Campaign Contributions / Lobbying. Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement. ATTACHMENT B COMPLIANCE WITH THE‌ "ENHANCEMENT OF CONTRACTOR PROTECTION FROM REPRISAL FOR DISCLOSURE OF CERTAIN INFORMATION" and NON-DEBARMENT CERTIFICATION AND WARRANTY Congress has enacted a law, found at 41 U.S.C. 4712, which encourages employees to report fraud, waste, and abuse. This law applies to all employees working for contractors, grantees, subcontractors and subgrantees on federal grants and contracts [for the purpose of this document, “Recipient of Funds”]. This program requires all grantees, their subgrantees and subcontractors to: • Inform their employees working on any Federal award they are subject to whistleblower rights and remedies, • Inform their employees in writing of employee whistleblower protections under 41 U.S.C. 4712 in the predominant native language of the workforce; and, • Contractors and grantees will include such requirements in any agreement made with a subcontractor or subgrantee. Employees of a contractor, subcontractor, grantee [or subgrantee] may not be discharged, demoted, or otherwise discriminated against as reprisal for ''whistleblowing." In addition, whistleblower protections cannot be waived by any agreement, policy, form or condition of employment. Whistleblowing is defined as making a disclosure "that the employee reasonably believes is evidence of any of the following: • Gross mismanagement of a federal contract or grant, • A gross waste of federal funds, • An abuse of authority relating to a federal contract or grant, • A substantial and specific danger to public health or safety; or, • A violation of law, rule, or regulation related to a federal contract or grant (including the competition for, or negotiation of, a contract or grant). To qualify under the statute, the employee's disclosure must be made to: • A Member of Congress or a representative of a Congressional committee, • An Inspector General, • The Government Accountability Office, • A federal employee responsible for contract or grant oversight or managemen...

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Campaign Contributions / Lobbying. Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement. KANSAS DEPARTMENT OF TRANSPORTATION Special Attachment To Contracts or Agreements Entered Into By the Secretary of Transportation of the State of Kansas NOTE: Whenever this Special Attachment conflicts with provisions of the Document to which it is attached, this Special Attachment shall govern. THE CIVIL RIGHTS ACT OF 1964, and any amendments thereto, REHABILITATION ACT OF 1973, and any amendments thereto, AMERICANS WITH DISABILITIES ACT OF 1990, and any amendments thereto, AGE DISCRIMINATION ACT OF 1975, and any amendments thereto, EXECUTIVE ORDER 12898, FEDERAL ACTIONS TO ADDRESS ENVIRONMENTAL JUSTICE IN MINORITY POPULATIONS AND LOW INCOME POPULATIONS 1994, and any amendments thereto, 49 C.F.R. Part 26.1 (DBE Program), and any amendments thereto NOTIFICATION The Secretary of Transportation for the State of Kansas, in accordance with the provisions of Title VI and Title VII of the Civil Rights Act of 1964 (78 Xxxx. 000), §000 of the Rehabilitation Act of 1973 (87 Stat. 355) and the Americans with Disabilities Act of 1990 (42 USC 12101), the Age Discrimination Act of 1975 (42 USC 6101), the regulations of the U.S. Department of Transportation (49 C.F.R., Part 21, 23, and 27), issued pursuant to such Act, Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low Income Populations (1994), and the DBE Program (49 C.F.R., Part 26.1), hereby notifies all contracting parties that, the contracting parties will affirmatively ensure that this contract will be implemented without discrimination on the grounds of race, religion, color, gender, age, disability, national origin, or minority populations and low income populations as more specifically set out in the following “Nondiscrimination Clauses”.

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Campaign Contributions / Lobbying. Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement. Attachment B Outreach, Prevention and Early Intervention Services Kansas Department of Health and Environment QUARTERLY REPORT Fiscal Year COUNTY HEALTH DEPARTMENT NEW PARTICIPANTS IN REPORTING QUARTER Q1 Q2 Q3 Q4 Total new participants Total prenatal referrals Total referrals at birth Total referrals at discharge Total of pregnant teens Total of post delivery teens Total home visits Total enrolled in Medicaid at first contact Total of applicants to Medicaid Total participating in family planning, if applicable Total with private health insurance TEEN PREGNANCY PARTICIPANTS IN REPORTING QUARTER Q1 Q2 Q3 Q4 Total pregnant teens in program Total teen mothers in program Total teen mothers with more than one child Total of pregnant teens receiving prenatal care Total enrolled in Medicaid at first contact Total of applicants to Medicaid Total participating in family planning, if applicable Total with private health insurance OVERALL PROGRAM PARTICIPATION Q1 Q2 Q3 Q4 Total enrolled in program Total enrollled in Medicaid Total participating in EPSDT Total number of home visits Total participants actively utilizating program services Total number unresponsive to outreach efforts Total number completing program through age 2 Total number completing program through age 3 Total number completing program through age 5 Total number dropping out of program or inactive for three or more months Total with private health insurance Total with drug/alcohol abuse history Total with daily tobacco use Attachment B Outreach, Prevention and Early Intervention Services Kansas Department of Health and Environment QUARTERLY REPORT Fiscal Year COUNTY HEALTH DEPARTMENT PROGRAM SUMMARY/COMMENTS: Attachment C Certification of Non-Federal Match Form (To be used to certify Medicaid Matching Funds) INSTRUCTIONS: Complete items 1 through 4 below, sign and date, and return the form to the address at the top of the second page. Please refer to your Invoice - Total Program Expenditures for this Quarter ...

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