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Home My WebLink AboutConCon Amend 9KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 2018 -2020 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH18249 AMENDMENTNUMBER: 9 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEAL TH 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: I. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows: ~ Adds Statements of Work for the following programs: • OICP-Promotion oflmmunizations to Improve Vaccination Rates -Effective July 1, 2019 • Zoonotic Disease Program-WNV Mosquito Surveillance -Effective June 1, 2019 ~ Amends Statements of Work for the following programs: • Office of Drinking Water Group A Program -Effective January 1, 2018 • Supplemental Nutrition Assistance Program-Education -Effective October 1, 2018 D Deletes Statements of Work for the following programs: 2. Exhibit B-9 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-8 Allocations as follows: ~ Increase of$11,829 for a revised maximum consideration of$347,483. 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-8 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C-7. 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 HEAL TH DEPARTMENT STATE OF WASHINGTON DEPARTMENT OF HEALTH Date ~,~·~iu~111 Da APPROVED AS TO FORM ONLY Assistant Attorney General Page 1 of20 2018-2020 CONSOLIDATED CONTRACT EXHIBIT A STATEMENTS OF WORK TABLE OF CONTENTS AMENDMENT #9 DOH Program Name or Title: Office of Drinking Water Group A Program -Effective January 1, 2018 ......................................................................................... 3 DOH Program Name or Title: OICP-Promotion oflmmunizations to Improve Vaccination Rates -Effective July 1, 2019 ............................. , ..... ._ ...... ,. ..... " ......... 8 DOH Program Name or Title: Supplemental Nutrition Assistance Program-Education -Effective October 1, 2018 ............................ , ......................................... 10 DOH Program Name or Title: Zoonotic Disease Program-WNV Mosquito Surveillance -Effective June 1, 2019 ........................................................................ 19 Exhibit A, Statements of Work Revised as of May 15, 2019 Page 2 of 20 Contract Number CLH18249-9 Exhibit A Statement of Work Contract Term: 2018-2020 AMENDMENT #9 DOH Program Name or Title: Office of Drinking Water Group A Program - Effective January 1, 2018 Local Health Jurisdiction Name: Kittitas County Public Health Department Contract Number: CLH18249 SOW Type: Revision Revision # (for this SOW) 3 Funding Source Federal Compliance Type of Payment [gl Federal Contractor (check if applicable) D Reimbursement Period of Performance: January 1, 2018 through December 31, 2020 [gl State D FF AT A (Transparency Act) [gl Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose of this statement of work is to provide funding to the LHJ for conducting sanitary surveys and providing technical assistance to small community and non-community Group A water systems . Revision Purpose: The purpose of this revision is to increase Total Consideration and revise Special Billing Requirements and Special Instructions. Chart of Accounts Program Name or Title Yr 20 SRF -Local Asst (15%) (FS) ss Sanitary Survey Fees (FO-E) SS-State Yr 20 SRF -Local Asst (15%) (FS) TA Yr 21 SRF -Local Asst (15%) (FS) ss Yr 21 SRF -Local Asst (15%) (FS) TA TOTALS Task Task/Activity/Description Number I Trained LHJ staff will conduct sanitary surveys of small community and non-community Group A water systems identified by the DOH Office of Drinking Water (ODW) Regional Office. See Special Instructions for task activity . Exhibit A , Statements of Work Revised as of May 15 , 2019 CFDA# NIA NIA NIA NIA NIA *May Support PHAB Standards/Measures BARS Master Funding Period Current Change Total Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration Code Code Start Date End Date 346.26.64 24139220 01/01/18 12 /31/18 0 0 0 346.26.65 24242522 01/01/18 12/31/19 5_,200 400 5_,600 346 .26.66 24139220 01/01/18 12/31/18 0 0 0 346.26.64 24139221 01 /01/18 12 /31/19 5,200 400 5,600 346.26.66 24139221 01 /01/18 12/31/19 4_,000 0 4,000 14,400 800 15,200 Deliverables/Outcomes Due Date/Time Payment Information and/or Amount Frame Provide Final* Sanitary Final Sanitary Survey Upon ODW acceptance of the Final Survey Reports to ODW Reports must be Sanitary Survey Report, the LHJ shall Regional Office . Complete received by the ODW be paid $400 for each sanitary survey of Sanitary Survey Reports shall Regional Office a non-community system with three or include: within 30 calendar fewer connections. I. Cover letter identifying days of conducting significant deficiencies, the sanitary survey. Upon ODW acceptance of the Final significant findings, Sanitary Survey Report, the LHJ shall observations, be paid $800 for each sanitary survey of recommendations, and a non-community system with four or referrals for further more connections and each community ODW follow-up . system . Page 3 of20 Contract Number CLH I 8249-9 Task Task/Activity/Description Number DOH will provide a tablet and GPS unit for the LHJ to gather source data during a routine sanitary survey. DOH expects the LHJ to commit to using the tablet and GPS for a five-year period. 2 Trained LHJ staff will conduct Special Purpose Investigations (SPI) of small community and non- community Group A water systems identified by the ODW Regional Office. See Special Instructions for task activity. 3 Trained LHJ staff will provide direct technical assistance (TA) to small community and non-community Group A water systems identified by the ODW Regional Office. See Special Instructions for task activity. Exhibit A, Statements of Work Revised as of May 15, 2019 *May Support PHAB Standards/Measures : Deliverables/Outcomes 2. Completed Small Water System checklist. 3. Updated Water Facilities Inventory (WFI). 4. Photos of water system with text identifying features 5. Any other supporting documents. * Final Reports reviewed and accepted by the ODW Regional Office. The LHJ surveyor will record at least two (2) GPS data points, for each source, into the preloaded Excel template on the tablet and submit that data file with the associated sanitary survey. Provide completed SP! Report and any supporting documents and photos to ODW Regional Office. Provide completed TA Report and any supporting documents and photos to ODW Regional Office. Page 4 of20 AMENDMENT #9 Due Date/Time Frame Payment Information and/or Amount Payment is inclusive of all associated costs such as travel, lodging, per diem . Payment is authorized upon receipt and acceptance of the Final Sanitary Survey Report within the 30-day deadline. Late or incomplete reports may not be accepted for payment. Completed SP! Upon acceptance of the completed SP! Reports must be Report, the LHJ shall be paid $800 for received by the ODW each SP!. Regional Office within 2 working Payment is inclusive of all associated days of the service costs such as travel, lodging, per diem. request. Payment is authorized upon receipt and acceptance of completed SPI Report within the 2 working day deadline. Late or incomplete reports may not be accepted for payment. Completed TA Upon acceptance of the completed TA Report must be Report, the LHJ shall be paid for each received by the ODW technical assistance activity as follows : Regional Office • Up to 3 hours of work: $250 within 30 calendar • 3-6 hours of work: $500 days of providing • More than 6 hours of work: $750 technical assistance. Contract Number CLH\8249-9 AMENDMENT #9 Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Number Standards/Measures Frame Payment Information and/or Amount Payment is inclusive of all associated costs such as consulting fee, travel, lodging, per diem. Payment is authorized upon receipt and acceptance of completed TA Report within the 30-day deadline. Late or incomplete reports may not be accepted for payment. 4 LHJ staff performing the activities Prior to attending the Annually LHJ shall be paid mileage, per diem, under tasks 1, 2 and 3 must have training, submit an lodging, and registration costs as completed the mandatory Sanitary "Authorization for Travel approved on the pre-authorization form Survey Training. (Non-Employee)" DOH in accordance with the current rates Form 710-013 to the ODW listed on the OFM Website See Special Instructions for task Program Contact below for h H12;f/www .o fm. wa. e.o v/resourte s/lravel activity. approval (to ensure that ~ enough funds are available). *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: hup://w \\'W .oh.ab onrd.or2.lwp-conccntf u ploads/PHA D-Standards-and-Measu resN ~rs.ion -I .0 .pelf Program Specific Requirements/Narrative Special References (RCWs, WACs, etc) Chapter 246-290 WAC is the set ofrules that regulate Group A water systems. By this statement of work, ODW contracts with the LHJ to conduct sanitary surveys (and SPis, and provide technical assistance) for small community and non-community water systems with groundwater sources. ODW retains responsibility for conducting sanitary surveys (and SPls, and provide technical assistance) for small community and non-community water systems with surface water sources, large water systems, and systems with complex treatment. LHJ staff assigned to perform activities under tasks 1, 2, and 3 must be trained and approved by ODW prior to performing work. See special instructions under Task 4, below. Special Billing Requirements The LHJ shall submit quarterly invoices within 30 days following the end of the quarter in which work was completed, noting on the invoice the quarter and year being billed for. Payment cannot exceed a maximum accumulative fee of $10,100 $11,200 for Task 1, and $4,000 for Task 2, Task 3 and Task 4 combined during the contracting period, to be paid at the rates specified in the Payment Method/Amount section above. When invoicing for sanitarv survevs. bill ha!ho BARS Revenue Code 346 .26.64-,and half to BAR-S Revenue Code 346.26.65. When invoicing for Task 1, submit the list ofWS Name, ID#, Amount Billed, Survey Date and Letter Date that you are requesting payment. When invoicing for Task 2-3, submit the list of WS Name, ID #, TA Date and description of TA work performed, and Amount Billed. Exhibit A, Statements of Work Revised as of May 15, 2019 Page 5 of20 Contract Number CLH18249-9 AMENDMENT #9 When invoicing for Task 4, submit receipts and the signed pre-authorization form for non-employee travel to the ODW Program Contact below and a signed A19-1A Invoice Voucher to the DOH Grants Management, billing to BARS Revenue Code 346.26.66 under Technical Assistance (TA). Special Instructions Task 1 Trained LHJ staff will evaluate the water system for physical and operational deficiencies and prepare a Final Sanitary Survey Report which has been accepted by ODW. Detailed guidance is provided in the Field Guide for Sanitary Surveys, Special Purpose Investigations and Technical Assistance (Field Guide). The sanitary survey will include an evaluation of the following eight elements: source; treatment; distribution system; finished water storage; pumps, pump facilities and controls; monitoring, reporting and data verification; system management and operation; and certified operator compliance. If a system is more complex than anticipated or other significant issues arise, the LHJ may request ODW assistance. • No more than 8 surveys of non-community systems with three or fewer connections to be completed between January 1, 2018 and December 31, 2018. • No more than 2 surveys of non-community systems with four or more connections and all community systems to be completed between January 1, 2018 and December 31, 2018. • No more than 4 surveys of non-community systems with three or fewer connections to be completed between January 1, 2019 and December 31, 2019 . • No more than 5-6 surveys of non-community systems with four or more connections and all community systems to be completed between January 1, 2019 and December 31, 2019. The process for assignment of surveys to the LHJ, notification of the water system, and ODW follow-up with unresponsive water systems; and other roles and responsibilities of the LHJ are described in the Field Guide. Task2 Trained LHJ staff will perform Special Purpose Investigations (SPis) as assigned by ODW. SPis are inspections to determine the cause of positive coliform samples or the cause of other emergency conditions. SPis may also include sanitary surveys of newly discovered Group A water systems. Additional detail about conducting SPis is described in the Field Guide. The ODW Regional Office must authorize in advance any SPI conducted by LHJ staff. Task3 Trained LHJ staff will conduct Technical assistance as assigned by ODW. Technical Assistance includes assisting water system personnel in completing work or verifying work has been addressed as required, requested, or advised by the ODW to meet applicable drinking water regulations. Examples of technical assistance activities are described in the Field Guide. The ODW Regional Office must authorize in advance any technical assistance provided by the LHJ to a water system. Task4 LHJ staff assigned to perform activities under tasks 1, 2, and 3 must be trained and approved by ODW prior to performing work. LHJ staff performing the activities under tasks 1, 2 and 3 must have completed, with a passing score, the ODW Online Sanitary Survey Training and the ODW Sanitary Survey Field Training. LHJ staff performing activities under tasks 1, 2, and 3 must attend the Annual ODW Sanitary Survey Workshop, and are expected to attend the Regional ODW LHJ Drinking Water Meetings. If required trainings, workshops or meetings are not available, not scheduled, or if the LHJ staff person is unable to attend these activities prior to conducting assigned tasks, the LHJ staff person may, with ODW approval, substitute other training activities to be determined by ODW. Such substitute activities may include one-on-one training with ODW staff, co-surveys with ODW staff, or other activities as arranged and pre-approved by ODW. LHJ staff may not perform the activities under tasks 1, 2, and 3 without completing the training that has been arranged and approved by ODW. Program Manual, Handbook, Policy References http://www.doh.wa.gov/Portals/1/Documents/Pubs/331-486.pdf Exhibit A, Statements of Work Revised as of May 15, 2019 Page 6 of20 Contract Number CLH 18249-9 DOH Program Contact Mark Steward DOH Office of Drinking Water 16201 E. Indiana Ave, Suite 1500 Spokane Valley, WA 99216 Mark.Steward@doh.wa.gov (509) 329-2136 Exhibit A, Statements of Work Revised as of May 15, 2019 DOH Fiscal Contact Karena McGovern DOH Office of Drinking Water 243 Israel Rd SE Twnwater, WA 98501 Karena.McGovern@doh.wa.gov (360) 236-3094 AMENDMENT #9 Page 7 of20 Contract Number CLH18249-9 Exhibit A Statement of Work Contract Term: 2018-2020 AMENDMENT #9 DOH Program Name or Title: OICP-Promotion of Immunizations to Improve Vaccination Rates -Effective July I, 2019 Local Health Jurisdiction Name: Kittitas County Public Health Department Contract Number: CLH I 8249 SOW Type: Original Revision # (for this SOW) Funding Source Federal Compliance Type of Payment [gJ Federal Subrecipient (check if applicable) [gJ Reimbursement Period of Performance: July 1, 2019 through June 30, 2020 D State [gJ FF AT A (Transparency Act) D Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose of this statement of work is to contract with local health to conduct activities to improve immunization coverage rates . Revision Purpose: NIA Chart of Accounts Program Name or Title FFY20 VFC Ops TOTALS Task Number Task/Activity/Description I Develop a proposal to improve immunization coverage rates for a target population by increasing promotion activities and collaborating with community partners. The proposal must meet guidelines outlined in the Local Health Jurisdiction Funding Opportunity, Promotion of Immunizations to Increase Vaccination Rates announcement. 2 Upon approval of proposal, implement the plan to increase immunization coverage rates with the target population identified. 3 Perform data collection necessary to enable a comparison of immunization rates from the start of the project. Exhibit A, Statements of Work Revised as of May 15, 2019 CFDA# BARS Master Funding Period Revenue Index (LHJ Use Only) Code Code Start Date End Date 93.268 333.93.26 74310292 07/01/19 ! 06/30/20 *May Support PHAB Standards/Measures Deliverables/Outcomes Written proposal and a report that shows starting immunization rates for the target population Written report describing the progress made on reaching milestones for activities identified in the plan (template will be provided) Final written report, including a report showing ending immunization rates for the target population (template will be -provided) Page 8 of20 Current Change Total Consideration Increase (+) Consideration 0 5,600 5,600 0 5,600 5,600 Due Date/Time Payment Frame Information and/or Amount August 1, 2019 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. See Restrictions on Funds below. November 30, 2019 March 3 1, 2020 June 15, 2020 Contract Number CLH18249-9 AMENDMENT #9 *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: hrtp J/ww w .phah oard.orn}wp-conten tl u plo1ldsf PH AB-Stnndards-and-M e-asurcs-V 1.trsion-l . o, pdf Program Specific Requirements/Narrative Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP . Special Requirements Federal Funding Accountability and Transparency Act (FFATA) 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. Restrictions on Funds (what funds can be used for which activities, not direct payments, etc.) Allowable Uses of Federal Operations Funds document (dated 12/20/2017) is posted on the DOH Consolidated Contract website at this link . These federal funds may not be used for expenses related to travel or attendance at any non-DOH sponsored conference, training, or event without prior written approval from the DOH Office of Immunization and Child Profile. DOH Program Contacts Tawney Harper, MPA Deputy Director I Operations Manager Office of Immunization and Child Profile Department of Health PO Box 47843, Olympia WA 98504-7843 tawney.harper(@,doh.wa.gov, 360-236-3525 Exhibit A, Statements of Work Revised as of May 15, 2019 DOH Program Contact Misty Ellis, Project Manager CDC Public Health Advisor Office of Immunization and Child Profile Department of Health PO Box 47843, Olympia WA 98504-7843 misty.ellis(@,doh.wa.gov, 360-236-3675 Page 9 of20 Contract Number CLH18249-9 Exhibit A Statement of Work Contract Term: 2018-2020 AMENDMENT #9 DOH Program Name or Title: Supplemental Nutrition Assistance Program- Education -Effective October I, 2018 Local Health Jurisdiction Name: Kittitas County Public Health Department Contract Number: CLH18249 SOW Type: Revision Revision # (for this SOW) 1 Funding Source Federal Compliance ~pc or ·Payment ~ Federal Subrecipient (check if applicable) R~imbursement Period of Performance: October l, 2018 through September 30, 2020 D State ~ FF AT A (Transparency Act) D Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose of this statement of work is to provide Supplemental Nutrition Assistance Program-Education (SNAP-Ed) to improve the likelihood that persons eligible for SNAP (Food Stamps) will make healthy food choices within a limited budget and choose active lifestyles consistent with the current USDA dietary guidance system. Revision Purpose: The purpose of this revision is to add funds in the FFY19 CSS IAR SNAP Ed Program Management category . Chart of Accounts Program Name or Title FFY18 CSS IAR SNAP ED PROG MGNT CF FFY19 CSS JAR SNAP ED PROG MGNT TOTALS :it .:ai: Task/Activity/Description "' OS E-- 1.0 For SNAP-Ed, the LHJ will perform work as described in their approved: • FFYI 9 SNAP-Ed project description and work plans approved by DOH, Department of Social and Health Services (DSHS), and United States Department of Agriculture (USDA) that was Exhibit A, Statements of Work Revised as of May 15, 2019 *May Support PHAB Standards/ Measures • • • • CFDA# BARS Master Funding Period Current Change rrotal Revenue Index (LHJ Use Only) Consideration Increase(+) !Consideration Code Code Start Date End Date 10.561 330.10.56 76211993 10101/18 I 09/30/19 858 0 858 10.561 330.10.56 76211991 10101/18 I 09/30/19 19 ,745 429 20,174 20,603 429 21,032 FFY19 FFY20 Payment Information Deliverables/Outcomes Due Date/Time Frame Due Date/Time Frame and/or Amount Project qualified target For the Period: For the Period: Reimbursement upon audiences reached 10/01/18 to 09/30/19 10/01/19 to 09/30/20 receipt and approval of Project activities deliverables for the completed (# direct Due: per the approved Due: per the approved funding period will not education, PSE, Etc.) work plan and no later work plan and no later exceed $20,MJJ noted in project plans and than 09/30/19 than 09/30/20 $21,032. workbooks. Required demographic Kittitas County data collected. Public Health Evaluation activities Department will be completed per the paid the allowable implementing agencv and costs incurred based Page 10 of20 Contract Number CLH18249-9 :it Task/Activity/Description ~ "' = E-- submitted to them via DOH email. • FFY 20 SNAP-Ed project description and work plans approved by DOH, Department of Social and Health Services (DSHS), and United States Department of Agriculture (USDA) that was submitted to them via DOH email. 2.0 Quarterly Progress Reports The following data is collected and submitted within DOH provided form /system: I. Project major achievements. 2. Project major challenges. 3. If projects are running on time with original timeline? If not why, and how will you correct the timeline? 4. Any PSE progress. 5. Any success stories to date. Exhibit A, Statements of Work Revised as of May 15, 2019 *May Support PHAB Deliverables/Outcomes Standards/ Measures state evaluation team (pre and post surveys, PSE tracking, success stories etc.). Submit Quarterly Progress Report for all SNAP-Ed projects within the DOH approved form/system. Page 11 of20 AMENDMENT #9 FFY19 FFY20 Payment Information Due Date/Time Frame Due Date/Time Frame and/or Amount on their approved budget and program allowability. See special billing requirements section. **NOTE: The SNAP- Ed program will deny payment for any costs not submitted by the due date and without prior DOH approval in writing. FFY 19 Quarterly Progress FFY20 Quarterly Progress See payment Reports due: Reports due: information as referenced in task • 1st quarter report for • 1st quarter report for number 1.0 the work completed the work completed during 10/01/18 to during 10/01 /19 to 12/31/18. 12/31/19. Final Due: COB Final Due: COB 01/10/19 01/10/20 • 2nd quarter report for • 2nd quarter report for the work completed the work completed during 01/01/19 to during 01/01/20 to 03/31/19. 03/31/20. Final Due: COB Final Due: COB 04/11/19 04/11/20 • 3rd quarter report for • 3rd quarter report for the work completed the work completed during 04/01/19 to during 04/0 l /20 to 06/30/19. 06/30/20. Final Due: COB Final Due: COB 07/11/19 07/11/20 Contract Number CLH18249-9 'It: Task/Activity/Description ~ "' ~ E-< 2.1 Education and Administrative Reporting System (EARS) Data and Reports EARS data is required for each project and in order to count clients toward unduplicated direct reach. Required entry for the PEARS database includes, but is not limited to: • Unduplicated number of clients served per project. • # unduplicated clients served per project based on the following: 0 Race/ethnicity 0 Gender 0 Age • % SNAP eligible per site • Setting type -school, church etc. • Top key messages delivered per project. • # partners • Partnership sectors This information is collected through the following modules in PEARS: Program Activity (direct education), Indirect Activity (indirect intervention channels), PSE, and Partnerships. Exhibit A, Statements of Work Revised as of May 15, 2019 *May Support PHAB Standards/ Measures I I AMENDMENT #9 FFY19 FFY20 Payment Information Deliverables/Outcomes Due Date/Time Frame Due Date/Time Frame and/or Amount I I • Final report for all • Final report for all work not already work not already reported. reported. Final Due: COB Final Due: COB 09/21/19 09/21/20 Submit EARS data for all FFY I 9 data should be FFY20 data should be See payment project(s). collected in real time and collected in real time and information as submitted to the state submitted to the state referenced in task LHJs are required to collect and office by the following office by the following number 1.0 1 submit EARS data dates: dates: 1 electronically or within a template provided by DOH. • EARS data collected • EARS data collected 10/01/18 to 09/13/19 . 10/01/19 to 09/13/20 . Direct education and completed Due: In real time Due: In real time activities should be reported in and no later than one and no later than one real time. Real time = As you (1) week after ( 1) week after I provide services and no later services are provided. services are provided . than one week after data is collected. PSE and partnerships (new or updates) may be reported quarterly. Page 12 of20 Contract Number CLH18249-9 'II: Task/Activity/Description ~ "' <1\1 E-, 2.2 Evaluation Data and Reports The following evaluation activities and information is required for all projects based on your approved projecUplan • Formative • Proces s • PSE • Outcome • Qualitative Please Note: the deliverables may change based on state evaluation team requirements. 3.0 Civil Rights All staff must be trained each fiscal year in civil rights. *See special requirements section- civil rights 3.1 Other Agency Training The following trainings are required for all agencies: • Fiscal -fiscal lead, coordinator, and an y staff Exhibit A, Statements of Work Revised as of May 15 , 2019 *May Support PHAB Deliverables/Outcomes Standards/ Measures I. Collect and report any formative and process data completed based on approved project plan. 2 . Submit PSE progre s s and outcomes based on approved project plan . 3. Capture and submit qualitative (success stories, pictures, etc.) information in PEARS per your approved work plan. 4. Submit a required release for all photos submitted . 5. Conduct and submiUmail pretest surveys for each project class ser ies . 6. Conduct and submiUmail posttest surveys for each project class series. Submit documentation showing Civil Rights training was completed for all SNAP-Ed paid staff. Documentation must include : • Training and source • Who attended • Date completed Fiscal and Data reporting training completed. Page 13 of20 AMENDMENT #9 FFY19 FFY20 Payment Information Due Date/Time Frame Due Date/Time Frame and/or Amount 1-4. Due : At minimum 1-4. Due: At minimum See payment quarterly . quarterly. information as • 1st quarter • 1st quarter referenced in task report due by report due by number 1.0 01 /10/19 01 /10/20 • 2nd quarter due • 2nd quarter due by 04/11/19 by 04/11/20 • 3rd quarter du e • 3rd quarter due by07/JJ/19 by 07/11 /20 • Fin al report for • Final report for all other work all other w ork due 09/21 /19 due 09/21/20 5-6. Due: Monthly 5-6 . Due: Monthl y No later than 30 days No later than 30 days after the end of the after the end of the previous month. (E .g. previous month. (E .g . October pre and post October pre and post surveys submitted no later surveys submitted no later than November 30 and so than November 30 and so on ... ). on ... ). Due: 12 /31/19 Due: 12 /31 /20 See payment information as I referenced in task number 1.0 Due: New staff trained Due: New staff trained See payment within 30 days of starting within 30 days of starting information as SNAP-Ed activities and SNAP-Ed activities and referenced in task again at least once every again at least once every number 1.0 five years . five years . Contract Number CLHl 8249-9 ' :;t Task/Activity/Description .::-: "' = E-- who will purchase items for the SNAP-Ed program. • Data collection and reporting -coordinator and program staff who are reporting data. 4.0 SNAP-Ed Inventory List Keep an up-to-date inventory list that includes all non-capital equipment, purchased curriculum, and other SNAP-Ed paid items that are not disposable. This list should include items purchased in prior fiscal years and be updated yearly. *See special requirements section- monitoring. 5.0 SNAP-Ed A19 Invoices Use the A 19-1 A specific to the DOH SNAP-Ed program. This document will be sent to all LHJs prior to October 16 th based on the current fiscal year. Exhibit A, Statements of Work Revised as of May 15, 2019 *May Support PHAB Deliverables/Outcomes Standards/ Measures SNAP-Ed inventory list Submit SNAP-Ed A 19 invoices and detailed ledger supporting the costs to be reviewed by SNAP-Ed program before approval of payment. Documentation of all costs incurred shall be accompanied by an agency financial system report. If your agency does not have a financial reporting system you must check with the SNAP-Ed program for further guidance. Page 14 of20 AMENDMENT #9 FFY19 FFY20 Payment Information Due Date/Time Frame Due Date/Time Frame and/or Amount If the data collection If the data collection system changes in FFY 19 system changes in FFY20 every staff member every staff member entering data into the entering data into the electronic system will be electronic system will be required to take training required to take training on new expectations or on any new expectations system changes. or system changes. Due: Yearly, at the time Due: Yearly, at the time See payment of a fiscal monitoring of a fiscal monitoring information as and/or site visit. It can and/or site visit. It can referenced in task also be requested when also be requested when number 1.0 deemed necessary. deemed necessary. Due: Monthly -Submit Due: Monthly -Submit See payment invoices to DOH no later invoices to DOH no later information as than 30 days after the end than 30 days after the end referenced in task of the preceding month. of the preceding month. number 1.0 (E.g. October A 19 invoice (E.g. October A 19 invoice submitted no later than submitted no later than November 30 and so November 30 and so on ... ). on ... ) Final invoice is due Final invoice is due October 30, 2019 October 30, 2020 Or Or *If pre-approved in *If pre-approved in writing by contract writing by contract manager, LHJ can submit manager, LHJ can submit invoices every two (2) invoices every two (2) months. Invoices must be months. Invoices must be Contract Number CLH18249-9 AMENDMENT #9 *May =It Support FFY19 .::ii: Task/Activity/Description PHAB Deliverables/Outcomes FFY20 Payment Information "' Standards/ Due Date/Time Frame Due Date/Time Frame and/or Amount = E--Measures received by DOH no later received by DOH no later than dates listed below: than dates listed below: 0 Oct and Nov 0 Oct and Nov due: 12/29/18 due: 12/29/19 0 Dec and Jan 0 Dec and Jan due: 02/28/19 due: 02/28/20 0 Feb and Mar 0 Feb and Mar due: 04/30/19 due: 04/30/20 0 Apr and May 0 Apr and May due: 06/29/19 due: 06/29/20 0 Jun and Jul 0 Jun and Jul due: 08/31/19 due: 08/31/20 0 Aug and Sept 0 Aug and Sept due: 10/30/19 due: 10/30/20 *For Information Only: Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how pro gram 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: h1tp:l/www . ph aboard .ore:/wp-contc.n !/up loads/PH AB-Standards -a nd-Meosures.-Version-1. 0 . pd f Special Requirements Federal Funding Accountability and Transparency Act (FFATA) This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act (FF AT A 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 contractor must have a Data Universal Numbering System (DUNS®) number. Information about the contractor and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282. *Program Specific Requirements/Narrative Staff Requirements Upon request by DOH, contractor must demonstrate that SNAP-Ed staff meet requirements appropriate to their positions including but not limited to: background checks, food handlers' permits, qualifications, and training required by DOH. SNAP-Ed Assurances: The following assurances must be followed (see program Guidance htin:,://!ffiaped . n,s.usda.no,'/nat1 o naJ-snap-ed /snau--ed -plan-!?uidance-and -!Cn,plates) • The LHJ is fiscally responsible for activities funded with Supplemental Nutrition Assistance Program Education funds and is liable for repayment ofunallowable costs. • Efforts are made to target SNAP-Ed to the SNAP-Ed target audience. Exhibit A, Statements of Work Revised as of May 15, 2019 Page 15 of20 Contract Number CLH18249-9 AMENDMENT #9 • Only expanded or additional coverage of those activities funded under the Expanded Food and Nutrition Education Program (EFNEP) may be claimed under the SNAP-Ed grant. Approved activities are those designed to expand the State's current EFNEP coverage in order to serve additional SNAP-Ed targeted individuals. In no case may activities funded under the EFNEP grant be included in the budget for SNAP-Ed. • Contracts are procured through competitive bid procedures governed by State procurement regulations. • Program activities are conducted in compliance with all applicable Federal laws, rules, and regulations including Civil Rights and 0MB regulations governing cost issues. • Program activities do not supplant existing nutrition education and obesity prevention programs, and where operating in conjunction with existing programs, enhance as well as supplement them. This applies to all activit ies and costs under the Federal budget. • Program activities are reasonable and necessary to accomplish SNAP-Ed objectives and goals. • All materials developed with SNAP-Ed funds include the appropriate USDA non-discrimination statement and credit SNAP as a funding source in standard font that is easily readable. Audits The LHJ must make State financial and program audits or reviews conducted by other entities available to the DOH, DSHS, USDA, or its designee. Monitoring Expectations The LHJ's premises and records will be made available upon request to DOH, DSHS, and USDA staff for the purposes of observing program activities and reviewing for program and fiscal compliance. All non-capital equipment and reusable educational materials should be tracked in an inventory list and available for review upon request. Curriculum Requirements Agencies are expected to communicate with, respond to, and comply with all state curriculum team requests, sites visits, approved curriculum list, training and curriculum fidelity findings. Any curriculum modifications should be developed and executed based on the most current curriculum modification guidance. Local Agencies must consult their DOH contract manager as directed. https://s3 .wp.wsu.edu/uo loads/si te s/2090no I i/0 I /Guidance-for-Curriculum-Modification-FFY2018-Modified-10 .9.17-PDF .pdf Indirect Rate/Allocation Plan All indirect rate/allocation plans must be submitted and preapproved by the DOH grants office and the DOH SNAP-Ed program. The LHJ is responsible for ensuring that indirect costs included in the LHJ's SNAP-Ed plan are supported by an indirect rate and/or cost allocation plan approved by the appropriate agency. The LHJ cannot bill indirect costs that are determined to be unacceptable and will be disallowed. Annual Civil Rights Training Requirement (see FNS Instruction Number 113-1 Chapter XI) http J/www.Fns .usda .gov/sites/defoult/filesll I 3-1.pdf "Training is required so that people involved in all levels of administration of programs that receive Federal financial assistance understand civil rights related laws, regulations, procedures, and directives. Local agencies are responsible for training their subrecipients, including 'frontline staff.' 'Frontline staff who interact with program applicants or participants, and those persons who supervise 'frontline staff must be provided civil rights training on an annual basis." Records -Record Retention and Management-State Agency and All Sub-grantees 7CFR 272.2 SNAP-Ed regulations require that all records be retained for six (6) years from fiscal closure. This requirement applies to fiscal records, program reports, and client information (pre/post surveys, demographics etc.). Supporting documentation may be kept at the sub-grantee level, but shall be available for review for six (6) years from the date of quarterly claim submittal. Any costs that cannot be substantiated by source documents will be disallowed as charges to SNAP-Ed. Travel The LHJ is expected to comply with the Ot1ice of Financial Management's Travel Management Requirement and Restrictions as found in policy 10.10. hµp://1,·w,1 .ofm . 11 a.gov/policv /10 .htm Exhibit A, Statements of Work Revised as of May 15, 2019 Page 16 of20 Contract Number CLH 18249-9 AMENDMENT #9 Amendments Agencies should check with the DOH contract manager to know what kinds of changes they can make on their own and what changes require an amendment and pre-approval in writing. Agencies must submit a written amendment request to DOH, and receive written pre-approval from DOH, prior to making/implementing any changes within their project or budget. Any requests needing FNS approval must be submitted to DOH no later than April I st of each fiscal year. If agencies are making smaller changes that do not require FNS approval, DOH can review those and make approvals on a case by case basis. All of these non FNS amendments should be submitted to DOH no later than July 16th of each fiscal year. Overtime Staff overtime is not billable in the DOH SNAP-Ed program unless it has been reviewed and preapproved by the state DOH SNAP-Ed program in advance and was approved in writing. Special Funding Requirements Payment for deliverables as specified herein is dependent on receipt of funding from the USDA funding sources. In the event funding is not received, DOH is under no obligation to make payments for the deliverables as specified . If funding is reduced or limited in any way after the effective date of this contract and prior to normal completion DOH may terminate task(s), remove funds, or reallocate funds at DOH's discretion under new funding limitations and conditions. DOH will make payments only upon the receipt of the funding. DOH will notify the LHJ within seven (7) working days upon notice by the funding source of funding availability. Special Billing Requirements 1. All invoices, billing, and reimbursements must be in compliance with all applicable Federal laws, rules, regulations including the current year SNAP-Ed Guidance and 0MB circulars governing cost issues. 2. Total costs billed will not exceed the USDA-approved budget amount listed in the box below. • Bills must be for only SNAP-Ed specific activities, using a DOH A 19-1 A Invoice Voucher. • A SNAP-Ed specific AI9-IA must be submitted to the agency's designated DOH SNAP-Ed staff member within 30 days of the last day of the month for which the work is being billed, OR • An agency may request pre-approval to bill every two (2) months instead, in which case, that agency is required to adhere to the billing due dates listed in Task 5 (see above) 3. In FFYI 9 and FFY20 the SNAP-Ed program will deny payment for any costs not submitted by the due date without prior approval. Iffor ANY reason the LHJ is unable to submit the SNAP-Ed A 19-1 A on the due date, the LHJ is required to submit a request for an exception to the DOH no later than seven (7) days prior to due date to the DOH SNAP-Ed program. The SNAP-Ed program reserves the right and responsibility to either approve or deny the request for an exception and will reply to the request. 4. Supporting documentation for each month must be submitted with each SNAP-Ed Al9-1A. • At the very least this means a copy of an agency's financial expanded/detailed general ledger level report. • Additionally, all receipts, timecards and other supporting documentation, as noted by USDA, must be available upon request. 5. If an agency meets one of the criteria below, they will need to submit all SNAP-Ed backup documentation with each bill and this requirement will continue until further notice by DOH SNAP-Ed program. • All new SNAP-Ed contractors within their I st fiscal year. • Contractors with current fiscal findings. • Contractors who have not submitted adequate or accurate backup documentation within the last year. Exhibit A, Statements of Work Revised as of May 15, 2019 Page 17 of20 Contract Number CLH 18249-9 BUDGET Source USDA DOH Program Contact Jamie Wells, SNAP-Ed Contract Manager Department of Health PO Box 47886, Olympia, WA 98504-7886 Jamie.Wells@doh.wa.gov / 360-236-3668 Exhibit A, Statements of Work Revised as of May 15, 2019 Amount ~JQ ~(H $21,032 DOH Fiscal Contact Kim Henderson, Fiscal Analyst Department of Health PO Box 47886, Olympia, WA 98504-7886 Kim.Henderson@doh.wa.gov / 360-236-3491 Page 18 of20 AMENDMENT #9 Contract Number CLH18249-9 Exhibit A Statement of Work Contract Term: 2018-2020 AMENDMENT #9 DOH Program Name or Title: Zoonotic Disease Program-WNV Mosquito Surveillance -Effective June l, 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 Period of Performance: June I, 2019 through June 30, 2020 D Federal <Select One> (check if applicable) ~ Reimbursement ~· State D FF AT A (Transparency Act) D Fixed Price D Other D Research & Development Statement of Work Purpose: The purpose of this statement of work is for Kittitas County Public Health Department to conduct weekly mosquito surveillance for West Nile virus in Kittitas County during mosquito season, June through September. The detection of the virus in mosquito populations serves as an early warning of disease risk in the localized area. It alerts the local health department to strengthen educational outreach and mosquito control to minimize the health impact of mosquito-borne disease on communities. In addition, data generated by surveillance advances our understand of the emergence and spead of vector mosquitoes and pathogens in eastern Washington. Revision Purpose: NIA Chart of Accounts Program Name or Title Zoonotics-GFS Zoonotics-GFS TOTALS Task Task/Activity/Description Number 1 Conduct weekly mosquito trapping at two (2) site locations or more in Kittitas County. • Purchase of dry ice, as needed • Set and collect traps • Record field data on DOH-provided reporting forms, including zero catch information. 2 Ship collected mosquitoes and completed data reporting forms via trackable method specified by DOH. Exhibit A, Statements of Work Revised as of May 15, 2019 CFDA# BARS Master Funding Period Current Change !Total Revenue Index (LHJ Use Only) Consideration Increase(+) K:onsideration Code Code Start Date End Date NIA 334.04.91 25411100 0610 II 19 I 06/3 0/19 0 971 971 NIA 334.04.91 25411100 01101n9 I 06130120 0 4,029 4,029 0 5,000 5,000 *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information Standards/Measures and/or Amount Submit weekly collection of Weekly by Wednesday Reimbursement up to mosquitoes along with completed during mosquito season, $5,000 (including staff corresponding data reporting forms June through September. time, transportation, for trapping events to DOH. training, and costs related to mosquito Should no mosquitoes be collected surveillance activities.) 1 during a trapping event, the data I reporting form documenting the effort is to be emailed to the DOH Program contact Page 19 of20 Contract Number CLH 18249-9 AMENDMENT #9 *For Information Only: Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how pro gram 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: hrtp :1/w.ww .p h.aboard .ora/wp -conmntlu plo:ud ~PHAB-Sm.ndards-.and-M eas.ures-V c rs ion,-1.0 .nd ( DOH Program Contact Anne Duffy, Public Health Advisor Zoonotic Disease Program Office of Environmental Public Health Sciences Division of Environmental Public Health Washington State Department of Health PO Box 47825, Olympia, WA 98504-7825 anne.duffy@doh. wa. gov Phone: 360-236-3372 / Fax: 360-236-2261 Exhibit A, Statements of Work Revised as of May 15, 2019 DOH Fiscal Contact Victoria Reyes, Management Analyst Financial Management Program Office of Financial Services Washington State Department of Health victoriaann.reyes@doh.wa.gov Phone: 360-236-3071 Page 20 of20 Contract Number CLH18249-9 EXHIBIT B-9 Kittitas County Public Health Department ALLOCATIONS Contract Number: CLH18249 Contract Term: 2018-2020 Date: May 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 Funding Period Period Accounts Chart of Account~ Pro1ram Title Identification # Amend# CFDA * Code** Start Date End Date Start Date~End Date Amount Sub Total Total FFY19 CSS IAR SNAP Ed Program Mgnt 197W AW A5Q3903 Amd9 10.561 333.10.56 I 0101/18 09130119 I 0101/18 09130119 $429 $20,174 $45,359 FFYI 9 CSS IAR SNAP Ed Program Mgnt 197W AW A5Q3903 Amd4 10.561 333 ,10 56 I 0101/18 09130/19 10101/18 09130119 $19,745 FFYl8 CSS JAR SNAP Ed Program Mgnt CF l 87WAWA5Q3903 Amd4 10 .56] 333.10.56 10/01/18 09130/19 10101118 09130119 $858 $858 FFY18 CSS JAR SNAP Ed Program Mgnt l 87WAWA5Q3903 Amd4 10 .561 333.10,56 01/01/18 09130/18 10101117 09130118 $3,000 $22,855 FFY18 CSS JAR SNAP ED Program Mgnt 187W AW A5Q3903 Amd2 10 .561 333.10 56 01/01/18 09130/18 10101/17 09130118 $11,025 FFYI 8 CSS JAR SNAP ED Program Mgnt 187W AW A5Q3903 NIA 10 .56] 333 .10 .56 01/01/18 09130118 10101/17 09130/18 $8,830 FFYI 7 CSS JAR SNAP ED Program Mgnt CF 1717WAWA5Q390 NIA 10.561 333 .10 ,56 01101/18 09130/18 10/01117 09/30118 $1,472 $1,472 FFYI 7 EPR PHEP BPI LHJ Funding NU90TP921889-0l Amd2 93 .069 333 .93 .06 01/01/18 06130118 07101/17 07102118 $565 $20,398 $20,398 FFYI 7 EPR PHEP BPI LHJ Funding NU90TP92 l 889-0 I NIA 93 .069 333.93 06 01101/18 06/30118 07/01/17 07102118 $] 9,833 FFY18 EPR PHEP BPI Supp LHJ Funding NU90TP92 l 889-0 I Amd5 93 .069 333.93 .06 07/01/18 06130/19 07/01/18 06/30119 $885 $49,134 $49,134 FFY18 EPR PHEP BPI Supp LHJ Funding NU90TP921889-01 Amd4 93 069 333 ,93 06 07101118 06130119 07/01/18 06130119 $48,249 FFY17 317 Ops 5NH231P000762-05-00 NIA 93 .268 333 .93 .26 01101/18 06/30/18 04101/17 06/30/18 $616 $616 $616 FFY17 AFIX 5NH23IP000762-05-00 NIA 93 268 333 93 ,26 01/01/18 06130/18 04101117 06130118 $2,226 $2,226 $2,226 FFYI 7 Increasing Immunization Rates NH231P000762 Amd3,4 93 268 333 93 26 07101/18 06130/19 07101118 06/30/19 $5,600 $5,600 $5,600 FFY20 VFC Ops NH231P922619 Amd9 93.268 333.93.26 07101/19 06130120 07101/19 06130120 $5,600 $5,600 $6,714 FFYI 7 VFC Ops 5NH23IP000762-05-00 NIA 93 268 333 93 26 01101/18 06130/18 04101117 06130118 $1,114 $1,114 FFYl 8 Phys Actvty & Nutrition Prog NU58DP006504 Amd 8 93.439 333 ,93.43 02119/19 09/29/19 09128118 09129119 $60,000 $60,000 $60,000 FFYl 9 MCHBG LHJ Contracts B04MC32578 Amd4 93 ,994 333 ,93 .99 10101/18 09130119 10101118 09130/19 $44,196 $44,196 $78,236 FFY18 MCHBG LHJ Contracts B04MC3!524 Amd2 93 .994 333 .93 99 01101/18 09130/18 10101117 09130118 $893 $34,040 FFY18 MCHBG LHJ Contracts B04MC31524 NIA 93 ,994 333 93 99 01/01/18 09130118 10101117 09130118 $33,147 GFS -Group B (FO-E) NIA NIA 334,04 90 01/01/18 06130/18 07101/17 06130/19 $5,000 $5,000 $5,000 FY2 Group B Programs for DW (FO-E) Amd3 NIA 334.04.90 07101/18 06130119 07101/17 06130119 $10,000 $10,000 $10,000 Zoonotics-GFS Amd9 NIA 334.04.91 07101/19 06130120 07101119 06130121 $4,029 $4,029 $5,000 Zoonotics-GFS Amd9 NIA 334.04.91 06/01/19 06130/19 07101/17 06130119 $971 $971 SFY2 Lead Environments of Children Amd8 NIA 334.04 .93 07/01118 06130/19 07101/18 06130119 ($1,500) $0 $2,000 SFY2 Lead Environments of Children Amd4 NIA 334 04.93 07101/18 06/30/19 07101/18 06130119 $1,500 SFYI Lead Environments of Children Amdl NIA 334 04.93 01 /0 I /18 06/30/18 07101117 06130118 $2,000 $2,000 Page I of2 EXHIBIT B-9 Kittitas County Public Health Department ALLOCATIONS Contract Number: CLH18249 Contract Term: 2018-2020 Date: May 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 Funding Period Period Accounts Chart of Accounts Pro.s.ram Title Identification # Amend# CFDA * Code** Start Date End Date Start Date End Date Amount Sub Total Total FPHS Funding for LHJs Dir Amd3 NIA 336 .04.25 07101/18 06130119 07101117 06130119 $42,000 $42,000 $42,000 YR 20 SRF -Local Asst (I 5%) (FS) SS Amd3 NIA 346 26 .64 01101/18 12131/18 07101/15 12131/18 ($2,400) $0 $0 YR 20 SRF -Local Asst (I 5%) (FS) SS NIA,Amd3 NIA 346 26 .64 01/01/18 12131/18 07101115 12131/18 $2,400 YR 21 SRF -Local Asst (15%) (FS) SS Amd9 NIA 346.26.64 01/01118 1213 Ill 9 07101/17 12131119 $400 $5,600 $5,600 YR 21 SRF -Local Asst (I 5%) (FS) SS Amd7 NIA 346 26 .64 01101/18 12131119 07101117 12/31/19 $2,800 YR 21 SRF-Local Asst (15%) (FS) SS Amd3, 7 NIA 346.26.64 01101118 12131/19 07101/17 12131/19 $2,400 Sanitary Survey Fees (FO-E) SS-State Amd9 NIA 346.26.65 01/01/18 12131/19 07/01/17 12/31/19 $400 $5,600 $5,600 Sanitary Survey Fees (FO-E) SS-State Amd7 NIA 346 .26 .65 01101/18 12131/19 07/01/17 12/31119 $2,800 Sanitary Survey Fees (FO-E) SS-State NIA,Amd 3, 7 NIA 346 26 ,65 01101/18 12131/19 07101/17 12131/19 $2,400 YR 20 SRF-Local Asst (15%) (FS) TA Amd3 NIA 346 26 66 01/01/18 12131/18 07/01115 12131/18 ($2,000) $0 $0 YR 20 SRF-Local Asst (15%) (FS) TA NIA,Amd3 NIA 346.26 ,66 01/01/18 12/31/18 07101/15 12/31118 $2,000 YR 21 SRF-Local Asst (15%) (FS) TA Amd7 NIA 346 26 66 01/01118 12131119 07101/17 12/31/19 $2,000 $4,000 $4,000 YR 21 SRF-Local Asst (15%) (FS) TA Amd 3, 7 NIA 346.26 66 01101/18 12131119 07101/17 12131119 $2,000 TOTAL $347,483 $347,483 Total consideration: $335,654 GRAND TOTAL $347,483 $11,829 GRAND TOTAL $347,483 Total Fed $268,283 Total State $79,200 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333" State revenue codes begin with "334" Page 2 of2 Exhibit C-8 Schedule of Federal Awards AMENDMENT #9 Date: May 15, 2019 KITTITAS COUNTY HEAL TH DEPT-SWV0010475-07 CONTRACT CLH18249-Kitlitas County Public Health Department CONTRACT PERIOD: 01/01/2018-12131/2020 DOH Total Amt Allocation Period Chart of Accounts Program Title BARS Federal Federal Start End Contract Amt CFDA CFDA Program Titie Federal Agency Name Federal Award Federal Grant Award Name Award Date Award Date Date Identification Number Stale Administrative Matching Department of Agriculture Food and FFY19 CSS IAR SNAP-ED PROG MGNT 333.10 56 09/28118 $5,386,268 10101118 09/30119 $20,174 10,561 Grants for the Supplemental 197WAWASQ3903 SNAP 2YR NUTRITION ED OBESITY Nutrition Assistance Program Nutrition Service - Stale Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY18 CSS IAR SNAP-ED PROGRAM MGNT CF 33310 56 09128/17 $5,300,000 10101118 09130119 $858 10561 Grants for the Supplemental 187WAWA5Q3903 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program Nutrition Service (SNAP-ED) --- Slate Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY18 CSS IAR SNAP-ED PROGRAM MGNT 333,1056 09/28/17 $5,300,000 01/01 /18 09/3 0/18 S22,855 10,561 Grants for the Supplemental 187WAWASQ3903 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program Nutrition Service (SNAP-ED) Stale Administrative Matching Department of Agriculture Food and 2018 SUPPLEMENTAL NUTRITION FFY17 CSS IAR SNAP-ED PROGRAM MGNT CF 333 10 56 09110/16 $5,739,856 01/01/18 09/30118 $1,472 10 561 Grants for the Supplemental Nulri1ion Service 1717WAWASQ390 ASSISTANCE PROGRAM EDUCATION Nutrition Assistance Program (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 07101/18 06130/19 $49,134 93.069 Preparedness Services Centers for Disease Control NU90TP921889-01 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 Services Centers for Disease Control NIJ90TI>9\Zll!8!1-0I Preparedness and Prevention AGREEMENT Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY20 VFC OPS 333.93,26 07/01/19 $9,234 ,835 07/01/19 06/30/20 SS ,600 93,268 Agreements Services Centers for Disease Control NHZ311'!12261 9 VACCINES FOR CHILDREN PROGRAM and Prevention - Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY17 VFC OPS 333 93 26 03103/17 $1,201,605 01/01118 06130/18 $1,114 93 268 Services Centers for Disease Control SNH231P000762-0S--OO 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 06130/19 $5,600 93,268 Services Centers for Disease Control NH231P000762 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM lrnnunization Cooperative Departmenl of Health and Human IMMUNIZATION GRANT AND FFY17 AFIX 333 93 26 03103117 $1,672,289 01/01/18 06130/18 $2,226 93 268 Services Centers for Disease Control SNH231P000762-0S--00 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM --- Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND FFY17 317 OPS 333 93 26 03103117 $575,969 01/01/18 06/30/18 $616 93-268 Services Centers for Disease Control 5NH231P000762-0S-O0 VACCINES FOR CHILDREN'S Agreements and Prevention PROGRAM FFY18 PHYS ACTVTY & NUTRITION PROG 333 93 43 09/01/18 $923,000 02/19/19 09/29/19 $60,000 93 439 Slate Physical Activity and Department of Health and Human NU58DP006504 STATE PHYSICAL ACTIVITY AND Nu1ritioo (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 11114/18 $2,225,977 10101/18 09/30/19 $44,196 93 994 Services Block Granl to the Services Health Resources and B04MC32578 SERVICES BLOCK GRANT States Services Administration -- Maternal and Child Health Department or Heallh and Human MATERNAL AND CHILD HEAL TH FFY18 MCHBG LHJ CONTRACTS 333.93 99 10/20/17 $1,650,528 01/01/18 09130/18 $34,040 93 994 Services Block Grant to the Services HeaHh Resources and B04MC31524 SERVICES States Services Administration TOTAL $268,283 Page 1 of 1 Kittitas County Review Form Grants & Contract Agreement Today's Date Agenda Date b/v/1c1 07/17/2019 Fund/Department ' 116-Public Health Contract/Grant Information Contract /Grant Agency: Consolidated Contract Amendment 9 Period Begin Date: 01/01/2018 l I Period End Date: 12/31/2020 Total Grant/Contract Amount: Increase of $11,829.00 for a revised maximum consideration of $347,483.00 Grant/Contract Number: CLH18249 Contract/Grant Summary: The Consolidated Contract Amendment 9 amends the following: Adds Statements of Work for the following-programs • OICP-Promotion of Immunizations to Improve Vaccination Rates: Effective July 1, 2019 • Zoonotic Disease Program-WNV Mosquito Surveillance-Effective June 1, 2019 Amends Statements of Work for the following: • Office of Drinking Water Group A Program-Effective January 1, 2018 • Supplemental Nutrition Assistance Program-Education: Effective October 1, 2018 Exhibit B-8 Allocations amends and replaces Exhibit B-7 allocations as follows: • Increase of $11,829.00 for a revised maximum consideration of $347,483.00 Recommendation for Board of Health and Board of Health Review on Date: t;t/¢1 Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: APPROV TO FORM : Date Signature of Board of Health member Date Grant/Contract Review Page 1 Financial Information Total Amount$ 11,829 State Funds $5,800 Federal Funds $ 6,029 Percentage County Funds Matching Funds$ CFDA# 10.561 & 93.268 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? YesO attach budget form No D Why not New Division Created? Revenue Code 116.612.94.333.10.56 $ 429 Snap-Ed 116.612.32.3.333.93.268 $5,600 VFC Ops I 116.615.05.334.04.91 $ 971 Zoonotics-GFS (June 2019) 116.615.05.334.04.91 $4,029 Zoonotics-G FS 07 /01/19-06/30/21 116.615.2.2.346.26.64 $ 400 Group A Water {FS) SS Federal 116.615.2.2.346.26.65 $ 400 Group A Water SS State 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 Yes D No D County Departments Impacted Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted I Signature : Department: I Date: Assignment of Tracking Information I Auditor's Office I Grant/Contract Review Page 2 Human Resource Prosecutor's Office Who Signed the grant application I Reviewer ] Date Grant/Contract Review Page 3