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HomeMy WebLinkAboutDivision of Public Health # 15820Z . , . fi "' r DIVISION OF PUBLIC HEALTH CONTRACT AGREEMENT DPH CONTRACT #15820 Contract Preamble F AN 0 3 2008 ; I CITY CLERKS OFFICE= This Contract Agreement is entered into for the period January 1, 2008 through December 31, 2008, by and between the State of Wisconsin represented by its Division of Public Health of the Department of Health and Family Services, whose.principal business address is One West Wilson Street, PO Box 2659, Madison WI 53701 -2659, hereinafter referred to as Contractor, and Oshkosh Health Department, whose principal business address is 215 Church Street, PO Box 1130, Oshkosh, WI 54902 -1130, hereinafter referred to as Contractee. The Contractee address above is the address to which payments shall be mailed. If any legal notices required to be sent to the Contractee in the execution of this Contract Agreement should be sent to an address different from the Contractee address noted above, that address should be provided below: Whereas, the Contractor wishes to purchase services from the Contractee as it is authorized to do by Wisconsin law; and Whereas, the Contractee is engaged in furnishing the desired services; Now, therefore, the Contractor and the Contractee agree as follows: L SERVICES TO BE PROVIDED The Contractee agrees to provide services consistent with the purposes and conditions of the objectives that it has agreed to attain within the contract period. A detailed description of the objectives to be attained and the documentation associated with that attainment is part of this Contract Agreement as listed in Exhibits I and II, which are attached to this Agreement. The Contractee also agrees to provide to the Contractor documentation (as agreed to in negotiations with the Contractor) of the attainment of those objectives no later than 30 days after the end of the contract period or as specified in Exhibit II. II. CONTRACT ADMINISTRATION The Contractor's Contract Administrator is Susan Nelson of the Division of Public Health, whose principal business address is 200 North Jefferson Street, Suite 511, Green Bay, WI 54301 - 5123. The telephone number of the Contractor's Contract Administrator is (920) 448 -5231. In the event its Contract Administrator is unable to administer this Contract Agreement, the Contractor will contact the Contractee and designate a new Contract Administrator. The Contractee's Contract Administrator is Paul Spiegel, whose principal business address is 215 Church Street, PO Box 1130, Oshkosh, WI 54902-1130. The telephone number of the Contractee's Contract Administrator is (920) 236 -503 1. In the event its Contract Administrator is unable to administer this Contract Agreement, the Contractee will contact the Contractor and designate a new Contract Administrator. III. PAYMENT LIMIT The Contractor agrees to pay the Contractee in accordance with the terms and conditions of this Contract Agreement, an amount not to exceed $63,860. This amount is contingent upon receipt of sufficient funds by the Contractor. The Contractor will not make payments in excess of the Contract Agreement amounts, with the exception of performance -based incentive funds pursuant to Section XXI. IV. PAYMENT PROCESS 1. Payments will be made on a monthly basis. The Contractee will receive onatwelfth (1/12) of the total contract amount each month unless Contractee has failed to maintain quality criteria or proposed progress towards achievement of Contract Agreement objectives as determined by the Contractor. In these situations, the Contractor can make reductions in the monthly payment pursuant to Section XVI. 2. All payments shall be released by the Department on the last business day before the fifth day of the month for municipalities, or the last business day of each month for nonmunicipalities, with the exception that the payment that would normally be released on the last working day of June shall be released instead on the first working day of July. Checks will be mailed to the Contractee's principal business address unless the Contractee requests, in writing, subject to approval, that the Department mail the checks to a different address. V. PROGRAM REPORTING The Contractee shall comply with the program reporting requirements of the Contractor as specified during the negotiation process and as stated in Exhibits I and II of this Contract Agreement. The required reports shall be forwarded to the Contractor's Contract Administrator according to the schedule as specified in Exhibits I and 1I. 2. Failure to submit the reports specified in the reporting instructions may result in the Contractor rendering sanctions pursuant to Section XVI of this contract. VI. STATE AND FEDERAL RULES AND REGULATIONS 1. The Contractee agrees to meet State and Federal laws, rules and regulations, and program policies applicable to this Contract Agreement. 2. The Contractee agrees to comply with Public Law 103 -227, also known as the Pro-Children Act of 1994, which prohibits tobacco smoke in any portion of a facility owned or leased or contracted for by an entity which receives Federal funds either directly or through the State, for the purpose of providing services to children under the age of 18. 3. Affirmative Action Plan /Civil Rights Compliance Affirmative Action Plans A. An Affirmative Action Plan is a written document that details an affrmative action program. Key parts of an affirmative action plan are: (1) a policy statement pledging nondiscrimination and affinnative action employment, (2) internal and external dissemination of the policy, (3) assignment of a key employee as the equal'opportunity officer, (4) a workforce analysis that identifies job classifications where there is an under representation of women, minorities, and persons with disabilities, (5) goals must be directed to achieving a balanced workforce, specific and measurd,le, having an implementation target date between six months and two years, and having a plan of action or description of procedures to implement the goals, (6) revision of employment practices to ensure that they do not have discriminatory effects, and (7) establishment of internal monitoring and reporting systems to regularly measure progress. B. An Affirmative Action Plan is required from a Contractee who receives a contract from the Contractor in the amount of 525,000 or more and who has a workforce of tventy -five (25) or more employees as of the award date, unless the Contractee is exempt by criteria listed in the Wisconsin Office of Contract Compliance, Department of Administration's Instruction for Vendors Affirmative Action Requirements (DOA -3021P (R06/96) s, 16765, Wis. Stats.), page 2. Universities, other states, and local governments, except those of the State Performance LHD w/o CARS Report 10/07 2 of Wisconsin who receive state or federal contracts over $25,000, must submit Affirmative Action Plans in the same manner as other Contractees. C. In addition, for agreements of twenty-five thousand ($25,000) or more, regardless of workforce size, the Contractee shall conduct, keep on file, and update annually, a separate and additional accessibility self - evaluation of all programs and facilities, including employment practices for compliance with ADA regulations, unless an updated self evaluation under Section 504 of the Rehabilitation Act of 1973 exists which meets the ADA requirements. Contractees are to contact the Affirmative Action /Civil Rights Compliance Office, Department of Health and Family Services, One West Wilson Street, Room 561, PO Box 7850, Madison WI 53707 -7850, for technical assistance on Equal Opportunity. Civil Rights Compliance A. For agreements for the provision of services to clients, the Contractee must comply with Civil Rights requirements. Contractees with an annual workforce of less than twentyfive (25) employees, regardless of contract amount, and Contractees with contracts of less than $25,000 are not required to submit a Civil Rights Compliance Action Plan, however, they must submit a Civil Rights Compliance Letter of Assurance. Contractees with an annual workforce of twenty -five (25) employees or more and contract agreements of $25,000 or more shall submit a written Civil Rights Compliance Plan which covers a three -year period within fifteen (15) working days of the award date of the agreement or contract. B. The Contractee assures that it has submitted to the Contractor's Affirmative Action /Civil Rights Compliance Office a current copy of its three -year Civil Rights Compliance Action Plan for meeting Equal Opportunity Requirements under Title VI and VlI of the Civil Rights Act of 1964, Section 503 and 504 of the Rehabilitation Act of 1973, Title VI and XVI of the Public Health Service Act, the Age Discrimination in Employment Act of 1967, the Age Discrimination Act of 1975, the Omnibus Reconciliation Act of 1981, the American with Disabilities Act (ADA) of 1990, and the Wisconsin Fair Employment Act. If the Plan was reviewed and approved during the previous year, a plan update must be submitted for this Contract Agreement period. 1) No otherwise qualified person shall be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination in any manner on the basis of race, color, national origin, sexual orientation, religion, sex, disability or age. This policy covers eligibility for and access to service delivery, and treatment in all programs and activities. All employees of the Contractee are expected to support goals and programmatic activities relating to nondiscrimination in service delivery. 2) No otherwise qualified person shall be excluded from employment, be denied the benefits of employment or otherwise be subjected to discrimination in employment in any manner or team of employment on the basis of age, race, religion, sexual orientation, color, sex, national origin or ancestry, disability (as defined in Section 504 and the American with Disability Act of 1990), or association witha person with a disability, arrest or conviction record, marital status, political affiliation, or military participation, unfair honesty testing and genetic testing, and use or non use of lawful products outside of working hours. All employees of the Cortractee are expected to support goals and rogrammatic activities relating to non. discrimination in employment. 3) The Contractee shall post the Equal Opportunity Policy, the name of the Equal Opportunity Coordinator and the Limited English Proficiency Coordnator, and the discrimination complaint process in conspicuous places available to applicants and clients of services, and applicants for employment and employees. The complaint process will be according to the Contractor's standards and the Contractee shall post the complaint process notice translated into the major primary languages of Performance LHD w/o CARS Report 10/07 1 f the limited English Proficient (LEP) participants in their service area. The notice will announce the availability of free oral interpretation of services if needed. The Contractee shall not request interpretation services from family members, friends and minors. 4) The Contractee agrees to comply with the Contractor's guidelines in the State of Wisconsin Department of Workforce Development and Department of Health and Family Services, Affirmative Action, Equal Opportunity, Limited English Proficiency and Civil Rights Compliance Plan for Profit and Non -Profit Entities DWSD -14045 (R. 11/2003)) or subsequent revisions. 5) Requirements herein stated apply to any subcontracts or grants. The Contractee has primary responsibility to take constructive steps, as per the State of Wisconsin Department of Workforce Development and Department of Health and Family Services, Affirmative Action, Equal Opportunity, Limited English Proficiencyand Civil Rights Compliance Plan for Profit and Non -Profit Entities DWSD -14045 (R. 11/2003), to ensure the compliance of its subcontractors. However, where the Contractor has a direct contract with another Contractee's subcontractor, the Contractee need not obtain a Subcontractor or Subgrantee Civil Rights Compliance Plan or monitor that subcontractor. 6) The Contractor will monitor the Civil Rights Compliance of the Contractee. The Contractor will conduct reviews to ensure that the Contractee is ensuring compliance by its subcontractors or grantees according to guidelines in the State of Wisconsin Department of Workforce Development and Department of Health and Family Services, Affirmative Action, Equal Opportunity and Limited English Proficiency, Civil Rights Compliance Plan for Profit and Non -Profit Entities, DWSD- 14045 (R. 11/2003). The Contractee agrees to comply with Civil Rights monitoring reviews, including the examination of records and relevant files maintained by Contractee, as well as interviews with staff, clients, and applicants for services, subcontractors, providers, and referral agencies, The reviews will be conducted according to Department procedures. The Contractor will also conduct reviews to address immediate concerns of complainants 7) The Contractee agrees to cooperate with the Contractor in developing, implementing and monitoring corrective action plans that result from complaint investigations or monitoring efforts. C. The Contractee agrees that it will: (1) hire staff with special translation or sign language skills and /or provide staff with special translation or sign language skills training, or find qualified persons who are available within a reasonable period of time and who can communicate with limited or non - English speaking or speech or hearing-impaired clients at no cost to the client; (2) provide aids, assistive devices and other reasonable accommodations to the client during the application process, in the receipt of services, and in the processing of complaints or appeals; (3) train staff in human relations techniques, sensitivity to persons with disabilities and sensitivity to cultural characteristics; (4) make programs and facilities accessible, as appropriate, through outstations, authorized representatives, adjusted work hours, ramps, doorways, elevators, or ground floor rooms, and Braille, large print or taped information for the visually or cognitively impaired; (5) post and /or make available informational materials in languages and formats appropriate to the needs of the client population. VII. SUBCONTRACTS 1. The Contractee may subcontract all or part of this Contract Agreement as agreed to during contract negotiation. The Contractor reserves the right of approval for any subcontracts and the Contractee shall report information relating to subcontracts to the Contractor. A change in a subcontractor or a change from direct service provision to a subcontract may only be executed with the prior written Performance LHD w/o CARS Report 10/07 1 4 approval of the Contractor. In addition, Contractor approval may be required regarding the terms and conditions of the subcontracts, and the subcontractors selected. Approval of the subcontractors will be withheld if the Contractor reasonably believes that the intended subcontractor will not be a responsible provider in terms of services provided, objectives to be attained, or required quality criteria. The Contractee retains responsibility for fulfillment of all terms and conditions of this Contract Agreement when it enters into sub - contractual agreements and will be subject to enforcement of all the terms and conditions of this Agreement. Recoupment of Contractor payments to the Contractee for failure to comply with either the attainment of contract objectives or the maintenance of quality criteria by either the Contracteeor its subcontractor(s) will be made from the Contractee. VIII. GENERAL PROVISIONS 1. Any payments of monies to the Contractee by the Contractor for services provided under this Contract Agreement shall be deposited in a bank with Federal Deposit Insurance Corporation (hereinafter FDIC) insurance coverage. Any balance exceeding FDIC coverage must be collaterally secured. 2. The Contractee shall conduct all procurement transactions in a manner that provides maximum open and free competition. 3. The Contractee shall not engage the services of any person or persons concurrently employed by the State of Wisconsin, including any Department, commission or board thereof, to provide services relating to this Contract Agreement without the written consent of the employer of arch person or persons and of the Contractor. 4. This Contract Agreement is voidable if the Contractee is a state public official, a member of a state public official's immediate family, or an organization in which the official or immediate family member owns or controls at least 10 % of the outstanding equity, voting rights, or outstanding indebtedness and failed to make the written disclosure required under sec. 19.45 Wis. Stats, This disclosure is required to be made to the State of Wisconsin Ethics Board, 44 East Mifflin Street, Suite 601, Madison WI 53703, [Telephone (608) 266 - 8123]. 5. If the Contractee or any subcontractor is a corporation other than a Wisconsin corporation, it must demonstrate prior to providing services under this Contract Agreement thatit possesses a certificate of authority frorn the Wisconsin Secretary of State, and must have, and continuously maintain, a registered agent, and otherwise conform to all requirements of Chapters 180 and 181, Wisconsin Statutes, relating to foreign corporations. 6. The Contractee agrees that funds provided under this Contract Agreement shall be used to supplement or expand the Contractee's current public health service efforts, not to replace or allow for the release of available local (Contractee) funds for alternative uses. If the Contractor determines that local funds supporting public health services or funds under this Agreement have been released for alternative uses (supplanting), the Contractee may be subject to a proportionate reduction in funding under this Agreement in the current or subsequent contract year. IX. ACCOUNTING REQUIREMENTS For Contract Agreements of twenty -five thousand dollars ($25,000) or more, the Contractee shall maintain a uniform double entry, full accrual accounting system and a fnancial management information system in accordance with Generally Accepted Accounting Principles. (See DHFS' Accounting Principles and Allowable Cost Policy Manual, available upon request from the Contract Administrator or from the Audit Section, Division of Enterprise Services, Department of Health and Family Services, One West Wilson Street, PO Box 7850, Madison WI 53707- 7850.) Performance LHD w/o CARS Report 10 /07 2. For Contract Agreements of less than twenty-five thousand dollars ($25,000), the Contractee shall at least maintain a simplified double entry bookkeeping system as defined in the Department's Accounting Principles and Allowable Cost Policy Manual. 3. The Contractee's accounting system shall allow for accounting of total funds included in this Contract Agreement, and document that contract funds were not diverted outside of such set of programs. Diversion outside of the set of programs included in this Agreement will be subject to recoupment. As an innovation involving Federal funds, the Department is in the process of securing Fderal agreement to the accounting reforms in this contract. Until such time as the Contractee receives final written notice from the Contractor that the Federal government has waived program specific cost based reporting requirements for all programs in this Contract Agreement, the Contractee shall maintain sufficient information within their accounting records to provide costbased information by program. The Contractee shall provide this information to the Contractor electronically, via the Web -based Grants and Contracts (GAC) application, upon request for statewide reconciliation; however, the Contractor will not request this information unless necessary to support the claiming of Federal funds. 5. If program specific cost information is requested under paragraph 4 above the Contractee shall provide the information within ninety (90) days after the end of the contract period. The Contractor will make the request in writing at least 30 days prior to the specified due date for such information; will limit the breakdown of the information to what is required by the Contractor's funding sources and; will only request the information as of the end of the contract period for the full contract period. 6. The Contractee shall reconcile costs and match to expenses remded in the Contractee's accounting or simplified bookkeeping system on an ongoing and periodic basis. The Contractee agrees that reconciliation will be completed at least quarterly, will be documented, and supplied to the Contractor upon request. The Contractee shall retain the reconciliation documentation in accordance with the record retention requirement specified in Section XIV. 7. Monthly submittals of expenditure reports on the use of funds within this Contract Agreement are not required for contract payment purposes. 8. Nothing in this Section precludes the Contractee from keeping such information as needed for its internal management purposes. 9. Expenditures of funds from this Contract Agreement must meet the Department's allowable cost definitions as defined in the Department's Accounting Principles and Allowable Cost Policy Manual. X. CHANGES IN ACCOUNTING PERIOD 1.' The Contractee's accounting records are maintained on a fiscal year basis, beginning on the date indicated in the CARS Payment Information Rction of this contract. During the contract period, the accounting period may only be changed with prior written approval from the Contractor. The Contractor may approve a change in accounting period only if the Contractee has a substantial, verifiable business reason for changing the accounting period and agrees to submit a closeout audit, as defined in section (XII, 8), within 90 days after the first day of the new accounting period. 2. Proof of Internal Revenue Service approval shall be considered verification that the Contractee has a substantial business reason for changing its accounting period. 3. A change in accounting period shall not relieve the Contractee of reporting or audit requirements of this Contract Agreement. An audit meeting the requirements of this Agreement shall be submitted within 90 days after the first day of the start of the new accounting period for the short accounting period and within 180 days of the close, of the new accounting period for the new period. For Performance LHD w/o CARS Report 10/07 purposes of determining audit requirements, expenses and revenues incurred during the short accounting period shall be annualized. XI. PROPERTY MANAGEMENT REQUIREMENTS Property insurance coverage will be provided by the Contractee for fire and extended coverage of any equipment funded under this Contract Agreement which the Contractor retains ownership of, and which is in the care, custody and control of the Contractee. The Contractor shall have all ownership rights in any hardware funded under this Contract Agreement or supplied by the Contractor and in any software or modifications thereof and associated documentation designed, developed or installed as a result of this Agreement. The Contractee is responsible for keeping all of Contractor's property secure from theft, damaW or other loss. The Contractee agrees that if any materials are developed under this Contract Agreement, the Contractor shall have a royalty- -free, non - exclusive, and irrevocable right to reproduce, publish or otherwise use, and to authorize others to use, such materials. Any discovery or invention arising out of, or developed in the course of work aided by this Agreement, shall be promptly and fully reported to the Contractor. XII. AUDIT REQUIREMENTS I . Requirement to Have an Audit: Unless waived by the Contractor, the Contractee shall submit an annual audit to the Contractor if the total amount of annual funding provided by the Contractor (from any and all of its Divisions taken collectively) through this and other contracts is $25,000 or more. In determining the amount of annual funding provided by the Contractor, the Contractee shall consider both: (a) funds provided through direct contracts with the Contractor; and (b) funds from the Contractor passed through another agency which has one or more contracts with the Contractee. Audit Requirements: The audit shall be performed in accordance with auditing standards generally accepted in the United States of America, s.46.036, Wis, Stats., Government Auditing Standards, and other provisions in this Contract Agreement. In addition, the Contractee is responsible for ensuring that the audit complies with other standards that may be applicable depending on the type of Contractee and the nature and amount of financial assistance received from all sources: • Federal OMB Circular A -133 "Audits of States, Local Governments and Nonprofit Organizations," which applies only to Contractees that expend $500,000 fromall federal funding sources (this grant and other grants, direct or indirect, from this Contractor or another) during a Contractee's fiscal year. • The State Single Audit Guidelines (SSAG), which are applicable to local governments having A- 133 audits; and/or • The Provider Agency Audit Guide (PAAG). All Contractees that do not meet the requirements of the SSAG shall have audits in conformance with the PAAG. Reporting Packager The Contractee shall submit to the Contractor a reporting package which includes the following: A. Financial statements and other audit schedules and reports required for the type of audit applicable to the Contractee. B. The Management Letter (or similar document conveying auditor's comments issued as a result of the audit) or written assurance that a Management Letter was not issued with the audit report. C. Management responses /corrective action plan for each audit issue identified in the audit. Performance LHD w/o CARS Report 10/07 D. If program specific cost -based information is needed, the Contractor may require it as part of the reporting package. Submitting the Reporting Package: The Contractee shall submit the required reporting package to the Contractor either: (a) within nine months of the end of the Contractee's fiscal year if the Contractee is a local government, or (b) within 180 days of the end of the Contractee's fiscal year for non - governmental Contractee agencies. Two copies of the audit report must be sent to the Contractor at the following address: Attn: Audit Section Division of Enterprise Services Wisconsin Department of Health and Family Services PO Box 7850 Madison WI 53707 -7850 5. Access to Auditor's Work Papers: When contracting with an audit firm, the Contractee shall authorize its auditor to provide access to work papers, reports, and other materials generated during the audit to the appropriate representatives of the Department. Such access shall inclu& the right to obtain copies of the work papers and computer disks, or other electronic media, upon which records /working papers are stored. 6. Access to Contractee Records: The Contractee shall permit appropriate representatives of the Department and /or the Contractor to have access to the Contractee's records and financial statements as necessary to review Contractee's compliance with the Federal and State requirements for the use of the funding. 7. Failure to Comply with the Requirements of this Section: In the event that the Contractee fails to have an appropriate audit performed or fails to provide a complete audit report to the Contractor within the specified timeframes, in addition to applying one or more of the sanctions available in Section XVI of this contract, the Contractor may: A. Conduct an audit or arrange for an independent audit of the Contractee and charge the cost of completing the audit to the Contractee; B. Charge the Contractee for all loss of Federal or State aid or for penalties assessed to the Contractor because the Contractee did not submit a complete audit report within the required timeframe; and /or C. Disallow the cost of audits that do not meet these standards. 8. Closeout Audits: A. A specific audit of an accounting period of less than twelve (12) months is required when an agreement is terminated for cause, when the Contractee ceases operations or when the Contractee changes its accounting period (fiscal year). The purpose of the audit is to closeout the short accounting period. The required closeout audit may be waived by the Contractor upon written request from the Contractee, except when the agreement is terminated for cause. The required closeout audit may not be waived when an agreement is terminated for cause. . B. The Contractee shall ensure that its auditor contacts the Contractor prior to beginning the audit. The Contractor, or its representative, shall have the opportunity to review the planned audit program, request additional compliance or internal control testing and attend any conference between the Contractee and the auditor. Payment of increased audit costs, as a result of the additional testing requested by the Contractor, is the responsibility of the Contractee. Performance LHD w/o CARS Report 10/07 C. The Contractor may require a closeout audit that meets the audt requirements specified in XII, 2. above. In addition, the Contractor may require that the auditor annualize revenues and expenditures for the purposes of applying OMB Circular A-] 33 and determining major Federal financial assistance programs. This information shall be disclosed in a note to the schedule of Federal awards. D. All other provisions in the Audit Requirements section apply to Closeout Audits unless in conflict with the specific Closeout Audits requirements. XIII. OTHER ASSURANCES The Contractee shall notify the Contractor in writing, within thirty (30) days of the date payment was due of any past due liabilities to the Federal Government, State Government or their agents for income tax withholding, FICA, Workers' Compensation, Unemployment Compensition, garnishments or other employee related liabilities, Sales Tax, Income Tax of the Contractee, or other monies owed. The written notice shall include the amount(s) owed, the reason the monies are owed, the due date, the amount of any penalties or interest, known or estimated, the unit of government to which the monies are owed, the expected payment date and other related information. The Contractee shall notify the Contractor, in writing, within thirty (30) days of the date payment was due, of any past due payment in excess of five hundred dollars ($500), or when total past due liabilities to any one or more vendors exceed one thousand dollars ($1000), related to the operation of this Contract Agreement for which the Contractor has reimbursed or will rimburse the Contractee. The written notice shall include the amount(s) owed, the reason the monies are owed, the due date, the amount of any penalties or interest, known or estimated, the vendor to which the monies are owed, the expected payment date and other related information. If the liability is in dispute, the written notice shall contain a discussion of facts related to the dispute and the information on steps being taken by the Contractee to resolve the dispute. The Contractor may require written assurance at the time of entering into this Contract Agreement that the Contractee has in force and will maintain for the course of this Agreement employee dishonesty bonding in a reasonable amount to be determined by the Contractor. 4. The Contractee certifies that neither the Contractee organization nor any of its principals are debarred, suspended, or proposed for debarment for Federal financial assistance (e.g., General Services Administration's List of Parties Excluded from Federal Procurement and NoaProcurement Programs). The Contractee further certifies that potential sub - recipients, contractors, or any of their principals are not debarred, suspended or proposed for debarment. XIV. RECORDS 1. The Contractee shall maintain such records (in either written orelectronic form) as required by State and Federal law and as required by program policies. Records shall be retained for no less than the retention period specified in law or policy. Records for periods which are under audit or subject to dispute or litigation must be retained until the audit, dispute or litigation, and any associated appeal periods, have ended. 2. The Contractee will allow inspection of records and programs, insofar as is permitted by State and Federal law, by representatives of the Contractor and its authorized agents, and Federal agencies, in order to confirm the Contractee's compliance with the specifications of this Contract Agreement. 3. The Contractee agrees to retain and make available to the Contractor all program and fiscal records in accordance with the retention period specified in paragraph 1 above. Upon the Contractor's request, at the expiration of the Contract Agreement, the Contractee will transfer at no cost to the Contractor, records regarding the individual recipients who received services from the Contractee under this Agreement. The transfer of records includes transfer of any record, regardless of media, if that is the only method under which records were maintained. Performance LHD w/o CARS Report 10 /07 4. The Contractee and its subcontractors shall comply with all State and Federal confidentiality laws concerning the information in both the records it maintains and in any of the Contractor's records that the Contractee accesses to provide the services under this Contract Agreement. XV. AGREEMENT REVISIONS AND /OR TERMINATION The Contractee agrees to re- negotiate with the Contractor this Contract Agreement or any part thereof in such circumstances as: • Increased or decreased volume of services as required by the Contractor; • Changes required by State and Federal law or regulations, or court action; or, • Increase or reduction in the monies available affecting the substance of this Agreement. Failure to agree to a re- negotiated Contract Agreement under these circumstances is cause for the Contractor to terminate this Agreement. 2. This Contract Agreement can be terminated for any reason by a 3aday written notice by either party. 3. Revision of this Contract Agreement may be made by mutual agreement The revision will be effective only when the Contractor and Contractee attach an addendum or amendment to this Agreement, which is signed by the authorized representatives of both parties, except in circumstances in which increased caseload or grant award amount, where such increase in funds is for the same purpose as originally agreed upon, the Agreement may be amended by a unilateral amendment made by the Contractor. 4. The Contractee shall notify the Contractor whenever it is unable to provide the required quality or quantity of services required. Upon such notification, the Contractor shall determine whether such inability will require revision or termination of this Contract Agreement. 5. if the Contractor finds it necessary to terminate this Contract Agreement prior to the stated expiration date for reason other than non-performance by the Contractee, payment by the Contractor shall cease upon tenmination. Termination of the contract does not nullify the recoupment of funds by the Contractor, per the negotiated Agreement, associated with failure to attain program objectives or the failure to maintain quality criteria. XVI. NON - COMPLIANCE SANCTIONS AND REMEDIAL MEASURES I . If the Contractor determines, after notice to the Contractee and opportunity to respond, that the Contractee: Is out of compliance with the program quality criteria as listed in Exhibit 1, the Contractor may withhold part or all of the Contractee's funding at a level deemed appropriate by the Contractor as defined in paragraph 3 below. Has not attained the negotiated objective(s) as listed in Exhibit II, the Contractee shall refund the amount designated in Exhibit 11 under Risk Profile. Recoupments will be collected during the subsequent contract year via an adjustment (decrease) in the CARS monthly payment. In such case where a Contractee is subject to recoupment and no longer holds a Contract Agreement with the Contractor, the Contractor will issue an invoice to be paid by the Contractee. The Contractor may also, at its sole discretion, effectuate such refunds by withholding money from future payments due the Contractee at any time during or after the contract period or may recover such funds by any other legal means. 2. Failure to comply with any part of this Contract Agreement may be considered cause for revision, suspension or termination of this Agreemant. Suspension includes withholding part or all of the payments that otherwise would be paid the Contractee under this Agreement, temporarily having others perform, and receive reimbursement for, the services to be provided under this Agreement and any ober Performance LHD w/o CARS Report 10/07 10 measure that suspends the Contractee's participation in the Agreement if the Contractor determines it is necessary to protect the interests of the State. The Contractee shall provide written notice to the Contractor of all instances of noncompliance with the terms of program quality criteria associated with this Contract Agreement by itself or its subcontractors. Notice shall be given as soon as practicable but in no case later than 15 days after the Contractee became aware, or should have been aware, of the non - compliance. Non - compliance can also be determined by the Division of Public Health Regional Office Contract Administrator through onsite inspection or desk review of documentation. The written notice shall include information on reason(s) Sr and effect(s) of the non - compliance. The Contractee shall provide the Contractor with a plan to correct the non compliance and a timetable for the implementation of that plan to correct. The plan to correct must be approved by the Contractor. If at the end of the implementation period, the Contractee is found to still be out of compliance, the Contractor may, at its sole discretion, take whatever action it deems necessary to protect the interests of the State, including withholding part or all of the Ccntractee's funding, if it reasonably believes that the non-compliance will continue or will reoccur. 4. The Contractee shall provide within 30 days after the end of the contract period (or by the date specified in Exhibit II) to the Contractor via the Contract Administrator, the documentation specified in Exhibit 11 relating to attainment or failure to attain the objectives agreed to in this Contract Agreement. If any objective is not attained, the Contractor will determine, at its sole discretion, the proportion of non - attainment and will recoup from the Contractee an amount as defined by the Risk Profile identified in Exhibit I1. Any degree of non - attainment, as judged by the sole discretion of the Contractor, shall be used by the Contractor in determining the conditions of any continuation of this Agreement. If the Contractor detennines that non - compliance with other requirements (not stated in Exhibit I or Exhibit II) in this Contract Agreement has occurred, or is occurring, it shall demand immediate correction of continuing non - compliance and it may impose whatever sanctions or remedial measures it deems necessary to protect the interests of the State. Such sanctions and measures may include termination of the Agreement, suspension of the Agreement as Mined in paragraph 2 above, imposing additional reporting requirements and monitoring of subcontractors and any other measures it deems appropriate and necessary. 6. If audits are not submitted when due, the Contractor may take action pursuant to Section XIIof this Contract Agreement. 7. If required program deliverables or other required information or reports, other than audits, are not submitted when due, the Contractor may withhold all payments that otherwise would be paid the Contractee under this Contract Agreement until such time as the reports and information are submitted. In addition, the Contractor can hold implementation of continuation of this Agreement pending submittal of this documentation. XVIL DISPUTE RESOLUTION If any dispute arises between the Contractor and Contractee under this Contract Agreement, including the Contractor's finding of non - compliance and imposition of sanctions or remedial measures, the following process will be the exclusive administrative review. The Contractor's and Contractee's Contract Administrators will attempt to resolve the dispute, in coordination with the Division of Public Health Regional Office Director and appropriate program staff within the Division. If the dispute cannot be resolved by the Contract Administrators, the Contractee may ask for review by the Administrator of the Division of Public Health. 3. If the dispute is still not resolved, the Contractee may request a final review by the Secretary of the Department of Health and Family Services. Performance LHD w/o CARS Report 10/07 1 1 XVIII. INDEMNITY The Contractor and Contractee agree they shall be responsible for any losses or expenses (including costs, damages, and attorney's fees) attributable to the acts or omissions of their officers, employees or agents. XIX. SURETY BOND The Contractor may require the Contractee to have a surety bond. The surety bond shall be in force for the period of the Contract Agreement and shall be a reasonable amount to be determined by the Contractor. XX. CONDITIONS OF THE PAR'T'IES' OBLIGATIONS I This Contract Agreement is contingent upon authorization of Wisconsin and United States law, and any material amendment or repeal of the same affecting relevant funding or authority of the Contractor shall serve to revise or terminate this Agreement, except as further agreed to by the parties hereto. 2. The Contractor and Contractee understand and agree that no clause, term or condition of this Contract Agreement shall be construed to supersede the lawful powers or duties of either party. 3. It is understood and agreed that the entire Contract Agreement between the parties is contained herein, except for those matters incorporated herein by reference, and that this Agreement supersedes all oral agreements and negotiations between the parties relating to the subject matter thereof. XXL SPECIAL PROVISIONS If the Contractor determines that the Contractee has exceeded the agreed upon program objective(s) to the level specified in Exhibit II, Conditions for an Incentive Payment, the Contractee may be eligible to receive performance -based incentive funds if such funds are available as determined by the Contractor. The Contractor may make these incentive awards at its discretion based on the amount of available incentive funding and the terms of agreement with the Federal agency(s) as to the distrbution of such incentive funding. The awards will be made during the subsequent contract year via an adjustment (increase) in the monthly CARS payment. In such case where a Contractee is eligible for an incentive payment and no longer holds a contract agreement with the Contractor, the Contractor will make a separate payment to the Contractee. The incentive funds must be expended by the Contractee within the subsequent contract or calendar year and can not be diverted outside of the set of programs defined by this Contract Agreement or used for supplanting purposes. The Contractee shall report, in a manner specified by the Contractor, on how the Contractee expended these incentive funds. To the extent allowed by law: All funding recouped by the Contractor from the Contractee shall be held by the Contractor in a fund designated for use within the program area associated with the recoupment action. These funds may be used to award other Contractees who have exceeded their objectives in that program, general funding of the program area to all Contractees via formula in the next contract period, general funding of the program for all Contractees during the current contract period, or returned to the Federal funding agency of that program. These funds cannot be used by the Contractor for their own operational costs. 4. If at the end of the contract year, the Contractee has attained its contract objectives and is in compliance with the quality criteria, it may retain any unspent funds from this Contract Agreement not expended during the contract year, except for unearned prepayments (advances). However, those funds must be expended in the current contract year or the contract year immediately following and Performance LHD w/o CARS Report 10/07 12 their use must fall within the program boundaries establhhed under this Agreement. These retained funds cannot be diverted outside of the scope of this Agreement, the Local Public Health Department's budget, or used to supplant local public health tax levy levels. These funds shall be retained in a non - lapsing account for the sole use of the Local Public Health Department; these funds may not lapse to the general fund. The Contractee shall report how these funds were utilized, as specified in Section IX. XXII. CONTRACT RENEWAL OPTIONS This contract can be renewed on an annual basis for up to two (2) one-year extensions with the mutual agreement of both the Contractor and Contractee. The objectives to be attained by program will be re- negotiated each year by the Contractor and Contractee, as well as documentation deliverables and risk conditions. Performance LHD w/o CARS Report 10/07 13 Y � XXIII. TIMELY CONTRACT SIGNING This Contract Agreement becomes null and void if the time between the earlier dated signature and the later dated signature of the Contractee's and Contractor's Authorized Representative on this Agreement (or addendum) exceeds sixty (60) days inclusive of the two signature dates. Date R. Ubrig, City Clerk Contractor's Authorized �C Sheri Johnson, Ph.D., A Division of Public Health, and State Health Officer nt of Health and Family Services 07 �— Date CARS PAYMENT INFORMATION The information below is used by the Department's Bureau of Fiscal Services, CARS Unit to facilitate the processing and recording of payments made under this Contract Agreement. Agency Name Oshkosh Health Department Agency Number 472894 Agency Type 860 Contract Period January 1, 2008 through December 31, 2008 Contract Amount $63860 Agency Fiscal Year January through December Profile ID# 155020 Immunization Profile ID# 157720 Childhood Lead Profile ID# 159320 Maternal Child Health Profile ID# 159220 Prevention DPH Contract # 15820 CFDA #s: Immunization 93.268 MCH 93.778 Prevention 93.991 Amount $15,071 Amount $9,717 Amount $30,570 Amount $8,502 have been made to pa ',h- I.abiIilty which vvii4 accrue under this contract. City Comptroller s r Contract Agreement Addendum: Exhibit I Program Quality Criteria Generally high program quality criteria for the delivery of quality and cost - effective administration of health care programs have been, and will continue to be, required in each public health program to be operated under the terms of this contract. This Exhibit contains only applicable quality criteria for this contract. 11/20/2007 03:55 PM DPH Chants and Contracts e Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Childhood Lead Poisoning Prevention Program Quality Criteria 1) Assessment and surveillance of public health to identify community needs and to support systematic, competent program planning and sound policy development with activities focused at both the individual and community levels. A) Contractees must assess local surveillance data for lead poisoning risks and known prevalence.. 2) Delivery of public health services to citizens by qualified health professionals in a manner that is family centered, culturally competent, and consistent with the best practices; and delivery of public health programs for communities for the improvement of health status. A) Contractees must provide services that support the elimination of childhood lead poisoning and the early detection and treatment of children with lead poisoning, including compliance with WI Statutes ch. 254 (Environmental Health), WI Administrative Rule HFS 181 (Reporting of Blood Lead Test Results), WI Administrative Rule HFS 163 (Certification for the Identification, Removal and Reduction of Lead -Based Paint Hazards), and the practice standards presented in the Wisconsin Childhood Lead Poisoning Prevention & Control Handbook and in Managing Elevated Blood Lead Levels Among Young Children (CDC, 2002). B) Contractees must assure the availability and accessibility of blood lead screening tests for children ages 0 -5 years who are at high risk of lead poisoning. 3) Record keeping for individual focused services that assures documentation and tracking of client health care needs, response to known health care problems on a timely basis, and confidentiality of client information. A) Contractees must maintain a central case registry to track follow -up of children with blood lead levels (BLLs) > 10 mg /dL and of properties where a lead hazard investigation was performed, including interventions and outcomes. 4) Information, education, and outreach programs intended to address known health risks in the general and certain target populations to encourage appropriate decision making by those at risk and to affect policy and environmental changes at the community level. A) Contractees must provide information to one or more target audiences within the community about lead hazards, lead hazard reduction methods, primary prevention of lead poisoning, and blood lead testing as referenced in the boundary statement. 5) Coordination with related programs to assure that identified public health needs are addressed in a comprehensive, cost- effective manner across programs and throughout the community. A) Contractees must build partnerships with local health care providers and agencies involved in health, social services, housing, and child care to incorporate lead hazard awareness into their activities with; or services to, families living in pre -1978 housing. B) Contractees must provide information, consultation and technical assistance to health care providers or other programs to assure that treatment of children with lead poisoning is efficient and effective, and to assure that lead -safe environments are available to children with lead poisoning. C) If the Contractee serves a community receiving HUD Community Development Block Grant (CDBG) funds, in order to accept the additional lead program formula allocation, it must establish and maintain a relationship with the local housing agency that distributes the CDBG funds in order to increase the 11/20/2007 03:55 PM DPH Grants and Contracts J � 3 Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 availability of lead -safe housing within the community. 6) A referral network sufficient to assure the accessibility and timely provision of services to address identified public health care needs. A) Contractees must assess the need for, and provide referrals for, supportive services to families of lead poisoned children. 7) Provision of guidance to staff through program and policy manuals and other means sufficient to assure quality health care and cost - effective program administration. A) Contractees must assure that local childhood lead poisoning prevention program staff have access to, are knowledgeable of, and in compliance with the Wisconsin Childhood Lead Poisoning Prevention & Control Handbook for Local Health Departments, the Wisconsin Blood Lead Screening Guidelines, Managing Elevated Blood Lead Levels Among Young Children (CDC, 2002), state statutes, administrative rules, and/or local ordinances. 8) Financial management practices sufficient to assure accurate eligibility determination, appropriate use of state and federal funds, prompt and accurate billing and payment for services provided and purchased, accurate expenditure reporting, and, when required, pursuit of third -party insurance and Medical Assistance Program coverage of services provided. A) Contractees must pursue third party payment and/or other funding sources for service provision to children who are eligible for third party payment, except when doing so is demonstrated to not be cost effective. 9) Data collection, analysis, and reporting to assure program outcome goals are met or to identify program management problems that need to be addressed. A) Contractees must regularly collect and analyze local data to determine the adequacy. of blood lead testing for children enrolled in WIC, timely follow -up of lead poisoned children, timely completion of lead hazard reduction work, and community lead poisoning prevention education. B) Contractee must submit the following forms and documents to the Wisconsin Childhood Lead Poisoning Prevention Program by the specified deadlines as stated in the WCLPPP Handbook. These forms are available on the Lead -Safe Wisconsin website, at: www.dhfs.wi.gov /lead. a) Nursing Case Management Report (DPH 4771A) Nursing Closure Report (DPH 477113) Property Investigation Report (DPH 4771 C) Property Investigation Closure Report (DPH 4771D) 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Immunization Program Quality Criteria 1) Assessment and surveillance of public health to identify community needs and to support systematic, competent program planning and sound policy development with activities focused at both the individual and community levels. A) Contractees must assure reported vaccine preventable diseases (VPD) are investigated and controlled as detailed in the most current edition Wisconsin Disease Surveillance Manual (EPINET). Immunization programs should maintain regular contact with local required reporters of VPDs to encourage and assure prompt reporting. Contractees should solicit the help of the Immunization Program when needed to help assure that an adequate system is in place to report and investigate vaccine preventable disease (VPD). B) Contractees must annually formally evaluate immunization delivery and vaccine preventable disease surveillance systems and improve those systems in their jurisdictions where needed. C) Contractees must work in collaboration with the Wisconsin Immunization Program to increase the use of existing electronic data collection systems for vaccine record keeping and vaccine preventable disease data systems. 2) Delivery of public health services to citizens by qualified health professionals in a manner that is family centered, culturally competent, and consistent with the best practices; and delivery of public health programs for communities for the improvement of health status. A) Contractees must assure the delivery of immunization services in a safe, effective and efficient manner as detailed in the Wisconsin Immunization Program Policies and Procedures Manual and in section 252, HFS 145, Wis. Admin. Code. Contractees must assure the immunization of children is consistent with Healthy People 2010 goals. 3) Record keeping for individual focused services that assures documentation and tracking of client health care needs, response to known health care problems on a timely basis, and confidentiality of client information. A) Contractees must use the Wisconsin Immunization Registry (WIR) or an electronic immunization population -based data system that links with the WIR. The data system must have a tracking and recall function to identify children whose immunization records are behind schedule. Tracking and recall shall be conducted at least bi- monthly as required by the Wisconsin "Policies and Procedures Manual for Immunization Programs ". B) Contractees' immunization practice must assure the immunization of children, and share children's immunization records with parents or guardians, schools and day care centers and other healthcare providers as provided by the Wisconsin School Immunization Law. 4) Information, education, and outreach programs intended to address known health risks in the general and certain target populations to encourage appropriate decision making by those at risk and to affect policy and environmental changes at the community level. A) Contractees must engage in community partnerships to identify and address the needs of high -risk populations, reduce racial and ethnic health disparities, and to educate families and the community on the importance of immunizations. 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 5) Coordination with related programs to assure that identified public health needs are addressed in a comprehensive, cost - effective manner across programs and throughout the community. A) Contractees must coordinate immunization services with local child healthcare (service) providers: e.g., WIC projects, Medical Assistance programs, and other local public health programs to assess the immunization status of, refer, and provide immunization services to under - immunized children. 6) A referral network sufficient to assure the accessibility and timely provision of services to address identified public health care needs. A) Contractees must develop relationships among public and private healthcare providers to facilitate access by children and families to immunization services. Contractees should work with these providers to assure that current immunization guidelines are followed. These relationships should also be used to promote the prompt reporting of suspect vaccine preventable diseases, and the use of the WIR or a registry capable of interfacing with the WIR. As follows in paragraphs B and C: B) The local health department (LHD) should promote the medical home concept by referring vaccine recipients to their medical home provider for subsequent immunizations and coordinate with this medical provider to assure adherence to the recommended immunization schedule. If no medical home exists, the LHD must continue to provide immunization services. C) LHDs should promote the exchange and sharing of immunization data using immunization registries. D) The LHD will assure adequate surveillance, prompt reporting and epidemiologic follow -up of vaccine preventable diseases. When prompt reporting of a vaccine preventable disease does not occur, the LPHD will formally address the issue with the reporting agency to assure that reports are made according to the latest EPINet Manual. 7) Provision of guidance to staff through program and policy manuals and other means sufficient to assure quality health care and cost - effective program administration. A) Contractees will ensure program staff is competent in current immunization program policy and processes, including that provided through the Centers for Disease Control and Prevention (CDC) distance learning course and CDC updates. B) The LHD will follow the Wisconsin "Policies and Procedures Manual for Immunizations" developed and distributed by the Wisconsin Immunization Program, unless otherwise agreed upon; as well as Immunization Policy Memos issues periodically from the Immunization Program and posted on the Health Alert Network (HAN). The LHD must have written policies on the proper handling and storage of state- supplied vaccine. These policies must be reviewed with all immunization program related staff on at least an annual basis. 8) Financial management practices sufficient to assure accurate eligibility determination, appropriate use of state and federal funds, prompt and accurate billing and payment for services provided and purchased, accurate .expenditure reporting, and, when required, pursuit of third -party insurance and Medical Assistance Program coverage of services provided. A) Billing for payment of childhood immunization services is not required under this section. 11/20/2007 03:55 PM DPH Grants and Contracts r Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 B) LHDs must assure that parents of children who are on Medical Assistance will not be charged a vaccine administration fee or be requested to make a donation for vaccine or vaccine related services. Administration fees cannot be mandatory and clients must be informed that failure to pay the administration fee or make a donation does not preclude them from receiving state - supplied vaccine. This information must be added to immunization advertising materials used by the LHD. The message must be given to the client in a way and in a language the client understands. 9) Data collection, analysis, and reporting to assure program outcome goals are met or to identify program management problems that need to be addressed. A) Contractees must collect and analyze agency and available private provider immunization data for children 12 -35 months of age, school immunization law reports and other available population -based information needed to identify strengths and weaknesses in local delivery systems and plan improvements. Only children who have moved out of the agency's jurisdiction may be removed from the cohort for analysis. B) LHDs will utilize the WIR for immunization level data analysis. C) LHDs and Tribes will assure staff competence with the WIR system. LHD and Tribal staff must attend at least one of the 2 or more annual Regional WIR User Group Meetings. Attendance at these meetings is necessary for staff to maintain a thorough working knowledge of the functionality of the WIR. 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Maternal and Child Health Block Grant Program Quality Criteria 1) Assessment and surveillance of public health to identify community needs and to support systematic, competent program planning and sound policy development with activities focused at both the individual and community levels. A) Contractees must include a maternal and child health needs assessment at least every five years in their community needs assessment process, as required by Title V of the Social Security Act. 2) Delivery of public health services to citizens by qualified health professionals in a manner that is family centered, culturally competent, and consistent with the best practices; and delivery of public health programs for communities for the improvement of health status. A) Contractees must assure that maternal and child health services are delivered and supervised by qualified staff as required by the activity or service being delivered. B) Contractees must designate a staff person as the maternal and child health contact to receive, disseminate, and respond to policy and program information provided by the State. C) Contractees must designate a staff person as the children and youth with special health care needs contact to receive and disseminate policy and program information provided by the State and Regional CYSHCN Centers. D) The Contractee must assure quality by utilizing one or more of the following documents as guidance in the organization and delivery of services: 1) Wisconsin Medicaid Prenatal Care Coordination Services Handbook and related Medicaid Updates, 2) Family Planning Reproductive Health Standards of Practice, 3) Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, (most recent edition), 4) Caring for Our Children: National Health and Safety Performance Standards Guidelines for Out -of -Home Child Care Programs: Second Edition, 2002, 5) Bright Futures in Practice: Oral Health, 6) Bright Futures in Practice: Physical Activity, 7) Bright Futures in Practice: Nutrition, Second Edition, 8) Bright Futures in Practice: Mental Health. All programs will be evaluated based on these best practice guidelines. If a local public health department (LPHD) wants to use an alternate, but comparable document, the State of Wisconsin Maternal and Child Health Program must approve it. E) Contractees must integrate the MCH Five Guiding Principles in MCH programs, services and systems: 1) Family- Centered Care, 2) Cultural Competence, 3) Community-wide Leadership, 4) Health Promotion and Resiliency, and 5) Outreach and Needs Assessment. 3) Record keeping for individual focused services that assures documentation and tracking of client health care needs, response to known health care problems on a timely basis, and confidentiality of client information. A) Contractees must assure that all general health care records are kept confidential as required by s. 146.82, Wis. Stats. 4) Information, education, and outreach programs intended to address known health risks in the general and certain target populations to encourage appropriate decision making by those at risk and to affect policy and environmental changes at the community level. A) Contractees must assure effective outreach strategies to high -risk women of childbearing age, pregnant women, and children birth to 21 years old, including children and youth with special health care needs and their families in the maternal and child health population. 11/20/2007 03:55 PM DPH Grants and Contracts �a Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 B) All materials for public distribution developed by a Contractee with Title V MCH Block Grant funds must identify the funding source on the publication as follows: "Funded in part by the MCH Title V Services Block Grant, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services." 5) Coordination with related programs to assure that identified public health needs are addressed in a comprehensive, cost- effective manner across programs and throughout the community. A) Contractees must have a mechanism in place to assure coordination with the Regional CYSHCN Centers. B) Contractees must coordinate maternal and child health programs with other community health programs. 6) A referral network sufficient to assure the accessibility and timely provision of services to address identified public health care needs. A) LPHDs that provide maternal and child health prevention and intervention services must have a referral network. Referral networks may include: healthcare providers including mental health and oral health, Regional CYSHCN Centers, child care centers, WIC, human or social services, schools, Birth to 3 programs, and other relevant services. 7) Provision of guidance to staff through program and policy manuals and other means sufficient to assure quality health care and cost - effective program administration. A) There are no separate sub - criterion to this Quality Criteria Category. 8) Financial management practices sufficient to assure accurate eligibility determination, appropriate use of state and federal funds, prompt and accurate billing and payment for services provided and purchased, accurate expenditure reporting, and, when required, pursuit of third -party insurance and Medical Assistance Program coverage of services provided. A) Contractees must seek other available funding sources, as Title V MCH Block Grant is payer of last resort. B) Contractees must bill the Wisconsin Medical Assistance (Medicaid) Program for all covered services provided to eligible recipients. C) Contractees must provide 75% match ($0.75 local contribution for every $1.00 federal) for all Title V MCH Block Grant funds and report through GAC and CARS system as described in the contract. 9) Data collection, analysis, and reporting to assure program outcome goals are met or to identify program management problems that need to be addressed. A) Contractees must collect and analyze data on all public health activities and interventions provided. B) Contractees must report using SPHERE (Secure Public Health Electronic Record Environment). C) Contractees will comply with year -end program reporting requirements set by the State of Wisconsin MCH Program including documentation of 75% match ($0.75 local contribution for every $1.00 federal) and report through GAC and CARS system as described in the contract. D) An agency narrative as defined by Maternal and Child Health (MCH) end -of -year reporting requirements (Enclosure 3) must be submitted by each agency receiving MCH/Title V funding including MCH, CYSHCN, EIDP -LHD, and FP/RH. This agency report will assist in demonstrating the comprehensiveness of the MCH work (both funded and unfunded by these dollars) being done by agencies across the state. 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Preventive Health and Health Services Block Grant Program Quality Criteria 1) Assessment and surveillance of public health to identify community needs and to support systematic, competent program planning and sound policy development with activities focused at both the individual and community levels. A) Involvement of key policymakers and the general public in the development of comprehensive public health plans. B) Development and implementation of a plan to address issues related to access to high priority public health services for every member of the community. 2) Delivery of public health services to citizens by qualified health professionals in a manner that is family centered, culturally competent, and consistent with the best practices; and delivery of public health programs for communities for the improvement of health status. A) There are no separate sub - criterion to this Quality Criteria Category. 3) Record keeping for individual focused services that assures documentation and tracking of client health care needs, response to known health care problems on a timely basis, and confidentiality of client information. A) There are no separate sub - criterion to this Quality Criteria Category. 4) Information, education, and outreach programs intended to address known health risks in the general and certain target populations to encourage appropriate decision making by those at risk and to affect policy and environmental changes at the community level. A) Provision of public information and education, and/or outreach activities focused on high -risk populations that increase awareness of disease risks, environmental health risks, and appropriate preventive activities. B) All materials produced with PHHS Block Grant funds must include the following statement: "This publication was made possible by the PHHS Block Grant from the Centers for Disease Control." 5) Coordination with related programs to assure that identified public health needs are addressed in a comprehensive, cost - effective manner across programs and throughout the community. A) There are no separate sub - criterion to this Quality Criteria Category. 6) A referral network sufficient to assure the accessibility and timely provision of services to address identified public health care needs. A) There are no separate sub - criterion to this Quality Criteria Category. 7) Provision of guidance to staff through program and policy manuals and other means sufficient to assure quality health care and cost - effective program administration. A) Provision of written policy and program information about the current guidelines,standards, and recommendations for community and/or clinical preventive care. 8) Financial management practices sufficient to assure accurate eligibility determination, appropriate use of state and federal funds, prompt and accurate billing and payment for services provided and purchased, accurate expenditure reporting, and, when required, pursuit of third -party insurance and Medical Assistance Program coverage of services provided. A) Program - specific data collection, analysis, and reporting to assure program outcome goals are met or to 11/20/2007 03:55 PM . DPH Grants and Contracts. Y Contract Agreement Addendum: Exhibit I Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 identify program management problems that need to be addressed. 9) Data collection, analysis, and reporting to assure program outcome goals are met or to identify program management problems that need to be addressed. A) There are no separate sub - criterion to this Quality Criteria Category 11/20/2007 03:55 PM DPH Grants and Contracts k X Contract Agreement Addendum: Exhibit II Program Objectives (A) Contract Funds, Program/Objective Values, and Other Contract Details (B) Objective Details 11/20/2007 03:55 PM DPH Grants and Contracts Q +. Y t Contract Agreement Addendum: Exhibit II(A) Contract #: 15820 Agency: Oshkosh Health Department Amount $9,717 $15,071 $30,570 $8,502 Contract Match Requirements Program Amount Childhood Lead $0 Immunization $0 MCH $22,928 Prevention $0 Contract Year: 2008 Program Sub - Contracts Program Contract Source of Funds Source Program Oshkosh Childhood Lead - Consolidated Oshkosh Immunization - Consolidated IAP Oshkosh Maternal Child Health - Consolidated Oshkosh Prevention - Consolidated Amount $9,717 $15,071 $30,570 $8,502 Contract Match Requirements Program Amount Childhood Lead $0 Immunization $0 MCH $22,928 Prevention $0 Contract Year: 2008 Program Sub - Contracts Program Sub - Contractee Childhood Lead None Reported Immunization None Reported MCH None Reported Prevention None Reported Sub - Contract Amount $0 $0 $0 $0 11/20/2007 03:55 PM DPH Grants and Contracts a Contract Agreement Addendum: Exhibit II(A) Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Childhood Lead Program Total Value $9,717 1 By December 31, 2008, 13 environmental lead hazard investigations will be completed on the primary residences $9,717 and pertinent secondary properties of children with venous blood lead levels >= 10 mcg/dL who reside in the City of Oshkosh according to the Elevated Blood Lead Investigation protocol. Immunization Program Total Value $15,071 1 By December 31, 2008, Agencies must attain or be making progress towards the goal of 90 %, there will be a 3% $15,071 increase in the percentage of infants born to families residing in the City Of Oshkosh Health Department jurisdiction who turn 24 months of age during the contract year will have received 4 DTaP, 3 Polio, 1 MMR, 3 Hib 3 Hepatitis B and 1 varicella vaccination. MCH Program Total Value $30,570 1 By December 31, 2008, 50 children ages birth through seven years from City of Oshkosh will be properly $7,500 positioned in a child safety seat as demonstrated by their parent or caregiver. 2 By December 31, 2008, 55 residences located within the City of Oshkosh with children ages birth to 4 years will $17,000 have a documented decrease in hazards previously identified through home safety assessments. 3 By December 31, 2008, 2 strategies to create environments that support and promote healthy eating, daily $6,070 physical activity and a healthy weight for school aged children and their families, will be implemented by the City of Oshkosh Health Division. Prevention Program Total Value $8,502 1 Contingent upon receiving Preventive Health and Health Services Block Grant (PHHSBG) funding for Fiscal $4,000 Year 2008, with no changes in past CDC PHHSBG funding guidance as to the use of these funds, during the contract period initiatives that conform to the Healthiest Wisconsin 2010 State Health Plan and are consistent with the Preventive Health and Health Services Block Grant guidelines will be undertaken by the City of Oshkosh Health Department. 2 Contingent upon receiving Preventive Health and Health Services Block Grant (PHHSBG) funding for Fiscal $4,502 Year 2008, with no changes in past CDC PHHSBG funding guidance as to the use of these funds, during the contract period initiatives that conform to the Healthiest Wisconsin 2010 State Health Plan and are consistent with the Preventive Health and Health Services Block Grant guidelines will be undertaken by the (insert name) Health Department. Total of Contract Objective Values $63,860 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Childhood Lead Poisoning Prevention Objective #: 1 of 1 Objective Value: $9,717 Objective: Primary Details Objective Statement By December 31, 2008, 13 environmental lead hazard investigations will be completed on the primary residences and pertinent secondary properties of children with venous blood lead levels >= 10 mcg /dL who reside in the City of Oshkosh according to the Elevated Blood Lead Investigation protocol. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) A report to document: 1) the number of environmental lead hazard investigations associated with children with venous blood lead levels > =10 mcg /dL who reside in (insert name of jurisdiction), 2) the childrenLs blood lead levels, 3) components of the environmental lead hazard investigation to include the risk assessment of property, issuance of lead hazard reduction work orders and property clearance. Programs Providing Funds for this Objective Childhood Lead Poisoning Prevention: $9,717 Agency Funds for this Objective: Data Source for Measurement SPHERE Individual/Household Report to include data from the following screens: (1) Lead Testing, including test date, result, and provider, and (2) Case Management for Wisconsin Childhood Lead Program; or an agency - generated report. Baseline for Measurement Currently, in 2007 we have identified and provided case management to 5 families whose children have had elevated lead levels. Context Acceptable value for this objective is up to $800 per environmental lead hazard investigation. The most important factor in managing childhood lead poisoning is reducing the child�s exposure to lead. CDC recommends that public health investigate the childLs primary residence and secondary properties, e.g., day care, to identify and reduce the lead hazards to prevent further exposure and reduce the blood lead level (Managing Elevated Blood Lead levels Among Young Children, CDC, March 2002). An environmental lead hazard investigation should be conducted according to Chapter 9 of the LWisconsin Childhood Lead Poisoning Prevention & Control Handbook (2002). Input Activities The City Of Oshkosh has a local ordinance that requires that any child who has a lead level of greater than 10mcg /dL must be followed up on with a full lead investigation. This includes a home visit by a nurse and certified lead inspector. The nurse provides educational information and answers questions regarding lead and lead poisoning. The nurse monitors that the child has follow up lead levels drawn until the lead level falls to below th l Omcg /dL level.The certified lead inspector inspects the home and develops a work plan to assure that any identifed lead hazards are remediated. We will continue to provide this service through this lead grant Objective: Risk Profile Percent of Objective Corresnondina Potential Recoupment Amounts Definition of Percent Accomplished Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts a i Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Program: Immunization Agency: Oshkosh Health Department Contract Year: 2008 Objective #: 1 of 1 Objective Value: $15,071 Objective: Primary Details Objective Statement By December 31, 2008, Agencies must attain or be making progress towards the goal of 90 %, there will be a 3% increase in the percentage of infants born to families residing in the City Of Oshkosh Health Department jurisdiction who turn 24 months of age during the contract year will have received 4 DTaP, 3 Polio, 1 MMR, 3 Hib 3 Hepatitis B and 1 varicella vaccination. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) A Wisconsin Immunization Registry (WIR) generated population based report documenting the number of children in the City Of Oshkosh Health Department jurisdiction who turned 24 months of age in 2008. Reports should be run with a 45 day buffer to ensure that all updated data has been received by the WIR. Programs Providing Funds for this Objective Immunization: $15,071 Agency Funds for this Objective: Data Source for Measurement Wisconsin Immunization Registry Records Baseline for Measurement By July 1, 2005, 78% of children turning 24 months have received 4 DTAP, 3 POLIO, 1 MMR, 3 HIB , 3 HEP B , AND 1 VARICELLA. Context Children will be assessed for having at 4 DTaP, 3 Polio, 1 MMR, 3 Hib 3 Hepatitis B and 1 varicella vaccination by 24 months of age. Progress towards reaching 90% will be measured using a WIR Benchmark report as that baseline and the Immunization Programs prescribed % increase based on the agencies baseline data. Only children who have moved out of the agency's jurisdiction may be removed from the cohort for analysis. Benchmark reports are available to show those clients who have reported refusals for recommended vaccines. These reports should be run to show agency effort toward achieving the objective goal. Guidelines for determining increase needed for progress towards 2010 goals. If Current baseline is, then % Increase in baseline required: 1) <50 %, 10% 2)50 - 59%,5% 3)60 - 69%,4% 4) 70 - 79%,3% 5) 80 - 85%,2% 6) 86 - 89%,1% 7) > 90 %, maintain. Agencies should consult with their Regional Immunization Program Advisor for assistance in determining activities and interventions that will help them achieve the required increase for their population assessment. Input Activities The Wisconsin Immunization Program recommends the following activities to help ensure success of this objective: 11/20/2007 03:55 PM DPH Grants and Contracts t ] �a Contract Agreement Addendum: Exhibit II(B) Contract M 15820 Agency: Oshkosh Health Department Program: Immunization Objective #: 1 of 1 Contract Year: 2008 Objective Value: $15,071 1)contacting parents of infants without immunization histories, 2)reminder /recall, a) three letters (1 certified), b) if no response to letters 1 phone call from health department, c) home visit (optional), 3)follow -up interventions to complete series, 4)tracking, 5) sharing information with area physicians, 6)requesting that information is entered into the WIR, 7)Coordination of immunization services with other LHD programs. Objective: Risk Profile Percent of Obiective Accomplished Corresponding Percentage Recoupment Corresponding Potential Recoupment Amounts Definition of Percent Accomplished Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts a Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Maternal and Child Health Block Grant Objective #: 1 of 3 Objective Value: $7,500 Objective: Primary Details Objective Statement By December 31, 2008, 50 children ages birth through seven years from City of Oshkosh will be properly positioned in a child safety seat as demonstrated by their parent or caregiver. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) A SPHERE report as defined within the Data Source for Measurement to document the number of children ages birth through seven years from City of Oshkosh who were properly positioned in a child car passenger seat system by their parents or other caregivers. Programs Providing Funds for this Objective Maternal and Child Health Block Grant: $7 Agency Funds for this Objective: Data Source for Measurement SPHERE Individual/Household Report to include MCH Required Demographic Data and data from the following screen: Intervention: Screening, Sub - Intervention: Child Passenger Safety Seat (child). If using the SafeKids form, the agency must also collect and report additional MCH Program required data; that is, the birth date and race of the child and health care coverage information. Baseline for Measurement This ongoing objective provides car seat information and education in collaboration with Fox Valley Safe Kids, Winnebago County Health, Town of Menasha Fire Department, City of Menasha and City of Neenah. The Winnebago County Health WIC program identifies low income families that may need to obtain low cost car seats. We provide those seats for them. We also are available to the rest of the population who has their own car seat and needs education and assistance in it's installation. We currently have 3 Certified Seat Technicians and one Senior Checker on staff at City of Oshkosh Division of Health. Context Acceptable value range for this objective is $40 -$125 per child. All MCH Quality Criteria apply to this objective. This objective is for local health department programs. that provide designated individual assessment, installation and instruction services on child passenger safety to families with one or more children in the selected age group. To count toward this objective a pregnant woman instructed on child passenger safety seat installation must return with the baby after the baby is born to document proper positioning. (However, there is in SPHERE a Child Passenger Safety Seat screen (pregnant woman) where you can document the instruction provided.).The new child safety seat law requires that children must be in a car seat until they reach the age of four years and in a booster seat until they reach the age of eight years. Input Activities Child safety seat programs are expected to follow the National Highway Traffic Safety Administration recommendations (www.nhtsa.dot.gov) and activities to meet this objective must be completed by NHTSA - certified staff. NOTE: These listed activities are required but are not intended to be all encompassing. Additional activities can be described. Objective: Risk Profile Percent of Objective Accomplished 0% 1 10% 1 20% 1 30% 1 40% 1 50% 1 60% 1 70% 1 80% 1 85% 1 90% 1 95% 1 100% Corresponding Percentage Recoupment Corresponding Potential Recoupment Amounts Definition of Percent Accomplished 11/20/2007 03:5.5 PM DPH Grants and Contracts Y Yy Contract Agreement Addendum: Exhibit II(B) Contract##: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Maternal and Child Health Block Grant Objective #: 1 of 3 Objective Value: $7,500 Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts ,x u Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Maternal and Child Health Block Grant Objective #: 2 of 3 Objective Value: $17,000 Objective: Primary Details Objective Statement By December 31, 2008, 55 residences located within the City of Oshkosh with children ages birth to 4 years will have a documented decrease in hazards previously identified through home safety assessments. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) A SPHERE report as defined within the Data Source for Measurement to document, 1) the number of residence (household) assessed using the home safety assessment tool and 2) the number and types of corrections made for hazards identified through home safety assessments per residence (household). Programs Providing Funds for this Objective Maternal and Child Health Block Grant: $17,000 Agency Funds for this Objective: Data Source for Measurement SPHERE Individual/Household Report to include MCH Required Demographic Data and data from the following screens: Intervention: Screening, Sub - Intervention: Home Safety Assessment (all appropriate fields), Intervention: Health Teaching, Sub - Intervention: Topics and Results, and Intervention: Referral and Follow- Up/Results if appropriate. Baseline for Measurement As of Sept.2007, 30 families have been served by the Home Safety / Child Proofing Program, by visiting and re- visiting these families. Households visited and revisited by Sept. 2007 totaling 30 safety assessments by this date. Context Acceptable value range for this objective is $125 -$250 for one annual assessment per household. All questions in the Home Safety Assessment must be answered to count toward the total number of households completed. All MCH Quality Criteria apply to this objective. The SPHERE Home Safety Assessment screen is provided as a PDF form and used as a tool for assessing hazards in homes until it can be printed from SPHERE. The SPHERE Home Safety Assessment screen was developed by representatives from local health departments and staff within the state MCH program and is based on national as well as international research. Input Activities A Registered Nurse will provide this service, with visits and re- visits to each residence to promote safety by doing a Home Safety Assessment. The State Home Safety Assessment Guide will be the tool used to assess each home environment. A copy of a home safety checklist is left with the parents to assist them in identifying hazards in each area/room of their home. Hazards found during initial visit are verbally discussed with parent/s and documented on assessment form. Many safety/childproofing products are given out and applied during first visit. Most families request and are given a child safety/ baby gate, along with a wide variety of products, as; cabinet latches, refrigerator latches, stove knob covers, bath mats or pads, furniture straps, etc. to child proof their home. A resource and referral guide is given out at visits, along with many safety educational brochures and booklets. Approximate time spent with each family is 8 hours, with assessment and documentation. Additional time is spent promoting the Child Proofing program by drawing up and printing the Home Safety brochure, attending conferences, attending and displaying information at Oshkosh events,and distributing brochures to Oshkosh community offices. Objective: Risk Profile Percent of Objective 11/20/2007 03:55 PM DPH Grants and Contracts r Contract Agreement Addendum: Exhibit II(B) Contract M 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Maternal and Child Health Block Grant Objective M 3 of 3 Objective Value: $6,070 Definition of Percent Accomplished Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Agency: Oshkosh Health Department Contract Year: 2008 Program: Preventive Health and Health Services Objective #: 1 of 2 Objective Value: $4,000 Block Grant Objective: Primary Details Objective Statement Contingent upon receiving Preventive Health and Health Services Block Grant (PHHSBG) funding for Fiscal Year 2008, with no changes in past CDC PHHSBG funding guidance as to the use of these funds, during the contract period initiatives that conform to the Healthiest Wisconsin 2010 State Health Plan and are consistent with the Preventive Health and Health Services Block Grant guidelines will be undertaken by the City of Oshkosh Health Department. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) An agency report that describes the life stage of the population addressed, the type of strategy or initiative implemented, and the number of individuals affected by the prevention - related strategy or initiative. A begin and end date of prevention- related strategy or initiative should be identified. Programs Providing Funds for this Objective Preventive Health and Health Services Block Grant: $4,000 Agency Funds for this Objective: Data Source for Measurement Health Department records Baseline for Measurement In our first collection of 2007 The City of Oshkosh residents brought in 423 pounds of medications. There were 6115 pills of controlled substances. We hope to conitinue this effort. Context The City of Oshkosh Health Division plans to use part of the prevention grant money to fund another household drug collection. Two drug collection activities were done in 2007 with very good response from the community. We hope to continue to be able to provide a disposal site that will assist in protecting our rich environment from the indiscriminate disposal of these potential toxins. Input Activities We currently are working together with Winnebago County Health and Winnebago County Waste to provide this to our communities. We will continue to use the pharmacies, senior centers, local newspapers and other media for our outreach. Objective: Risk Profile Percent.of Objective Accomplished Corresponding Potential Recoupment Amounts Definition of Percent Accomplished Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts Contract Agreement Addendum: Exhibit II(B) Contract #: 15820 Agency: Oshkosh Health Department Program: Preventive Health and Health Services Objective #: 2 of 2 Block Grant Objective: Primary Details Contract Year: 2008 Objective Value: $4,502 Objective Statement Contingent upon receiving Preventive Health and Health Services Block Grant (PHHSBG) funding for Fiscal Year 2008, with no changes in past CDC PHHSBG funding guidance as to the use of these funds, during the contract period initiatives that conform to the Healthiest Wisconsin 2010 State Health Plan and are consistent with the Preventive Health and Health Services Block Grant guidelines will be undertaken by the (insert name) Health Department. Deliverable Due Date: 01/31/2009 Contract Deliverable (Evidence) An agency report that describes the life stage of the population addressed, the type of strategy or initiative implemented, and the number of individuals affected by the prevention - related strategy or initiative. A begin and end date of prevention - related strategy or initiative should be identified. Programs Providing Funds for this Objective Preventive Health and Health Services Block Grant: $4,502 Agency Funds for this Objective: Data Source for Measurement Health Department records. Baseline for Measurement 224 children participated in Safety City in 2007. Context The City of Oshkosh Health Division is involved with a program that focuses on injury prevention. The city will provide safety education; regarding bike and pedestrian safety, poison safety, fire safety , etc. along with other city partners, during a 5 week Safety City event during the summer. Safety City targets children and their caregivers, and families. Input Activities We are involved with Safety City along with many other partners /sponsors as the Oshkosh Police Department, Oshkosh Fire Department, etc. to provide all aspects of teaching and promoting safety to our families with young children. We provide many opportunities of learning and activities to educate about safety. Demonstrations and interaction with the children and caregivers is provided, movies on safety topics are shown, educational worksheets and color sheets are given out to practice on, also a pre- and post- test is used for evaluation. Objective: Risk Profile Percent of Objective Percentage Corresponding Potential Recoupment Amounts Definition of Percent Accomplished Conditions of Eligibility for an Incentive 11/20/2007 03:55 PM DPH Grants and Contracts