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Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br />DOH Program Name or Title: Climate & Health Wildfire Smoke Indoor Air Quality <br />Project - Effective January 1. 2022 <br />SOW Type: Ori�alal Revision # (for this SOW) <br />Period of Performance: January 1 202 through August 31, 2022 <br />Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: CLH31015 <br />Funding Source Federal Compliance Type of Payment <br />® Federal Subrecipient (check if applicable) ® Reimbursement <br />❑ State 0 FFATA (Transparency Act) ❑ Fixed Price <br />❑ Other ❑ Research & Development <br />Statement of Work Purpose: The purpose of this statement of work is two -fold and is being done as part of the Center of Disease Contol and Prevention's (CDC's) original and <br />supplementa I grant "Strengthening environmental health capacity (EHC) to detect, prevent, and control environmental health hazards in through data -driven, evidence -based <br />approaches" initially awarded to DOH on September 1, 2020. <br />1) The first is to respond to declared wildfire disasters in Washington state by identifying the most vulnerable populations, assessing ambient wildfire smoke infiltration into <br />indoor air in places where vulnerable populations reside, and providing resources to protect those populations in areas where indoor air quality needs improvement. This statement <br />of work provides KCPHD $21,00 to continue this work of the original grant. <br />2) The second is to increase readiness to apply ventilation practices that reduce wildfire smoke exposure and transmission of airborne COVID-19 and, while considering extreme <br />heat, in residences or facilities used by vulnerable populations. This work will include distributing wildfire smoke interventions to vulnerable individuals and repeating the <br />residential cleaner air room project from the original grant with improvements and incorporation of heat. This statement of work provides KCPHD $83,000 to perform these <br />activities of the supplemental grant that was awarded to DOH on September 1, 2021. <br />Revision Purpose: N/A <br />DOH Chart of Accounts Master Index Title <br />Master <br />Index <br />Code <br />Assistance <br />Listing <br />Number <br />BARS <br />Revenue <br />Code <br />LHJ Funding Period <br />Start Date End Date <br />Current <br />Allocation <br />Allocation <br />Change <br />g <br />Increase (+) <br />Total <br />Allocation <br />FFY20 ENVIRO HEALTH CAPACITY -C (CDC) NCE <br />25440100 <br />93.070 <br />333.93.07 <br />01/01/22 08/31/22 <br />0 <br />21,000 <br />21,000 <br />FFY22 CDC EHC EHR SUPPLEMENTAL <br />25450222 <br />93.070 <br />333.93.07 1 <br />01/01/22 08/31/22 <br />0 <br />83,000 <br />83,000 <br />Code 25440100. <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />TOTALS <br />0 <br />1 104,000 <br />1 104,000 <br />Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />1 <br />Collaborate with DOH to identify larger facilities for indoor air <br />LHJ presents selected long-term care <br />August 31, 2022 <br />Reimbursement for actual <br />quality consultation pilot within the selected target vulnerable <br />facility (2) and school (2) <br />costs not to exceed <br />population to include: <br />A written protocol for conducting <br />$21,000 on Master Index <br />consultation in larger facilities <br />Code 25440100. <br />Exhibit A, Statement of Work Page 1 of 5 Contract NumberCLH31015 <br />