participate in contract for actual costs, every month, with DOH contract manager. management calls. not to exceed Dates and time for calls are mutually agreed total contract upon between DOH and Kittitas County funding. See Public Health Department (KCPHD). j Program Specific Requirements lb PROGRAM ADMINISTRATION: Designated KCPHD staff February 19, 2019-September 29, 2019 Reimbursement Participate in DOH-sponsored LSP AN will participate in calls, for actual costs, related quarterly conference calls and/or webinars, and meetings. not to exceed webinars, including up to one (1) in-person total contract meeting . funding. See Program Specific Requirements I Exhibit A, Statements of Work Revised as of March 15, 2019 Page 7 of 10 Contract Number CLH18249-8 Task Number Task/ Activityillescription le PROGRAM ADMINISTRATION: Perform administrative duties related to LSPAN . - 2a PROGRAM IMPLEMENTATION: Finalize Work Plan and Budget Workbook using DOH-provided templates. 2b PROGRAM IMPLEMENTATION: Implement finalized community work plan focused on LSP AN that include: -Addressing at least two (2) state strategies required by this grant funding. -Achieving policy, systems, or environmental changes consistent with the strategies. -Identifying and reaching populations with health disparities. 2c PROGRAM IMPLEMENTATION: Report quarterly expenditures using DOH-provided template . 3 PROGRAM EVALUATION: Participate in performance measure data collection and program evaluation activities in collaboration with DOH. Exhibit A, Statements of Work Revised as of March 15, 2019 *May Support PHAB Standards/Measures I I I I I I I i I AMENDMENT #8 Payment Deliverables/Outcomes Due Date/Time Frame Information and/or Amount Quarterly progress reports to April 15 , 2019 (covering Reimbursement DOH via SharePoint site or February 19, 2019 -March 30, 2019) for actual costs , email not to exceed July 15, 2019 (covering total contract March 31, 2019-June 29 , 2019) funding. See Program Specific October 15, 2019 (covering Requirements June 30 , 2019-September 29 , 2019) Submit Work Plan to DOH Draft due : Reimbursement contract manager via email March 15 , 2019 for actual costs , not to exceed Final due: total contract March 29, 2019 funding . See Program Specific Requirements Quarterly progress reports to April 15 , 2019 (covering Reimbursement DOH via SharePoint site or February 19 , 2019-March 30, 2019) for actual costs, email not to exceed October 15 , 2019 (covering total contract June 30, 2019-September 29 , 2019) funding . See Program Specific Requirements Report quarterly expenditures April 15, 2019 (covering Reimbursement using DOH-provided February 19 , 2019-March 30 , 2019) for actual costs , template . not to exceed July 15, 2019 (covering total contract March 3 I, 2019-June 29 , 2019) funding . See Program Specific October 15, 2019 (covering Requirements June 30, 2019-September 29, 2019) Quarterly progress reports to April 15, 2019 (covering Reimbursement DOH via SharePoint site or February 19, 2019-March 30, 2019) for actual costs , email not to exceed July 15 , 2019 (covering total contract March 31 , 2019-June 29 , 2019) funding. Page 8 of IO Contract Number CLH18249-8 AMENDMENT #8 Task *May Support PHAB Payment Task/ Activityffiescription Deliverables/Outcomes Due Date/Time Frame Information Number Standards/Measures and/or Amount October 15, 2019 (covering June 30, 2019-September 29, 2019) *For Information Only: Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: htlp://www.pbaboard .org/wp_-comenr/uoloads/PHAB-S tandards-and -Measures-Version-1.0 .pd f Program Specific Requirements/Narrative The Local Strategies for Physical Activity and Nutrition (LSPAN) project is providing funds to Kittitas County Public Health Department to implement policy, systems and environmental changes at the community level to enact healthy nutrition guidelines and support breastfeeding-friendly environments. These changes must support the health of priority populations who experience health disparities. LSP AN is part ofDOH's State Physical Activity and Nutrition-Washington (SPANW A) Program. Funding for SPANW A is through a cooperative agreement awarded to DOH from the Centers for Disease Control and Prevention's (CDC) DP 18 -1807 : State Phvsical Activitv and N utriti on Program Special Requirements Federal Funding Accountability and Transparency Act (FF AT A) This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act (FFATA or the Transparency Act). The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent. To comply with this act and be eligible to perform the activities in this statement of work, the LHJ must have a Data Universal Numbering System (DUNS®) number. Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282. Required Disdosn.res for Federal Award ee P·criormance and Integrity Infor ma tion Svstem (FAPITS }: Consistent with 45 CFR 75.113, applicants and recipients must disclose in a timely manner, in writing to the Centers for Disease Control and Prevention (CDC), with a copy to the Health and Human Services (HHS) Office oflnspector General (OIG), all information related to violations offederal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Subrecipients must disclose, in a timely manner in writing to the prime recipient (pass through entity) and the HHS OIG, all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Disclosures must be sent in writing to the CDC and to the HHS OIG at the following addresses: CDC, Office of Grants Services, Romero Stokes, Grants Management Officer/Specialist, Centers for Disease Control and Prevention Chronic Disease and Birth Defects Services Branch, 2920 Brandywine Road, Mailstop E-09, Atlanta, Georgia 30341, Email: lnjO@cdc.gov (Include "Mandatory Grant Disclosures" in subject line) AND U.S. Department of Health and Human Services, Office of the Inspector General, ATTN: Mandatory Grant Disclosures, Intake Coordinator, 330 Independence Avenue SW, Cohen Building, Room 5527, Washington, DC 20201, Fax: (202) 205-0604 (Include "Mandatory Grant Disclosures" in subject line) or Email: MandatorvGranteeDisclosures@oig,bhs .go v Exhibit A, Statements of Work Revised as of March 15, 2019 Page 9 of 10 Contract Number CLH18249-8 AMENDMENT #8 Restrictions on Funds (what funds can be used for which activities, not direct payments, etc) • Only DOH-approved budget expenditures will be reimbursed. • Subrecipients may not use funds to purchase furniture or equipment. • Funds cannot be spent on capital projects to support built environment changes. • Reimbursement of pre-award costs generally is not allowed, unless DOH provides written approval to the subrecipient. • The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project outcomes and not merely serve as a conduit for an award to another party or provider who is ineligible. Monitoring Visits (frequency, type) • In-person site visits at least once a year Special Billing Requirements • Must use the budget workbook supplied by the program DOH Program Contact Chris Zipperer, Physical Activity Coordinator Washington State Department of Health PO Box 47848 Olympia, WA 98504 360-236-3614 (desk)/ chris .zipperer@doh.wa.gov Exhibit A, Statements of Work Revised as of March 15, 2019 Page 10 of 10 Contract Number CLH18249-8 EXHIBIT 8-8 Kittitas County Public Health Department ALLOCATIONS Contract Number: CLH18249 Contract Term: 2018-2020 Date: March 15 , 2019 Indirect Rate as of January 2018: 29.50% Public Health Dept & 12.50% County Central Svcs Indirect Rate as of January 2019: 28.25% Public Health Dept & 12.75% County Central Svcs DOH Use Only BARS Statement of Work Chart of Accounts Funding Chart of Federal Award Revenue Funding Period Fnnding Period Period Accounts Chart of Accounts Program Title Identification # Amend# CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total FFYI 9 CSS JAR SNAP Ed Program Mgnt l 97WAWA5Q3903 Amd4 10 .561 333.10.56 10101/18 09130119 10101118 09130119 $19,745 $19,745 $44,930 FFY18 CSS JAR SNAP Ed Program Mgnt CF I 87WAWA5Q3903 Amd4 10 .561 333.10.56 10101/18 09130/19 10101/18 09130/19 $858 $858 FFY18 CSS JAR SNAP Ed Program Mgnt l 87WAWASQ3903 Amd4 10 .561 333 .10.56 0 l/01118 09130/18 10101/17 09130/18 $3,000 $22,855 FFY18 CSS JAR SNAP ED Program Mgnt l 87WAWASQ3903 Amd2 10 .561 333.1 0.56 01101/18 09130/18 10101117 09130118 $11,025 FFYl8 CSS JAR SNAP ED Program Mgnt 187 WAWA5Q3903 NIA 10 .561 333 .1 0.56 01101 118 09130/18 10101117 09130118 $8,830 FFYI 7 CSS JAR SNAP ED Program Mgnt CF 171 7WAWA5Q390 NIA 10 .561 333.1 0.5 6 01 101/18 09130118 10101/17 09/30118 $1,472 $1,472 FFYI 7 EPR PHEP BPI LHJ Funding NU90TP92!889-01 Amd2 93.069 333 .93 .06 01 101/18 06130118 07101117 07102118 $565 $20,398 $20,398 FFYI 7 EPR PHEP BPI LHJ Funding NU90TP921889-01 NIA 93 .069 333 .93 .06 01 101/18 06130/18 07101/17 07102/18 $19,833 FFYI 8 EPR PHEP BPI Supp LHJ Funding NU90TP92I889-01 AmdS 93.069 333.93.06 07101/18 06130119 07101118 06130/19 $885 $49,134 $49,134 FFYl 8 EPR PHEP BPI Supp LHJ Funding NU90TP92l889-01 Amd4 93 .069 333.93.06 07101/18 06130/19 07101118 06130/19 $48,249 FFYI 7 317 Ops 5NH23IP000762-05-00 NIA 93 .268 333.93.26 01101/18 06130118 04101117 06130/18 $616 $616 $616 FFY17 AFIX 5NH23IP000762-05-00 NIA 93.268 333.93.26 01101/18 06130118 04101117 06130/18 $2,226 $2,226 $2,226 FFYI 7 Increasing Immunization Rates NH23IP000762 Amd3,4 93 .268 333.93.26 07 101 118 06130/19 07101/18 06130/19 $5,600 $5,600 $5,600 FFYI 7 VFC Ops 5NH23IP000762-05-00 NIA 93.268 333.93.26 01 101/18 06130/18 04101/17 06130/18 $1,114 $1,114 $1,114 FFY18 Phys Actvty & Nutrition Prog NU58DP006504 AmdS 93.439 333.93.43 02/19/19 09129/19 09128/18 09129/19 $60,000 $60,000 $60,000 FFYI 9 MCHBG LHJ Contracts B04MC32578 Amd4 93 .994 333.93.99 1010 1/18 09130/19 10101118 09130119 $44,196 $44,196 $78,236 FFYl8 MCHBG LHJ Contracts B04MC31524 Amd2 93 .994 333.93.99 01101/18 09130/18 10101117 09130118 $893 $34,040 FFYI 8 MCHBG LHJ Contracts B04MC31524 NIA 93.994 333.93.99 01101/18 09130118 10101117 09130118 $33,147 GFS -Group B (FO-E) NIA NIA 334.04.90 01101/18 06130118 07101117 06130119 $5,000 $5,000 $5,000 FY2 Group B Programs for OW (FO-E) Amd3 NIA 334.04.90 07101118 06130119 07101117 06130/19 $10,000 $10,000 $10,000 SFY2 Lead Environments of Children Amd8 NIA 334.04.93 07101118 06/30/19 07101/18 06130/19 ($1,500) so $2,000 SFY2 Lead Environments of Children Amd4 NIA 334.04.93 07/01118 06130/19 07/01/18 06130119 $1,500 SFYI Lead Environments of Children Amd I NIA 334.04.93 01101/18 06130/18 07101117 06130118 $2,000 $2,000 FPHS Funding for LHJs Dir Amd3 NIA 336.04.25 07101/18 06130/19 07101/17 06130119 $42,000 $42,000 $42,000 Page 1 of2 Kittitas County Public Health Department Indirect Rate as or January 2018 : 29.S0% Public Health Dept & 12.S0% County Central Svcs Indirect Rate as or January 2019: 28 .2S% Public Health Dept & 12.7S% County Central Svcs Chart of Accounts Prog ram Title YR 20 SRF -Local Asst (I 5%) (FS) SS YR 20 SRF -Local Asst (15%) (FS) SS YR 21 SRF -Local Asst (I 5%) (FS) SS YR 21 SRF -Local Asst (15%) (FS) SS Sanitary Survey Fees (FO-E) SS-State Sanitary Survey Fees (FO-E) SS-State YR 20 SRF -Local Asst (15%) (FS) TA YR20 SRF-Local Asst (15%) (FS) TA YR 21 SRF -Local Asst (15%) (FS) TA YR 21 SRF -Local Asst (15%)(FS) TA TOTAL Total consideration: GRAND TOTAL *Catalog of Federal Domestic Assistance Federal Award Identification # S277,1S4 SSS,500 S33S,6S4 **Federal revenue codes begin with "333". State revenue codes begin with "334". Amend# Amd3 NIA, Amd 3 Amd7 Amd3 , 7 Amd7 NIA, Amd3, 7 Amd3 NIA, Amd 3 Amd7 Amd3, 7 EXHIBIT B-8 ALLOCATIONS Contract Term: 2018-2020 DOH UseOnJy BARS Statement of Work Chart of Accounts Revenue Funding Period Fonding Period CFDA* Code** Start Date End Date Start Date End Date NIA 346.26.64 01101/18 12131118 01101115 12131/18 NIA 346.26.64 01/01118 12131 118 07101115 12/31/18 NIA 346.26.64 01/01/18 1213 1119 07101/17 12131/19 NIA 346.26.64 01/01/18 1213 1119 07/011,17 12131119 NIA 346.26.65 01101/18 1213 1119 07101/17 12/31/19 NIA 346.26.65 01101/18 1213 1/19 07101/17 12131/19 NIA 346.26.66 01 101/18 12131/18 07/01/15 12131/18 NIA 346.26.66 01101/18 12131/18 07101/15 12131/18 NIA 346.26.66 01101/18 12131119 07/01/'17 12131/19 NIA 346.26.66 01101/18 12131119 07/0'1111 12131/19 Page2 of2 Amount ($2,400) $2 ,400 $2,800 $2 ,400 $2,800 $2,400 ($2,000) $2,000 $2,000 $2,000 $335,654 Contract Number: Date : Funding Period Sub Total $0 $5,200 $5 ,200 $0 $4,000 $33S,6S4 GRAND TOTAL Total Fed Total State CLH18249 March 15 , 2019 Chart of Accounts Total $0 $5,200 $5,200 $0 $4,000 $335,654 $262,254 $73,400 Exhibit C-7 Schedule of Federal Awards AMENDMENT #8 Date: March 15, 2019 KITTITAS COUNTY HEALTH DEPT-SWV0010475--07 CONTRACT CLH18249-Kittitas County Public Health Department CONTRACT PERIOD: 01/01/2018-12/31/2020 DOH Total Amt Allocat ion Peri od Chan of Aocou 111s Progra m T i tle BARS Federal f edo ral Start End Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award Federal Grant Award Name Awa.rd D ate Alli/3 rd Date Date ldentifu:aljon /llurnber State Administrative Matching Department of Agriculture Food and FFY19 CSS IAR SNAP-ED PROG MGNT 33310.56 09/28/18 $5,386,268 10/01/18 09/30/19 $19,745 10 561 Grants for the Supplemental Nutrition Service 197WAWA5Q3903 SNAP 2YR NUTRITION ED OBESITY Nutrition Assistance Program State Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY18 CSS IAR SNAP-ED PROGRAM MGNT CF 333.10 56 09/28/17 $5,300,000 10/01/18 09/30/19 $858 10 561 Grants for the Supplemental 187WAWA5Q3903 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program Nutrition Service (S NAP-ED) - State Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY18 CSS IAR SNAP-ED PROGRAM MGNT 33310 56 09/28/17 $5,300,000 01/01/18 09/30/18 $22,855 10 561 Grants for the Supplemental Nutrition Service 187WAWA5Q3903 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program (SNAP-ED) State Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY17 CSS IAR SNAP-ED PROGRAM MGNT CF 333.10.56 09/10/16 $5,739,856 01 /0 1/18 09/30/18 $1.472 10.561 Grants for the Supplemental 1717WAWA5Q390 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program Nutrition Service (SNAP-ED) Department of Health and Human HOSPITAL PREPAREDNESS Public Health Emergency PROGRAM AND PUBLIC HEAL TH FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333 93 06 08/01/18 $11,062,782 07/01/18 06/30/19 $49,134 93.069 Preparedness Services Centers for Disease Control N U90TP921889-01 EMERGENCY PREPAREDNESS and Prevention COOPERATIVE AGREEMENT Public Health Emergency Department of Health and Human HPP AND PHEP COOPERATIVE FFY17 EPR PHEP BP1 LHJ FUNDING 333 93 06 07/18/17 $11,062,782 01 /01/18 06/30/18 $20,398 93,069 Preparedness Services Centers for Disease Control N U90TP921889-01 AGREEMENT and Prevention Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY17 VFC OPS 333 93 26 03/03/17 $1,201,605 01/01/18 06/30/18 $1,114 93.268 Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722.443 07/01/18 06/30/19 $5,600 93.268 Services Centers for Disease Control NH231P000762 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM - Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY17 AFIX 333 93 26 03/03/17 $1,672,289 01/01/18 06/30/18 $2,226 93 268 Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY1 7 317 OPS 333 93.26 03/03/17 $575,969 01/01/18 06/30/18 $616 93 268 Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM State Physical Activity and Department of Health and Human NU58DP006504 STATE PHYSICAL ACTIVITY AND FFY18 PHYS ACTVTY & NUTRITION PROG 333 93 43 09/01/18 $923,000 02/19/19 09/29/19 $60,000 93 439 Nutrition (SPAN) Services NUTRITION-WASHINGTON (SPANWA) Maternal and Child Health Department of Health and Human MATERNAL AND CHILD HEALTH FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $44,196 93,994 Services Block Grant to the Services Health Resources and B04MC32578 SERVICES BLOCK GRANT States Services Administration Malemal and Child Heallh Department of Health and Human MATERNAL AND CHILD HEAL TH FFY18 MCHBG LHJ CONTRACTS 333 93.99 10/20/17 $1,650,528 01/01/18 09/30/18 $34,040 93.994 Services Block Grant to the Services Health Resources and 804MC31524 SERVICES States Services Administration TOTAL $262,254 Page 1 of 1 Today's Date 05/03/2019 Fund/Department 116 -Public Health Kittitas County Review Form Grants & Contract Agreement Agenda Date Contract/Grant Information Contract /Grant Agency: Consolidated Contract Amendment 8 ~1 l L\ \ \ c, I I Period Begin Date: 01/01/2018 I J Period End Date: 12/31/2020 Total Grant/Contract Amount: Increase of $58,500.00 for a new maximum consideration of $335,654.00 Grant/Contract Number: CLH18249 Contract/Grant Summary: The Consolidated Contract Amendment 8 amends the following: Adds Statements of Work for the following programs • LSPAN-Local Strategies for Physical Activity and Nutrition-Effective February 19, 2019 Amends Statements of Work for the following: • Childhood Lead Poisoning Prevention Program: Effective January 1, 2018 Exhibit B-8 Allocations amends and replaces Exhibit B-7 allocations as follows: • Increase of $58,500.00 for a revised maximum consideration of $335,654.00 Recommendation for Board of Health and Board of Health Review on Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: A PPR OVED AS TO FO RM : Date Date Signature of Board of Health member Date Financial Information Grant/Contract Review Page 1 Total Amount$ 58,500 State Funds$ {1,500) Federal Funds $ 60,000 Percentage County Funds Matching Funds$ CFDA# 93.439 In-Kind$ Explain Is Equipment being purchased? Who owns equipment? New Personnel being hired? Contact HR hiring -reporting requirements Future impacts or liability to Kittitas County: Budget Information Budget Amendment Needed? Yes D attach budget form NoO Whynot New Division Created? Revenue Code LSPAN 612.31.333.93.43 $60,000 Lead Environment 612.334.04.93 (-$1,500) Pass Through Information Agency to Pass Through Amount to Pass Through $ Sub-Contract Approved Date : Prosecutor Review I Has the Prosecutor reviewed this agreement? I YesD No D County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted I Signature: Department: I Date: Assignment of Tracking _ Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application I Reviewer ] Date Grant/Contract Review Page 2