HomeMy WebLinkAboutConCon Amendment 19KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
2018 – 2021 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH18249 AMENDMENT NUMBER: 19
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
“DOH”, and KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT, a Local Health Jurisdiction, 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:
Amends Statements of Work for the following programs:
• COVID-19 Coordinated Response - Effective July 1, 2020
• Division of Emergency Preparedness & Response COVID-19 - Effective January 20, 2020
• Office of Drinking Water Group A Program - Effective January 1, 2018
Deletes Statements of Work for the following programs:
2. Exhibit B-19 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-18 Allocations
as follows:
Increase of $1,134,441 for a revised maximum consideration of $3,569,426.
Decrease of for a revised maximum consideration of .
No change in the maximum consideration of .
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C-16 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces
Exhibit C-15.
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 STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Date Date
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 30
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 2 of 30 Contract Number CLH18249-19
2018-2021 CONSOLIDATED CONTRACT
EXHIBIT A
STATEMENTS OF WORK
TABLE OF CONTENTS
DOH Program Name or Title: COVID-19 Coordinated Response - Effective July 1, 2020 ............................................................................................................... 3
DOH Program Name or Title: Division of Emergency Preparedness & Response-COVID-19 - Effective January 20, 2020 ......................................................... 16
DOH Program Name or Title: Office of Drinking Water Group A Program - Effective January 1, 2018 ........................................................................................ 26
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 3 of 30 Contract Number CLH18249-19
Exhibit A
Statement of Work
Contract Term: 2018-2021
DOH Program Name or Title: COVID-19 Coordinated Response -
Effective July 1, 2020
Local Health Jurisdiction Name: Kittitas County Public Health Department
Contract Number: CLH18249
SOW Type: Revision Revision # (for this SOW) 2 Funding Source
Federal Subrecipient
State Other
Federal *Contractor
Federal Compliance
(check if applicable)
FFATA (Transparency Act)
Research & Development
Type of Payment
Reimbursement
Fixed Price
Period of Performance: July 1, 2020 through December 31, 2021
Statement of Work Purpose: The purpose of this statement of work is to provide supplemental funding for the LHJ to ensure adequate culturally and lingui stically responsive
testing, investigation and contact tracing resources to limit the spread of COVID -19
NOTE: Pending execution of a new consolidated contract term or an extension to the 2018-2021 consolidated contracts which currently end December 31, 2021, DOH plans to
continue the task activities and funding as noted in the task(s) below in a new or revised statement of work effec tive January 1, 2022.
Revision Purpose: The purpose of this revision is to extend the period of performance from June 30, 2021 to December 31, 2021; add funding and extend end date for Task 3
FFY21 COVID19 VACCINE SERVICES-CARES through December 31, 2021; add FFY20 ELC EDE LHJ ALLOCATION and FFY19 ELC COVID ED LHJ ALLOCATION
funding and revise language for Tasks 1 and 2; add Task 4 and funding information for MASS VACCINATION FEMA 100% and add Prog ram Specific Requirements and DOH
program and fiscal contact information.
Chart of Accounts Program Name or Title CFDA # BARS
Revenue
Code
Master
Index
Code
Funding
(LHJ Use
Start Date
Period
Only)
End Date
Current
Consideration
Change
Increase (+)
Total
Consideration
BITV-COVID ED LHJ ALLOCATION-CARES 21.019 333.21.01 1897129V 07/01/20 12/30/21 252,036 0 252,036
FEMA-75 COVID LHJ ALLOCATION 97.036 333.97.03 1897129W 07/01/20 12/30/20 0 0 0
FFY21 COVID19 VACCINE SERVICES-CARES 93.268 333.96.26 74310209 07/01/20 12/31/21 14,582 354,803 369,385
FFY20 ELC EDE LHJ ALLOCATION 93.323 333.93.32 1897120D 01/15/21 12/31/21 0 530,161 530,161
FFY19 ELC COVID ED LHJ ALLOCATION 93.323 333.93.32 1897129G 01/01/21 12/31/21 0 237,077 237,077
*MASS VACCINATION FEMA 100% 97.036 33.97.03 934V0200 01/21/21 04/20/21 0 0 0
TOTALS 266,618 1,122,041 1,388,659
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
Participate in public health emergency preparedness and response activities for COVID -19. This may include surveillance, epidemiology, laboratory capacity, infection control,
mitigation, communications and or other preparedness and response activities for COVID-19.
Examples of key activities include:
• Incident management for the response
• Testing
• Case Investigation/Contact Tracing
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 4 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
• Sustainable isolation and quarantine
• Care coordination
• Surge management
• Data reporting
Previous funding provided by DOH for COVID response (federal Crisis Cooperative Agreement funding, state Disaster Recovery Ac count funding) must be fully utilized before
these funds can be accessed. The total state funding consideration is for the period o f December 31, 2020 through June 30, 2021.
NOTE: The purpose of this agreement is to supplement existing funds for local health jurisdictions to carry out surveillance, epidemiology, case investigations & contact tracing,
laboratory capacity, infection co ntrol, mitigation, communications, community engagement, and other public health preparedness and response activities for COV ID-19.
DCHS COVID-19 Response - Tasks 1 and 2
1 Establish a budget plan and narrative to be submitted to the
Department of Health (DOH) Contract Manager. DOH will
send the “Budget narrative Template”, “Budget Guidance”
and any other applicable documents that may be identified.
DOH does recognize the public health response goes
beyond December 2020 2021 and authorizes local health
jurisdictions the ability to maximize funding streams
available to them by using short term funding first to
have longer term funding available to continue to
support the local health jurisdiction response activities
beyond December 2020 2021 as applicable.
Submit the budget plan
and narrative using the
template provided.
Within 30 days of
receiving any new
award for DCHS
COVID-19 Response
tasks.
Reimbursement of
actual costs
incurred, not to
exceed $1,019,274
total.
$252,036 BITV-
COVID ED LHJ
ALLOCATION-
CARES Funding
(MI 1897129V)
$530,161 FFY20
ELC EDE LHJ
ALLOCATION
Funding
(MI 1897120D)
$237,077 FFY19
ELC COVID ED
LHJ ALLOCATION
Funding
(MI 1897129G)
2 1) LHJ Active monitoring activities. In partnership with
WA DOH and neighboring Tribes, the LHJ must ensure
adequate culturally and linguistically responsive testing,
investigation and contact tracing resources to limit the
spread disease. LHJs must conduct the following
activities in accordance with the guidance to be provided
by DOH.
a. Allocate enough funding to ensure the following
Contact Tracing and Case Investigation Support:
Hire a minimum of 1.0 data entry FTE to assure
system requirements for task 2.1.a.
i. Contact tracing
1. Strive to maintain the capacity to surge a
minimum of five (5) contact tracers for
every 100,000 people in the jurisdiction, as
needed, based on disease rates. DOH
Data collected and
reported into DOH
systems daily.
Enter all contact tracing
data in CREST following
guidance from DOH.
Enter performance
metrics daily into DOH
identified systems
Quarterly performance
reporting updates
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 5 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
centralized investigations will count
towards this minimum.
2. Have staff that reflect the demographic
makeup of the jurisdiction and who can
provide culturally and linguistically
competent and responsive services. In
addition, or alternatively, enter into an
agreement(s) with Tribal, community-
based and/or culturally-specific
organizations to provide such services.
DOH centralized investigations will count
towards this minimum.
3. Ensure all contact tracing staff are trained
in accordance with DOH investigative
guidelines and data entry protocols.
4. Coordinate with Tribal partners in
conducting contact tracing for Tribal
members.
5. Follow up with 90% of contacts within two
(2) days of positive lab reporting. This can
be modified and adapted based on
caseloads and current case investigation
and contact tracing prioritization
recommendations.
6. Ensure contact tracing and case
investigations activities meet DOH case
and Contact Tracing Metrics. (Metrics to
be determined collaboratively by DOH,
LHJs and Tribes.) Work with DOH to
develop a corrective action plan if unable
to meet metrics. Strive to achieve DOH
Case and Contact Tracing Metrics.
(https://www.doh.wa.gov/Portals/1/Documents
/1600/coronavirus/data-tables/COVID19-
CaseInvestigationContractTracingReport.pdf)
7. Perform daily monitoring for symptoms
during quarantine period of contacts
ii. Case investigation
1. Strive to maintain the capacity to surge a
minimum of five (5) case investigators and
contact tracers for every 100,000 people in
Enter all case
investigation data in
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 6 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
the jurisdiction, as needed, based on
disease rates. DOH centralized
investigation will count toward this
minimum.
2. Enter all case investigation and outbreak
data in WDRS following DOH guidance.
a) Strive to enter all case investigation
and outbreak data into CREST as
directed by DOH.
b) Ensure all staff designated to utilize
WDRS have access and are trained in
the system.
c) Include if new positive cases are tied
to a known existing positive case or
indicate community spread.
d) Conduct case investigation and
monitor outbreaks.
e) Coordinate with Tribal partners in
conducting case investigations for
tribal members.
Strive to achieve DOH Case and
Contact Tracing Metrics.
(https://www.doh.wa.gov/Portals/1/Documents/
1600/coronavirus/data-tables/COVID19-
CaseInvestigationContractTracingReport.pdf)
3. Ensure contact tracing and case
investigation activities meet DOH Case
and Contact Tracing Metrics. (Metrics to
be determined collaboratively by DOH,
LHJs, and Tribes.) Work with DOH to
develop a corrective action plan if unable
to meet metrics.
b. Testing
i. Work with partners and Tribes to ensure
testing is available to every person within the
jurisdiction meeting current DOH criteria for
testing and other local testing needs.
ii. Work with partners and Tribes to ensure
testing is provided in a culturally and
linguistically responsive manner with an
emphasis on making testing available to
disproportionately impacted communities and
WDRS following
guidance from DOH.
Maintain a current list of
entities providing
COVID-19 testing and at
what volume. Provide
reports to DOH Contract
manager on testing
locations and volume as
requested.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 7 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
as a part of the jurisdiction’s contact tracing
strategy.
iii. Maintain a current list of entities providing
COVID-19 testing and at what volume.
Provide reports to DOH on testing locations
and volume as requested.
c. Surveillance FTE support at a minimum of .5 FTE
Epidemiologist to support daily reporting needs
below.
i. Ensure all COVID positive lab test results from
LHJ are entered in to WDRS by 1) entering data
directly in to WDRS, 2) sending test results to
DOH to enter, or 3) working with DOH and
entities conducting tests to implement an
electronic method for test result submission.
ii. Maintain records of all COVID negative lab test
results from the LHJ and enter into WDRS when
resources permit or send test results to DOH.
iii. Collaborate with Tribes to ensure Tribal entities
with appropriate public health authority have
read/write access to WDRS and CREST to
ensure that all COVID lab results from their
jurisdictions are entered in WDRS or shared
with the LHJ or DOH for entry.
d. Tribal Support. Ensure alignment of contact tracing
and support for patients and family by coordinating
with local tribes if a patient identified as American
Indian/Alaska Native and/or a member of a WA
tribe, if patient providers permission to notify tribes.
e. Support Infection Prevention and control for high-
risk populations
i. Migrant and seasonal farmworker support.
Partner with farmers, agriculture sector and
farmworker service organizations to develop
and execute plans for testing, quarantine and
isolation, and social service needs for migrant
and seasonal farmworkers.
ii. Congregate care facilities: In collaboration
with the state licensing agency (DSHS),
Quarterly performance
updates related to
culturally and linguistic
competency and
responsiveness, tribal
support, infection
prevention and control for
high-risk populations,
community education and
regional active monitoring
activities. Performance
update should include
status of all projects
listed.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 8 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
support infection prevention assessments,
testing. Infection control and isolation and
quarantine protocols in congregate care
facilities.
iii. High risk businesses or community-based
operations. In collaboration with state
licensing agencies and Labor and Industries,
partner with food processing and
manufacturing businesses to ensure adequate
practices to prevent COVID-19 exposure,
conduct testing and respond to outbreaks.
iv. Healthcare: Support infection prevention and
control assessments, testing, cohorting, and
isolation procedures. Provide educational
resources to a variety of healthcare setting
types (e.g., nursing homes, hospitals, dental,
dialysis).
v. Non-healthcare settings that house vulnerable
populations: In collaboration with state
corrections agency (DOC) and other state
partners, support testing, infection control,
isolation and quarantine and social services
and wraparound supports for individuals living
or temporarily residing in congregate living
settings, including detention centers, prisons,
jails, transition housing, homeless shelters,
and other vulnerable populations.
vi. Schools: In collaboration with OSPI and local
health jurisdictions, support infection
prevention and control and outbreak response
in K-12 and university school settings.
f. Ensure adequate resources are directed towards
H2A housing facilities within communities, fishing
industries and long-term care facilities to prevent
and control disease transmission. Funds can be
used to hire support staff, provide incentives or
facility-based funding for onsite infection
prevention efforts, etc.
g. Community education. Work with Tribes and
partners to provide culturally and linguistically
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 9 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
responsive community outreach and education
related to COVID-19.
h. Establish sustainable isolation and quarantine
measures.
i. Have at least one (1) location identified and
confirmed through contract/formal agreement
that can support isolation and quarantine
adequate to the population for your jurisdiction
with the ability to expand; alternatively,
establish with an adjacent jurisdiction a formal
agreement to provide the isolation and
quarantine capacity adequate to the population
for your jurisdiction with the ability to expand.
ii. Conduct at least one (1) exercise per year with
the identified isolation and quarantine site to
include a minimum of: confirmation of wrap
around services (food service/delivery, laundry
service, water/septic, garbage, ambulance
service, cleaning/sanitation), facility intake and
discharge procedures, transport procedures,
and staffing.
iii. Planning must incorporate transfer or receipt of
isolation and quarantine patients to from
adjacent jurisdictions or state facilities in the
event of localized increased need.
iv. Planning must incorporate triggers and
coordination to request state isolation and
quarantine support either through mobile teams
or the state facility to include site identification
and access
Quarterly performance
updates to include name,
address and capacity of
identified location that
can support isolation and
quarantine, date of
exercise to be conducted
and confirmation of
appropriate planning and
coordination as required.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 10 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
COVID-19 Vaccine Services - Task 3 – will be extended through June 30, 2022 in new contract term effective January 1, 2022. Any unspent funds may be carried forwa rd.
3.A Identify activity/activities to support COVID vaccine
response in your community, using the examples below as a
guideline.
Example 1: Develop and implement communication
strategies with health care providers, community, and/or
other partners to help build vaccine confidence broadly and
among groups anticipated to receive early vaccination, as
well as dispel vaccine misinformation. Document and
provide a plan that shows the communication strategies used
with health care providers and other partners and the locally
identified population anticipated to reach.
Example 2: Engage in other vaccination planning activities
such as partnership development, provider education,
vaccination point of dispensing (POD) planning, tabletop
exercises, engagement with communities, leaders, non-
traditional provider, or vulnerable populations to develop
strategies to ensure equitable access to vaccination services
Summary of the
engagement strategies to
be used with health care
providers and other
partners, and the locally
identified population to be
reached.
January 31, 2021
Annually
Reimbursement of
actual costs
incurred, not to
exceed:
$14,582 $369,385
FFY21 COVID19
VACCINE
SERVICES-CARES
Funding
(MI 74310209)
3.B Implement the communication strategies or other activities,
working with health care providers and other partners to
reach the locally identified population, support providers in
vaccination plans, and support equitable access to
vaccination services.
Mid-term written report
describing
activity/activities and
progress made to-date and
strategies used (template
to be provided)
March 31, 2021
Annually
3.C Catalog activities and conduct an evaluation of the strategies
used
Final written report,
showing the strategies
used and the final
progress of the reach
(template to be provided)
June 30, 2021 Annually
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 11 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
Regional Incident Management Team (IMT) Mass Vaccination Clinics – Task 4
*NOTE: Task 4 activities for Mass Vaccination Clinics in
this statement of work are NOT CONSIDERED
SUBRECIPIENT but are as a CONTRACTOR of DOH.
*Reimbursement of
eligible costs.
DOH reimbursement provided for local mass vaccination
clinic (see definition below) planning, implementation and
operations in coordination between Unified Command and
the Regional IMT to administer the vaccine as efficiently,
quickly, equitably, and safely in all regions of Washington
State. State Supported, Regionally Coordinated, Locally
Implemented.
Definition: Mass vaccination clinics defined as those
outside of the usual healthcare delivery. method such as
pop-up clinics, mobile clinics, non- clinical facility
(fairgrounds, arenas, etc.).
MASS
VACCINATION
FEMA 100%
Funding
(MI 934V0200)
(See Program
Specific
Requirements for
Mass Vaccination
Task 4 below)
Leaders Intent about this work from DOH is included as an
attachment.
Guidance on vaccination protocols must be followed as
provided by DOH and CDC.
4.A Local health jurisdiction (LHJ) will coordinate planning
and implementation of mass vaccination clinics/sites
provided within the county(s) with a regional incident
management team/organization as approved by DOH.
Submit to DOH a mass
vaccination plan
including:
• type of site,
• site locations,
• throughput,
• considerations
made to ensure
equity to
historically
marginalized
populations,
• and to the extent
possible a
regional map of
sites/locations.
Within 30 days of
contract amendment
execution.
Request for regional IMT should be submitted through the
normal process through WebEOC.
Local health jurisdiction is the coordinating agency for the
mass vaccination plan within the county.
Regional IMT will be under the delegation authority of
DOH and they are to provide support and coordination for
all efforts around vaccine planning, resource support and
general guidance and information sharing in order to
regionally coordinate efforts. Local jurisdictions will
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 12 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
maintain all decisional authority around vaccination
planning and execution within their jurisdiction/district.
Provide any information as requested by the regional IMT.
4.B Funding for eligible Mass Vaccination activities are
reimbursed on actual costs as outlined in the DOH guidance
to provide the services and to carry out the mission.
Funding will be dependent on full participation in the LHJ
and IMT processes and all documentation will be required
to be provided to fully close out funding requests by the end
of the mission period of performance.
Submit estimated budget
for the mass vaccination
plan.
Monthly Cost Summary
Spreadsheet to the
IMT/IMO by the fifth of
the following month.
Within 30 days of
contract amendment
execution.
Monthly
Allowable costs include expenses such as facility rentals,
staff to conduct planning, management, support and
operation of the site, medical personnel for vaccinations,
site security personnel, wrap around services for staff
(meals, travel, lodging), equipment (which must be pre-
approved by IMT/DOH if it exceeds $5,000 each), supplies
for vaccinations and site operation. LHJs should provide
narratives to help assist IMT and DOH finance know what
expenditures were necessary to carry out the mission.
4.C Vaccination data – will be maintained according to current
state and federal requirements.
Submission of vaccine use
into WA IIS database
within 24hrs of use.
Daily
Vaccine Registration Systems – If a local jurisdiction or
region does not have a registration system(s) the include
internet based, phone option and other methods to ensure
equitable registration, the state PrepMod system and tools
will be available for use.
Jurisdiction/Regions will
ensure a fair and
equitable process for
registration of eligible
Washingtonians across all
available modalities.
4.D Regularly report on vaccinations sites and operational
activities (number of vaccinations, personnel to operate the
site, challenges, successes to share for learning across the
public health system).
Provide monthly situation
report to IMT/IMO on
status of implementation
of mass vaccination plan,
or more frequently if that
is the LHJ procedure.
Sites operating for the
time period, vaccines
administered by site for
the time period, estimated
Monthly
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 13 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes
Due Date/Time Frame
Payment
Information and/or
Amount
costs for the time period,
any challenges/successes
of note, including
assistance requested.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how prog ram 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://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
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 Tran sparency 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 Univers al 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.
Program Specific Requirements/Narrative
DCHS COVID-19 Response - Tasks 1 and 2
Restrictions on Funds: Indirects are NOT allowable for CARES funding from September 2, 2020 forward – LHJ can charge administrative activities as direct costs but not
incur indirects from September 2, 2020 through December 30, 2020 for activities funded with CARES funds (COVID LOCAL CARES - COVID LHJ OFM
ALLOCATION-CARES, BITV-COVID ED LHJ ALLOCATION-CARES, FEMA-75 COVID LHJ ALLOCATION)
o Since the federal guidance was not updated until September 2, 2020, DOH understands th at indirects could be charged from March–August, 2020.
Payment: Upon approval of deliverables and receipt of an invoice voucher, DOH will reimburse for actual allowable costs incurred. Bill ings for services on a monthly fraction of
the budget will not be accepted or approved.
Submission of Invoice Vouchers: The LHJ shall submit correct monthly A19-1A invoice vouchers for amounts billable under this statement of work to DOH by the 25 th of the
following month or on a frequency no less often than quarterly.
Mass Vaccination – Task 4
Program Manual, Handbook, Policy References
Emergency Response Plan (or equivalent)
Medical Countermeasure/Mass Vaccination Plan
Restrictions on Funds (what funds can be used for which activities, not direct payments, etc.):
Non-mass vaccination efforts are not allowable through this funding stream.
Duplication of billing (sending request for reimbursement) to entities outside of this agreement is prohibited.
Indirect rates are not applicable to these funds.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 14 of 30 Contract Number CLH18249-19
Special References (RCWs, WACs, etc.)
County Health Emergency Documentation if applicable
Monitoring Visits (frequency, type):
Occasional visits from DOH or IMT/IMO personnel for the purpose of monitoring and surveillance of mass vaccination activities may be expected.
Definitions
Mass vaccination clinic are those outside of the usual healthcare delivery methods such as pop -up clinics, mobile clinics, non-clinical facility clinics (i.e., fairgrounds, arenas,
etc.).
Special Billing Requirements:
Monthly invoices must be submitted timely to the regional IMT/Organization for review/approval prior to submission to DOH for reimbursement.
Contract (MI) Code: 934V0200 General Mass Vaccination
BARS Revenue Code: 333.97.03 Mass Vaccination Reimbursement
Special Instructions:
The LHJ is considered a CONTRACTOR of DOH not a subrecipient for this portion of the statement of work. An allocation of fund s is not provided as these FEMA funds are only
available as reimbursement of costs associated with implementation of the mass vaccination plan.
Detailed documentation must be maintained as directed by the regional IMT/Organization and DOH to substantiate costs associat ed with these activities for submission to FEMA
upon request by DOH.
Eligible costs from the timeframe of January 21, 2021 through April 20, 2021 include facility rentals, medical and support staff for planning, managem ent, support, and
operations; as well as wrap-around services for staff (i.e., meals, travel, lodging). Regular and overtime pay as sociated with this project is allowable for all staff working under
this project and must be billed as a direct charge; timesheets are required documentation and must be available upon request by DOH. Indirect rates are not applicable to these
funds. Eligible equipment includes facility infection control measures, personal protective equipment (PPE), storage equipment, coolers, freezers, temperature monitoring devices,
portable vaccine units for transportation, supplies such as emergency medical supplies (for emergency medical care needs that may arise in the administration of the vaccine),
containers for medical waste, as well as proper storage as needed for canisters of liquid nitrogen or dry ice. Eligible equip ment purchase costs should not exceed $5,000 per piece.
Equipment over $5,000 a piece must be preapproved by the IMT and should be leased rather than purchased. Any diversion from t he list of pre-approved expenses will require a
narrative on the purchase rationale and will be subject to IMT approval prior to reimbursement. Timesheets are required documentation for all activities related to this project.
Staff time-in / time-out must be recorded, as well as a brief description of their activities. A general description of activities is acceptable f or those working at the vaccine site;
more detailed/specific description is required for those not working at the vaccine site.
DOH Program Contact
Kasey Walker Alyssa Lavin, LHJ Contract Manager
DOH, PHOCIS
1610 NE 150th St, Shoreline, WA 98155
kasey.walker@doh.wa.gov alyssa.lavin@doh.wa.gov / 360-236-3273
DOH BITV-COVID ED LHJ Allocation-CARES Fiscal Contact (Tasks 1 and 2)
Sheri Spezze
DOH, Office of Program Financial Management
PO Box 47840, Olympia, WA 98504-7841
Ph: 360-236-4447 / Fax: 360-664-2216 / sheri.spezze@doh.wa.gov
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 15 of 30 Contract Number CLH18249-19
DOH ELC Allocation Fiscal Contact (Tasks 1 and 2)
Christie Durkin
DOH, Office of Program Financial Management
PO Box 47840, Olympia, WA 98504-7841
Ph: 360-236-4235 / christie.durkin@doh.wa.gov
DOH COVID19 Vaccine Services Program Contacts (Task 3)
Tawney Harper, MPA Misty Ellis, Project Manager Sonja Morris, Program Manager
Deputy Director | Operations Manager CDC Public Health Advisor Enhanced Influenza and COVID-19 Response
Office of Immunization and Child Profile Office of Immunization and Child Profile Office of Immunization and Child Profile
Department of Health Department of Health Department of Health
PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia, WA 98504-7843
tawney.harper@doh.wa.gov / 360-236-3525 misty.ellis@doh.wa.gov / 360-236-3675 sonja.morris@doh.wa.gov / 360-236-3545
DOH General Mass Vaccination Program and Fiscal Contact (Task 4)
Patrick Plumb Janice Baumgardt
COVID FEMA Project Management Analyst Financial Operations Manager
Washington State Department of Health Washington State Department of Health
Office of Financial Services Office of Financial Services
111 Israel Road SE, Tumwater, WA 98501 111 Israel Road SE, Tumwater, WA 98501
patrick.plumb@doh.wa.gov / (360) 236-4291 janice.baumgardt@doh.wa.gov / (360) 236-4505
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 16 of 30 Contract Number CLH18249-19
Exhibit A
Statement of Work
Contract Term: 2018-2021
DOH Program Name or Title: Division of Emergency Preparedness & Response-
COVID-19 - Effective January 20, 2020
Local Health Jurisdiction Name: Kittitas County Public Health Department
Contract Number: CLH18249
SOW Type: Revision Revision # (for this SOW) 2 Funding Source
Federal Subrecipient
State
Other
Federal Compliance
(check if applicable)
FFATA (Transparency Act)
Research & Development
Type of Payment
Reimbursement
One-Time
Distribution
Period of Performance: January 20, 2020 through December 31, 2021
Statement of Work Purpose: The purpose of this statement of work is to establish funding and tasks for LHJs to prevent, prepare for, and respond to the COVID-19 disease
outbreak.
Revision Purpose: The purpose of this revision is to extend the period of performance from June 30, 2021 to December 31, 2021, extend the fundi ng period for federal
COVID-19 funds, and add report deliverables and due dates. The funding period end date for the state Disaster Response funds remains June 30, 2021.
NOTE: Pending execution of a new contract or an extension to the 2018 -2021 consolidated contracts which currently end December 31, 2021, program plans to extend the period
of performance and funding in this statement of work through March 15, 2022. Deliverable due dates after December 31, 2021 are referenced for informational purposes only and
will be updated in a new or revised statement of work effective January 1, 2022.
Chart of Accounts Program Name or Title CFDA # BARS
Revenue
Code
Master
Index
Code
Funding
(LHJ Use
Start Date
Period
Only)
End Date
Current
Consideration
Change
None
Total
Consideration
FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe 93.354 333.93.35 31104102 01/20/20 12/31/21 78,522 0 78,522
FY20/21 COVID-19 Disaster Response N/A 334.04.92 934A0101 01/20/20 06/30/21 71,478 0 71,478
TOTALS 150,000 0 150,000
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes Due Date/Time
Frame
Payment Information
and/or Amount
1 Federal Funds
Participate in public health emergency preparedness
and response activities for COVID-19. This may
include surveillance, epidemiology, laboratory
capacity, infection control, mitigation,
communications, and or other preparedness and
response activities for COVID-19.
Activities must address one or more of the following
six domains:
Activity report(s) on template
to be provided DOH.
June 30, 2020
December 31, 2020
March 15, 2021
June 30, 2021
December 31, 2021
March 15, 2022
Frequency and due
dates of reports may
change based on
Reimbursement for actual
costs not to exceed total
funding consideration
amount
Note: Per Federal
funding requirements,
prior approval from
DOH is required for
reimbursement of
expenses incurred on or
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 17 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes Due Date/Time
Frame
Payment Information
and/or Amount
• Incident management for early crisis
response
• Jurisdictional recovery
• Information management
• Countermeasures and mitigation
• Surge management
• Biosurveillance
DOH will provide additional guidance and technical
assistance.
federal requirements.
DOH will notify LHJ
of any changes via
email.
A final activity report
is required prior to
DOH releasing the
final amount of
funding.
after January 20, 2020
through March 4, 2020.
After approval is
received from DOH,
LHJ must submit a
separate invoice for
reimbursement of these
expenses.
Note: The total federal funding consideration is for
the period of January 20, 2020 through March 15,
2021 2022. Any unspent funds, tasks and deliverables
with due dates after December 31, 2021 will be
included in a new statement of work under the new
consolidated contract term beginning January 1,
2022.
2 State Funds
Participate in public health emergency preparedness
and response activities for COVID-19. This may
include surveillance, epidemiology, laboratory
capacity, infection control, mitigation,
communications, and or other preparedness and
response activities for COVID-19.
Activity report(s) on template
to be provided DOH.
July 15, 2020
October 15, 2020
January 15, 2021
April 15, 2021
June 30, 2021
LHJ has already received
these funds as a one-time
distribution.
Activities must address one or more of the following
six domains:
• Incident management for early crisis
response
• Jurisdictional recovery
• Information management
• Countermeasures and mitigation
• Surge management
• Biosurveillance
DOH will provide additional guidance and technical
assistance.
Note: The total state funding consideration is for the
period of January 20, 2020 through June 30, 2021.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 18 of 30 Contract Number CLH18249-19
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how prog ram 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://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
Program Specific Requirements/Narrative
Any subcontract/s must be approved by DOH prior to executing the contract/s.
Deliverables are to be submitted to the ConCon deliverables mailbox at concondeliverables@doh.wa.gov
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 (FFAT 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 LHJ must have a Data Univers al 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)
Please reference the Code of Federal Regulations:
https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=58ffddb5363a27f26e9d12ccec462549&ty=HTML&h=L&mc=true&r=PART&n=pt2.1.200#se2.1.200_1439
Allowable Activities - See list of allowable activities below, Appendix 2 from COVID-19 Crisis Response Cooperative Agreement – Components A and B Supplemental Funding,
Interim Guidance, March 15, 2020.
Costs that are NOT allowable
• Facility purchases – May be if prior approval received from the feds and state. Send those requests to Amy.Ferris@doh.wa.gov
• Research
• Clinical care except as provided for individuals while under state or federal quarantine and isolation orders that are not eligible for payment by another source.
• Publicity and propaganda (lobbying):
• Other than for normal and recognized executive -legislative relationships, no funds may be used for:
o publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any
legislative body
o the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity design ed to influence the enactment of
legislation, appropriations, regulation, administrative action, or Executive order proposed or pen ding before any legislative body
o See Additional Requirement (AR) 12 for detailed guidance on this prohibition and additional guidance on lobbying for CDC reci pients:
https://www.cdc.gov/grants/documents/Anti-Lobbying_Restrictions_for_CDC_Grantees_July_2012.pdf
• Funds cannot be used to supplant existing federal funds awarded by other federal sources
• Funds cannot be used to match funding on other federal awards.
DOH Program Contact
Tory Henderson, Contracts & Finance Specialist
Department of Health
P O Box 47960, Olympia, WA 98504-7960
Office: 360-236-4596 Mobile: 360-789-7262 / tory.henderson@doh.wa.gov
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 19 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 20 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 21 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 22 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 23 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 24 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 25 of 30 Contract Number CLH18249-19
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 26 of 30 Contract Number CLH18249-19
Exhibit A
Statement of Work
Contract Term: 2018-2021
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) 7 Funding Source
Federal Contractor
State
Other
Federal Compliance
(check if applicable)
FFATA (Transparency Act)
Research & Development
Type of Payment
Reimbursement
Fixed Price Period of Performance: January 1, 2018 through December 31, 2021
Statement of Work Purpose: The purpose of this statement of work is to provide funding to the LHJ for conducting sanitary surveys and providing technica l assistance to small
community and non-community Group A water systems.
Revision Purpose: The purpose of this revision is to extend the Period of Performance thru December 31, 2021, provide Sanitary Survey and Technical Assistance funding in
Year 23, revise Special Billing Requirements and Special Instructions, and change DOH Fiscal Contact.
Chart of Accounts Program Name or Title CFDA # BARS
Revenue
Code
Master
Index
Code
Funding
(LHJ Use
Start Date
Period
Only)
End Date
Current
Consideration
Change
Increase (+)
Total
Consideration
Yr 20 SRF - Local Asst (15%) (FS) SS N/A 346.26.64 24139220 01/01/18 12/31/18 0 0 0
Sanitary Survey Fees (FO-E) SS-State N/A 346.26.65 24242522 01/01/18 12/31/20 9,000 0 9,000
Yr 20 SRF - Local Asst (15%) (FS) TA N/A 346.26.66 24139220 01/01/18 12/31/18 0 0 0
Yr 21 SRF - Local Asst (15%) (FS) SS N/A 346.26.64 24139221 01/01/18 06/30/19 2,400 0 2,400
Yr 21 SRF - Local Asst (15%) (FS) TA N/A 346.26.66 24139221 01/01/18 06/30/19 0 0 0
Yr 22 SRF - Local Asst (15%) (FO-E) SS N/A 346.26.64 24249222 01/01/19 12/31/20 6,600 0 6,600
Yr 22 SRF - Local Asst (15%) (FO-E) TA N/A 346.26.66 24249222 01/01/19 12/31/20 2,000 0 2,000
Yr 23 SRF - Local Asst (15%) (FO-E) SS N/A 346.26.64 24249223 01/01/21 01/31/21 0 10,400 10,400
Yr 23 SRF - Local Asst (15%) (FO-E) TA N/A 346.26.66 24249223 01/01/21 01/31/21 0 2,000 2,000
TOTALS 20,000 12,400 32,400
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes Due Date/Time
Frame
Payment Information and/or Amount
1 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.
Provide Final* Sanitary
Survey Reports to ODW
Regional Office. Complete
Sanitary Survey Reports shall
include:
1. Cover letter identifying
significant deficiencies,
Final Sanitary Survey
Reports must be
received by the ODW
Regional Office
within 30 calendar
days of conducting
the sanitary survey.
Upon ODW acceptance of the Final
Sanitary Survey Report, the LHJ shall
be paid $400 for each sanitary survey of
a non-community system with three or
fewer connections.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 27 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes Due Date/Time
Frame
Payment Information and/or Amount
See Special Instructions for task
activity.
significant findings,
observations,
recommendations, and
referrals for further
ODW follow-up.
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.
Upon ODW acceptance of the Final
Sanitary Survey Report, the LHJ shall
be paid $800 for each sanitary survey of
a non-community system with four or
more connections and each community
system.
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.
*Final Reports reviewed and
accepted by the ODW
Regional Office.
Late or incomplete reports may not be
accepted for payment.
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.
Provide completed SPI
Report and any supporting
documents and photos to
ODW Regional Office.
Completed SPI
Reports must be
received by the ODW
Regional Office
within 2 working
days of the service
request.
Upon acceptance of the completed SPI
Report, the LHJ shall be paid $800 for
each SPI.
Payment is inclusive of all associated
costs such as travel, lodging, per diem.
See Special Instructions for task
activity.
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.
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.
Provide completed TA
Report and any supporting
documents and photos to
ODW Regional Office.
Completed TA
Report must be
received by the ODW
Regional Office
within 30 calendar
days of providing
technical assistance.
Upon acceptance of the completed TA
Report, the LHJ shall be paid for each
technical assistance activity as follows:
• Up to 3 hours of work: $250
• 3-6 hours of work: $500
• More than 6 hours of work: $750
Payment is inclusive of all associated
costs such as consulting fee, travel,
lodging, per diem.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 28 of 30 Contract Number CLH18249-19
Task
Number
Task/Activity/Description *May Support PHAB
Standards/Measures
Deliverables/Outcomes Due Date/Time
Frame
Payment Information and/or Amount
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
under tasks 1, 2 and 3 must have
completed the mandatory Sanitary
Survey Training.
See Special Instructions for task
activity.
Prior to attending the
training, submit an
“Authorization for Travel
(Non-Employee)” DOH
Form 710-013 to the ODW
Program Contact below for
approval (to ensure that
enough funds are available).
Annually LHJ shall be paid mileage, per diem,
lodging, and registration costs as
approved on the pre-authorization form
in accordance with the current rates
listed on the OFM Website
http://www.ofm.wa.gov/resources/travel
.asp
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how prog ram 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://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
Program Specific Requirements/Narrative
Special References (RCWs, WACs, etc)
Chapter 246-290 WAC is the set of rules that regulate Group A water systems. By this statement of work, ODW contracts with the LHJ to con duct 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
SPIs, 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 $18,000 $28,400 for Task 1, and $2,000 $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 sanitary surveys, bill half to BARS Revenue Code 346.26.64 and half to BARS
Revenue Code 346.26.65.
When invoicing for Task 1, submit the list of WS 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.
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).
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 29 of 30 Contract Number CLH18249-19
Special Instructions
Task 1
Trained LHJ staff will evaluate the water system for physical and oper ational 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 facil ities 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 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.
• No more than 3 surveys of non-community systems with three or fewer connections to be completed between January 1, 2020 and December 31, 2020.
• No more than 8 surveys of non-community systems with four or more connections and all community systems to be completed between January 1, 2020 and
December 31, 2020.
• No more than 2 surveys of non-community systems with three or fewer connections to be completed between January 1, 2021 and December 31, 2021.
• No more than 12 surveys of non-community systems with four or more connections and all community systems to be completed between January 1, 2021 and
December 31, 2021.
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.
Task 2
Trained LHJ staff will perform Special Purpose Investigations (SPIs) as assigned by ODW. SPIs are inspections to determine the cause of positive coliform sa mples 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.
Task 3
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 t echnical 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 .
Task 4
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 Sur vey 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 Drinki ng Water Meetings.
If required trainings, workshops or meetings are not available, not scheduled, or if the LHJ staff person is unable to attend these activitie s prior to conducting assigned tasks, the
LHJ staff person may, with ODW approval, substitute other training activities to be deter mined 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.
AMENDMENT #19
Exhibit A, Statements of Work
Revised as of January 15, 2021
Page 30 of 30 Contract Number CLH18249-19
Program Manual, Handbook, Policy References
http://www.doh.wa.gov/Portals/1/Documents/Pubs/331 -486.pdf
DOH Program Contact DOH Fiscal Contact
Mark Steward Karena McGovern Marcea Kato
DOH Office of Drinking Water DOH Office of Drinking Water
16201 E. Indiana Ave, Suite 1500 243 Israel Rd SE
Spokane Valley, WA 99216 Tumwater, WA 98501
Mark.Steward@doh.wa.gov Marcea.Kato@doh.wa.gov
(509) 329-2136 (360) 236-3094
EXHIBIT B-19
ALLOCATIONS Kittitas County Public Health Department Contract Number: CLH18249
Page 1 of 4
Indirect Rate as of January 2018: 29.50% Public Health Dept & 12.50% County Central Svcs
Contract Term: 2018-2021 Date: January 15, 2021
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 Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total
FFY19 CSS IAR SNAP Ed Program Mgnt 197WAWA5Q3903 Amd 9 10.561 333.10.56 10/01/18 09/30/19 10/01/18 09/30/19 $429 $20,174 $45,359
FFY19 CSS IAR SNAP Ed Program Mgnt 197WAWA5Q3903 Amd 4 10.561 333.10.56 10/01/18 09/30/19 10/01/18 09/30/19 $19,745
FFY18 CSS IAR SNAP Ed Program Mgnt CF 187WAWA5Q3903 Amd 4 10.561 333.10.56 10/01/18 09/30/19 10/01/18 09/30/19 $858 $858
FFY18 CSS IAR SNAP Ed Program Mgnt 187WAWA5Q3903 Amd 4 10.561 333.10.56 01/01/18 09/30/18 10/01/17 09/30/18 $3,000 $22,855
FFY18 CSS IAR SNAP ED Program Mgnt 187WAWA5Q3903 Amd 2 10.561 333.10.56 01/01/18 09/30/18 10/01/17 09/30/18 $11,025
FFY18 CSS IAR SNAP ED Program Mgnt 187WAWA5Q3903 N/A 10.561 333.10.56 01/01/18 09/30/18 10/01/17 09/30/18 $8,830
FFY17 CSS IAR SNAP ED Program Mgnt CF 1717WAWA5Q390 N/A 10.561 333.10.56 01/01/18 09/30/18 10/01/17 09/30/18 $1,472 $1,472
FFY21 IAR SNAP Ed Prog Mgnt-Region 2 NGA Not Received Amd 17 10.561 333.10.56 10/01/20 09/30/21 10/01/20 09/30/21 $26,046 $26,046 $46,649
FFY20 IAR SNAP Ed Prog Mgnt-Region 2 207WAWA5Q3903 Amd 10 10.561 333.10.56 10/01/19 09/30/20 10/01/19 09/30/20 $20,603 $20,603
BITV-COVID Ed LHJ Allocation-CARES NGA Not Received Amd 18 21.019 333.21.01 07/01/20 12/30/21 07/01/20 12/30/21 $189,027 $252,036 $252,036
BITV-COVID Ed LHJ Allocation-CARES NGA Not Received Amd 16, 18 21.019 333.21.01 07/01/20 12/30/21 07/01/20 12/30/21 $63,009
COVID LHJ OFM Allocation-CARES NGA Not Received Amd 16, 18 21.019 333.21.01 03/01/20 06/30/21 03/01/20 06/30/21 $909,400 $909,400 $909,400
FFY17 EPR PHEP BP1 LHJ Funding NU90TP921889-01 Amd 2 93.069 333.93.06 01/01/18 06/30/18 07/01/17 07/02/18 $565 $20,398 $20,398
FFY17 EPR PHEP BP1 LHJ Funding NU90TP921889-01 N/A 93.069 333.93.06 01/01/18 06/30/18 07/01/17 07/02/18 $19,833
FFY18 EPR PHEP BP1 Supp LHJ Funding NU90TP921889-01 Amd 5 93.069 333.93.06 07/01/18 06/30/19 07/01/18 06/30/19 $885 $49,134 $49,134
FFY18 EPR PHEP BP1 Supp LHJ Funding NU90TP921889-01 Amd 4 93.069 333.93.06 07/01/18 06/30/19 07/01/18 06/30/19 $48,249
FFY20 PHEP BP2 LHJ Funding NU90TP922043 Amd 17 93.069 333.93.06 07/01/20 06/30/21 07/01/20 06/30/21 $19,653 $49,133 $98,266
FFY20 PHEP BP2 LHJ Funding NU90TP922043 Amd 16, 17 93.069 333.93.06 07/01/20 06/30/21 07/01/20 06/30/21 $29,480
FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 10 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $49,133 $49,133
FFY20 Envir Health Capacity-C (CDC) NUE1EH001445 Amd 18 93.070 333.93.07 09/01/20 08/31/21 09/01/20 08/31/21 $111,000 $111,000 $111,000
FFY17 317 Ops 5NH23IP000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $616 $616 $616
FFY17 AFIX 5NH23IP000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $2,226 $2,226 $2,226
FFY21 COVID19 Vaccine Services-CARES NH23IP922619 Amd 19 93.268 333.93.26 07/01/20 12/31/21 07/01/20 12/31/21 $354,803 $369,385 $369,385
FFY21 COVID19 Vaccine Services-CARES NH23IP922619 Amd 18, 19 93.268 333.93.26 07/01/20 12/31/21 07/01/20 12/31/21 $14,582
FFY21 Enhanced Influenza Coverage CARES NH23IP922619 Amd 17 93.268 333.93.26 07/01/20 06/30/21 06/05/20 06/30/21 $2,800 $5,600 $5,600
FFY21 Enhanced Influenza Coverage CARES NH23IP922619 Amd 16, 17 93.069 333.93.06 07/01/20 06/30/21 06/05/20 06/30/21 $2,800
EXHIBIT B-19
ALLOCATIONS Kittitas County Public Health Department Contract Number: CLH18249
Page 2 of 4
Indirect Rate as of January 2018: 29.50% Public Health Dept & 12.50% County Central Svcs
Contract Term: 2018-2021 Date: January 15, 2021
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 Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total
FFY17 Increasing Immunization Rates NH23IP000762 Amd 3, 4 93.268 333.93.26 07/01/18 06/30/19 07/01/18 06/30/19 $5,600 $5,600 $5,600
FFY21 VFC Ops NH23IP922619 Amd 17 93.268 333.93.26 07/01/20 06/30/21 07/01/20 06/30/21 $2,800 $5,600 $12,314
FFY21 VFC Ops NH23IP922619 Amd 15, 17 93.268 333.93.26 07/01/20 06/30/21 07/01/20 06/30/21 $2,800
FFY20 VFC Ops NH23IP922619 Amd 9 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $5,600 $5,600
FFY17 VFC Ops 5NH23IP000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $1,114 $1,114
FFY19 COVID CARES NU50CK000515 Amd 15, 18 93.323 333.93.32 06/01/20 12/31/21 06/01/20 12/31/21 $61,177 $61,177 $61,177
FFY19 ELC COVID Ed LHJ Allocation NGA Not Received Amd 19 93.323 333.93.32 01/01/21 12/31/21 01/01/21 12/31/21 $237,077 $237,077 $237,077
FFY20 ELC EDE LHJ Allocation NGA Not Received Amd 19 93.323 333.93.32 01/15/21 12/31/21 01/15/21 12/31/21 $530,161 $530,161 $530,161
FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 13, 18, 19 93.354 333.93.35 01/20/20 12/31/21 01/01/20 12/31/21 $78,522 $78,522 $78,522
FFY20 Phys Actvty & Nutrition Prog NGA Not Received Amd 17 93.439 333.93.43 09/30/20 09/29/21 09/30/20 09/29/21 $60,000 $60,000 $180,000
FFY19 Phys Actvty & Nutrition Prog NU58DP006504 Amd 10 93.439 333.93.43 09/30/19 09/29/20 09/30/19 09/29/20 $60,000 $60,000
FFY18 Phys Actvty & Nutrition Prog NU58DP006504 Amd 8, 15 93.439 333.93.43 02/19/19 09/29/20 09/28/18 09/29/20 $60,000 $60,000
FFY21 MCHBG LHJ Contracts B0440169 Amd 17 93.994 333.93.99 10/01/20 09/30/21 10/01/20 09/30/21 $44,196 $44,196 $166,628
FFY20 MCHBG LHJ Contracts B04MC32578 Amd 10 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $44,196 $44,196
FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $44,196 $44,196
FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $893 $34,040
FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $33,147
FEMA-75 COVID LHJ Allocation NGA Not Received Amd 18 97.036 333.97.03 07/01/20 12/30/20 07/01/20 12/30/20 ($189,027) $0 $0
FEMA-75 COVID LHJ Allocation NGA Not Received Amd 16 97.036 333.97.03 07/01/20 12/30/20 07/01/20 12/30/20 $189,027
GFS-Group B (FO-E) Amd 10 N/A 334.04.90 07/01/20 12/31/20 07/01/19 06/30/21 $20,000 $20,000 $25,000
GFS - Group B (FO-E) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $5,000 $5,000
FY2 Group B Programs for DW (FO-E) Amd 3 N/A 334.04.90 07/01/18 06/30/19 07/01/17 06/30/19 $10,000 $10,000 $10,000
Zoonotics-GFS Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $4,029 $4,029 $5,000
Zoonotics-GFS Amd 9 N/A 334.04.91 06/01/19 06/30/19 07/01/17 06/30/19 $971 $971
FY20/21 COVID-19 Disaster Response Acct Amd 13, 18 N/A 334.04.92 01/20/20 06/30/21 01/01/20 06/30/21 $71,478 $71,478 $71,478
EXHIBIT B-19
ALLOCATIONS Kittitas County Public Health Department Contract Number: CLH18249
Page 3 of 4
Indirect Rate as of January 2018: 29.50% Public Health Dept & 12.50% County Central Svcs
Contract Term: 2018-2021 Date: January 15, 2021
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 Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total
SFY2 Lead Environments of Children Amd 8 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 ($1,500) $0 $2,000
SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $1,500
SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $2,000
FPHS Funding for LHJs Amd 16, 18 N/A 336.04.25 07/01/20 06/30/21 07/01/19 06/30/21 $58,000 $100,000 $242,000
FPHS Funding for LHJs Amd 10, 18 N/A 336.04.25 07/01/20 06/30/21 07/01/19 06/30/21 $42,000
FPHS Funding for LHJs Amd 16 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,000 $100,000
FPHS Funding for LHJs Amd 10 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $42,000
FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $42,000 $42,000
YR 20 SRF - Local Asst (15%) (FS) SS Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 ($2,400) $0 $0
YR 20 SRF - Local Asst (15%) (FS) SS N/A, Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 $2,400
YR 21 SRF - Local Asst (15%) (FS) SS Amd 10 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($3,200) $2,400 $2,400
YR 21 SRF - Local Asst (15%) (FS) SS Amd 9, 10 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $400
YR 21 SRF - Local Asst (15%) (FS) SS Amd 7, 10 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $2,800
YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 7, 10 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $2,400
YR 22 SRF - Local Asst (15%) (FO-E) SS Amd 14 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 ($400) $6,600 $6,600
YR 22 SRF - Local Asst (15%) (FO-E) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,800
YR 22 SRF - Local Asst (15%) (FO-E) SS Amd 10, 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,200
YR 23 SRF - Local Asst (15%) (FO-E) SS Amd 19 N/A 346.26.64 01/01/21 12/31/21 09/01/20 12/31/21 $10,400 $10,400 $10,400
Sanitary Survey Fees (FO-E) SS-State Amd 14 N/A 346.26.65 01/01/18 12/31/20 07/01/17 06/30/21 ($400) $9,000 $9,000
Sanitary Survey Fees (FO-E) SS-State Amd 12 N/A 346.26.65 01/01/18 12/31/20 07/01/17 06/30/21 $3,800
Sanitary Survey Fees (FO-E) SS-State Amd 9, 12 N/A 346.26.65 01/01/18 12/31/20 07/01/17 06/30/21 $400
Sanitary Survey Fees (FO-E) SS-State Amd 7, 12 N/A 346.26.65 01/01/18 12/31/20 07/01/17 06/30/21 $2,800
Sanitary Survey Fees (FO-E) SS-State N/A, Amd 3, 7, 12 N/A 346.26.65 01/01/18 12/31/20 07/01/17 06/30/21 $2,400
YR 20 SRF - Local Asst (15%) (FS) TA Amd 3 N/A 346.26.66 01/01/18 12/31/18 07/01/15 12/31/18 ($2,000) $0 $0
YR 20 SRF - Local Asst (15%) (FS) TA N/A, Amd 3 N/A 346.26.66 01/01/18 12/31/18 07/01/15 12/31/18 $2,000
YR 21 SRF - Local Asst (15%) (FS) TA Amd 10 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($4,000) $0 $0
YR 21 SRF - Local Asst (15%) (FS) TA Amd 7, 10 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000
YR 21 SRF - Local Asst (15%) (FS) TA Amd 3, 7, 10 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000
EXHIBIT B-19
ALLOCATIONS Kittitas County Public Health Department Contract Number: CLH18249
Page 4 of 4
Indirect Rate as of January 2018: 29.50% Public Health Dept & 12.50% County Central Svcs
Contract Term: 2018-2021 Date: January 15, 2021
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 Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total
YR 22 SRF - Local Asst (15%) (FO-E) TA Amd 14 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 ($2,000) $2,000 $2,000
YR 22 SRF - Local Asst (15%) (FO-E) TA Amd 12 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000
YR 22 SRF - Local Asst (15%) (FO-E) TA Amd 10, 12 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000
YR 23 SRF - Local Asst (15%) (FO-E) TA Amd 19 N/A 346.26.66 01/01/21 12/31/21 09/01/20 12/31/21 $2,000 $2,000 $2,000
TOTAL
$3,569,426
$3,569,426
Total consideration: $2,434,985 GRAND TOTAL $3,569,426
$1,134,441
GRAND TOTAL $3,569,426 Total Fed $3,181,548
Total State $387,878
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with "333". State revenue codes begin with "334".
Exhibit C-16 Schedule of Federal Awards AMENDMENT #19
Date: January 15, 2021
KITTITAS COUNTY HEALTH DEPT-SWV0010475-07
CONTRACT CLH18249-Kittitas County Public Health Department
CONTRACT PERIOD: 01/01/2018-12/31/2021
Page 1 of 3
DOH Total Amt Allocation Period
Chart of Accounts Program Title BARS Federal
Award Date
Federal
Award
Start
Date
End
Date
Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award
Identification Number Federal Grant Award Name
FFY20 IAR SNAP ED PROG MGNT-REGION 2 333.10.56 09/30/19 $5,300,000 10/01/19 09/30/20 $20,603 10.561
State Administrative Matching
Grants for the Supplemental
Nutrition Assistance Program
Department of Agriculture Food and 207WAWA5Q3903 Nutrition Service
2019 SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM-EDUCATION
(SNAP-ED)
FFY19 CSS IAR SNAP-ED PROG MGNT 333.10.56 09/28/18 $5,386,268 10/01/18 09/30/19 $20,174 10.561
State Administrative Matching
Grants for the Supplemental
Nutrition Assistance Program
Department of Agriculture Food and 197WAWA5Q3903 SNAP 2YR NUTRITION ED OBESITY Nutrition Service
FFY18 CSS IAR SNAP-ED PROGRAM MGNT 333.10.56 09/28/17 $5,300,000 01/01/18 09/30/18 $22,855 10.561
State Administrative Matching
Grants for the Supplemental
Nutrition Assistance Program
Department of Agriculture Food and 187WAWA5Q3903 Nutrition Service
2018 SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM EDUCATION
(SNAP-ED)
COVID LHJ OFM ALLOCATION-CARES 333.21.01 NGA Not
Received
NGA Not 03/01/20 06/30/21 $909,400 21.019 Coronavirus Relief Fund Department of the Treasury NGA Not Received NGA Not Received Received
FFY20 PHEP BP2 LHJ FUNDING 333.93.06 06/12/20 $11,365,797 07/01/20 06/30/21 $49,133 93.069
Public Health Emergency
Preparedness
Department of Health and Human
Services Centers for Disease Control
and Prevention
NU90TP922043
PUBLIC HEALTH EMERGENCY
PREPAREDNESS (PHEP)
COOPERATIVE AGREEMENT
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 Public Health Emergency
Preparedness
Department of Health and Human
Services Centers for Disease Control
and Prevention
NU90TP921889-01
HOSPITAL PREPAREDNESS
PROGRAM AND PUBLIC HEALTH
EMERGENCY PREPAREDNESS
COOPERATIVE AGREEMENT
Environmental Public Health and Department of Health and Human STRENGTHENING ENVIRONMENTAL
HEALTH CAPACITY (EHC) TO DETECT,
FFY20 ENVIR HEALTH CAPCITY-C (CDC) 333.93.07 04/02/00 $489,093 09/01/20 08/31/20 $111,000 93.070 Emergency Response Services Centers for Disease Control
and Prevention
NUE1EH001445 PREVENT & CONTROL
ENVIRONMENTAL HEALTH HAZARDS
FFY21 ENHANCED INFLUENZA COVERAGE CARES 333.93.26 08/13/20 $12,548,955 07/01/20 06/30/21 $5,600 93.268
Immunization Cooperative
Agreements
Department of Health and Human
Services Centers for Disease Control
and Prevention
NH23IP922619
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN PROGRAM
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN PROGRAM
Department of Health and Human
Services Centers for Disease Control NH23IP922619
and Prevention
$5,600 93.268 Immunization Cooperative
Agreements $9,234,835 07/01/20 06/30/21 07/01/19 333.93.26 FFY21 VFC OPS
HPP AND PHEP COOPERATIVE
AGREEMENT
Department of Health and Human
Services Centers for Disease Control NU90TP921889-01
and Prevention
$20,398 93.069 Public Health Emergency
Preparedness $11,062,782 01/01/18 06/30/18 07/18/17 333.93.06 FFY17 EPR PHEP BP1 LHJ FUNDING
PUBLIC HEALTH EMERGENCY
PREPAREDNESS (PHEP)
COOPERATIVE AGREEMENT
Department of Health and Human
Services Centers for Disease Control NU90TP922043
and Prevention
$49,133 93.069 Public Health Emergency
Preparedness $11,307,904 07/01/19 06/30/20 06/29/19 333.93.06 FFY19 PHEP BP1 LHJ FUNDING
NGA Not Received NGA Not Received Department of the Treasury $252,036 21.019 Coronavirus Relief Fund NGA Not 07/01/20 12/30/21 Received
NGA Not
Received 333.21.01 BITV-COVID ED LHJ ALLOCATION-CARES
2018 SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM EDUCATION
(SNAP-ED)
1717WAWA5Q390 Department of Agriculture Food and
Nutrition Service
State Administrative Matching
$1,472 10.561 Grants for the Supplemental
Nutrition Assistance Program
$5,739,856 01/01/18 09/30/18 09/10/16 333.10.56 FFY17 CSS IAR SNAP-ED PROGRAM MGNT CF
2018 SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM EDUCATION
(SNAP-ED)
187WAWA5Q3903 Department of Agriculture Food and
Nutrition Service
State Administrative Matching
$858 10.561 Grants for the Supplemental
Nutrition Assistance Program
$5,300,000 10/01/18 09/30/19 09/30/19 333.10.56 FFY18 CSS IAR SNAP-ED PROGRAM MGNT CF
NGA Not Received NGA Not Received Department of Agriculture Food and
Nutrition Service
State Administrative Matching
$26,046 10.561 Grants for the Supplemental
Nutrition Assistance Program
NGA Not
Received 10/01/20 09/30/21 NGA Not
Received 333.10.56 FFY20 IAR SNAP ED PROG MGNT-REGION 2
Exhibit C-16 Schedule of Federal Awards AMENDMENT #19
Date: January 15, 2021
KITTITAS COUNTY HEALTH DEPT-SWV0010475-07
CONTRACT CLH18249-Kittitas County Public Health Department
CONTRACT PERIOD: 01/01/2018-12/31/2021
Page 2 of 3
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN PROGRAM
Department of Health and Human
Services Centers for Disease Control NH23IP922619
and Prevention
$369,385 93.268 Immunization Cooperative
Agreements $68,807,053 07/01/20 12/31/21 01/15/21 333.93.26 FFY21 COVID19 VACCINE SERVICES-CARES
DOH Total Amt Allocation Period
Chart of Accounts Program Title BARS Federal
Award Date
Federal
Award
Start
Date
End
Date
Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award
Identification Number Federal Grant Award Name
FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $5,600 93.268
Immunization Cooperative
Agreements
Department of Health and Human
Services Centers for Disease Control
and Prevention
NH23IP922619
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN PROGRAM
FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $5,600 93.268
Immunization Cooperative
Agreements
Department of Health and Human
Services Centers for Disease Control
and Prevention
NH23IP000762
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN'S
PROGRAM
FFY17 317 OPS 333.93.26 03/03/17 $575,969 01/01/18 06/30/18 $616 93.268
Immunization Cooperative
Agreements
Department of Health and Human
Services Centers for Disease Control
5NH23IP000762-05-00
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN'S
FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/21 $78,522 93.354
Public Health Emergency
Response: Cooperative
Agreement for Emergency
Response: Public Health Crisis
Department of Health and Human
Services Centers for Disease Control
and Prevention
NU90TP922069
CDC COOPERATIVE AGREEMENT
FOR EMERGENCY RESPONSE:
PUBLIC HEALTH CRISIS RESPONSE
CDC-RFA-TP18-1802
FFY19 PHYS ACTVTY & NUTRITION PROG 333.93.43 07/24/19 $1,846,000 09/30/19 09/29/20 $60,000 93.439 State Physical Activity and
Nutrition (SPAN)
Department of Health and Human
Services NU58DP006504 STATE PHYSICAL ACTIVITY AND
NUTRITION-WASHINGTON (SPANWA)
FFY21 MCHBG LHJ CONTRACTS 333.93.99 02/08/21 $2,662,201 10/01/20 09/30/21 $44,196 93.994
Maternal and Child Health
Services Block Grant to the
States
Department of Health and Human
Services Health Resources and
Services Administration
B0440169
MATERNAL AND CHILD HEALTH
SERVICES BLOCK GRANT
FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20
Maternal and Child Health
$44,196 93.994 Services Block Grant to the
States
Department of Health and Human
Services Health Resources and
Services Administration
B04MC32578 MATERNAL AND CHILD HEALTH
SERVICES BLOCK GRANT
FFY18 PHYS ACTVTY & NUTRITION PROG 333.93.43 09/01/18 $923,000 02/19/19 09/29/20 $60,000 93.439 State Physical Activity and
Nutrition (SPAN)
Department of Health and Human
Services NU58DP006504 STATE PHYSICAL ACTIVITY AND
NUTRITION-WASHINGTON (SPANWA)
NGA Not Received NGA Not Received Department of Health and Human
Services $60,000 93.439 State Physical Activity and
Nutrition (SPAN)
NGA Not 9/30./20 09/29/21 Received
NGA Not
Received 333.93.43 FFY20 PHYS ACTVTY & NUTRITION PROG
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN'S
PROGRAM
Department of Health and Human
Services Centers for Disease Control 5NH23IP000762-05-00
and Prevention
$2,226 93.268 Immunization Cooperative
Agreements $1,672,289 01/01/18 06/30/18 03/03/17 333.93.26 FFY17 AFIX
IMMUNIZATION GRANT AND
VACCINES FOR CHILDREN'S
PROGRAM
Department of Health and Human
Services Centers for Disease Control 5NH23IP000762-05-00
and Prevention
$1,114 93.268 Immunization Cooperative
Agreements $1,201,605 01/01/18 06/30/18 03/03/17 333.93.26 FFY17 VFC OPS
and Prevention PROGRAM
NGA Not NGA Not Epidemiology and Laboratory Department of Health and Human
FFY20 ELC EDE LHJ ALLOCATION 333.93.32 Received Received 01/15/21 12/31/21 $530,161 93.323 Capacity for Infectious Diseases Services Centers for Disease Control NGA Not Received NGA Not Received
(ELC) and Prevention
NGA Not NGA Not Epidemiology and Laboratory Department of Health and Human
FFY19 ELC COVID ED LHJ ALLOCATION 333.93.32 Received Received 01/01/21 12/31/21 $237,077 93.323 Capacity for Infectious Diseases Services Centers for Disease Control NGA Not Received NGA Not Received
(ELC) and Prevention
Epidemiology and Laboratory
Capacity for Infectious Diseases
Department of Health and Human
EPIDEMIOLOGY & LABORATORY
CAPACITY FOR INFECTIOUS FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/21 $61,177 93.323 (ELC)-Building and Services Centers for Disease Control NU50CK000515 DISEASES (ELC)-BUILDING &
Strengthening Epidemiology, and Prevention STRENGTHENING EPIDEMIOLOGY,
Exhibit C-16 Schedule of Federal Awards AMENDMENT #19
Date: January 15, 2021
KITTITAS COUNTY HEALTH DEPT-SWV0010475-07
CONTRACT CLH18249-Kittitas County Public Health Department
CONTRACT PERIOD: 01/01/2018-12/31/2021
Page 3 of 3
DOH Total Amt Allocation Period
Chart of Accounts Program Title BARS Federal
Award Date
Federal
Award
Start
Date
End
Date
Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award
Identification Number Federal Grant Award Name
FFY19 MCHBG LHJ CONTRACTS
333.93.99
11/14/18
$2,225,977 10/01/18
09/30/19
$44,196
93.994
Maternal and Child Health
Services Block Grant to the
Department of Health and Human
Services Health Resources and B04MC32578 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT
States Services Administration
FFY18 MCHBG LHJ CONTRACTS
333.93.99
10/20/17
$1,650,528 01/01/18
09/30/18
$34,040
93.994
Maternal and Child Health
Services Block Grant to the
Department of Health and Human
Services Health Resources and B04MC31524 MATERNAL AND CHILD HEALTH SERVICES
States Services Administration
TOTAL
$3,181,548