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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 XXXXxxxxxxx.xxx 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. OH Program Contacts DOH Program Contact Xxxxxx Xxxxxx, MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office of Immunization and Child Profile Office of Immunization and Child Profile Department of Health Department of Health PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 xxxxx.xxxxx@xxx.xx.xxx, 000-000-0000 DOH Use Only Federal Award BARS Revenue Statement of Work Funding Period Chart of Accounts Funding Period Funding Period Chart of Accounts Chart of Accounts Program Title ~~Federal Award~~ Identification # Amend # CFDA* ~~BARS Revenue~~ Code** ~~Statement of Work Funding Period~~ Start Date End Date ~~Chart of Accounts Funding Period~~ Start Date End Date Amount ~~Funding Period~~ Sub Total ~~Chart of Accounts~~ Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Federal Award BARS Revenue Statement of Work Funding Period Chart of Accounts Funding Period Funding Period Chart of Accounts Chart of Accounts Program Title ~~Federal Award~~ Identification # Amend # CFDA* ~~BARS Revenue~~ Code** ~~Statement of Work Funding Period~~ Start Date End Date ~~Chart of Accounts Funding Period~~ Start Date End Date Amount ~~Funding Period~~ Sub Total ~~Chart of Accounts~~ Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention ~~Department of Health and Human~~ NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT ~~HOSPITAL PREPAREDNESS PROGRAM~~ FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control ~~and Prevention~~ NU90TP921889-01 and Prevention HOSPITAL PREPAREDNESS PROGRAM AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256AGREEMENT

Appears in 1 contract

Samples: destinyhosted.com

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 XXXXxxxxxxx.xxx 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. OH DOH Program Contacts DOH Program Contact Xxxxxx Xxxxxx, MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office of Immunization and Child Profile Office of Immunization and Child Profile Department of Health Department of Health PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 xxxxx.xxxxx@xxx.xx.xxx, 000-000-0000 DOH Use Only Federal Award BARS Revenue Statement of Work Funding Period Chart of Accounts Funding Period Funding Period Chart of Accounts Chart of Accounts Program Title ~~Federal Award~~ Identification # Amend # CFDA* ~~BARS Revenue~~ Code** ~~Statement of Work Funding Period~~ Start Date End Date ~~Chart of Accounts Funding Period~~ Start Date End Date Amount ~~Funding Period~~ Sub Total ~~Chart of Accounts~~ Total BITV-COVID Ed LHJ Allocation-CARES NGA Not Received Amd 14 21.019 333.21.01 07/01/20 12/30/20 07/01/20 12/30/20 $147,409 $147,409 $147,409 XXXXX XXX OFM Allocation-CARES NGA Not Received Amd 14 21.019 333.21.01 03/01/20 12/30/20 03/01/20 12/30/20 $2,179,000 $2,179,000 $2,179,000 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY20 PHEP BP2 LHJ Funding NU90TP922043 Amd 15 93.069 333.93.06 07/01/20 06/30/21 07/01/20 06/30/21 $31,630 $79,074 $158,148 FFY20 PHEP BP2 LHJ Funding NU90TP922043 Amd 14, 15 93.069 333.93.06 07/01/20 06/30/21 07/01/20 06/30/21 $47,444 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 ~~$79,074~~ $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 15 93.268 333.93.26 07/01/20 ~~12/31/20~~ 06/30/21 07/01/20 06/30/21 $3,637 $7,274 $14,548 FFY21 VFC Ops NH23IP922619 Amd 13, 15 93.268 333.93.26 07/01/20 06/30/21 07/01/20 06/30/21 $3,637 ~~$10,911~~ FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY21 MCHBG LHJ Contracts NGA Not Received Amd 15 93.994 333.93.99 10/01/20 09/30/21 10/01/20 09/30/21 $105,006 $105,006 $403,033 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 ~~$298,027~~ FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 FEMA-75 COVID LHJ Allocation NGA Not Received Amd 14 97.036 333.97.03 07/01/20 12/30/20 07/01/20 12/30/20 $442,227 $442,227 $442,227 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 DOH Use Only Federal Award BARS Revenue Statement of Work Funding Period Chart of Accounts Funding Period Funding Period Chart of Accounts Chart of Accounts Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total 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 $20,000 $20,000 $20,000 FPH Lead Case Mgmt-GFS Amd 14 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 $3,425 $3,425 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 14 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 ($3,425) $0 $0 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 14 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $74,902 $133,641 $326,021 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 FPHS Funding for LHJs Amd 14 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $~~58,739~~ 74,902 $~~176,217~~ 133,641 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 ~~$58,739~~ $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 DOH Use Only Federal Award BARS Revenue Statement of Work Funding Period Chart of Accounts Funding Period Funding Period Chart of Accounts Chart of Accounts Program Title Identification # Amend # CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $~~1,351,063~~ 4,457,220 $~~1,351,063~~ 4,457,220 Total consideration: $~~1,171,278~~ 4,316,947 GRAND TOTAL $~~1,351,063~~ 4,457,220 $~~179,785~~ 140,273 GRAND TOTAL $~~1,351,063~~ 4,457,220 Total Fed $~~926,256~~ 3,882,609 Total State $~~424,807~~ 574,611 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 XXXXX XXX OFM ALLOCATION-CARES 333.21.01 NGA Not Received NGA Not Received 03/01/20 12/30/20 $2,179,000 21.019 Coronavirus Relief Fund Department of the Treasury NGA Not Received NGA Not Received BITV-COVID ED LHJ ALLOCATION-CARES 333.21.01 NGA Not Received Received NGA Not 07/01/20 12/30/20 $147,409 21.019 Coronavirus Relief Fund Department of the Treasury NGA Not Received NGA Not Received FFY20 PHEP BP2 LHJ FUNDING 333.93.06 06/12/20 $11,365,797 07/01/20 06/30/21 $79,074 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 FFY19 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control NU90TP922043 and Prevention ~~Department of Health and Human NU90TP922043~~ PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT ~~HOSPITAL PREPAREDNESS PROGRAM~~ FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 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 FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control ~~and Prevention~~ NU90TP921889-01 and Prevention HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 ~~Injury Prevention and Control~~ Research and State and Services Centers for Disease Control NU17CE002734 STATES Community-Based Programs and Prevention FFY21 VFC OPS 333.93.26 07/01/20 $9,082,252 07/01/20 06/30/21 $7,274 Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND VACCINES 93.268 Agreements Services Centers for Disease Control NH23IP922619 FOR CHILDREN PROGRAM Injury Prevention and ~~Prevention NU17CE002734~~ Control Department of Health and Human PRESCRIPTION DRUG OVERDOSE FOR ~~STATES FFY21~~ and Prevention FFY20 VFC OPS 333.93.26 ~~NGA Not Received NGA Not Received 07/01/20 12/31/20~~ 07/01/19 $~~3,637~~ 9,234,835 07/01/19 06/30/20 $7,274 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention ~~NGA Not Received NGA Not Received rol~~ NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM ~~FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention~~ FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 93.268 Immunization Cooperative ~~Department of Health and Human93.268~~ Agreements ~~Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases~~ Department of Health and Human ~~rol~~ Services Centers for Disease Control NH23IP000762 and Prevention IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Epidemiology and Laboratory Capacity for Infectious Diseases (ELC)-Building and Strengthening Epidemiology, Laboratory and Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis ~~Response~~ Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human Services Centers for Disease Control and Prevention NU50CK000515 NU90TP922069 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING EPIDEMIOLOGY, LABORATORY & Maternal and Child Health Department of Health and Human 10/01/20 09/30/21 $105,006 93.994 Services Block Grant to the Services Health Resources and NGA Not Received NGA Not Received CDC COOPERATIVE AGREEMENT FOR EMERGENCY RESPONSE: PUBLIC HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 States Services Administration Maternal and Child Health Department of Health and Human MATERNAL AND CHILD HEALTH FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 Maternal and Child Health Department of Health and Human MATERNAL AND CHILD HEALTH FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 Maternal and Child Health Department of Health and Human MATERNAL AND CHILD HEALTH FFY18 MCHBG LHJ CONTRACTS 333.93.99 10/20/17 $1,650,528 01/01/18 09/30/18 $88,015 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~~ FFY21 MCHBG LHJ CONTRACTS 333.93.99 NGA Not Received NGA Not Received DOH Total Amt Allocation Period Chart of Accounts Program Title BARS Federal Award Date NGA Not Federal Award NGA Not Start Date End Date Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award Identification Number Disaster Grants-Public Federal Grant Award Name FEMA-75 COVID LHJ ALLOCATION 333.97.03 Received Received 07/01/20 12/30/20 $~~926,256~~442,227 97.036 Assistance (Presidentially Declared Disasters) Department of Homeland Security NGA Not Received NGA Not Received

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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 XXXXxxxxxxx.xxx 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~~ Please reference the Code 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. OH Program Contacts Regulations: xxxxx://xxx.xxxx.xxx/cgi-bin/retrieveECFR?gp=1&SID=58ffddb5363a27f26e9d12ccec462549&ty=HTML&h=L&mc=true&r=PART&n=pt2.1.200#se2.1.200_1439 DOH Program Contact ~~Xxxxxx Xxxxxx~~Xxxx Xxxxxxxxx, ~~MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office~~ Contracts and Finance Specialist Division of ~~Immunization~~ Emergency Preparedness and ~~Child Profile Office of Immunization and Child Profile~~ Response Department of Health ~~Department of Health PO~~ P O Box ~~47843~~47960, ~~Olympia~~ Olympia, WA 98504-~~7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx,~~ 7960 Desk 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx,~~ / Mobile 000-000-0000 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** xxxx.xxxxxxxxx@xxx.xx.xxx Exhibit A Statement of Work ~~Funding~~ Contract Term: 2018-2021 DOH Program Name or Title: Maternal & Child Health Block Grant - Effective January 1, 2018 SOW Type: Revision Revision # (for this SOW) 5 Period ~~Start Date End Date Chart~~ of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 FFY17 Increasing Immunization Rates NH23IP000762 Amd 3Performance: January 1, 4 93.268 333.93.26 07/01/18 06/30/19 07/01/18 06/30/19 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 YR 20 SRF - 2018 through September 30, 2021 Local Asst (15%) (FS) SS Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total considerationHealth Jurisdiction Name: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department ~~CONTRACT PERIOD~~Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Contract Number: ~~01/01/2018-12/31/2020 Date~~CLH18242 Statement of Work Purpose: ~~May 15, 2020 DOH Total Amt Allocation Period Chart~~ The purpose 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department this statement of ~~Health and Human Services Centers for Disease Control and Prevention Department~~ work is to support local interventions that impact the target population of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 93.994 the 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256Grant.

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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 ~~XXXXxxxxxxx.xxx~~ xxxx://XXXXxxxxxxx.xxx 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. OH Program Contacts DOH Program Contact ~~Xxxxxx Xxxxxx, MPA Xxxxx~~ Xxxxxxx Xxxxx, ~~Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office of Immunization and Child Profile~~ MPH Deliverables may be sent electronically via email at XXXXXxxxxxxxx@xxx.xx.xxx VTrckS/IIS Coordinator by fax to 000-000-0000, or by mail to XX Xxx 00000, Xxxxxxx XX 00000-0000 Office of Immunization and Child Profile Department of Health ~~Department of Health PO Box 47843~~XX Xxx 00000, ~~Olympia WA 98504~~Xxxxxxx XX 00000-~~7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx,~~ 0000 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~Xxxxxxx.xxxxx@xxx.xx.xxx Exhibit A Statement of Work Contract Term: 2012-2014 DOH Program Name or Title: Public Health Emergency Preparedness & Response (PHEPR) – Effective July 1, ~~000-000-0000 DOH Use Only~~ 2012 Local Health Jurisdiction Name: Xxxxx County Public Health Contract Number: C16893 SOW Type: Revision Revision # (for this SOW) 3 Funding Source Federal Subrecipient State Other Federal Compliance (if applicable) ARRA (Recovery Act) FFATA (Transparency Act) Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2012 through June 30, 2013 Statement of Work Purpose: The purpose of this statement of work is to provide funding for Public Health Emergency Preparedness and Response activities for the period of July 1, 2012 through June 30, 2013. Revision Purpose: The purpose of this revision is to correct the period of performance effective date to begin 07/01/12 instead of 08/10/12 to incorporate activities covered under the PHEPR HC Systems - Prep funding and to add two PHEP Admin tasks. Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change None Total ~~Chart of Accounts Total FFY17 EPR PHEP BP1~~ Consideration FFY12 PHEPR LHJ ~~Funding NU90TP921889-01 Amd 2~~ FUNDING 93.069 333.93.06 ~~01/01/18 06/30/18 07/01/17 07/02/18 $15,611 $47,529 $47,529 FFY17 EPR PHEP BP1 LHJ Funding NU90TP921889-01 N~~18101272 08/10/12 06/30/13 83,399 0 83,399 FFY12 PHEPR HC SYSTEMS - PREP 93.889 333.93.88 61309201 07/01/12 06/30/13 2,000 0 2,000 TOTALS 85,399 0 85,399 FFY12 PHEPR HC SYSTEMS – PREP (HPP) Task Number Task/A 93.069 333.93.06 01/01/18 06/30/18 07/01/17 07/02/18 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 FFY17 Increasing Immunization Rates NH23IP000762 Amd 3Activity Description *May Support PHIP State and Local Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount HPP 1 Coordinate training for healthcare responders and coalition entities in order to provide the required knowledge, 4 93.268 333.93.26 07/01/18 06/30/19 07/01/18 06/30/19 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 FY2 Group B Programs skills, and abilities needed to prepared and respond to a disaster. Submit training records. Training records not contained in SmartPH must be submitted on a DOH- provided form. 06/30/13 Reimbursement for DW (FO-E) Amd 3 N/A 334.04.90 07/01/18 06/30/19 07/01/17 06/30/19 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $0 $0 YR 20 SRF - Local Asst (15%) (FS) SS N/Acosts, Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333"not to exceed total funding consideration amount. State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 FFY12 PHEPR LHJ FUNDING ~~333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069~~ (PHEP) Task Number Task/Activity Description *May Support PHIP State and Local Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount Admin Complete and submit the Public Health Emergency Preparedness ~~Department of Health and Human Services Centers~~ Cooperative Agreement BP1 Performance Measures Reporting Templates provided by DOH. Submit completed performance measure report templates. 01/14/13 Reimbursement for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and costs, not to exceed total funding consideration amount AMENDMENT #7 Task Number Task/Activity Description *May Support PHIP State and ~~Community~~Local Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount Admin Complete a DOH-~~Based Programs Department of Health and Human Services Centers~~ provided work plan template outlining details for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJthe July 2013-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256June 2014 program year. Submit a completed work plan. 03/29/13

Appears in 1 contract

Samples: www.co.mason.wa.us

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 XXXXxxxxxxx.xxx 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~~ Please reference the Code 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. OH Program Contacts Regulations: xxxxx://xxx.xxxx.xxx/cgi-bin/retrieveECFR?gp=1&SID=58ffddb5363a27f26e9d12ccec462549&ty=HTML&h=L&mc=true&r=PART&n=pt2.1.200#se2.1.200_1439 DOH Program Contact ~~Xxxxxx Xxxxxx~~Xxxx Xxxxxxxxx, ~~MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office~~ Contracts and Finance Specialist Division of ~~Immunization~~ Emergency Preparedness and ~~Child Profile Office of Immunization and Child Profile~~ Response Department of Health ~~Department of Health PO~~ P O Box ~~47843~~47960, ~~Olympia~~ Olympia, WA 98504-~~7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx,~~ 7960 Desk 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx,~~ / Mobile 000-000-0000 xxxx.xxxxxxxxx@xxx.xx.xxx Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: Emergency Preparedness & Response COVID-19 Local CARES - Effective March 1 2020 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Original Revision # (for this SOW) 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: March 1, 2020 through December 31, 2020 Statement of Work Purpose: The purpose of this statement of work is to provide additional funding to supplement existing funds for LHJs to prevent, prepare for, and respond to the COVID-19 disease outbreak. Note: Pending execution of a one-year extension to the 2018-2020 consolidated contracts which currently end December 31, 2020, DOH will extend the period of performance in this statement of work through the end of January 2021 to include additional time for submission of the Final Report. LHJ may not bill for any time spent or costs incurred after December 30, 2020. Revision Purpose: N/A Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts~~ Current Consideration Change Increase (+) Total Consideration XXXXX XXX OFM Allocation-CARES 21.019 333.21.01 934E0200 03/01/20 12/30/20 0 5,402,000 5,402,000 TOTALS 0 5,402,000 5,402,000 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. The CARES Act (Coronavirus Relief Fund) provides that payments from the Fund may only be used to cover costs that: Complete Federal Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B Certification (~~FO-SW~~provided by DOH). Activity report(s) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333"on template to be provided DOH. State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15September 30, 2020 ~~DOH Total Amt Allocation Period Chart~~ September 30, 2020 October 31, 2020 November 30, 2020 December 31, 2020 Final Report: January 30, 2021 Reimbursement for actual costs not to exceed total funding consideration amount. 1. Are necessary expenditures incurred due to the public health emergency with respect to the Coronavirus Disease 2019 (COVID–19); 2. Were not accounted for in the budget most recently approved as 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department March 27, 2020 (the date of ~~Health~~ enactment of the CARES Act) for the State or government; and; 3. Were incurred during the period that begins on March 1, 2020, and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiologyends on December 30, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 93.994 Maternal and Child Health Services Block Grant to 2020 The guidance on the Department of ~~Health~~ the Treasury’s interpretation of these limitations on the permissible use of Fund payments can be found at this link: xxxxx://xxxx.xxxxxxxx.xxx/system/files/136/Coronav irus-Relief-Fund-Guidance-for-State-Territorial- Local-and-Tribal-Governments.pdf DOH will provide additional guidance and ~~Human Services Health Resources~~ technical assistance. Note: These funds are available through December 30, 2020. DOH will work closely with LHJ on the status of spending. By December 1, 2020, if funding is projected to be unspent, then DOH will reallocate those funds based on OFMs approval for the month of December. The purpose of this agreement is to supplement existing funds for local health jurisdictions to carry out surveillance, epidemiology, case investigations and ~~B04MC32578 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT States Services Administration FFY19 MCHBG~~ contact tracing, laboratory capacity, infection control, mitigation, communications, community engagement, and other public health preparedness and response activities for COVID-19. Existing funds for COVID-19 public health response activities may not be displaced by these funds and reallocated for other organizational expenses. No funds from this agreement shall be used to supplant existing federal, state or local funds nor any funding allocations or commitments made before August 31, 2020. Frequency and due dates of reports may change based on federal requirements. DOH will notify LHJ ~~CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 93.994 Maternal~~ of any changes via email. A final activity report is required prior to DOH releasing the final amount of funding. DOH does recognize the public health response goes beyond December 2020 and ~~Child Health Services Block Grant~~ 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 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 $88,015 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 $926,256local health jurisdiction response activities beyond December 2020 as applicable.

Appears in 1 contract

Samples: kitsappublichealth.org

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 XXXXxxxxxxx.xxx by DOH as required by P.L. 109-282. ~~Restrictions on Funds~~ Program Manual, Handbook, Policy References Staffing Requirements Provide notification via email to xxxxxxxxxxxxx@xxx.xx.xxx within fifteen (~~what funds can be used~~ 15) days of any changes to staffing for ~~which activities~~those who conduct work outlined in this statement of work. DOH Contract Manager DOH Program Contact DOH Fiscal Contact Xxxxxx Xxxxxx, ~~not direct payments, etc.) Allowable Uses of Federal~~ MPA Xxxxxxx Xxxxxx Xxxxxxx Xxxxxx Budget and 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 Manager Perinatal Hepatitis B Coordinator Special Projects Coordinator Office of Immunization and Child ~~Profile. OH Program Contacts DOH Program Contact Xxxxxx Xxxxxx, MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor~~ Profile Office of Immunization and Child Profile Office of Immunization and Child Profile 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 xxxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~xxxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: OICP-Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Original Revision # (for this SOW) Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2018 through June 30, 2019 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: N/A Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change Increase (+) Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 Consideration FFY18 ~~EPR PHEP BP1 Supp LHJ Funding NU90TP921889-01 Amd 5 93.069 333.93.06~~ Increasing Immzs Rates ConCon 93.268 333.93.26 74310285 07/01/18 06/30/19 ~~07/01/18 06/30/19 $1,424 $79,074 $79,074 FFY18 EPR PHEP BP1 Supp LHJ~~ 0 16,134 16,134 TOTALS 0 16,134 16,134 Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 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 NU90TP921889-01 Amd 4 93.069 333.93.06 07/01/18 06/30/19 07/01/18 06/30/19 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd Opportunity, Promotion of Immunizations to Increase Vaccination Rates announcement. Written proposal and a report that shows starting immunization rates for the target population August 1, 2018 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. See Restrictions on Funds below. 2 ~~93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 FFY17 Increasing Immunization Rates NH23IP000762 Amd 3~~Upon approval of proposal, 4 93.268 333.93.26 07/01/18 06/30/19 07/01/18 06/30/19 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 Nimplement the plan to increase immunization coverage rates with the target population identified. Written report describing the progress made on reaching milestones for activities identified in the plan (template will be provided) November 30, 2018 March 31, 2019 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. See Restrictions on Funds below Task Number Task/~~A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B~~ Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 3 Conduct an evaluation of the interventions implemented. Final written report, including a report showing ending immunization rates for the target population (~~FO-SW~~template will be provided) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May June 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers 2019 Reimbursement for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiologyactual costs incurred, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 93.994 Maternal and Child Health Services Block Grant not to the Department of Health and Human Services Health Resources and B04MC32578 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT States Services Administration FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256exceed total funding consideration amount. See Restrictions on Funds below

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx 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~~ Please reference the Code 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. OH Program Contacts Regulations: xxxxx://xxx.xxxx.xxx/cgi-bin/retrieveECFR?gp=1&SID=58ffddb5363a27f26e9d12ccec462549&ty=HTML&h=L&mc=true&r=PART&n=pt2.1.200#se2.1.200_1439 DOH Program Contact ~~Xxxxxx Xxxxxx~~Xxxxxxxx Xxxxxxxxx, ~~MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office of Immunization~~ Contract and ~~Child Profile Office of Immunization and Child Profile~~ Finance Specialist Department of Health ~~Department of Health PO~~ P O Box ~~47843~~47960, ~~Olympia~~ Olympia, WA 98504-~~7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx,~~ 7960 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~/ xxxxxxxx.xxxxxxxxx@xxx.xx.xxx Exhibit A Statement of Work Contract Term: 2018-2020 DOH Program Name or Title: Office of Immunization & Child Profile-Perinatal Hepatitis B - Effective July 1, ~~000-000-0000 DOH Use Only~~ 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Revision Revision # (for this SOW) 1 Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2018 through June 30, 2019 Statement of Work Purpose: The purpose of this statement of work is to define required Perinatal Hepatitis B activities, deliverables, and funding. Revision Purpose: The purpose of this revision is to correct the Chart of Accounts Program Name/Title ~~Federal Award Identification # Amend # CFDA* BARS Revenue~~ and the Master Index Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only . Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change None Total ~~Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93~~ Consideration FFY18 PPHF Ops 93.268 333.93.26 74310284 07/01/18 06/30/19 2,500 -2,500 0 FFY17 PPHF Ops 93.268 333.93.26 74310274 07/01/18 06/30/19 ~~$7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N~~0 2,500 2,500 TOTALS 2,500 0 2,500 Task Number Task/~~A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N~~Activity/~~A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N~~Description *May Support PHAB Standards/~~A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N~~Measures Deliverables/~~A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N~~Outcomes Due Date/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256Time Frame Payment Information and/or Amount

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx by DOH as required by P.L. 109-282. ~~Restrictions on Funds~~ Staffing Requirements Provide notification via email to xxxxxxxxxxxxx@xxx.xx.xxx within fifteen (~~what funds can be used~~ 15) days of any changes to staffing for ~~which activities~~those who conduct work outlined in this statement of work. DOH Contract Manager DOH Program Contact DOH Fiscal Contact Xxxxxx Xxxxxx, ~~not direct payments, etc.) Allowable Uses of Federal~~ MPA Xxxxxxx Xxxxxx Xxxxxxx Xxxxxx Budget and 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 Manager Perinatal Hepatitis B Coordinator Special Projects Coordinator Office of Immunization and Child ~~Profile. OH Program Contacts DOH Program Contact Xxxxxx Xxxxxx, MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor~~ Profile Office of Immunization and Child Profile Office of Immunization and Child Profile 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 xxxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~xxxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: OICP-Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Revision Revision # (for this SOW) 1 Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2018 through June 30, 2019 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: The purpose of this revision is to correct the Chart of Accounts Program Name/Title ~~Federal Award Identification # Amend # CFDA* BARS Revenue~~ and the Master Index Code** Statement of Work Funding Period Start Date End Date . Chart of Accounts Program Name or Title CFDA # BARS Revenue Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Amount Funding Period Sub~~ Current Consideration Change None Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 Consideration FFY18 ~~EPR PHEP BP1 Supp LHJ Funding NU90TP921889-01 Amd 5 93.069 333.93.06~~ Increasing Immzs Rates ConCon 93.268 333.93.26 74310285 07/01/18 06/30/19 07/01/18 06/30/19 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 16,134 -16,134 0 FFY17 Increasing Immunization Rates ~~NH23IP000762 Amd 3, 4~~ 93.268 333.93.26 74310276 07/01/18 06/30/19 07/01/18 06/30/19 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 0 16,134 16,134 TOTALS 16,134 0 16,134 Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 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. Written proposal and a report that shows starting immunization rates for the target population August 1, 2018 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. See Restrictions on Funds below. 2 ~~93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N~~Upon approval of proposal, implement the plan to increase immunization coverage rates with the target population identified. Written report describing the progress made on reaching milestones for activities identified in the plan (template will be provided) November 30, 2018 March 31, 2019 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. See Restrictions on Funds below Task Number Task/~~A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B~~ Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 3 Conduct an evaluation of the interventions implemented. Final written report, including a report showing ending immunization rates for the target population (~~FO-SW~~template will be provided) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May June 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers 2019 Reimbursement for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiologyactual costs incurred, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 93.994 Maternal and Child Health Services Block Grant not to the Department of Health and Human Services Health Resources and B04MC32578 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT States Services Administration FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256exceed total funding consideration amount. See Restrictions on Funds below

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx 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. ~~OH Program Contacts~~ Other Deliverables may be sent electronically via email to xxxxxxxxxxxxx@xxx.xx.xxx, by fax to 000-000-0000, or by mail to PO Box 47843, Olympia WA 00000-0000 DOH Program Contact DOH Fiscal Contact Xxxxxx Xxxxxx, MPA ~~Xxxxx Xxxxx, Project Manager Deputy Director |~~ Xxxxxxx Xxxxxx Budget and Operations Manager ~~CDC Public Health Advisor~~ Special Projects Coordinator Office of Immunization and Child Profile Office of Immunization and Child Profile Department of Health Department of Health PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia WA 98504-7843 ~~xxxxxx.xxxxxx@xxx.xx.xxx,~~ xxxxxx.xxxxxx@xxx.xx.xxx / 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx, 000~~xxxxxxx.xxxxxx@xxx.xx.xxx /000-000-0000 Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: P-TCPI Regional Care Coordination Project - Effective January 1, 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 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 Fixed Price Period of Performance: January 1, 2018 through September 28, 2018 Statement of Work Purpose: The purpose of this statement of work is to enhance and mobilize the Medical Home Neighborhood model of care for the whole child and family in pediatric practice transformation, a statewide network of Regional Care Facilitators (RCF), one in each of the nine Accountable Communities of Health (ACHs), will be created to join the Pediatric-Transforming Clinical Practice Initiative (P-TCPI) regional teams to emphasize physical and behavioral health integration and care coordination for children within participating practices, the ACH regional partners, and the state. Each RCF will have state, regional, and Practice Facilitator interface roles to facilitate the Medical Home Neighborhood concept and have a lasting impact on the system of pediatric services for children on Medicaid in Washington to improve children’s health. Revision Purpose: The purpose of this revision is to adjust the start date for TCPi funding from 02/01/18 to 01/01/18, clarify deliverable due dates, modify some tasks for clarity, revise staffing requirements, add special billing requirements, remove special instructions and change the DOH program contact. Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change None Total ~~Chart of Accounts Total 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 $15,611 $47,529 $47,529 FFY17 EPR PHEP BP1 LHJ Funding NU90TP921889-01~~ Consideration SFY17 MANAGED CARE ORG N/A ~~93.069 333.93.06~~ 334.04.98 78301680 01/01/18 06/30/18 ~~07/01/17 07/02/18 $31,918 FFY18 EPR PHEP BP1 Supp LHJ Funding NU90TP921889~~6,536 0 6,536 FFY17 TCPI PTN CONTRACTS 93.638 333.93.63 78450271 01/01/18 09/28/18 73,117 0 73,117 TOTALS 79,653 0 79,653 Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 Staffing Support a system of care coordination that strengthens linkages to primary care providers and improves health outcomes for children. 1a: Designate staff to s Serve as the Regional Care Facilitator (RCF) for the Olympic Region. 1b: In conjunction with DOH, participate in orientation and project start-01 Amd 5 93.069 333.93.06 07/01/18 06/30/19 07/01/18 06/30/19 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 FFY17 Increasing Immunization Rates NH23IP000762 Amd 3up activities. 1c: In conjunction with DOH, 4 93.268 333.93.26 07/01/18 06/30/19 07/01/18 06/30/19 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B participate in project evaluation activities. Narrative Report using the templates provided by DOH, that includes: • Staffing plan and implementation • Description of evaluation activities • Completed travel log for all travel billed (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart Template to be provided by DOH). • Quarterly TCPI reporting using the provided template Quarterly by the 15th of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $0 $0 YR 20 SRF - Local Asst (15%) (FS) SS N/AJanuary, Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6March, ~~9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3~~June, 6and September TCPI quarterly report due: April 30, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 92018 July 30, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) YR 20 SRF - Local Asst (15%) (FS) TA N/A2018 October 30, Amd 3 N/A 346.26.66 01/01/18 12/31/18 07/01/15 12/31/18 $2,000 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 2018 July 15, ~~2020~~ 2018 September 28, 2018 Reimbursement for actual staff time and travel related to TCPI activities. Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1d: Complete and submit quarterly TCPI related reporting to 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 93.994 Maternal and Child Health Services Block Grant to by the Department of Health and Human Services Health Resources and B04MC32578 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT States Services Administration FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256required deadline.

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx 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. ~~OH Program Contacts~~ Other Deliverables may be sent electronically via email to xxxxxxxxxxxxx@xxx.xx.xxx, by fax to 000-000-0000, or by mail to PO Box 47843, Olympia WA 00000-0000 DOH Program Contact DOH Fiscal Contact Xxxxxx Xxxxxx, MPA ~~Xxxxx Xxxxx, Project Manager Deputy Director |~~ Xxxxxxx Xxxxxx Budget and Operations Manager ~~CDC Public Health Advisor~~ Special Projects Coordinator Office of Immunization and Child Profile Office of Immunization and Child Profile Department of Health Department of Health PO Box 47843, Olympia WA 98504-7843 PO Box 47843, Olympia WA 98504-7843 ~~xxxxxx.xxxxxx@xxx.xx.xxx,~~ xxxxxx.xxxxxx@xxx.xx.xxx / 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx, 000~~xxxxxxx.xxxxxx@xxx.xx.xxx /000-000-0000 Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: Office of Immunization & Child Profile-Regional Representatives - Effective July 1, 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Revision Revision # (for this SOW) 1 Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2018 through June 30, 2019 Statement of Work Purpose: The purpose of this statement of work is to define required Vaccines for Children (VFC) activities for regional representatives and identify funding for the period July 1, 2018 through June 30, 2019. Revision Purpose: The purpose of this revision is to correct the Chart of Accounts Program Name/Title ~~Federal Award Identification # Amend # CFDA* BARS Revenue~~ and the Master Index Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only . Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change Increase (+) Total ~~Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93~~ Consideration FFY18 AFIX 93.268 333.93.26 74310282 07/01/18 06/30/19 27,563 -27,563 0 FFY17 AFIX 93.268 333.93.26 74310272 07/01/18 06/30/19 ~~$7,000 $7,000 $12,000 SFY1 Lead Environments of~~ 0 27,563 27,563 TOTALS 27,563 0 27,563 Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount Perform as the regional representative for Region Two (Clallam County, Jefferson County, Kitsap County) conducting activities in accordance with state and federal requirements for the Vaccines for Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 YR 20 SRF - Local Asst (~~15%~~VFC) (FS) SS Amd 3 N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services as outlined in the Centers for Disease Control and Prevention ~~Department~~ (CDC) VFC Operations Guide and as directed by the state administrators of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 the VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256program.

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx by DOH as required by P.L. 109-282. Program Manual, Handbook, Policy References VFC Operations Guide - A copy will be provided by the Office of Immunization and Child Profile. (Note: All site visit reviewers are required to have access to the most current CDC VFC Operations Guide at every VFC compliance site visit). Staffing Requirements Provide notification via email to xxxxxxxxxxxxx@xxx.xx.xxx within fifteen (15) days of any changes to staffing for those who conduct work outlined in this statement of work. 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. ~~OH Program Contacts~~ DOH Program Contact Xxxxxx Xxxxxx, MPA ~~Xxxxx Xxxxx~~Deliverables may be sent electronically via email at xxxxxxxxxxxxx@xxx.xx.xxx, ~~Project Manager Deputy Director |~~ Budget and Operations Manager ~~CDC Public Health Advisor Office of Immunization and Child Profile~~ by fax to 000-000-0000, or by mail to PO Box 47843, Olympia WA 98504-7843 Office of Immunization and Child Profile Department of Health ~~Department of Health PO Box 47843, Olympia WA 98504-7843~~ PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~DOH Fiscal Contact Xxxxxxx Xxxxxx Special Projects Coordinator Office of Immunization and Child Profile PO Box 47843, Olympia WA 98504-7843 Xxxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 Exhibit A Statement of Work Contract Term: 2018-2020 DOH ~~Use Only~~ Program Name or Title: Supplemental Nutrition Assistance Program- Education - Effective January 1, 2018 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 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 Fixed Price Period of Performance: January 1, 2018 through September 30, 2018 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 FFY18 CSS IAR SNAP ED funding to complete approved FFY18 activities and shorten the Period of Performance from 09/30/20 to 09/30/18. Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue Code** Code Master Index Code Funding (LHJ Use Start Date Period Only) End Date Current Consideration Change Increase (+) Total Consideration FFY18 CSS IAR SNAP ED PROG MGNT 10.561 333.10.56 76211981 01/01/18 09/30/18 61,131 8,150 69,281 FFY17 CSS IAR SNAP ED PROG MGNT CF 10.561 333.10.56 76211971 01/01/18 09/30/18 6,917 0 6,917 TOTALS 68,048 8,150 76,198 Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 FFY17 EPR PHEP BP1 LHJ Funding NU90TP921889-01 NOctober 1, 2017 – September 30, 2018 Task Number Task/A 93.069 333.93.06 01/01/18 06/30/18 07/01/17 07/02/18 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 NActivity/~~A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N~~Description *May Support PHAB Standards/~~A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N~~Measures Deliverables/~~A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N~~Outcomes Due Date/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256Time Frame Payment Information and/or Amount

Appears in 1 contract

Samples: Consent Agenda Agreement

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 XXXXxxxxxxx.xxx 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. OH Program Contacts DOH Program Contact Manager Xxxxxx Xxxxxx, MPA ~~Xxxxx Xxxxx, Project Manager~~ Deputy Director | Operations Manager ~~CDC Public Health Advisor Office of Immunization and Child Profile~~ Office of Immunization and Child Profile Department of Health ~~Department of Health PO Box 47843, Olympia WA 98504-7843~~ PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx, 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~Exhibit A Statement of Work Contract Term: 2018-2020 DOH Program Name or Title: OICP-Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, ~~000-000-0000 DOH Use Only~~ 2020 Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) Type of Payment Reimbursement Fixed Price FFATA (Transparency Act) Research & Development SOW Type: Original Revision # (for this SOW) Period of Performance: July 1, 2020 through December 31, 2020 AMENDMENT #16 Local Health Jurisdiction Name: Snohomish Health District Contract Number: CLH18261 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: N/A Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding Period (LHJ Use Only) Start Date End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change Increase (+) Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 Consideration FFY21 VFC Ops ~~NGA Not Received Amd 13~~ 93.268 333.93.26 74310202 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 0 22,575 22,575 TOTALS 0 22,575 22,575 Task Number Task/Activity/Description *May Support PHAB Standards/Measures Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 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. Written proposal and a report that shows starting immunization rates for the target population August 1, 2020 Reimbursement for actual costs incurred, not to exceed total funding consideration amount. *See Restrictions on Funds below. 2 ~~93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N~~Upon approval of proposal, implement the plan to increase immunization coverage rates with the target population identified. Written report describing the progress made on reaching milestones for activities identified in the plan (template will be provided) November 30, 2020 *For Information Only: Funding is not tied to the revised Standards/~~A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B~~ 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 (~~FO-SW~~PHAB) ~~Amd 9 N~~Standards/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement Measures that may apply can be found at: xxxx://xxx.xxxxxxxx.xxx/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf Exhibit A, Statements of Work ~~Funding Period Start Date End Date Chart~~ Page 18 of ~~Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart~~ 35 Contract Number CLH18261-16 Revised as of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/20 12/31/20 07/01/19 06/30/21 $58,739 $58,739 $176,217 FPHS Funding for LHJs Amd 9 N/A 336.04.25 07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739 FPHS Funding for LHJs Dir Amd 3 N/A 336.04.25 07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 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 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 AMENDMENT #16 Program Specific Requirements/Narrative Tasks in this statement of work may not be subcontracted without prior written approval from 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 07/01/20 12/31/20 $3,637 93.268 Immunization Cooperative Agreements Department of Health and Human Services Centers for Disease Control and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256OICP.

Appears in 1 contract

Samples: snohd.novusagenda.com

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 XXXXxxxxxxx.xxx 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~~ Please reference the Code of Federal ~~Operations Funds~~ Regulations: xxxxx://xxx.xxxx.xxx/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 Coronavirus Relief Fund - Guidance for State, Territorial, Local, and Tribal Governments Updated September 2, 2020 and a link: xxxxx://xxxx.xxxxxxxx.xxx/system/files/136/Coronavirus-Relief-Fund-Guidance-for-State-Territorial-Local-and-Tribal-Governments.pdf The purpose of this document ~~(dated 12/20/2017)~~ is ~~posted on~~ to provide guidance to recipients of 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. OH Program Contacts funding DOH Program Contact ~~Xxxxxx Xxxxxx~~Xxxx Xxxxxxxxx, ~~MPA Xxxxx Xxxxx, Project Manager Deputy Director | Operations Manager CDC Public Health Advisor Office of Immunization and Child Profile Office of Immunization and Child Profile~~ Contracts & Finance Specialist Department of Health ~~Department of Health PO~~ P O Box ~~47843~~47960, ~~Olympia~~ Olympia, WA 98504-~~7843 PO Box 47843, Olympia WA 98504-7843 xxxxxx.xxxxxx@xxx.xx.xxx,~~ 7960 000-000-0000 ~~xxxxx.xxxxx@xxx.xx.xxx~~/ xxxx.xxxxxxxxx@xxx.xx.xxx Exhibit A Statement of Work Contract Term: 2018-2020 DOH Program Name or Title: Foundational Public Health Services (FPHS) - Effective July 1, ~~000~~2019 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH18248 SOW Type: Revision Revision # (for this SOW) 1 Funding Source Federal <Select One> State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Periodic Distribution Period of Performance: July 1, 2019 through December 31, 2020 Statement of Work Purpose: The purpose of this statement of work is to specify how state funds for Foundational Public Health Services (FPHS) will be used for the period of July 1, 2019 through June 30, 2021. Note: The total consideration is for the period of July 1, 2019 through June 30, 2021. 2019-~~000~~2021 biennial funding allocations will be divided into four six-~~0000~~ month lump sum amounts that will be disbursed at the beginning of each six month period as follows: July, 1, 2019; January 1, 2020; July 1, 2020; January 1, 2021. Pending execution of a one-year extension to the 2018-2020 consolidated contracts which currently end December 31, 2020, DOH ~~Use Only~~ plans to extend the period of performance and funding in this statement of work through June 30, 2021. The final disbursement of funds scheduled for January 1, 2021 and deliverable due dates after December 31, 2020 are included in this statement of work for informational purposes only and will be carried forward into the extended contract term beginning January 1, 2021. FPHS funds must be spent in the state fiscal year (SFY) in which they are disbursed: SFY20 07/01/19-06/30/20 and SFY21 07/01/20-06/30/21. 2019-2021 Biennial Allocation: $424,268 Annual Allocation: $212,134 Six Month Disbursement: $106,067 Revision Purpose: The purpose of this revision is to increase the 2019-2021 funding allocation, add task 2 and funding to address hepatitis C, revise the SFY20 deliverable due date for task 1, and add language in the Program Specific Requirements/Narrative section concerning flexible use of FPHS funding during the COVID-19 pandemic response. Chart of Accounts Program Name or Title ~~Federal Award Identification~~ CFDA # Amend # CFDA* BARS Revenue ~~Code** Statement of Work~~ Code Master Index Code Funding ~~Period~~ (LHJ Use Start Date Period Only) End Date ~~Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub~~ Current Consideration Change Increase (+) Total Chart of Accounts Total 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 $15,611 $47,529 $47,529 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 $31,918 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 $1,424 $79,074 $79,074 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 $77,650 FFY19 PHEP BP1 LHJ Funding NU90TP922043 Amd 9 93.069 333.93.06 07/01/19 06/30/20 07/01/19 06/30/20 $79,074 $79,074 $79,074 FFY17 Prescription Drug OD-Enhanced NU17CE002734 Amd 2 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $45,000 $45,000 $45,000 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 $7,274 $7,274 $7,274 FFY21 VFC Ops NGA Not Received Amd 13 93.268 333.93.26 07/01/20 12/31/20 07/01/20 06/30/21 $3,637 $3,637 $10,911 FFY20 VFC Ops NH23IP922619 Amd 8 93.268 333.93.26 07/01/19 06/30/20 07/01/19 06/30/20 $7,274 $7,274 FFY19 COVID CARES NU50CK000515 Amd 13 93.323 333.93.32 06/01/20 12/31/20 06/01/20 06/30/21 $176,148 $176,148 $176,148 FFY20 CDC COVID-19 Crisis Resp LHJ-Tribe NU90TP922069 Amd 11 93.354 333.93.35 01/20/20 12/31/20 01/01/20 06/30/21 $183,219 $183,219 $183,219 FFY20 MCHBG LHJ Contracts B04MC32578 Amd 9 93.994 333.93.99 10/01/19 09/30/20 10/01/19 09/30/20 $105,006 $105,006 $298,027 FFY19 MCHBG LHJ Contracts B04MC32578 Amd 4 93.994 333.93.99 10/01/18 09/30/19 10/01/18 09/30/19 $105,006 $105,006 FFY18 MCHBG LHJ Contracts B04MC31524 Amd 2 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $9,260 $88,015 FFY18 MCHBG LHJ Contracts B04MC31524 N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $78,755 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/20 12/31/20 07/01/20 06/30/21 $10,000 $10,000 $30,000 GFS-Group B (FO-SW) Amd 9 N/A 334.04.90 07/01/19 06/30/20 07/01/19 06/30/21 $10,000 $10,000 GFS - Group B (FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $10,000 $10,000 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 $20,000 $20,000 $20,000 Healthy Communities Amd 10 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 ($3,425) $0 $0 Healthy Communities Amd 9 N/A 334.04.91 07/01/19 06/30/20 07/01/19 06/30/21 $3,425 FY20/21 COVID-19 Disaster Response Acct Amd 11 N/A 334.04.92 01/20/20 12/31/20 01/01/20 06/30/21 $166,781 $166,781 $166,781 FPH Lead Case Mgmt-FPH Amd 10 N/A 334.04.93 07/01/19 06/30/20 07/01/19 06/30/20 $3,425 $3,425 $3,425 DOH Use Only Chart of Accounts Program Title Federal Award Identification # Amend # CFDA* BARS Revenue Code** Statement of Work Funding Period Start Date End Date Chart of Accounts Funding Period Start Date End Date Amount Funding Period Sub Total Chart of Accounts Total SFY2 Lead Environments of Children Amd 4 N/A 334.04.93 07/01/18 06/30/19 07/01/18 06/30/19 $7,000 $7,000 $12,000 SFY1 Lead Environments of Children Amd 2 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $2,000 $5,000 SFY1 Lead Environments of Children Amd 1 N/A 334.04.93 01/01/18 06/30/18 07/01/17 06/30/18 $3,000 Consideration FPHS ~~Funding for LHJs Amd 9~~ FUNDING FOR LHJS N/A 336.04.25 ~~07/01/20 12/31/20~~ 99202101 07/01/19 ~~06/30/21 $58,739 $58,739 $176,217~~ 06/30/20 147,345 28,000 175,345 FPHS ~~Funding for LHJs Amd 9~~ FUNDING FOR LHJS N/A 336.04.25 ~~07/01/19 06/30/20 07/01/19 06/30/21 $58,739 $58,739~~ 99202101 07/01/20 12/31/20 147,345 28,000 175,345 FPHS ~~Funding for LHJs Dir Amd 3~~ - Hepatitis C N/A 336.04.25 ~~07/01/18 06/30/19 07/01/17 06/30/19 $58,739 $58,739 YR 20 SRF~~ 99202101 07/01/19 06/30/20 0 36,789 36,789 FPHS - ~~Local Asst (15%) (FS) SS Amd 3~~ Hepatitis C N/A 346.26.64 01/01/18 12/31/18 07/01/15 12/31/18 ($3,750) $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 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 ($4,250) $3,750 $3,750 YR 21 SRF - Local Asst (15%) (FS) SS Amd 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $4,250 YR 21 SRF - Local Asst (15%) (FS) SS Amd 3, 6, 9 N/A 346.26.64 01/01/18 06/30/19 07/01/17 06/30/19 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 12 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $500 $8,000 $8,000 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $3,250 YR 22 SRF - Local Asst (15%) (FO-SW) SS Amd 9, 10 N/A 346.26.64 01/01/19 12/31/20 01/01/19 06/30/21 $4,250 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) ($2,000) ($2,000) 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 $2,000 $2,000 YR 21 SRF - Local Asst (15%) (FS) TA Amd 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 ($3,116) $884 $884 YR 21 SRF - Local Asst (15%) (FS) TA Amd 6, 9 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, 6, 9 N/A 346.26.66 01/01/18 06/30/19 07/01/17 06/30/19 $2,000 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $2,000 $3,750 $3,750 YR 22 SRF - Local Asst (15%) (FO-SW) TA Amd 9, 10 N/A 346.26.66 01/01/19 12/31/20 01/01/19 06/30/21 $1,750 TOTAL $1,351,063 $1,351,063 Total consideration: $1,171,278 GRAND TOTAL $1,351,063 $179,785 GRAND TOTAL $1,351,063 Total Fed $926,256 Total State $424,807 *Catalog of Federal Domestic Assistance **Federal revenue codes begin with "333". State revenue codes begin with "334". Exhibit C-11 Schedule of Federal Awards AMENDMENT #13 COWLITZ COUNTY HEALTH DEPT-SWV0000537-08 CONTRACT CLH18242-Cowlitz County Health & Human Services Department CONTRACT PERIOD: 01/01/2018-12/31/2020 Date: May 15, 2020 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 PHEP BP1 LHJ FUNDING 333.93.06 06/29/19 $11,307,904 07/01/19 06/30/20 $79,074 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention Department of Health and Human NU90TP922043 PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE AGREEMENT HOSPITAL PREPAREDNESS PROGRAM FFY18 EPR PHEP BP1 SUPP LHJ FUNDING 333.93.06 08/01/18 $11,062,782 07/01/18 06/30/19 $79,074 93.069 Public Health Emergency Preparedness Services Centers for Disease Control and Prevention NU90TP921889-01 AND PUBLIC HEALTH EMERGENCY PREPAREDNESS COOPERATIVE AGREEMENT FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/18 06/30/18 $47,529 93.069 Public Health Emergency Preparedness Department of Health and Human Services Centers for Disease Control and Prevention NU90TP921889-01 HPP AND PHEP COOPERATIVE AGREEMENT FFY17 PRESCRIPTION DRUG OD-ENHANCED 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/18 $45,000 93.136 Injury Prevention and Control Research and State and Community-Based Programs Department of Health and Human Services Centers for Disease Control and Prevention NU17CE002734 PRESCRIPTION DRUG OVERDOSE FOR STATES FFY21 VFC OPS 333.93.26 NGA Not Received NGA Not Received 336.04.25 99202101 07/01/20 12/31/20 ~~$3,637 93.268 Immunization Cooperative Agreements Department~~ 0 36,789 36,789 TOTALS 294,690 129,578 424,268 Task Number Task/Activity/Description Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 These funds are for delivering ANY or all of ~~Health~~ the FPHS communicable disease, environmental public health or assessment service and ~~Human Services Centers~~ can also be used for ~~Disease Control~~ any of the other FPHS capabilities that support these FPHS as defined in the most current version of FPHS Definitions. Annual Report (template provided by DOH) for SFY20 (07/01/19 – 06/30/20) Annual Report (template provided by DOH) for SFY21 (07/01/20 – 06/30/21) By 08/15/20 09/15/20 Note: January 2021 payment is dependent on submission of this annual report. By 08/15/21 Funds are available beginning July 1, 2019. Half of the annual allocation will be disbursed each July upon receipt of the Annual Report and Prevention NGA Not Received NGA Not Received rol NH23IP922619 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN PROGRAM FFY20 VFC OPS 333.93.26 07/01/19 $9,234,835 07/01/19 06/30/20 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention FFY17 INCREASING IMMUNIZATION RATES 333.93.26 06/29/18 $1,722,443 07/01/18 06/30/19 $7,274 Immunization Cooperative Department of Health and Human93.268 Agreements Services Centers for Disease Cont and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases Department of Health and Human rol NH23IP000762 IMMUNIZATION GRANT AND VACCINES FOR CHILDREN'S PROGRAM FFY19 COVID CARES 333.93.32 04/23/20 $22,581,799 06/01/20 12/31/20 $176,148 93.323 the second half will be disbursed each January. Note: Funds must be spent in the state fiscal year (ELC)-Building and Strengthening Services Centers for Disease Control NU50CK000515 EPIDEMIOLOGY & LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC)-BUILDING & STRENGTHENING Epidemiology, Laboratory and Public Health Emergency Response: Cooperative and Prevention Department of Health and Human EPIDEMIOLOGY, LABORATORY & FFY20 CDC COVID-19 CRISIS RESP LHJ-TRIBE 333.93.35 03/16/20 $13,230,799 01/20/20 12/31/20 $183,219 93.354 Agreement for Emergency Response: Public Health Crisis Response Services Centers for Disease Control and Prevention NU90TP922069 HEALTH CRISIS RESPONSE CDC-RFA- TP18-1802 FFY20 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/19 09/30/20 $105,006 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 FFY19 MCHBG LHJ CONTRACTS 333.93.99 11/14/18 $2,225,977 10/01/18 09/30/19 $105,006 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 $88,015 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 $926,256SFY) in which they are disbursed.

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